The Person in Environment (PIE) System

Understanding the PIE System and Learning

How to use It
BIO PSYCHO SOCIAL ASSESSMENT
 What is PIE?
• PIE is a system that facilitates the conducting of a
comprehensive biopsychosocial assessment of clients.
• The focus of PIE is on assessing the "social functioning”
problems/needs of clients while simultaneously
recognizing problems in the social systems and institutions
of society that affect social functioning.
• PIE recognizes that there is no separation between
individuals and their environment.
 What is PIE?

•PIE was developed as an alternative to the

commonly used disease models (DSM, ICD).

•PIE was developed to be applicable for use in

all areas of social work practice.
 PIE’s History

• During the 1980’s the PIE system was developed

under the auspices of the National Association of Social
Workers (NASW) by a group of practitioners and
academicians who were charged with the task of
developing a classification system useable in all field of
social work.

• In 1994, James M. Karls and Karin E. Wandrei

edited a book and wrote the manual,
Person-in-Environment System: The PIE Classification System fo
r Social Functioning
Problems (NASW Press) .  
 PIE’s History
• In 2000, an instructional software program was
developed by James Karls to facilitate the use of PIE
(CompuPIE, 2000).

• In 2008, a new version of PIE and its

accompanying software were developed which
incorporated suggestions and ideas from PIE enthusiasts
on how to improve PIE (James Karls & Maura O’Keefe)

• In 2017, a new CompuPIE was developed that

was significantly more comprehensive, user friendly,
compatible with both Mac and PC and included DSM 5.
 The PIE System: Basic Structure

• Factor 1 What are the problems and strengths in

social functioning presented by this client?
• Factor 2 What problems/needs exist in the social
institutions in this community that are affecting the
client? What resources/strengths are available?
• Factor 3 What mental health problems are present?
What are strengths does the client present?
•Factor 4 What physical health problems are noted?
What are the client strengths in this area?
The PIE System: Basic Structure
• Factor I: Social Role and Relationships
• Problems/needs, type, severity, duration, ability to cope, priority
• Strengths
• Goals, recommended interventions, expected outcome

• Factor 2: The Environment

• Problems/Needs, type, severity, duration & ability to cope, priority
• Strengths
• Goals, recommended interventions, expected outcome

• Factor 3: Mental Health

• DSM 5, severity, duration ability to cope, priority
• Strengths
• Goals, recommended interventions, expected outcome

• Factor 4: Physical Health

• ICD 10, severity, duration, ability to cope, priority
• Strengths
• Goals, recommended interventions, expected outcome
Factor 1: Social Roles/Relationships
Problems/Needs
Subheadings or Areas of Social Role Functioning
•Familial
• Parent, spouse or partner, child, sibling, extended family
•Interpersonal (other than family)
• Lover, friend, neighbor, member, other
•Occupational
• Worker (paid, home or voluntary), student, other
•Special Life Situation
• Consumer, caretaker, inpatient, outpatient, prisoner
/probationer/parolee, substance abuse client, immigrant (legal,
refugee, undocumented), other
Factor 1: Types of Relationship Problems

Problem Descriptors
• Abuse of power
• Ambivalence
• Conflict
• Responsibility
• Dependency
• Loss
• Isolation 
• Oppressed
• Mixed
• Other
 Factor 1: Types of Relationship Problems

Problem Descriptors

•Abuse of power This social role problem type involves the misuse of power
most often through the use of physical or psychological force. Examples include: a
husband who physically abuses his wife or refuses to allow her to see her friends; a son
who steals money from his elderly parent; a supervisor who bullies employees.

•Ambivalence This social role problem type is often accompanied by feelings of

uncertainty, indecisiveness and vacillation. Some examples include: a college student
who is caught between what he desires and his parents’ expectations of him is having
difficulty deciding which major to choose; a woman who is undecided about her
relationship; an individual who is unhappy at his/her job and vacillates between
quitting and taking steps to find another job.

•Conflict This social role problem type involves some form of friction,
disagreement, or discord that arises between individuals. Some examples include: a
woman who has a long standing rivalry with her sister is upset when she and her sister
have an argument about the sale of their mother’s home; a man reports ongoing
arguments with his wife causing him anxiety and upset; a person is having heated
arguments with their neighbor over loud music.
 Factor 1: Types of Relationship Problems
Problem Descriptors

•Responsibility This social role problem type may occur when one’s role
responsibilities or expectations are felt to be too difficult and/or a person fails to live up to
role expectations or responsibilities. Some examples include: an unemployed father
reports feeling anxious because he is unable to support his children; an employee feels
unable to do her work well unless she works many overtime hours, for which she does not
get paid; a college student feels overwhelmed and unable to keep up with coursework.
 
