Something else is brewing

Peter Cockersell has produced a book (and written most of it himself), called 'Social Exclusion, Compound Trauma and Recovery. Applying psychology, psychotherapy and PIE to homelessness and social exclusion'. Most interesting I think is a lovely clear account of 'compound trauma' - which seems to be a considerable improvement on the much-overused 'complex trauma'.

Here's my blurb for the back cover:

By drawing on modern psychoanalytic thinking, developmental neurobiology and current ideas of therapeutic environments, Cockersell presents the most complex problems in an accessible and engaging way.

And here's a lengthier piece I have written about his work at CHT:

Many things about the new world of social media, artificial intelligence and compliance metrics are a bit bewildering to digital dinosaurs like myself – but there is something else brewing as well. In the midst of all the turmoil that surrounds us, I am hearing different voices from all sorts of directions saying something new. I hear it at professional conferences, at policy meetings, during clinical discussions, in the newspapers and on the radio. There are also many places where people are talking about it – and feeling that it is what is missing – but can’t quite clearly pin down or articulate just what it is. It is the whole area of needing to make relationships the priority. Inspectors and regulators are starting to see that numbers cannot describe some of the most important things about schools, prisons or care homes; commissioners are recognising that complex systems cannot be purchased like cans of beans; professionals are starting to understand that their work is ultimately a bit empty and meaningless unless they consider the relationship that they are working with. Perhaps even politicians and policy-makers will soon realise that top-down command-and-control systems will not get the best out of people. As resources dwindle, and there seems to be little hope for funders to pay for anything more than the bare minimum. But CHT is now forging a new direction, which will not only be more therapeutic and humane than the ‘industrialised’ alternatives, but will be at the cutting edge of the emerging realisation that genuinely therapeutic care is not a luxury, but a necessity. Unless ‘relational practice’ is in place, outcomes will be worse, more people will complain, and the eventual costs will be much higher. From the work we are now doing with our commissioners, perhaps along with the wider crisis in social care provision, things are looking up. The fees we can ask are no longer dropping, and there seems to be increased recognition of the quality of our services, and the way in which we can provide a ‘value-added’ which is significantly more than the similarly-funded routine care services. In the world of therapeutic communities, a similar process is under way. Although few of the traditional residential TCs have survived, the newer adaptations and modified TCs are now bringing the TC philosophy into new areas. Again, CHT is at the forefront of this: the organisation is pioneering relational practice, based on the therapeutic philosophy of TCs, in developing CHT as a provider of a new intensive form of Psychologically Informed Environments (PIEs). It is widely acknowledged, through evaluation and research in the homelessness sector, that this will help us to engage people who would not normally be able to be helped, and provide a therapeutic environment for treatment that would otherwise not be possible.

This work is built on decades of what has been central at CHT. The broad-based understanding of mental distress, including biopsychosocial understanding, the importance of trauma, and the need for a wider frame of reference than either psychiatry or social care can offer, is something that CHT has always proudly asserted and disseminated. We are now entering the next phase of that, and I am confident that we can look forward to a future at the forefront of progressive practice in mental health.