PACEs Science 101 (FAQs) — Positive and Adverse Childhood Experiences

Jane Stevens Jane Stevens 10/1/191:00 AM

What is PACEs science?

The science of PACEs refers to the research about the stunning effects of positive and adverse childhood experiences (PACEs) and how they work together to affect our lives, as well as our organizations, systems and communities. It comprises:

  1. The CDC-Kaiser Permanente ACE Study and subsequent surveys that show that most people in the U.S. have at least one ACE, and that people with four ACEs— including living with an alcoholic parent, racism, bullying, witnessing violence outside the home, physical abuse, and losing a parent to divorce — have a huge risk of adult onset of chronic health problems such as heart disease, cancer, diabetes, suicide, and alcoholism.
  2. Brain science (neurobiology of toxic stress) — how toxic stress caused by ACEs damages the function and structure of kids’ developing brains.
  3. Health consequences — how toxic stress caused by ACEs affects short- and long-term health, and can impact every part of the body, leading to autoimmune diseases, such as arthritis, as well as heart disease, breast cancer, lung cancer, etc.
  4. Historical and generational trauma (epigenetic consequences of toxic stress) — how toxic stress caused by ACEs can alter how our DNA functions, and how that can be passed on from generation to generation.
  5. Positive Childhood Experiences and resilience research and practice — Building on the knowledge that the brain is plastic and the body wants to heal, this part of PACEs science includes evidence-based practice, as well as practice-based evidence by people, organizations and communities that are integrating trauma-informed and resilience-building practices. This ranges from looking at how the brain of a teen with a high ACE score can be healed with cognitive behavior therapy, to how schools can integrate trauma-informed and resilience-building practices that result in an increase in students’ scores, test grades and graduation rates.

1. What are ACEs?

ACEs are adverse childhood experiences that harm children’s developing brains and lead to changing how they respond to stress and damaging their immune systems so profoundly that the effects show up decades later. ACEs cause much of our burden of chronic disease, most mental illness, and are at the root of most violence.

“ACEs” comes from the CDC-Kaiser Adverse Childhood Experiences Study, a groundbreaking public health study that discovered that childhood trauma leads to the adult onset of chronic diseases, depression and other mental illness, violence and being a victim of violence, as well as financial and social problems. The ACE Study has published about 70 research papers since 1998. Hundreds of additional research papers based on the ACE Study have also been published.

The 10 ACEs the researchers measured:

— Physical, sexual and verbal abuse.

— Physical and emotional neglect.

— A family member who is:

  • depressed or diagnosed with other mental illness;
  • addicted to alcohol or another substance;
  • in prison.

— Witnessing a mother being abused.

— Losing a parent to separation, divorce or other reason.

Subsequent to the ACE Study, other ACE surveys have expanded the types of ACEs to include racism, gender discrimination, witnessing a sibling being abused, witnessing violence outside the home, witnessing a father being abused by a mother, being bullied by a peer or adult, involvement with the foster care system, living in a war zone, living in an unsafe neighborhood, losing a family member to deportation, etc.

ACEs fall into three large categories:

  • Adverse childhood experiences
  • Adverse community experiences
  • Adverse climate experiences

Resources:

CDC ACE Study site

Wikipedia — Adverse Childhood Experiences Study

The 10 ACE Questions (and 14 resilience survey questions)

The Pair of ACEs: The Soil in Which We’re Rooted, the Branches on Which We Grow

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Why are ACEs significant?

1. The ACE Study revealed six main discoveries:

  • ACEs are common…nearly two-thirds (64%) of adults have at least one.
  • They cause adult onset of chronic disease, such as cancer and heart disease, as well as mental illness, violence and being a victim of violence
  • ACEs don’t occur alone….if you have one, there’s an 87% chance that you have two or more.
  • The more ACEs you have, the greater the risk for chronic disease, mental illness, violence and being a victim of violence. People have an ACE score of 0 to 10. Each type of trauma counts as one, no matter how many times it occurs. You can think of an ACE score as a cholesterol score for childhood trauma. For example, people with an ACE score of 4 are twice as likely to be smokers and seven times more likely to be alcoholic. Having an ACE score of 4 increases the risk of emphysema or chronic bronchitis by nearly 400 percent, and attempted suicide by 1200 percent. People with high ACE scores are more likely to be violent, to have more marriages, more broken bones, more drug prescriptions, more depression, and more autoimmune diseases. People with an ACE score of 6 or higher are at risk of their lifespan being shortened by 20 years.
  • ACEs are responsible for a big chunk of workplace absenteeism, and for costs in health care, emergency response, mental health and criminal justice. So, the fifth finding from the ACE Study is that childhood adversity contributes to most of our major chronic health, mental health, economic health and social health issues.
  • On a population level, it doesn’t matter which four ACEs a person has; the harmful consequences are the same. The brain cannot distinguish one type of toxic stress from another; it’s all toxic stress, with the same impact.  

What’s particularly startling is that the 17,000 ACE Study participants were mostly white, middle- and upper-middle class, college-educated, and all had jobs and great health care (they were all members of Kaiser Permanente).

Resources:

ACE Study primer — KPJR Films, which came out with Paper Tigers in 2015 and Resilience in 2016, put together this five-minute overview of the ACE Study.

ACE Study video — Three-minute trailer for a four-hour CD of interviews with ACEs researchers produced by the Academy on Violence and Abuse.

How childhood trauma affects health across a lifetime (16-minute TED Talk by Dr. Nadine Burke Harris)

The Adverse Childhood Experiences Study – the largest public health study you never heard of – started in an obesity clinic

Has anyone else done an ACE Study?

Thirty-six states and Washington, D.C. (infographic) have done one or more ACE surveys. Here are links to some of their reports (some states haven’t produced reports).

There are numerous other ACE surveys, including cities, such as Philadelphia; organizations, including the Crittenton Foundation; schools, including Spokane elementary schools; by pediatricians, including Dr. Nadine Burke Harris and Dr. Victor Carrion (2011 and 2013); several countries, including EnglandSaudi Arabia, and a World Health Organization ACE survey of university students in Romania,; and 64,000 juvenile offenders in the Florida juvenile justice system. You can find a list of ACE surveys, including expanded ACE surveys with more questions, in the Resources Section of ACEsConnection.com.


2. What’s the neurobiology of toxic stress?

Brain science shows that, in the absence of protective factors, toxic stress damages children’s developing brains. Stress is the body’s normal response to challenging events or environments. Positive stress — the first day of school, a big exam, a sports challenge — is part of growing up, and parents or caregivers help children prepare for and learn how to handle positive stress, which is moderate and doesn’t last long. It increases heart rate and the amount of stress hormones in the body, but they return to normal levels quickly.

But when events or the environment are threatening or harmful – we stumble across a bear in the woods – our brains instantly zap into fight, flight or freeze mode and bypass our thinking brains, which can be way too analytical to save us (Is the bear really mean? Is it more interested in berries or killing me? Should I wait until I see it charge?). With help from caring adults, children also recover from this tolerable stress.

Too much stress – toxic stress – occurs when that raging bear comes home from the bar every night, says pediatrician Nadine Burke Harris. Then a child’s brain and body will produce an overload of stress hormones — such as cortisol and adrenaline — that harm the function and structure of the brain. This can be particularly devastating in children, whose brains are developing at a galloping pace from before they are born to age three. Toxic stress is the kind of stress that can come in response to living for months or years with a screaming alcoholic father, a severely depressed and neglectful mother or a parent who takes out life’s frustrations by whipping a belt across a child’s body.

