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Ladder4Life - Dr Ray Middleton

I am Dr Ray Middleton, an expert in trauma-informed approaches to helping people.



Just type in your email in the box opposite for me to send you my FREE mini-course explaining Trauma-Informed Practice.

In my free course you will learn about “Trauma” and the five areas people experience Reactions to trauma, ‘social resilience’ and self-care - and you will start to build confidence in your knowledge and skills in this area - and avoid feeling overwhelmed, confused/incompetent when trying to help someone with a complex trauma history.

YES - I am ready to learn more about trauma informed practice NOW!
If you would like to know more about any of my training courses to help your staff development just email me at:
Ray.middleton@ladder4life.com

A wide range of Trauma Informed Training Courses for developing knowledge and skills

I deliver live/recorded, online/in person training for people who work with people with past trauma, ‘mental health’, substance misuse ​or housing needs.
For more information about training I offer on Trauma Informed Practice (TIP) or PIE (Psychologically Informed Environments) The Power Threat Meaning Framework (PTMF) or Reflective Practice - just email me: Ray.middleton@ladder4life.com

I consistently receive excellent Feedback on my training courses - here are some examples from people who have been on my training courses:

Below is feedback from Therapists and Clinical Psychologists from Devon NHS Mental Health Trust on my training

Book published

I have a chapter on my Ladder4Life PIE approach in a new book edited by Jay Levy and Robin Johnson (Developer of PIE). The Kindle version is only £5.95 - "Cross Cultural Dialogues on Homelessness" (2018)

Recent News



I have recently completed a new course in “Pre-treatment” based on Jay Levy’s approach - it is particularly helpful for staff working with people with complex needs who are far from mainstream services. It covers a wide range of skills from engagement to supportive supervision - or as Jay puts it - ‘co-vision’! - it is a great set of knowledge and skills and is really helpful with lots of practical tips to use on the frontline !

I also offer online Trauma Informed Practice (TIP) training, and also in PIE, How to facilitate reflective practice - and I offer Group Reflective Practice to staff teams. I also offer live and recorded training on the Power Threat Meaning framework (PTMF) - I am on the National Steering Committee for the PTMF framework.

Topics covered in my training include; an awareness of the impact trauma, validation skills, motivational interviewing, solution focussed practice, collaborative problem solving, building trusting relationships and collaborative problem-solving.


Ray.Middleton@ladder4life.com


In addition to my online trining, once the coronavirus social distancing restrictions are lifted I offer two levels of Training:
Level One is for whole teams of front-line staff and covers the PIE areas with a focus on Reflective Practice and Understanding Complex Needs.
Level Two is a "Training the PIE Facilitator" training course to train staff within services to develop PIE within their own service.
I also deliver “How to facilitate group reflective practice” training.
To find out more about either training course just email me at Ray.Middleton@ladder4life.com
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I have written a Psychological Framework in plain English called Ladder4Life.
​Staff and Clients feedback they find this easy to use and understand. Here is the framework:
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The PIE I have developed in services has been researched and evaluated very positively and the report can be read here: 

How to develop PIE Psychologically Informed Environment (PIE)

If you are involved in delivering a service to people with complex trauma or multiple needs there are a number of ways to move forward. You could start by registering to be a member of pielink.net which is free and is a community of practice around PIE sharing ideas and resources. You could read the PIE guidance document written by Claire Richy for Westminster City Council available on pielink.net.
You could also watch some of Films about my Ladder 4 Life PIE framework or email me Ray.Middleton@ladder4life.com
The PIE I have developed in front-line services were referenced in Westminster City Council's PIE Guidance

The Kings Fund and Public Health England invitation to talk about Dialogical PIE

I was also invited by The Kings Fund and Public Health England to talk about my Dialogical PIEs at their Health and Housing Conference. A 15minute Film of Robin Johnson and myself explaining PIE at this conference can be viewed below

The Story of my Recovery Journey published by AFT CONTEXT magazine "Open Dialogue" ed 

I experienced Complex Needs in the 1990's and since finding ways to get better have been passionate for 20 years about developing and delivering better services for this client group. I have managed Personality Disorder Accommodation services and been a senior Care Co-coordinator in an Early Intervention in Psychosis (EIP) service.  I am also a Systemic Practitioner within Systemic Family Psychotherapy and  wrote an article about my recovery from trauma and how it relates to the"Open Dialogue" approach to mental health recovery. I am currently completing a PhD in Complex Needs.
​My article was published by the Association for Family Therapy and Systemic Practice (AFT) CONTEXT magazine, Issue 138 on "Open Dialogue", April 2015 and can be read here:
context138-raym.pdf
File Size: 2750 kb
File Type: pdf
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    If you have any comments or questions about PIE just email me:

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