Case Study 1 – Sarah’s Story
Sarah presented to DCD&AT in late 2013. She isin her early thirties and living in a city council flat with her husband and child. She is friendly.
Sarah is on 75mls of methadone and attends a HSE methadone clinic. She uses heroin, prescription tablets, cannabis and alcohol.
Sarah has been diagnosed with a mental illness receiving injections twice weekly at a psychiatric day service. Sarah is linked in with a mental health nurse.
Sarah has been married for 10 years and has one child. A social worker is linked-in with the family due to child protection issues. Sarah expresses feeling very unhappy in her marriage and reasons her drug use on this. She states her husband regularly abuses her, both physically and verbally.
Sarah has experienced significant tragedy in her life. In recent years Sarah has lost both a sibling and a parent from drug overdoses. Sarah had close relationships with both family members, and has no contact with her remaining parent or siblings.
Sarah has a probation officer due to theft offences.
- Problematic drug abuse
- Mental health issues
- Accommodation issues–wants to live in supported housing
The DCD&AT provides the following interventions:
- Building a trusting and therapeutic relationship.
- Working with Sarah to develop her individual care plan.
- Offering support to Sarah and advocacy on her behalf.
- Assigned Keyworker to:
- Attend regular case conference meetings.
- Ensure the client got her travel pass.
- Contact and meet Sarah’s Social Worker and Mental Health Nurse to advocate on her behalf.
- Linking in with housing services and workers to meet Sarah’s housing needs.
The staff of DCD&AT will continue to build a trusting relationship with Sarah, will continue to advocate on her behalf in a supportive manner. The Service will progress her individual care plan while providing a safe, confidential and nurturing environment and, assisting her in reducing harm in her life.
CASE STUDY 2 – Joe’s Story
Joe is in his late twenties, unemployed with no dependents.
Joe has a history of developmental trauma, poor attachment and prolonged periods of physical abuse and emotional neglect. He has a criminal history starting in his late teens. Joe’s history of family physical violence began from the age of 2 years old until early adulthood. Joe is socially isolated with no support network or family involvement. Joe has experienced two significant deaths.
Currently, Joe is a poly-drug user (cocaine and hash), with above average levels of alcohol consumption. Joe is dependent on prescribed anti-depressants to stabilise his mood. During periods of alcohol consumption Joe expresses heightened violent reactions to others and self (deliberate self – harm).
Joe is currently on a 12 month probation order for previous offences.
- Low self-esteem
- Two previous suicide attempts
- Depression first diagnosed in early adolescence and psychiatrically treated.
- Inclusive trauma history review
- Stabilisation through establishing a safe environment and developing his support network.
- Multimodal approach using a combination of Cognitive Behavioural Therapy, Person – Centred Therapy, Sensory – Motor Psychotherapy.
- Explore cognitive capabilities and thinking patterns.
- Body orientation psychotherapy.
- Titration: Supporting initial exploration and acceptance of bodily sensations.
- Provide a corrective experience by supplanting the passive responses of collapse and helplessness with active, empowered defensive responses.
- Actively separate associated conditions of fear and helplessness from biological immobility responses.
- Resolve hyper-arousal states by releasing toxic energy and restoring equilibrium.
- Talk therapy and psycho – education especially around trauma and attachment.
- Referral to Men Overcoming Violent Emotions (MOVE).
- Liaison between the DCD&AT and the Probation service.