Resources:

Harvard University Center on the Developing Child

Video: Toxic Stress Derails Healthy Development (2 min)

An Unhealthy Dose of Stress (Center for Youth Wellness white paper)

The Science Behind PTSD Symptoms: How Trauma Changes the Brain

Brain Story Certification, Alberta Family Wellness Initiative


3. What are the health effects of toxic stress?

Chronic toxic stress—living in a red alert mode for months or years — can also damage our bodies. In a red alert state, the body pumps out adrenaline and cortisol continuously. Over time, the constant presence of adrenaline and cortisol keep blood pressure high, which weakens the heart and circulatory system. They also keep glucose levels high to provide enough energy for the heart and muscles to act quickly; this can lead to type 2 diabetes. Too much adrenaline and cortisol can also increase cholesterol.

Too much cortisol can lead to osteoporosis, arthritis, gastrointestinal disease, depression, anorexia nervosa, Cushing’s syndrome, hyperthyroidism and the shrinkage of lymph nodes, leading to the inability to ward off infections.

If the red alert system is always on, eventually the adrenal glands give out, and the body can’t produce enough cortisol to keep up with the demand. This may cause the immune system to attack parts of the body, which can lead to lupus, multiple sclerosis, rheumatoid arthritis, and fibromyalgia.

Cortisol is also extremely important in maintaining the body’s appropriate inflammation response. In a normal response to a bee sting or infection, the body rushes antibodies, white blood cells and other cell fighters to the site and the tissues swell while the battle rages. But too much swelling damages tissue. Cortisol controls this fine balance. So without the mediating effects of cortisol, the inflammatory response runs amok and can cause a host of diseases.

If you’re chronically stressed and then experience an additional traumatic event, your body will have trouble returning to a normal state. Over time, you will become more sensitive to trauma or stress, developing a hair-trigger response to events that other people shrug off.

Biomedical researchers say that childhood trauma is biologically embedded in our bodies: Children with adverse childhood experiences and adults who have experienced childhood trauma may respond more quickly and strongly to events or conversations that would not affect those with no ACEs, and have higher levels of indicators for inflammation than those who have not suffered childhood trauma. This wear and tear on the body is the main reason why the lifespan of people with an ACE score of six or higher is likely to be shortened by 20 years.

Resources:

What Happened To You? Conversations on Trauma, Resilience and Healing, by Dr. Bruce Perry and Oprah Winfrey

Childhood Disrupted: How Your Biography Becomes Your Biology and How You Can Heal, by Donna Jackson Nakazawa

The Body Keeps the Score: Brain, Mind and Body in the Healing of Trauma, by Bessel Van Der Kolk

The Deepest Well: Healing the Long-Term Effects of Childhood Adversity, by Nadine Burke Harris, 2018.

Scared Sick: The Role of Childhood Trauma in Adult Disease by Robin Karr-Morse with Meredith S. Wiley

Biologial Embedding of Early Social Adversity, Proceedings of the National Academy of Sciences, 2012

PubMed childhood adversity research publications

4. What’s epigenetics and how does that relate to historical or generational trauma?

Most people believe that the DNA we’re born with does not change and that it determines all that we are during our lifetime. That’s true, but the research from epigenetics — the study of how social and other environments turn our genes on and off — shows that toxic stress can actually change how our genes function, which can lead to long-term changes in all parts of our bodies and brains. What’s more, these changes can be transferred from generation to generation.

Epigenetics means “above the genome” and refers to changes in gene expression that are not the result of changes in the DNA sequence (or mutations).

Resources:

WhatIsEpigenetics.com — This New York-based blog and news aggregator covers the field of epigenetics and is funded by EpiGentek. It includes backgrounders, including epigenetics fundamentals.

Epigenetics — From the Genetics Science Learning Center at the University of Utah, this section includes explainers and an overview of how the social environment affects your epigenome.

Epigenetics 101: A beginner’s guide to explaining everything (TheGuardian.com, 2014)

5. Positive Childhood Experiences and resilience research: If you have a high ACE score, are you doomed? No!

The good news is that the brain is plastic, and the body wants to heal.

The brain is continually changing in response to the environment. If the toxic stress stops and is replaced by practices that build resilience, the brain can slowly undo many of the stress-induced changes.

There is well documented research on how individuals’ brains and bodies become healthier through mindfulness practices, exercise, good nutrition, adequate sleep, and healthy social interactions.

Here’s a good article that weaves the unified science of human development together: Scars That Don’t Fade, from Massachusetts General Hospital’s Proto Magazine.

In the last few years, researchers have started to examine the impacts of positive childhood experiences (PCEs) on children and adults. We at PACEs Connection are particularly interested in the interplay between positive and adverse childhood experiences. Here’s some of the relevant research:


Who’s using PACEs science?

Many people, organizations, agencies, systems and communities are beginning to implement trauma-informed, resilience-building practices based on PACEs science.

Resources:

Growing Resilient Communities provides guidelines and tools for communities to launch and grow local PACEs initiatives, and measure the progress of their work.

What does trauma-informed mean?

According to the Substance Abuse and Mental Health Services Administration (SAHMSA), part of the U.S. Department of Health and Human Services, a trauma-informed approach refers to how an organization or community thinks about and responds to children and adults who have experienced or may be at risk for experiencing trauma. In this approach, the whole community understands the prevalence and impact of ACEs, the role trauma plays in people’s lives, and the complex and varied paths for healing and recovery.

A trauma-informed approach asks: “What happened to you?” instead of “What’s wrong with you?” It is designed to avoid re-traumatizing already traumatized people, with a focus on “safety first” (including emotional safety), and a commitment to do no harm. But a trauma-informed approach is most successful when an organization or community builds policies and practices based on a foundation of ACEs science.  

Resources:

SAMHSA overview of what trauma-informed is and isn’t

National Center for Trauma-Informed Care

SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach — Introduces a concept of trauma and offers a framework for how an organization, system, or service sector can become trauma-informed. Includes a definition of trauma (the three “E’s”), a definition of a trauma-informed approach (the four “R’s”), 6 key principles, and 10 implementation domains.

Any legislation or federal policies?

Updates on U.S. state and federal legislation can be found in the State ACEs Resolutions and Laws section of State PACEs Action on PACEsConnection.com. Some examples:

California legislature resolution to reduce ACEs

Massachusetts bill on trauma-informed schools

Vermont attempt to pass ACEs bill

Overview of state, federal legislation

US Department of Health and Human Services guidelines to state health directors (and the letter to state health directors)

All resources:

CDC ACE Study site

A Critical Assessment of the Adverse Childhood Experiences Study at 20 Years (attached)

Wikipedia — Adverse Childhood Experiences Study

The 10 ACE Questions (and 14 resilience survey questions)

Harvard University Center on the Developing Child (neurobiology of toxic stress)

Alberta Family Wellness Initiative (Canada)

ACEsTooHigh.com – News site covering PACEs research and practices

PACEsConnection.com – Social network (with 60,000+ members across sectors) and more than 400 community sites that support ACEs initiatives in cities, counties, states, regions and nations.

