LIVEWORK –CI & IMPACT PROJECTS

1. LIVEWORK –CI & IMPACT PROJECTS Facilitating psychologically-informed planned environments: Training as a vehicle for reshaping psychosocial interventions for PD in community & forensic settings

2. Who we are • LIVEWORK CI – Initially funded by DoH as one of eleven pilots to offer training and consultation to staff in primary care and the voluntary sector about PD, now part of C&I Personality Disorder Services • IMPACT – pilot project funded for one year by the Impact fund of the MoJ in collaboration with C&I NHS. Overall aim is to reduce the number of recalls back to prison

3. Our Aims • Improve the quality of care for PD clients across all agencies • Facilitate psychosocial adjustment and integration of PD clients into mainstream society • Improve the working environment of staff who work with PD clients

4. How do we do this? • Training and consultation in working with PD to staff in a variety of settings • Facilitating the development of psychologically-informed planned environments (PIPES) by utilising the model of the ‘healthy organisation’ • Contributing to establishment of coherent pathways for PD clients in the C&I area by establishing multi-agency commissioning of services for PD clients

5. Our joint strategy Strengthening Pathways

6. PIPES – Psychologically Informed Planned Environments • PIPE – A bounded setting for a particular purpose in which events, interactions and relationships are subject to discussion with consideration given to psychological theories in the planning and general day to day functioning of the environment

7. Facilitating PIPES: Model of the Healthy Organisation • Shared clarity about the primary task • Shared clarity about hierarchy of roles and responsibilities • Agreed shared operating principles • Integrated established regular forum for reflection

8. Which means? • Facilitating clarity in staff about their primary task, organisational structures and hierarchies thus equipping the organisation to work with PD • Staff having a compassionate understanding of the individual’s primary needs that lie behind the surface behaviour/ presentation. • Instilling and atmosphere of empowerment, confidence and self-efficacy in staff and service user • Increasing optimism & hope and reduce pessimism & hopelessness • Increase awareness of how staff’s own reactions can improve or perpetuate relational problems • Making risk management / care planning and meeting service user needs • Facilitating the development of a reflective space where issues arising from the work can be discussed and understood ↑ mindful responding ↓ mindless reacting Better understanding of PD = More options

9. Utilising the Knowledge & Understanding Framework (KUF) • Attendance at the KUF Awareness Level training • Project team members will attend the KUF Facilitator Training in December • Adapting the KUF awareness training to address the training needs of the local workforce

10. Challenges • Organisational obstacles – structure of the organisation, management support, time constraints • Lack of clarity about the primary task and how the training equips the workers in their role • Most often those who need the training are not motivated to receive it • Securing future funding (for IMPACT project)

11. Evaluation – LIVEWORK - CI • Reactions to the training indicated it was appropriate & relevant to the staff • Participants reported that they gained knowledge from the training and felt that this would improve the way they worked with service-users • PD-KASQ was administered before and after the training – significant improvements were made in understanding, capabilities and emotional reaction scores following the training

12. IMPACT evaluation • Training needs analysis completed with PPU and AP staff • Staff conveyed a need for training that offers practical ways of engaging and working with offender service-users with PD presentations

13. Future directions • Interface between the two projects to address the needs of offenders with PD at different points in the pathway (prison, probation services, housing, employment and training services) with the aim to strengthen collaboration between the health service, local authorities, local police and probation and the voluntary sector • Multi-agency commissioning of PD services