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M E G A N B E E R S , P H . D .
C H I L D H A V E N
Resilience after ACES: An Introduction to
Trauma-Informed Care
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My Lens
A therapist (clinical psychologist by training)
Infant/Early Childhood Mental Health specialist
A White woman
Belief that learning and healing happen through relationship
Belief that trauma-informed care is the business of everyone interacting with children and families
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Learning Objectives
Participants will gain a basic understanding of the Adverse Childhood Experiences study and the impact of early trauma on lifelong health and well-being.
Participants will be able to identify examples of how trauma in early childhood can impact the behavior of adults.
Participants will be able to describe the basic tenets of Trauma-Informed Care.
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Experience, positive and negative, builds the brain.
This is true throughout the lifespan, but is
exponentially so in the first five years of life.
The “Why”
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ACEs and Trauma
ACEs are one way to think about trauma
Adverse Childhood
ExperiencesTrauma
Examples: Divorce of Parents, Witnessing a Car Accident, Community Violence
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Layers of Trauma/ACEs
An individual can be impacted by:
Individual/family trauma (e.g., domestic violence)
Collective/community trauma (e.g., neighborhood violence, institutional racism)
Historical trauma (e.g., history of slavery in the individual’s community)
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Adverse Childhood Experiences
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Adverse Childhood Experiences
Study originally completed by CDC and Kaiser-Permanente (1995-1997)
17,000 people living in Southern California
Primarily White (74.8%), educated (75.2% some college or greater) sample
Demonstrated the significant impact of adversity during childhood on lifelong health and well-being
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Original ACE Questionnaire
1. Emotional Abuse
2. Physical Abuse
3. Sexual Abuse
4. Emotional Neglect
5. Physical Neglect
6. Parental Separation
7. Domestic Violence
8. Caregiver Substance Abuse
9. Caregiver Mental Health Issue
10. Caregiver Incarceration
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Adapted from Center on Youth Wellness ACES Conference October 2016
Impact of ACEs on Health
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Levels of Stress
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Discrimination based on race or ethnicity
Homelessness
Neighborhood violence
Some studies have taken off divorce/separation
ACE Questionnaire is a quick way to estimate how much toxic stress a person/community has been exposed to (for public health reasons).
Additional ACEs Research
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The ACE Pyramid
15
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Thinking about History
16
Birth
Death
Historical Trauma, Parents’ trauma history, Stress during pregnancy…
Before Birth
Str
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Death
Birth
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Race, Privilege and Trauma
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Trauma-Informed Care (SAMHSA)
A program, organization, or system that:
• Realizes the widespread impact of trauma and understands potential paths for recovery
• Recognizes the signs and symptoms of trauma in clients, families, staff, and others involved with the system;
• Responds by fully integrating knowledge about trauma into policies, procedures, and practices,
• Seeks to actively resist re-traumatization.
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The Central Question
A non-trauma informed system punishes and blames your adult actions and asks, “What’s wrong with you?”
A trauma-informed system will hold you accountable for your adult actions, but give you space and time to process “What happened to you?” without adding guilt and more trauma.
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Guiding Principles of Trauma-Informed Care (SAMHSA)
1. Safety
2. Trustworthiness and transparency
3. Peer support and mutual self-help
4. Collaboration and mutuality
5. Empowerment, voice, and choice
6. Cultural, historical, and gender issues
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What do I do now?
Talk about it!
Ask “What happened to you?”, versus “What’s wrong with you?”
Additional resources
SAMHSA guide (Google: SAMHSA, Trauma-Informed Care)
Trauma Transformed www.traumatransformed.org
Sanctuary Model, Sandra Bloom