WhatIsEpigenetics.com – News site covering epigenetics

Epigenetics — Explainers and backgrounders about epigenetics

National Center for Trauma-Informed Care

Community Resilience Cookbook — Nine case studies of cities and states that are integrating PACEs research)

SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach — Introduces a concept of trauma and offers a framework for how an organization, system, or service sector can become trauma-informed. Includes a definition of trauma (the three “E’s”), a definition of a trauma-informed approach (the four “R’s”), 6 key principles, and 10 implementation domains.

Videos:

ACE Study video (three minute trailer)

Video: Toxic Stress Derails Healthy Development (2 min)

How childhood trauma affects health across a lifetime (16-minute TED Talk by Dr. Nadine Burke Harris)

Books:

Childhood Disrupted: How Your Biography Becomes Your Biology and How You Can Heal, by Donna Jackson Nakazawa

The Body Keeps the Score: Brain, Mind and Body in the Healing of Trauma, by Bessel Van Der Kolk

The Deepest Well: Healing the Long-Term Effects of Childhood Adversity, by Nadine Burke Harris, 2018.

Scared Sick: The Role of Childhood Trauma in Adult Disease by Robin Karr-Morse with Meredith S. Wiley

The Last Best Cure: My Quest to Awaken the Healing Parts of My Brain and Get Back My Body, My Joy, and My Life, by Donna Jackson Nakazawa

For other books, go to the ACEs Connection Books community.

Documentaries:

Paper Tigers — What does it mean to be a trauma-informed school? And how do you educate teens whose childhood experiences have left them with a brain and body ill-suited to learn? This film follows six students through a year in America’s first trauma-informed high school.

Resilience — Resilience chronicles how trailblazers in pediatrics, education, and social welfare are using cutting-edge science and field-tested therapies to protect children from the insidious effects of toxic stress.

CAREgivers — How is the professional care provider affected emotionally and physically, and who helps them?

For a list of all documentaries addressing PACEs science, and how to access them, go here.

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MSMary SoleroMember

If individuals want society to be less aggressive, more calm, less reactive, and more cooperative and collaborative… For the developing brain to develop the capacity for empathy, compassion, and all that comes to mind when thinking about what it means to be human, it requires certain developmental and social experiences at crucial junctures. Drywall Installation Arlington Drywall Contractor Pros

 

FMFormer Member

ACE Science is woefully limited by leaving out everything about the development of the stress response system and healthy brain architecture, Resiliency is developed in infancy via a secure attachment.  A secure and loving attachment in infancy develops a brain’s limbic and cortical regulation over the brainstem’s reactivity  leading to control over violent, aggressive and impulsive behavior.   Focusing on anything but healthy early brain development will always be radically suboptimal. 

If people want the society to be less violent and more cooperative and collaborative, more relaxed and less reactive… the developing brain needs certain developmental and relational experiences at critical points in time in order for a brain to bring forth the capacity for empathy and compassion and everything one thinks of when one considers what it means to be human. 

 

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Jane StevensJane StevensPublisher, ACEsTooHigh; founder, PACEs Connection

We’re in the process of revising our ACEs Science 101 PPT, Elaine. We’ll post it when it’s finished.

 

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ESElaine SpicerMember

My question:  is there a powerpoint that goes along with the ACES Science 101?

Thank you!

 

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Dale FletcherDale FletcherMember

Gail Kennedy (ACEs Connection Staff) posted:

Dale- i encourage you to post your question to the ACEs in the Faith Based community!

I did that too Gail.  Thanks!!

 

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Gail KennedyGail KennedyMember

Dale- i encourage you to post your question to the ACEs in the Faith Based community!

 

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Dale FletcherDale FletcherMember

I’m presenting a talk to a group of Pastors on ACES but the slide deck on ACES that I received does not have any slides on Neuroplasticity, from either a science perspective or from a biblical perspective. 

Do any of you have a few slides that you’d be willing to share with me?

Thanks so much in advance!!

Have an awesome day!

 

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Dominic CappelloDominic CappelloMember

May I stress the link between family trauma and poverty. Living without resources means lack of access to survival resources like food, safe shelter, medical care, behavioral health care and transport to vital services. It also means lacking the resources to thrive: family centered schools, parent support, early childhood learning programs, youth mentors and job training. ACEs prevention programs, if it is to include our most vulnerable children and families, can build into theor strategic plan and priorities the strengthening of ten key family resources. For more information on a data-driven and cross-sector approach that addresses health disparities please visit www.resilienceleaders.org

 

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Gail KennedyGail KennedyMember

Thanks for identifying that, Dale!  I just fixed it.

 

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Dale FletcherDale FletcherMember

Hi Jane,

FYI – a link above in the paragraph:

Who’s using ACEs science?

 – Faith-Based Community – is broken. I found the new link:

http://www.mercedsunstar.com/n…/article3306980.html

Hope this helps!  Have a great day!

Dale 

 

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Emily Read DanielsEmily Read DanielsMember

Jane, this is great!  Great!  I love ACES Connection;  I am grateful for the resource.  It is connecting me to fabulous people and fabulous efforts – thank you! 

But there is one “bone of contention” that I will pick – this reference list is missing the work of Bessel Van Der Kolk, Peter Levine, Pat Ogden, Bruce Perry… we DESPERATELY NEED TO MOVE BEYOND COGNITIVE/BEHAVIORAL APPROACHES to treating trauma.  As someone that has YEARS of experience working with children and teens and working with that kind of approach to treating depression, anxiety, suicidality, substance misuse, cutting, ODD – you name it, I have worked with it – it’s an epic fail.  EPIC!  The emerging modalities of treatment (e.g. somatic experiencing, trauma-informed yoga, trauma drama, rhythmic movement and music, etc.) make way for regulating the body’s stress response! 

We are a culture OBSESSED with the mind and the power of the mind – to the detriment of the body.  We must remember that when someone is struggling with anxiety, depression, rage, etc., the individual is experiencing an overwhelming visceral body experience.  

I just had to share this…in all the trauma-informed training and efforts I see going on, I am thrilled.  But then I get “un-thrilled” when it’s the same means of practice we have been endorsing and implementing for years (without success!).  It’s time to move beyond behavioral and cognitive behavioral approaches to resolving trauma.  

 

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Jane StevensJane StevensPublisher, ACEsTooHigh; founder, PACEs Connection

Thank you for your comment, Vincent, and for all the work you did that provided the solid foundation for this new understanding of us humans!

 

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Vincent J. Felitti, MDVincent J. Felitti, MDMember

Jane, I am repeatedly grateful to you for your skills in disseminating all this information so interestingly and understandably.  Thank you!

 

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Jane StevensJane StevensPublisher, ACEsTooHigh; founder, PACEs Connection

Thanks, Melissa & Paul. If there’s anything else we need to add, let me know.

 

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Melissa L. Baker, MPHMelissa L. Baker, MPHMember

Jane, this is SUCH a valuable compilation to have in one place!

i will use these resources and links in my next presentation.

thanks!

 

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Paul GilmorePaul GilmoreMember

Thank you for this concise review of ACE’s. My senior research project looks at the use of ACE scores in serving adjudicated youth with histories of harmful sexual behaviors. Your post provides a lot of information and resources that will be helpful to my project. Much appreciated! 

