The Balance - Finding the right time to engage with service users

By Chris English

The following is a case study from the RSMS’ Domestic Abuse Perpetrator Programme, in which a service user was struggling to find themselves in the right headspace to engage fully with the programme and how our facilitator navigated their difficulties:

Concerns for the Service User’s current partner had been raised by her father to the police due to the SU’s problematic behaviours exacerbated by cocaine addiction which had caused them to separate. Police investigated and were told that an argument had taken place. The Service User (SU) had taken his partner’s mobile phone, thrown it to the wall and had physically assaulted her by punching her on the arm and then made threats to end her life. It was established by Police that the SU was having an episode. Police referred him for mental health support, drug and alcohol support and to our Domestic Abuse Prevention Programme (DAPP) via The Chrysalis Centre.

The SU displayed a pattern of problematic behaviour. He has four children with his previous partner who he had split from some years ago due to his addiction and problematic behaviours towards her. The SU has since lost contact other than by phone with his children. When he arrived on DAPP, he was 5 weeks clean, honest about his history and displayed a positive attitude towards behavioural change.

The facilitator and SU developed a rapport during his assessment and the first few sessions where the facilitator offered him much-needed unconditional positive regard, hoping this would build trust to allow him to work on his behaviours. The SU appeared to find it easy to be open and said this gave him the encouragement back to himself and wanted to make his children proud. As the holidays approached, it was evident to the facilitator that the SU was not his usual self, there was a lack of enthusiasm that he had previously displayed. The SU admitted this was a hard time of the year for him because he couldn’t see or be with his children. He said he was down and depressed but on a positive note, he had completed his out of session work. He said he had been more patient, less angry and, although down, he was calmer than usual. He said felt good doing the work and that he “Felt better for being here.”. At the start of Session 3, the SU admitted to relapsing with alcohol and cocaine stating, “I didn’t want to come to the session but have made myself come. I’m not feeling good and gutted that I have relapsed.” He was disappointed in himself, and this was evident in his demeanour; his sad face, the lack of enthusiasm, he was presenting as totally different.

He was given the option to postpone the session, but he wanted to go ahead with it. He said he was feeling under a lot of pressure and juggling a lot of things, he was encouraged to continue to use the emotional regulation skills he had been taught so far on the programme and use his diary on his phone to keep a daily positive activity log. He believed he had been so keen to succeed this time that he was now overwhelmed and “Running before I can walk.” The facilitator reminded the SU that he should be proud of himself for showing up despite how he was feeling. The SU stated, “I didn’t want to come to the session mainly because I didn’t want to disappoint you because you have believed in me and have given me faith that I can do this.”

Overwhelmed, the Service User (SU) was struggling to engage in the learning and skills practise expected of him on the programme, although he had been very positive at the start, the addiction lapse had derailed his progress. He admitted to disengaging with AA and the facilitator encouraged him to return. They also done some work together in Session 3 around his difficult childhood experiences and the effect on his own children in witnessing domestic abuse. This appeared to have been difficult for the SU and he stated, “It has brought up a lot of history for me and brought back memories that are difficult for me to think about, that, along with another Christmas without seeing my children, I think has led me back into a lapse.”

The facilitator and SU agreed that offering to pause for 4 weeks on the programme, not removing him, whilst he reengaged with addiction services would give him the space to choose recovery and that we would be here for him when he has done that. The facilitator agreed to complete weekly welfare checks on him during the pause and provided him with additional support services referral options including residential rehab, men’s addiction support groups, and for him to work with his GP to support his recovery.

The Domestic Abuse Prevention Programme (DAPP) is holistic in its approach, the service needs to be person centred and flexible. It is not uncommon that Service Users have comorbidity of issues, the process cannot be linear and must work alongside a SU’s needs where we remain open to continued support and making the right support referrals during and after our intervention. We are hoping to welcome the SU back to the programme in the next few weeks and he is currently working hard on his own addiction recovery. If now is not the right time for him, we will, as a service, remain open to him to re-engage when he is ready.