Challenges, relationship and outcomes in low-threshold drug services

Abstract

Purpose This paper reports on the findings of an action research study that sought to explore the development and provision of community-based low-threshold services within a socially disadvantaged area. In the context of debates, in regard to both the nature and efficacy of low-threshold drugs services and increasingly neo-liberal policy approaches to drug service provision that prioritise outcomes and drug treatment interventions, the purpose of this paper is to report on practitioners’ understandings of challenges, relationship building and outcomes within community-based low-threshold service provision in Dublin, Ireland. Design/methodology/approach An action research method of co-operative inquiry groups was utilised, with nine practitioners from one community-based drug agency participating in a series of four sessions over a three-month period. Findings Three key themes emerged in relation to building and sustaining client–practitioner relationships: the mechanisms by which the practitioners engaged with their clients and sought to develop relationships; how safe spaces were created and maintained in order to address client needs; and practitioners’ understanding of challenges and outcomes in low-threshold intervention work. Originality/value Drawing on a co-operative inquiry method, this paper concludes that practitioner attention to relational distance evidenced in community-based low-threshold service provision, may provide an alternative to episodic, outcome driven drug treatment and intervention.

Adverse Childhood Experiences, Domestic Violence and Substance Misuse: An Action Research Study on Routine Enquiry and Practice Responses

“…These are aspects of practice that may be difficult to capture in terms of quantifiable outcomes ( 55 ), and may require long-term trauma-informed interventions to address ( 56 ). Importantly, though, the impact on practitioners of support work needs to be attended to in the context of trauma-informed service delivery.…”