 

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Carey Sipp commented:
Thanks for posting, Laura! For posting this, and so many more blogs over the years. I’m thinking of the ones YOU’VE written (you are…

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Thanks, Jeoff. A lot of great relationships and ongoing work came from this incredible gathering. It laid the groundwork for deepening…

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David Dooley commented:
Thank you for commenting, Mr. Holmes. I’m not sure what you’re getting at. Can you give me an example?

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Tommy Holmes commented:
I loved how you highlighted the connection between ACEs and community resilience! It’s so important to empower people with this…

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This one landed, Dr. Long. What I’d underline is that you’ve framed being pushed out as a pattern rather than a run of bad luck — and…

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That story is heartbreaking and really shows how history and present-day realities can intersect. Reading about Black history in China…

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Thank you for writing, Mr. Anderson. You wrote… “Your instinct that the utopia requires entirely new forms of parenting education that…

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Trauma-Informed Money Management: ACE Score of 7+; Gaining Clarity in My Third Act (careysipp.com)

Carey Sipp Carey Sipp 7/24/174:56 PM

I almost felt slapped in the face – a wakeup slap; not a punishment – when I read Cissy White’s groundbreaking post describing her joy in finding out her “ACE score.”

Her writing about her elation at learning about the Adverse Childhood Experiences (ACE) study and questionnaire was an unintentional throw-down on her part. As I read her post I was compelled to reframe my shame, fear, and overall sense of dread about my own high ACE score. (Cissy has given me permission to use her name and to mention her writing.)

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Robert OlcottRobert OlcottMember

Carey,

I’m quite certain that “Fore-Shortened Sense of the Future” PTSD ‘symptom’, was a ‘contributing factor’ in some of my own adolescent ‘Independent Living’ challenges, such as moving into my own apartment during my Senior Year of High School, after ‘couch surfing’ with friends, for a couple months. …

I wonder what in the World Health Organization’s ACE Screening Tool might address this, as it’s quite a bit more extensive than the CDC/Kaiser 8/10 question ACE Screening tool. It’s called the ‘WHO ACE International Questionaire’, and is available in over 100 languages on the WHO main page: lower Right corner-last time I checked.

 

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Christine Cissy WhiteChristine Cissy WhiteIt’s not trauma-informed unless it’s informed by trauma survivors.

Carey:

You bring up such an important topic and you write so well. It’s a little strange to read my name in your piece but if I helped provoke thoughts, feelings or writing in any way – that makes me so happy.

You wrote:

“Do you think, possibly, that people with high scores who have money issues could be spending money quickly because we think, on some deep level, we might not live to see the next day?” I asked.

Isn’t it cool how we get that aha awareness when curious and open and we feel safe? And when we feel we can talk and think and share about our actual issues and experiences? I think there’s so much freedom and relief in that even if we have to face uncomfortable stuff. 

I can’t wait to learn more from you about trauma-informed approaches to money and security and finances!. Lots of us have been, will be or are in the same boat or one like it floating on the same ocean 

Thanks for sharing. I love this passage, too. 

It was a soul-searing moment, as I let what I had asked sink in. The resulting pain and my awareness of it led to the realization that I needed to do more work on my trauma issues and start managing my finances in a “trauma-informed” way, as I realized, on a deep level, that have been a fear-based spender and under-earner most of my life.  How to get to the solution? Sometimes we have to look backward to go forward.

You are a beautiful writer and have so much insight, honesty, and passion. I’m glad writing and this page helped us get to know each other better. Thank you for helping all of us all better understand this issue.

THANK YOU!

Cissy

 

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Preventing Medical Error Takes Big Courage for Children of Alcoholics; Patients or Advocates with ACEs Scores

Carey Sipp Carey Sipp 2/16/183:02 PM

Mon 16 Jul 2012 19:56:56 |

By Carey Sipp

Almost nine years ago, over the course of four days, I let my doctor send me home from his office three times before I almost died of pneumonia. I spent two weeks in the hospital; it took many months to fully recover.  It was a life-changing experience, and I continue to learn from it.

About three years ago a physician’s assistant skipped a basic, obvious test for a 17-year-old with swollen glands. Twelve hours later, in the emergency room, physicians glanced at my daughter, diagnosed mononucleosis, and confirmed it shortly thereafter with a “spot mono test.” The greater danger though, came from a severe reaction to antibiotics, medication my daughter would never have taken had the mono test been done at the doctor’s office. The horrifically painful reaction could have killed her.

Despite the fact that I’ve helped in marketing and fundraising for more than a dozen medical entities, including a hospital safety consultancy, in my 30+year career, it’s taken years of a different type of recovery to realize that no physician has what it takes for me to care for my family and myself.  That requires the self-awareness, trust in my own intuition, and courage to risk evoking anger in someone in “authority” by calling them into question, if need be. That type of courage comes from becoming an emotionally healthy adult.

As a person healing from abuse, I must work doubly hard to stay in the moment and not let fears from the past keep me from doing “the next right thing.”  An overwhelming fear of authority, desire to “people please,” and a sometimes crippling self-doubt can prevent me from questioning others, especially if I am not taking great care of myself; if I am not “living in the moment.”

“I am a real bulldog when it comes to advocating for my mom,” I said to the staff at the infusion clinic where my mother was to receive three pints of blood recently.  The staff wanted to give her all three pints on the same day. My gut told me that at almost 87, my mom, who had just lost her husband to Alzheimer’s the night before, and has been weakened for years by an autoimmune disorder, did not need to be in that clinic for 16 hours straight. When, three days later, we received her diagnosis of congestive heart failure, the doctor said we’d made a good choice to stretch the procedures over two days.

My mother, daughter, and I survived each of those medical crises. I wonder, though, had I known more or followed my intuition earlier when my daughter and I were sick, if our outcomes could have been better.

By the time we got to my mom’s situation, I knew that relying solely on medical professionals does not ensure the best care. More important was learning how to trust my instincts and speak up. This is equally important for the millions upon millions of addiction and abuse survivors. We, especially, need to remember these bottom lines:

1. We need to practice “extreme self-care,” and try to stay out of the hospital; our health is already compromised by the stress of “adverse childhood experiences.”

2. If we do go to the hospital, just like everyone else, we need an advocate friend or family member to help us watch what’s going on – right down to asking hospital staff if they’ve washed their hands before we’re touched. We must value ourselves and have the courage to ask for help.

3. If you yourself are filled with the self-doubt, insecurity, and fear of authority that can come from growing up in addiction and abuse, these emotions can keep you from getting the best care for yourself and your loved ones. This is a good time to learn more about emotional healing that can help you, and your loved ones, learn how to speak up and become healthier on all counts.

There is not a surgical procedure that can cure the more than 30 million children of alcoholics who live, as I do at times, affected by some or all of the  14 characteristics of adult children of alcoholics called “The Laundry List,” by the ACOA fellowship. If there were such a surgical procedure, it could save our health care system literally billions upon billions of dollars from family addiction and abuse passed on from generation to generation.  Addictions to alcohol, food, drugs, cigarettes, and harmful behavioral addictions to sex, gambling, spending, pornography, and toxic relationships, cost our health care system more than any other single condition.

The most amazing thing? One of the most effective treatments for these addictions, and the co-addictions suffered by the family members, is free. It just takes the courage to find a support group such as Alcoholics Anonymous, Al-Anon, Adult Children of Alcoholics, Overeaters Anonymous, or the like. Again, the meetings are free. You can even call a toll-free number and attend meetings in complete anonymity, via a conference call.

