In Episode 6, I sat down with Jay S. Levy to dig into what it really takes to co-create psychological safety in homelessness services. Jay’s work—grounded in decades of practice, lived experience, and a clear commitment to trauma-informed principles—argues that psychological safety isn’t something you sprinkle on top of a program. It’s something you build together: with staff, with people who have lived experience, and with the community you serve.
Why “co-creation” matters
Too often services are designed top-down, with professional language, power dynamics, and protocols driving the interaction. Jay reminded us that the same dynamics that get in the way of good care with clients also show up inside organizations. Bringing people with lived experience into the heart of design and delivery changes that dynamic. It shifts interaction from transactional to human-centered partnership.
“It’s all human, all too human — these hierarchies and patterns show up everywhere. We need true dialogue, level playing fields, and shared language so different perspectives can come together.”
Common language: houses and the playground
One of Jay’s clearest metaphors is the “houses of language” and the “playground of language.” Each discipline or role brings its own house: medical professionals speak from diagnosis and medication; social workers from assessment and systems; people with lived experience from connection, survival, and practical knowledge. The playground is where those houses meet — where communication is facilitated so each perspective can contribute.
Recognizing these houses does three things:
- It reduces the impulse to treat one perspective as the single “right” answer.
- It opens space for co-production—working with people to set goals rather than imposing them.
- It helps teams make pragmatic decisions about sequencing interventions (e.g., engagement before medication).
Pre-treatment: five guiding principles
Jay outlines a simple, flexible framework he calls pre-treatment—principles rather than prescriptions. These help teams create an environment where co-creation is possible:
- Relationship building: Prioritize human connection and trust before clinical labeling.
- Common language development: Build shared ways of speaking so different houses of language can communicate.
- Supporting transitions: Understand how people have adapted before and use that knowledge to design supports.
- Promoting safety: Use harm reduction and crisis-intervention approaches to keep people safer in the short and long term.
- Facilitating positive change: Use change models (e.g., stages of change, motivational interviewing) to support meaningful, person-led progress.
These five principles aren’t step-by-step rules. They’re guardrails that let workers use their creativity and strengths to meet people where they are.
Embedding lived experience staff: benefits and pitfalls
Hiring people with lived experience (peer workers, experts by experience) does more than add authenticity: it changes team culture, improves outreach, and can boost engagement metrics. But embedding lived experience staff well requires deliberate choices:
- Equity in role and pay: Avoid tokenism. If people’s responsibilities or qualifications change, reflect that in role classification and pay.
- Stable support and scaffolding: Build team structures so someone who needs time off can be covered by colleagues who share the same language and philosophy.
- Reflective practice: Regular, cross-disciplinary team meetings let different perspectives surface and inform care.
- Self-care and safety: Expect triggers and secondary trauma—support everyone, not only peer workers, with clear self-care policies and shared coverage models.
“People come to us as a trust gateway. Peer workers can be that gateway both for clients and for staff—helping create a level playing field for meaningful dialogue.”
Supervision as co-vision
Jay prefers the term “co-vision” to supervision. Rather than a top-down checklist, co-vision treats supervision like co-production: supervisors and staff collaboratively reflect on practice, strengths, and matches between worker and client. This is also where you identify who on the team is a good fit for particular people—for instance, a worker skilled in music or art connecting meaningfully with a client through those outlets.
Co-vision supports innovation: when staff are trusted to use their strengths, engagement deepens and staff feel valued. That, in turn, supports retention and better outcomes.
Practical outreach lessons: eyes, ears, and situational risk
Jay shared practical examples that illustrate the power of lived experience in outreach. Early in his career, people hired as van drivers—initially a logistical role—were quickly recognized as essential outreach workers: they knew the terrain, spoke local languages, and could make first contact in ways clinicians could not.
That frontline knowledge becomes a safety mechanism too. Sometimes the peer-led approach is the one to step forward first while clinicians sit back to observe, prioritizing safety and engagement. Knowing when to push and when to step back is a learned, situational skill—often intuitive to those with lived experience but still something that teams must reflect on and support.
Thresholds, discomfort, and how to normalize learning
Introducing lived experience into teams can create discomfort—staff worry about making mistakes, crossing boundaries, or losing professional control. Jay’s experience shows that the antidote is structure plus dialogue:
- Regular reflective meetings where mistakes are discussed without blame.
- Clear expectations and boundaries co-developed with peer staff.
- Pathways for career growth so lived experience roles aren’t a dead end (e.g., paid progression if someone earns a professional qualification).
- Team design that deliberately mixes backgrounds so different perspectives become a norm rather than an exception.
Actionable steps to start co-creating psychological safety
- Map the “houses of language” on your team—identify dominant languages (medical, social work, peer, etc.) and create the playground for dialogue.
- Schedule regular co-vision sessions where staff bring cases and perspectives, and decisions are made collaboratively.
- Embed harm reduction and trauma-informed practices into your safety plans and training.
- Ensure equitable roles and compensation for staff with lived experience and create career paths.
- Design team structures with shared coverage so workers can step back when triggered without service collapse.
- Celebrate and leverage worker strengths (art, music, language skills) as engagement tools, not just add-ons.
Conclusion
Co-creating psychological safety is practical, messy, and deeply human work. It requires humility from professionals, respect for lived experience as expertise, and organizational structures that make dialogue and reflection routine. When teams commit to those basics—shared language, co-vision supervision, harm reduction, and meaningful inclusion of peer staff—the result is services that are safer, more engaging, and more effective.
If you want to explore Jay S. Levy’s ideas more, his work is a good place to start (JaySLevy.com), and continuing this conversation inside your teams is the best next step.
