The Well Space: A trauma-informed group for well being “The Well Space helped me reignite my zest for living and helped me to move forward with positivity in my life.” - Steven Marcus*, spent much of his childhood hiding in the kennel with his dog. Being in the house was terrifying and dangerous because of physical and emotional abuse from his father. Spending his childhood hungry and afraid, it is unsurprising that Marcus’ problems with alcohol started when he was 10 years of age. Marcus is not an exception amongst the people with whom we work. If there is no safety or support for victims of trauma, many will self-medicate (using alcohol or drugs) to escape the pain and memories. Marcus spent 30 years of his life in addiction, homelessness, relationship difficulties and offending. We generally find that therapeutic services, especially those that offer structured therapy, expect our clients to be substance-use free before accessing their service. Whilst, clinically, this is understandable in many ways, it effectively expects people to be 'treatment ready' before they have ever received treatment. It is a Catch-22 that means our clients rarely have the opportunity to access any form of therapeutic support. Using drugs or alcohol to cope with emotional pain is often described as a 'maladaptive' or 'adverse' coping strategy. However, in the absence of other therapeutic support, it is often one of the few coping mechanisms available. At FLIC we work together with clients and services to try and find solutions to such challenges. We’re looking for ways of working that keep people safe and take into account their multiple needs. As a result, we decided to develop and trial ‘The Well Space’ a light-touch mental health support group, which is open and welcoming to people, regardless of their substance misuse issues. We are now in our third term of running the Well Space, at Camden’s Routes Off the Street (RtS) hub. The RtS hub is a building-based service, working alongside Camden’s Homelessness Street Outreach team, striving to support rough sleeping people off the street and into accommodation. It’s fair to say we have had a LOT of learning to do. This has come from feedback, collaboration and a few CRINGE moments. But the first learning is to try. And don’t be deterred. Collaboration The greatest and most important aspect to us was that of collaboration. From day one, we hoped to create a space where attendees were able to own the group and for it to be a place where activities and topics were designed by everyone. Getting started The conception came from the experiences of our clients and speaking with them about what they felt would help them. Initially a small team of FLIC workers, including our psychologist and two workers (with experience of running ‘recovery’ groups) met together to devise a 6-week program, which was run fortnightly. We anticipated potential challenges in gaining engagement, interest, promotion and how to most effectively manage challenging behavior within the group. Consistency It became clear that meeting weekly rather than fortnightly was better. Having a regular and consistent time and location was vital to building trust and embedding it into clients’ routines. We also learnt that running a group that depended on having attended the previous week's session could be a barrier to people with a lot of competing challenges in their lives Therefore, we changed our group to an open-ended model, running weekly, with standalone sessions. This enabled people to attend as much or as little as was good for them & effectively removed the fear of having missed a session or needing to ‘catch-up’ with others. “Our service users really enjoy it and are always eager for the next session. My team and I are enthusiastic about working with FLIC in the future to ensure that the Well Space sessions continue to be such a success.” - Lee Savage, RTS Expectations and Structure Creating a safe environment was vital. This was achieved by having consistent people running the sessions, regular check-ins with attendees about their views and progress and creating a clear structure. This included an hour of activity, with five different sections so we could hold concentration and if an individual disliked an activity it helped that they were short, and we could move on quickly. The session included an introduction and re-iteration of the group agreement, check in, mindfulness, a creative exercise and a discussion around a broad theme, such as “Peace”, “Hope” or “Discipline”. The session being an hour enabled even the most committed smoker to stay, without disappearing on a break! The monthly check in’s were useful to continually agree, as a group, what was important in terms of behavior from both facilitators & participants. Variety and accessibility Understanding and creating a broad range of activities around the potential needs of those in the group was important to ensure everybody was comfortable. Every session had access to drinks, snacks and ‘fiddle’ toys. One participant who has ADHD said this was refreshing and enabled her to maintain focus for an hour. Beforehand we discussed what might get in the way, such as use of language, learning barriers and having alternative plans and materials to cater for these differences. And after each session we evaluated what worked and what didn’t. “I found the meetings and content inspirational as a place to meet new people and share in a non-judgemental, supportive and safe environment and got so much out of these meetings that they became the highlight of my week as I looked to get my life back on track.” - Steven We have all benefited from the sense of unity and sharing that the Well Space created. We’ve learnt that success is not seeing the individual or their behavior as the barrier but seeing the opportunity to learn together and create an environment that works for us all. Creating a society that seeks equality and shared ownership. Every session I was a part of, the resilience openness and stories shared, were what I valued the most. “Since the launch, every group has been extremely well attended and, perhaps more importantly, service users are completely engaged in the process. Covering issues such as loneliness, self-identity, relaxation etc, I feel that Laura, Joe and the team have identified issues that really resonate with our service users.” - Lee Savage, RTS Keen to hear more about The Well Space, or pick the brains of the team behind it? Send us an email at [email protected]. *Marcus is a pseudonym.