Nine years ago,  had I not prayed for the strength to stand up and ask for what I believed I needed – a surgical procedure to remove fluid from my lungs – I may well have died.  I had to trust God, and my own God-given intelligence and courage to speak up.

The big lesson: recovery really does save lives, one day at a time, whether we’re in the hospital, or at the kitchen table.

Carey Sipp’s first book, The TurnAround Mom – How an Abuse and Addiction Survivor Stopped the Toxic Cycle for Her Family, and How You Can, Too, guides fellow “children of chaos” to create the kind of sane and loving home life that helps prevent next-generation addiction and abuse. Her book is available here.

RESOURCES:

acesconnection.com

 CDC Adverse Childhood Experiences 

Cost of Alcohol and Drug Abuse

There is help for Children of Alcoholics at

nacoa.org

(National Association for Children of Addiction)

and

adultchildren.org 

(Adult Children of Alcoholics World Service Organization Worldwide, Inc.)

Read more articles by Carey Sipp here.

Carey Smith Sipp

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Karen ClemmerKaren ClemmerMember

The “Laundry List” so enlightening …

 

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Trauma researchers continue community-driven work to disrupt poverty in Edgecombe (EducationNC)

Carey Sipp Carey Sipp 3/29/185:16 PM

For months, Rural Opportunity Institute co-founders Seth Saeugling and Vichi Jagannathan have gathered Tarboro community members, interviewed families and leaders, and analyzed research around intergenerational trauma in a Pattillo Middle School office. 

“Where we’re headed is to really identify where is the leverage?” Saeugling said. “What’s the North Star and how can we all start rowing in the same direction when it comes to trauma and trying to provide healing opportunities?”

On Tuesday, healthcare providers, pastors, education leaders, and other Tarboro residents met to dissect a map of the largest issues in their community. 

Seth Video Shot

Karen Grattan, CEO and co-founder of Engaging Inquiry, led the group through “systems thinking” practices that allow analyzation of a larger system before focusing in on one solution. Groups of three or four community members took one “leverage point” and identified what is already happening in the community and how those resources can be used to shift negative patterns of trauma.

For more of EducationNC reporter Liz Bell’s continuing coverage of this story on community-based efforts to disrupt multigenerational trauma, please click here.

To see her video report and interview with Seth Saeugling and community members, please click here.

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Closer Look: The Plight of Asylum-Seekers in the U.S.; Immigration and Trauma; Archdeacon Juan Sandoval; And More [Station WABE: A Closer Look]

Carey Sipp Carey Sipp 6/30/182:55 PM

(L-R) Janet Cox, PhD, ACEs Connection member and Atlanta psychologist, Rose Holmes, host of A Closer Look, and Carey Sipp, SE Community Facilitator for ACEs Connection.

This week I was a guest on A Closer Look, a news show hosted by journalist Rose Holmes on WABE, the National Public Radio (NPR) affiliate in Atlanta, GA. Psychologist Janet Cox, PhD, joined me on the second segment of the show. We talked about the impact of trauma on children who are separated from their parents, and the impact of trauma on the parents themselves. We were preceded by asylum seekers, and heard the harrowing story of a young mother desperate to leave her country for fear of losing her life, and the life of her child, at the hand of a gang that was angry with her for giving water to a police officer. Dr. Cox and I were followed by Archdeacon Juan Sandoval of the Episcopal Diocese of Atlanta, who spoke of the role of the church as families are separated at the U.S. border.

1:00:53 | Play story Add to My List

Monday on “Closer Look with Rose Scott”:

Today’s special edition of “Closer Look” focuses on the experience of asylum-seekers and the local response to U.S. immigration policies.

  • 0:00: President Donald Trump last week signed an executive order meant to end the separation of families at the border by detaining parents and children together for an indefinite period. But many say that it’s not enough. Now, a number of Georgia-based immigrant and minority advocacy groups are planning a “Families Belong Together” rally in Atlanta on Saturday, June 30. One of the major organizing forces behind the rally is the Georgia Alliance for Social Justice, which worked on Atlanta’s March for Our Lives earlier this year and grew into existence from Atlanta’s local Women’s March in 2017. We speak with Executive Director Janel Green about the rally, the intended messaging, and possible solutions.
  • 7:50: Our special edition of Closer Look continues as we hear the personal stories of those who sought – and were granted – asylum here in the U.S. We’re joined by Estrella and Erika, two of asylum-seekers here in Atlanta. We’re also joined by Shirley Zambrano, associate attorney with Kuck and Baxter Immigration Partners, and Sarah Owings, owner and attorney at Owings Immigration Law.
  • 29:23: What kinds of trauma can children experience when they are abruptly separated from their parents? We’ll ask Dr. Janet Cox, a clinical psychologist, and Carey Sipp, the southeast regional community facilitator at ACEs Connection Network, a social network helping communities accelerate the global science movement to prevent trauma and adverse childhood experiences (ACEs), heal trauma, and build resilience.
  • 42:33: Archdeacon Juan Sandoval, who leads the Episcopal Diocese of Atlanta’s immigration support programs, talks about how this issue places America at the intersection of compassion and politics.

Closer Look is hosted by Rose Holmes produced by Candace Wheeler, Emilia Brock and Trevor Young. To hear the broadcast, click here.

Carey Smith Sipp

carey.pacescommunites@gmail.com

Tags: Janet Cox, PhDAtlanta Diocese of the Episcopal ChurchRose HolmesEpiscopal ChurchImmigrationChildhood traumaBorder

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Some 350 Florida Leaders Expected to Attend Think Tank with Dr. Vincent Felitti, Co-Principal Investigator of the ACE Study

Carey Sipp Carey Sipp 8/5/1811:49 AM

Leaders from across the Sunshine State will take part in a “Think Tank” in Naples, FL, on Monday, August 6, to help create a more trauma-informed Florida. The estimated 350 attendees will include policy makers and community teams made up of school superintendents, law enforcement officers, judges, hospital administrators, mayors, PTA presidents, child welfare experts, mental health and substance abuse treatment providers, philanthropists, university researchers, state agency heads, and faith-based leaders. 

Hosted by Florida State University’s Center for Prevention, the Think Tank features Dr. Vincent Felitti, who was principal investigator with Dr. Robert Anda of the CDC-Kaiser Permanente Adverse Childhood Experiences (ACE) Study. The study of 17,337 mostly white, middle-class and college-educated Kaiser patients in San Diego, asked participants 10 questions about abuse, neglect and family dysfunction, including violence, drug or alcohol addiction, divorce or separation, mental illness, or having someone in the immediate household jailed. The number of these “adverse childhood experiences” became known as a person’s ACE score.

ACEs science became a public health phenomenon over the past 20 years because it proves the relationship between adverse childhood experiences and the increased likelihood of cancer, heart disease, mental illness, drug or alcohol addictions, criminality, and more,” Felitti said.

The study found that almost two-thirds of those questioned had at least one ACE. The higher the score, the higher the risk of consequences. For example, people with four or more ACEs have a 700 percent increased risk of alcoholism, and a 1200 percent increased risk of attempted suicide. (Got Your ACE Score?)

ACEs are not limited to the original 10 in the ACE Study. Subsequent ACE surveys include other types of childhood adversity, such as: racism, sexism, bullying, witnessing violence outside the home, and living in an unsafe neighborhoods, to name just a few. 

