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Leathersellers’ Review 2024–2025
Incidence of what are called Adverse Childhood Experiences (such as abuse and neglect) is higher amongst people who are homeless, which increases individual risk of mental health conditions as does the stress of homelessness itself. At DENS, what practitioners see in clients is a complexity of both childhood and adult trauma – for example, some clients might have a complex post-traumatic stress disorder diagnosis. Last year at DENS, the average age of a therapy client was 39 and the average ‘ACE score’ of clients – a method to understand and quantify the impact of childhood trauma – was 6+ ACEs out of a possible 10. This means that the average client had experienced six or seven different forms of loss, abuse or neglect before adulthood. Over 30 clients seen by the service last year scored eight or more, while a score of over six cuts life expectancy on average by 20 years. DENS is unique in offering long-term individual and group work, with clients seeing the same practitioner for over a year. Although long-term work is strongly recommended for people with relational trauma such as abuse, neglect, bereavement or abandonment, it is extremely difficult to fund and provide, and therefore few UK charities can offer it. Warren, now 57, started therapy at DENS when he was in recovery from alcohol addiction. He had lost his father to suicide, experienced self-harm, and four years ago was asked to leave the home he shared with his mum owing to problems arising from his addiction. With the help of DENS, Warren managed to stop drinking and move into his own place. But when he started living alone for the first time, he relapsed. In hospital, he was referred to DENS’s therapy service and began one-to-one therapy with Paula when he got out. Three years later, he’s grateful. “In just the first couple of sessions, I could really feel relief in being able to open up about my past,” he says. ”My recovery wouldn’t have worked without the therapy; I started drinking at an early age at school because of abuse and bullying – that was my way of just covering it up. In recovery your body doesn’t want the alcohol anymore, but all the other underlying things from the past have to be sorted, because they crop up again.” After individual therapy, despite his misgivings, Warren moved into group therapy. “The first day I went, I was so close to running away! But then when I got in there it was like, ‘What was I so scared of?’ The atmosphere was calm and relaxed. That was the beauty of it: talking about myself, listening to other people, and relating to their problems. Their circumstances might have been different from mine, but the suffering resulting from it was similar.” Today Warren works in DENS’s bike project, looks after an allotment, and his doctor says he’s reversed his cirrhosis diagnosis. He’s also cultivated a better relationship with his adult daughter, who’s now 33. ”Of all the benefits from
the therapy and the absence of alcohol, the greatest is my daughter. We have this beautiful relationship now. We can talk! We talk about psychology and everything. She never got that from me in the past, but she’s got it now. She’ll always have that from now on.” DENS’s emphasis on long-term work for people recovering from ACEs, and to prevent ACEs in their own families, helped The Leathersellers’ Foundation to improve its understanding and giving approach. “DENS was integral to challenging our perceptions of what ‘ACEs as a core focus’ looked like in real terms,” says Stacey Lamb, Head of Charity Grants at the Foundation. “By any description, DENS is first and foremost a ‘homelessness’ charity, but their understanding of the origin of their service users’ journeys demonstrated that experience of multiple ACEs was interlaced with the immediate housing need.” This learning was significant because it prevents future charities from being overlooked as a result of a focus on core activity alone. Since working with DENS, the Foundation’s approach is more nuanced. As Stacey explains, “We now determine ‘ACEs-focused’ by considering the prevalence of ACEs across the client group, not by the primary purpose of the activity.” Sammi, 27, also had long-term therapy at DENS. When she was 22 her relationship with her mum broke down. She moved out into her aunt’s house temporarily, but sharing with her seven cousins wasn’t a long-term solution. Sammi’s brother had previously stayed with DENS so she followed him there. She stayed in the charity’s emergency accommodation for a fortnight before getting a room in a shared house. However, it was not long after that when lockdown hit. Sammi referred herself to one-to-one therapy to cope with the loneliness and isolation. “I didn’t want to do it,” Sammi says. “I didn’t really like opening up then and I was so quiet. I wouldn’t talk to anyone; I was just so scared.” It took her several months to open up; in her first session, she and Paula sat in silence for 30 to 45 minutes. After they developed a relationship in therapy, Paula suggested that like Warren, Sammi could try group therapy. “I was nervous, very nervous. I said no, first of all. I wouldn’t talk; it was like being back in one-to-one therapy for the first time, I just sat there.” As the groups went on, Sammi got more confident. “They couldn’t stop me talking by the end of it,” she jokes. Since finishing group therapy, Sammi has completed several online training courses to become a teaching assistant and has begun volunteering in a local school. She plans to start work again at the start of the next school year. She hopes to specialise in working with autistic children (her younger brother is autistic). Sammi credits the therapy with her improved confidence and mood. “When I first came in, I didn’t know what was going on, but I knew I needed to do it. I needed to find myself, and I
DENS is unique in offering long-term individual and group work, with clients seeing the same practitioner for over a year.
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