News > Trauma-Informed Practice in Drug & Alcohol Services: DM’s Experience

Introduction

Following the publication of Inclusion’s Trauma-Informed Practice Guidance, services are working to embed these principles in everyday practice. This case study from our Telford STaRS service talks about DM’s journey through treatment and highlights how working in a trauma-informed way can be beneficial.

DM’s story

DM’s experience with substance use began at an early age, starting with cannabis before moving on to other drugs with peers, and later progressing to crack and heroin. He initially funded his use through his work as a plasterer, but over time his substance use began to affect his ability to work. His use of both prescribed and non-prescribed substances led to multiple hospital admissions following overdoses.

Trauma History

DM experienced domestic violence in the home from an early age and was subjected to abuse from both parents. He felt treated differently from his siblings, which contributed to a sense of isolation.

As an adult, he moved to Cornwall during a settled relationship, but following a pregnancy termination the relationship broke down. He later returned to Shropshire to care for his grandfather, who died due to medical complications. Although this was not his responsibility, family members blamed him for his grandfather’s death.

DM has received little support from his siblings and has often felt rejected and excluded by his family. Attempts to rebuild relationships, particularly with his mother, were unsuccessful and at times led to further substance use. He now has no contact with her.

Trauma Informed Treatment

DM has been working with TACT outreach for some time and has developed a strong working relationship with his key worker, Fi Stone. Joint visits are often planned, which DM finds supportive and helps him feel more comfortable with coordinated care.

While family interventions have been offered, DM does not feel ready to engage with these at present. Key work sessions usually take place in the therapy room at TACT, which is spacious and well-lit, providing a comfortable and accessible environment. Upon arrival, DM is met in the garden, where he likes to have a cigarette before the session. He is given time to settle, ensuring he is calm before starting.

DM has been referred to the CMHT for psychological intervention, which is due to begin. He was supported during the assessment, and ongoing communication with the team helps maintain a consistent understanding of his presentation and mood.

DM demonstrates insight into his substance use, recognizing links to past experiences and triggers. He has tended to manage his mental health through isolation, with limited contact outside the drug scene, though he is working to build a relationship with his older brother. He has expressed a desire to manage triggers more effectively and sees psychological support as helpful in this process.

Trauma is always considered in key work sessions, with no ‘quick fixes’ offered. Progress and achievements are reflected upon, and DM is consistently praised for his efforts in recovery, including reduced hospital admissions and engagement with services. His skills and strengths, such as his training as a plasterer, are highlighted during sessions to provide positive reinforcement and encouragement.