The ACE Study is one part of ACEs science, which also includes:

  1. Brain science (neurobiology of toxic stress) — how toxic stress caused by ACEs damages the function and structure of kids’ developing brains.
  2. Health consequences — how toxic stress caused by ACEs affects short- and long-term health, and can impact every part of the body, leading to autoimmune diseases, such as arthritis, as well as heart disease, breast cancer, lung cancer, etc.
  3. Historical and generational trauma (epigenetic consequences of toxic stress) — how toxic stress caused by ACEs can alter how our DNA functions, and how that can be passed on from generation to generation.
  4. Resilience research and practice — Building on the knowledge that the brain is plastic and the body wants to heal, this part of ACEs science includes evidence-based practice, as well as practice-based evidence by people, organizations and communities that are integrating trauma-informed and resilience-building practices. This ranges from looking at how the brain of a teen with a high ACE score can be healed with cognitive behavior therapy, to how schools can integrate trauma-informed and resilience-building practices that result in an increase in students’ scores, test grades and graduation rates.


A study by the Florida Department of Juvenile Justice found that early adversity increased delinquency. While at the same time all youths involved with the agency had at least one ACE,  the study showed that half had experienced four or more ACEs.

Subsequent studies also found that resiliency or protective factors, such as having a caring adult in one’s life, could buffer the negative impact of ACEs. 

“Our work as judges, teachers, doctors, therapists, officers and community leaders must be infused with an understanding of ACEs and trauma.  We can end the cycle of abuse, addiction, jail and chronic illness for this generation and the next, one individual at a time,” said Judge Lynn Tepper, whose court became a nationally ranked trauma-informed court as a result of ACEs science. It was Tepper who invited Felitti to Florida to lead the Think Tank.

Dr. Mimi Graham, the director of the FSU Center for Prevention, who spearheaded the event, said the idea is to create statewide momentum to build Florida’s trauma initiatives into a collective effort that can reduce some of the state’s most intractable problems. 

Concurrent with the Think Tank, the FSU Center for Prevention is releasing a book, Creating a Trauma Informed State – A Showcase of Florida’s Cutting Edge Trauma Initiatives, which features 50 innovations from many of the attendees at the event. Those initiatives include programs such as trauma-informed courts and schools, partnerships between sheriffs and doctors, classes in yoga in women’s jails, ACE screenings in pediatric clinics, resiliency efforts for college students, and pet therapies to help traumatized kids.

Thanks to the Charles & Margery Barancik Foundation, each of the attendees will receive a copy of the book. A PDF of the book is attached to this post.  

The book is designed to help other communities see the benefits of cross-sector teams working together to prevent trauma, heal trauma, and build resilience, Graham said. This collection of actual ‘boots-on-the-ground’ programs that are in various stages of implementation in Florida is the first collection of its kind.

“We believe that many of Florida’s most costly, intractable social problems, including our opioid and substance abuse crisis, our growing public health costs, tragic school failures, and the multigenerational cycle of families into our criminal justice and child welfare systems, can be decreased by addressing early trauma,” Graham said.

Supreme Court Justice Barbara Pariente said, “Our courts see the effects of trauma every day, most importantly in cases involving children and families from dependency to delinquency to dissolution of marriage to domestic violence. Our ability to view the children and families with a trauma-informed lens, especially for the youngest and most vulnerable children, can help to change the trajectory of that child and family’ lives.” 

“Our vision is that through Dr. Felitti’s inspiration, our Think Tank and showcase of Florida’s trauma initiatives will create statewide momentum for replication and expansion of trauma work to achieve collective impact,” Graham said.

Details: Felitti Think Tank:  Creating A Trauma-Informed State

Monday August 6, 2018 1:30-6:00 pm. Naples Grande Beach Resort, Orchid Ballroom. 475 Seagate Drive, Naples FL 34103

For live streaming of the event, go to: https://tinyurl.com/ya5mh3ga

To download Creating a Trauma Informed State — A Showcase of Florida’s Cutting-Edge Trauma Initiatives, go to: http://www.floridatrauma.org

For further information, contact: Mimi Graham, FSU Center for Prevention & Early Intervention Policy (mgraham@fsu.edu) or cell: 850-922-1302. 

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Lynn TepperLynn TepperMember

Thank you Dr. Mimi Graham for pulling all of this together. Dr. Vincent Felitti, how can we ever thank you for what you have been doing to transform the lives of those impacted by trauma and Adverse Childhood Experiences. Jane  Stevens, this ACEsConnection is an endless resource. Thank you. and Thank you Carey Sipp for posting this. 

 

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Lisa FrederiksenLisa FrederiksenMember

Carey S. Sipp (ACEsConnection Staff) posted:

Download the booklet with the link above. It is one of the resources.  It is beautiful, inspiring, and a game plan for programs that can be adopted in other communities. 

Hi Carey – I just skimmed through a portion of this — here’s a shocking fact: “According to the American Academy of Pediatrics, the average pediatrician will see 2-4 children each day with an ACE Score of 4+.” I’m downloading it, now – thanks!!

 

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Carey SippCarey SippFormer Volunteer Co-Director, PACEs Connection Revitalization

Yes Lisa! It’s great that we could attend part of it via webcast! I would love to have been there.

Download the booklet with the link above. It is one of the resources.  It is beautiful, inspiring, and a game plan for programs that can be adopted in other communities. 

 

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Lisa FrederiksenLisa FrederiksenMember

What an incredible opportunity to attend this event!

 

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Think Tank and Showcase of Florida’s Trauma Initiatives Begins Showing Collective Impact of Using Trauma Informed Lens

Carey Sipp Carey Sipp 8/8/187:15 PM

Dr. Vincent Felitti is shown with Dr. Mimi Graham, who spearheaded the event (center) Dr. Celeste Phillips, Florida’s Surgeon General, and Kelly Romanoff, Director of the Barancik Foundation, which underwrote expenses for the Think Tank and printing of the booklet, Creating a Trauma Informed State – A Showcase of Florida’s Cutting Edge Trauma Initiatives, for each attendee. 

Many of the more than 560 leaders from around Florida who attended Monday’s Trauma Informed Florida Think Tank – 350 in person and 266 joining via  webcast – are already asking event organizers when the next event such as this will be held.

“We had a great mix of state agency folks and local community folks, as well as great diversity from systems,” said Dr. Mimi Graham, the director of the Florida State University Center for Prevention and Policy.

Graham, who, with others from FSU, spearheaded the event, said many attendees made great effort to come, as Naples, the site of the Think Tank, is at the bottom tip of Florida. 

“The Sheriff from Pensacola drove 10 hours down and back each way. We had a committed group. Workgroups were super focused and enthusiastic,” she added.

Dr. Vincent Felitti, co-principle investigator with Dr. Robert Anda, of the Adverse Childhood Experiences (ACE) Study, was the keynote speaker for the event, which also included the attendees who joined his audience via webcast. 

Among those joining online was Sharon Miller, a Florida Guardian ad Litem (GAL), who had not heard Filetti speak before. She said of the experience, “This was mind boggling! So insightful and just so consice in amalgamating the adverse childhood experiences into charts in a way that made perfect sense. And the interviews!! So powerful.”

Miller, who works at the Kearney Center, which provides temporary emergency shelter and housing-focused services in Tallahassee, said she is “aware of how adults (with high ACE scores) have suffered growing up, but now I realize that having multiple ACE experiences just exponentially multiplies the trauma that they are trying to escape. They are just children in adult bodies desperately dealing with these memories.”