•Dependency Dependency usually becomes a problem when there is a pervasive
or excessive need to be taken care of or when there is a denial of normal dependency
needs. Adults with dependency problems may exhibit submissive/clinging behaviors and
perceive themselves as being unable to function independently. Alternatively, they may
refuse to recognize any need for help or reliance on others. Some examples include: a
woman who differs all decisions regarding her health care to her doctor; a 45-year-old
male who is unemployed living at home and financially dependent on his parents.

•Loss This social role problem type often occurs following a significant separation or
loss and may be accompanied by reactions such as anxiety, depression, fear, anger, or
loneliness. Examples include: the death of a loved one, divorce, loss of a personal
relationship, a move, loss of income, home, or a significant decline in health just to name a
few.
 Factor 1: Types of Relationship Problems
• Problem Descriptors 
• Isolation Individuals who withdraw from others do so for varied reasons: in response
to a perceived hurt, a stressful situation or due to problems stemming from a medical or
mental health problem. For some, social isolation may be a chronic state and stem from long
standing problems of low self-esteem, insecurity or a mental disorder. Some examples of
isolation type problems include: a man in a nursing home who no longer wishes to
communicate with others; a returning vet who moves to an isolated cabin because he can no
longer tolerate being near others; a woman who learns she is HIV positive no longer
communicates with friends and family.

• Victimized/Oppressed. Victimization/oppression is the result of exploitation and the

unjust use of force. Relationships involving physical or psychological abuse or often result in a person
feeling intimidated, fearful, and exploited by others. Victims often experience a range of symptoms
including fear, anxiety, distress, numbing, anger, self-blame, alienation, and powerlessness. Examples of
the victimized/oppressed problem type include: a woman who is raped by her partner, an
undocumented immigrant who is forced to work for low wages; an elderly woman who is financially
abuse by her daughter.

• Mixed. Mixed type should be used when no one dimension of role performance difficulty
predominates and the role performance problem is best described by a mixture of dimensions. An
example would be a mother who withdraws from friends and family after the death of one of her
children. (A mixture of Parental role – Loss and Isolation types).

• Other. Other type should be used when none of the listed dimensions of role performance adequately
describes the case dynamic.
Factor 2: Problems in the Environment
Environment = Social systems, institutions, or services that Impede clients’
functioning.

1. Economic/Basic Needs
• Food/Nutrition
• Shelter
• Economic Resources
• Transportation
2. Education/Training
3. Judicial/Legal
4. Health, Safety & Social Services
• Health/Mental Health Services
• Safety Services
• Social Services
5. Voluntary Associations
• Religious Groups
• Community Groups
6. Affectional Supports
Factor 2 - Examples
For each of these 6 Environmental Systems, specific
problems can be chosen.
Under Basic Needs: Shelter:
Absence of shelter
Inadequate or substandard housing
Other shelter problem
Discrimination in housing

Under Health, Safety, and Social Services System: Health:

Absence
Inadequate
Regulatory Barriers
Lack of Support
Other

Indicate for mental health, health and substance abuse services.

Factor 3: Mental Health Problems

•DSM 5 Mental Health DX

•Client report or Professional dx

Factor 4: Physical Health Problems

•ICD 10 Physical Health Problems

•Client report or Professional dx
 Factors 1 through 4: Specifiers and Strengths
• For each of the 4 Factors:
1. Identify the problems/needs?
2. What is the nature of these problems? (Type)
3. How severe are they? (Severity scale)
1 = low
2 = moderate
3 = high
4. How long have they been present? (Duration)
1 = 5+ years, 4. = 1 – 6 months
2 = 1 - 5 years 5. = Less than 1 month
3 = 6 months – 1 year,
5. Client’s coping ability
1 = Excellent 4. Below Average
2 = Good 5. Poor
3 = Average 6. Unable to judge at this time
6. Priority of problem/needs
1 = low
2 = Moderate
3 = High
 Goals, Intervention & Expected Outcomes

•Factor 1:
•Factor 2:
•Factor 3:
•Factor 4:
Strengths & Resources

• Factor I Identity the social relationships which

may prove beneficial in working with this client

• Factor 2 Identify the environmental resources

that may prove helpful in working with client

• Factor 3 Identify the mental health strengths that

may prove helpful in working with client

• Factor 4 Identify the physical health strengths

that may prove helpful in working with client
 Summing up
A comprehensive assessment is critical to the successful resolution of
a client’s problems.
The purpose of an assessment is to meet the needs of the client
rather than the needs or requirements of the agency or the
practitioner.
Clearly identifying problems in social functioning is critical to providing
effective help.
Seeing environmental, mental health and physical health as
contributing to social functioning problems is a key aspect of the
holistic approach that PIE employs.
PIE provides a system for conducting and recording a comprehensive
holistic assessment that stays focused on the client’s problems in
social functioning and guides the intervention process.