Evaluation of the Bristol City Council Substance Use Support Team (SUST) Trauma Informed Recovery Pathway (TIRP)

Evaluation in progress. Expected completion date December 2023

Outputs coming soon

What does the research mean for Local Authorities?

The evaluation of the TIRP aims to produce learning about the early delivery of a newly implemented intervention to address barriers to service use among clients with substance use and complex needs. Local evaluation partners and stakeholders have indicated that they would use the evaluation findings to inform improvements to the delivery of TIRP in future as well as potentially informing future commissioning decisions about drug and alcohol services in the city. Although the intervention is modest in scale, our evidence review suggests an evaluation can also contribute to addressing a gap in scientific evidence as much of the research on trauma-informed approaches has been undertaken in the US context. 

What does the evaluation research mean for the Public?

The evaluation of the TIRP aims to produce learning about the delivery of a newly implemented intervention to address barriers to service use among clients who use substances and have complex needs. Local evaluation partners and stakeholders have indicated that they would use the evaluation findings to inform improvements to the delivery of TIRP in future as well as potentially informing future commissioning decisions about drug and alcohol services in the city.  

How are the public involved in the project?

Plans for public involvement in the evaluation have been discussed with and will continue to be overseen by the PHIRST LiLaC Public Adviser Panel. One of the Public Adviser Panel public contributors is leading on supporting the public involvement in the TIRP evaluation. This has included contributing to the design and delivery of a peer workshop; commenting on the evaluation’s lay summary and continuing to have a role in supporting evaluation activities. 

Peer volunteers with lived experience of substance use and recovery advised on the evaluation plan through a workshop that was held with the support of the peer co-ordinator and the LiLaC PHIRST public contributor.  This group of peers with lived experience of addiction and recovery have agreed to remain involved in the evaluation. We anticipate that they would be involved in helping us to understand the findings and also in thinking about creative ways of sharing findings with people who might be thinking about entering TIRP. This may also include, for example, as a member of the local Project Evaluation Group 

Lay Summary of Research

The Trauma Informed Recovery Pathway (TIRP) recognises that many people who use substances have experienced trauma and that these trauma experiences can have a negative effect on how they access services because of difficulties around regulating their emotions and building trusting relationships with others. Some people (clients) might not be able to complete detox and rehab because they have experienced trauma. Bristol Substance Use Support Team (SUST) are using a Trauma Informed approach to work with clients who have tried many times to complete detox or who have complex needs 

The overarching aims of the evaluation are to understand how it is delivered, what affects its delivery and to understand client experiences and early impacts of TIRP. The study also aims to explore the economics of delivering TIRP. 

More specifically the evaluation objectives are: 

  1. To describe how TIRP is implemented and whether the intervention is delivered as intended  
  1. To explore how TIRP and its different components works  
  1. To investigate the context of the TIRP’s delivery including the individual, organisational factors that shape how it is implanted and what its outcomes are 
  1. To understand who engages with TIRP and how the intervention is experienced by the clients 
  1. To understand perceived early outcomes for clients (e.g., coping skills, patterns of substance use, and engagement with wider services) 
  1. To explore the costs and potential savings of delivering TIRP 
  1. To identify lessons for future delivery and evaluation of similar trauma-informed interventions for substance use programmes  

The evaluation will include three main components involving both qualitative investigation and analysis of routine data: (i) a qualitative investigation of TIRP’s delivery, contexts and mechanisms of change; (ii) a qualitative investigation of client experiences of TIRP and its perceived impacts on people’s lives (iii) an exploratory economic assessment of resources, costs and potential savings associated with TIRP. 


Local Authority/Partner(s) 

Bristol City Council 

PHIRST LiLaC Research Team* 

Prof Benjamin Barr, Prof Bruce Hollingsworth, Prof David Taylor-Robinson, Dr Emma Coombes, Dr Emma Halliday, Dr Joy Spiliopoulos, Prof Iain Buchan, Ms Irrum Durrani, Ms Jacqui Cannon, Prof Jennie Popay, Prof Karen Broadhurst, Prof Matthew Ashton, Dr Michelle Collins, Dr Sakthi Karunanithi, Prof Sarah Rogers, Mr Tim Wilson

*All PHIRST LiLaC members input into every project