As a GAL for a family of four children coming from “unspeakable abuse and abandonment,” Miller said she has a new appreciation for “how bravely” people with whom she volunteers are handling their lives.

Graham said she and others leading the event were thrilled with Dr. Felitti’s presentation and the standing ovation he received, as well as with the lively question and answer session following, and the day’s closing talk by Supreme Court Justice Barbara Pariente, one of the hosts for the event.

“Our courts see the effects of trauma every day, most importantly in cases involving children and families, from dependency to delinquency to dissolution of marriage to domestic violence. Our ability to view the children and families with a trauma informed lens, especially for the youngest and most vulnerable children, can help change the trajectory of that child and families’ lives,” Justice Pariente has said.

Concurrent with the Think Tank, the FSU Center for Prevention released a book, Creating a Trauma Informed State – A Showcase of Florida’s Cutting Edge Trauma Initiatives, which features 50 innovations from many of the attendees at the event. Initiatives featured programs such as trauma informed courts and schools, partnerships between sheriffs and doctors teaming up to address trauma, classes in yoga in women’s jails, ACEs screenings in pediatric clinics, resiliency efforts for college students, and pet therapies to help traumatized kids.

 Thanks to the Charles & Margery Barancik Foundation, each of the attendees received a copy of the booklet. (Available here.)

 “Everyone loved the booklet. Attendees who had submitted descriptions of their programs were so excited to see their program showcased. We had all those whose programs were featured to stand up and take a bow,” said Graham.

 “The book is designed to help other communities see the benefits occurring when cross-sector teams come together to prevent trauma, heal trauma, and build resilience. We believe that many of Florida’s most costly, intractable social problems, including our opioid and substance abuse crisis, our growing public health costs, tragic school failures, and the multigenerational cycle of families into our criminal justice and child welfare systems, can be decreased by addressing early trauma,” Graham said.

 “Our vision is that through Dr. Felitti’s inspiration, our Think Tank and showcase of Florida’s trauma initiatives will continue our statewide momentum to replicate and expand trauma work to achieve collective impact,” Graham added.

Thanks to the Charles & Margery Barancik Foundation for generously sponsoring this Think Tank and underwriting the printing of this Showcase of Florida’s Cutting- Edge Trauma Initiatives; and to the Florida State University College of Medicine, Center for Child Stress & Health in Immokalee, FSU Center for Prevention & Early Intervention Policy, the Governor’s Office of Adoption & Child Protection, Florida’s Children & Youth Cabinet, and the Naples Children & Education Foundation.

Showcase of Florida’s Cutting Edge Trauma Initiativeswww.floridatrauma.org

For further information, contact:   Mimi Graham, FSU Center for Prevention & Early Intervention Policy (mgraham@fsu.edu) or office (850-922-1302).

To download the Creating a Trauma Informed State – A Showcase of Florida’s Cutting Edge Trauma Initiatives – please click here

Carey Smith Sipp

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Carey SippCarey SippFormer Volunteer Co-Director, PACEs Connection Revitalization

Cissy and Karen – Thank you all for letting me know the upload of the booklet didn’t actually upload! I have linked copy in the article to the PDF online, and it is also available here.

 

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Christine Cissy WhiteChristine Cissy WhiteIt’s not trauma-informed unless it’s informed by trauma survivors.

Carey:
It’s SO exciting to hear about this amazing event. WOW! 

I can’t see that the handbook was attached. How can that be referenced because it sounds incredible??? 

Cissy

 

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Karen ClemmerKaren ClemmerMember

Incredible!  I can’t wait to learn more about 50 innovative efforts to Create a Trauma Informed State – A Showcase of Florida’s Cutting Edge Trauma Initiatives!  
Best quote – “This was mind boggling! So insightful and just so concise in amalgamating the adverse childhood experiences into charts in a way that made perfect sense. And the interviews!! So powerful.”

 

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“Moving from Understanding to Implementing Trauma-Responsive Services” — Takeaways from SAMSHA Forum in Johnson City, TN

Carey Sipp Carey Sipp 9/10/182:16 PM

Speakers and guests at the SAMSHA Forum included (l-r) Mary Rolando of the Department of Children’s Services; Chrissy Haslam, First Lady of Tennessee; Dr. Joan Gillece, SAMSHA Center for Trauma Informed Care; Dr. Andi Clements, East Tennessee State University; Becky Haas, Johnson City Police Department; Carey Sipp, ACEs Connection, and Robin Crumley, Boys & Girls Club of Johnson City/Washington County.

It was easy to be both inspired and a bit overwhelmed at the Substance Abuse and Mental Health Services Administration (SAMSHA) forum hosted by Johnson City, TN, and Northeast Tennessee ACEs Connection last week. 

Amazing work is being done in Johnson City by more than 30 organizations that have come together under the leadership of Becky Haas of the Johnson City Police Department and Dr. Andi Clements of East Tennessee State University to create this growing system of care. Just keeping track of the number of programs (31) — and imagining the amount of time, talent, and treasure going into this effort to help the area become a Trauma-Informed Care Community — is a bit overwhelming, in the best of ways.

Below are just a few of the quotes and takeaways from the day-long seminar, which featured more than 20 speakers, and was almost balletic in how beautifully one portion of the program flowed into the next; how each speaker’s comments supported those of the prior speaker, setting the stage for the next.

“We all want to decrease crime. We want to see people who need health and human services get those services, and it’s all interconnected. Leadership is very important — to have a commitment and a passion for wanting to see your community survive,” said Stephanie McCladdie, SAMSHA regional administrator for Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee.

“If you prevent things, you don’t have to fix them,” said McCladdie. “We have a lot of talented people sitting in our prison system. We have to look at how we can prevent trauma.”

“Include the voice of people you are serving, ” said Dr. Joan Gillece of the National Center for Trauma Informed Care. She talked about the need to have peer support immediately available for people receiving Narcan, the drug given to revive and save people who have overdosed on opioids.

To help people heal, and help prevent childhood trauma, “We must switch from control to comfort,” said Gillece. Working with women prisoners, she said, “there was overwhelming trauma.” Using a strengths-based approach, to see what people are doing right instead of what they are doing ‘wrong’, and going to comforting people first, instead of trying to control them, is what works, said Gillece.

“You don’t have to be a therapist to be therapeutic,” she said, in talking about the importance of having trauma survivors support other trauma survivors. “We must see people as more than their trauma. Up to 75% of women in substance abuse treatment report trauma histories. There is meaning in behavior.”

Oftentimes, “trauma survivors push people away rather than be vulnerable,” according to Gillece.

Quoting SAMSHA research, Becky Haas of the Johnson City Police Department added, “The number one reason for homelessness is trauma.”

“In beginning this work, I filled a notebook with trauma-informed practices being done in other places, it mostly came through ACEs Connection,” said Haas.

“Our towns are burning, and we must sound the alarm,” said Haas when speaking about trauma, the impact of trauma on drug abuse, homelessness, and gangs. “If I knew I had the ability to prevent cancer, and I did nothing, I couldn’t live with myself. Preventing trauma is the same thing. We can create a trauma-informed community that helps prevent trauma. Why give out Band Aids when we can do some healing?”

