Trauma-Informed care approach with people who use drugs

Background
Trauma-Informed Care (TIC) is a person-centered approach aimed at recognizing trauma, taking a holistic view of individuals' life situations to provide effective healthcare, enhance patient engagement, treatment adherence, and improve health outcomes. This approach seeks to understand the widespread impact of trauma, formulate paths to recovery, identify signs and symptoms, and prevent situations that may trigger trauma reactivation. 
A following approach model has been planned to take place in two services in the area of substance addictions in the Lisbon Metropolitan Area, specifically in the field of treatment, comprising its development in a detox unit and therapeutic community.
 
Methodology
The interventions developed based on Nola Pender's theory and Health Promotion Model were divided into two components: organizational and clinical.  
In organizational activities, the initial aim was to reach the teams in the services where we implement the TIC approach, as they are the main drivers of this approach for the individuals under their care. To achieve these defined objectives, we conducted the following activities: training team members (both clinical and non-clinical) in TIC approaches, facilitating mutual support spaces for secondary trauma and stress events within the teams, creating spaces for reflection on the creation of safe environments, and jointly planning organizational services between people who use drugs (PWUD) and teams.
In clinical activities, the goal was to involve users in the treatment processes, incorporating TIC approaches to understand the traumatic life stories of the users and assisting in planning interventions, with PWUD playing an active role in decision-making processes. This includes conducting psychoeducational and psychotherapeutic group sessions on trauma for PWUD and their families. 
 
Results
The planning and execution of activities have allowed for an increased understanding of TIC approaches among the professionals in the multidisciplinary team. This includes the facilitation of spaces for preventive action and health promotion for the technical team, as well as the exploration of physical and socio-emotional environments within the services, including PWUD, in order to enhance these services.
The facilitation of psychoeducational and psychotherapeutic activities has enabled an exploration of trauma-related issues and coping mechanisms with PWUD, adapting them to the heterogeneous stages of change and motivation among individuals.

Conclusions
These results underscore the positive impact of the undertaken initiatives on both professional development and the quality of care provided, emphasizing the importance of continued efforts to improve and adapt strategies in addressing the complex challenges within this field.