“Imprisonment has not reduced Tennessee’s drug problems. The cause of drug addiction isn’t drug addicts,” said Dr. Andi Clements of East Tennessee State University, who partners with Haas in working toward making Johnson City a trauma informed community. “If you are looking to self-medicate, you will self-medicate.”

“People (with addiction problems) must be heard,” said Clements. Ninety-two percent of homeless mothers report severe trauma histories.”

“Don’t ever underestimate the impact you can have on the life of a child,” said Robin Crumley, President and CEO of the Boys & Girls Club of Johnson City/Washington County. This club has a trauma-informed care room, where children can go to feel safe. “We can’t help everyone can help someone,” she added.

“We know children are stressed, distracted, and strained by toxic stress. ACEs science and the trauma-informed communities work being done here could help every one of our state’s problems,” said Crissy Haslam, First Lady of Tennessee.

“My husband and I are so proud of Johnson City, Tennessee, and how it is a model for the rest of the state, as we work to make Tennessee the best place to live and work and raise a family,” said Haslam. 

“A lot of states are working toward becoming trauma-informed; Tennessee is on the forefront,” she added. 

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Peter ChiavettaPeter ChiavettaMember

Jane Stevens (ACEs Connection staff) posted:

Does Care 7 use the ACE survey as you do, Peter?

I was told the  Care 7 counselors use the ACE survey, but I don’t know to what extent.

My first day on the job, I interview a man that I felt had a medical problem. So, as he drank his Jack & Coke in an insulated 32 oz sippy cup (It’s hot in Tempe), I asked him “You don’t have to answer my question. But did you have a rough childhood?” His reply was “Just consider me as the hated red headed step child. My father beat me often and one time I couldn’t get out of bed for 3 days.”  I told him that his medical condition and as I looked as his beverage cup, were two conditions from his childhood. With a real surprised look he said you’re kidding. I replied “no”. On be-known to me I met his two grand children earlier. I would describe them of a condition I call Darkness Behind The Eyes. It doesn’t take much of a peripheral lens to see the need that is out there.

I didn’t have my handouts the first day. Be sure I had them the rest of my stay.

Jane, You should contact them and see if they will share their Ace survey from 9th graders. 20% scored having a family member being incarcerated. The other %s on most questions were higher than the original 1986 ACE Survey.

 

Jane StevensJane StevensPublisher, ACEsTooHigh; founder, PACEs Connection

Does Care 7 use the ACE survey as you do, Peter?

 

Peter ChiavettaPeter ChiavettaMember

This Spring I was invited to shadow Care 7 community trauma mitigation team in Tempe, AZ. The team is on call 24-7, responding to 5 call per day on average, and serves a population of 180,000. My first day was a residential fire which displaced the physical and cognitive impaired home owner. The team member and I worked with the fire department to retrieve mail so that we could determine the insurance home owner policy and initiate the coverage for temporary housing. We also provided peripheral mitigation for children and families that could not get back to their homes until the fire was out. Day four the team included a victim advocate, a team member and myself. The team provided legal advocacy, emotional first aid and transportation to a proper medical facility. The client was transgender, post rape and suicidal.  

Care 7 is another great tool communities could use in the mitigation and prevention of trauma in people’s every day lives.

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Care 7: Care 7 Tempe, AZ

 

Hurricane Florence first responders receive free trauma/resilience training

Carey Sipp Carey Sipp 9/27/184:23 PM

In a webinar offered this morning by Elaine Miller Karas, executive director of the Trauma Resource Institute in Claremont, CA, leaders from several North Carolina ACEs Connection communities affected by flooding and other damage by Hurricane Florence learned more about trauma response and how to better help their communities find resilience.

Karas, who was delivering her Community Resiliency Model (CRM) training at Duke University in Durham, NC, offered the free training and provided materials for the 70-minute webinar, available to watch now by clicking here. 

 A major takeaway from the webinar is the importance of helping traumatized people find their “resilient zone.” 

 “Your resilient zone is that state of wellbeing in mind, body, and spirit when one is able to handle the stresses of life,” Karas said. She discussed the importance of using resiliency skills in the face of climate change, as well as ways to help people access positive thoughts, recognition of their and others’ strengths, and things to be grateful for in the face of natural and other disasters. For Karas, the thought of her two-year-old granddaughter helps to calm her nervous system so she can be present and focused.

 “When you’re in your resilient zone you can better take care of yourself and your family, help rebuild the community. You’re more open to the ways of creating better communities to meet challenges from the past, present, and future.”

About 40 people joined the webinar, and asked questions about how employers can better support workers still traumatized by the flooding, as well as how to help caregivers care for themselves.

 “It was valuable for our team to take the time to reflect together in the trauma our community is experiencing,” said Mebane Boyd, resiliency task force coordinator in New Hanover County, NC.

 Boyd, who is also the New Hanover County North Carolina ACEs Connection website community manager, added that she appreciated the insights into the fact her community is currently in the “honeymoon period” of disaster response.

 “We have had so many helping hands and experienced such generosity, and we need to figure out how now to work and prepare for the response for the long haul,” she said.

 Jenny Cooper, project director for Benchmarks’ Partnering for Excellence (PFE), an alliance of nationally accredited agencies providing care for children and adults and families in North Carolina, provided technical support by hosting the webinar, and added perspective as a professional trained in CRM.

“A ‘community’ can be defined as a feeling of fellowship with others, and community is exactly what we experienced this morning. We put aside our busy schedules and learned how we can help friends, family, neighbors, clients and coworkers who experienced tremendous loss and upset. Now that we have more knowledge, thanks to this introduction to CRM, we can think about next steps through a trauma-informed lens,” said Cooper, who is also a community manager for her organization’s ACEs Connection website, Benchmarks’ PFE of North Carolina.

Karas provided access to the materials she shared: the slide presentation and a three-page handout, THE BASIC SKILLS-The Community Resiliency Model® Wellness Skills. Cooper provided access to the webinar, which can replayed by clicking here

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Carey Smith Sipp

carey.pacescommunites@gmail.com

Finding Resilience in the Midst of Hurricane Florence

Carey Sipp Carey Sipp 10/4/187:09 PM

Avis and her brother, Bruce, have seen some hard knocks in their lives. 

At 60, she’s his sole caretaker. She’s taught school, worked as a receptionist, always worked, or wanted to work.

Since she started caring for her brother, full-time work has seemed hard to find. 

He was born with autism 51 years ago.

They share her little house in Pamlico County, North Carolina, where she now hopes to be called in to substitute teach, and he looks forward to her home cooked meals. 

Their lives revolve around family, friends, and church. She plays the piano for Sunday services and writes articles for the congregation’s paper.

A car accident some years ago left her terrified of driving. But in the last six months or so, she’s gotten her courage up and driven alone several times, most recently to the school where she just started getting called in again to help out in the after-school program. This is a good thing, as it could ultimately lead to more work as a substitute teacher. Avis is hopeful.

When her cousin called to say that Hurricane Florence meant she needed to evacuate her home, Avis dutifully packed up her brother and herself.

I can imagine her humming a hymn as she put a few things in suitcases for the two of them. I can imagine that she was praying hard as she drove to the community college where she would have to leave her old van, and feeling nervous as she and Bruce boarded the bus that would take them to the high school gymnasium where they would ride out the storm.

Avis stays in the moment. 

Even though she knew her house could be gone by the end of this “storm of a lifetime,” Avis got onto the bus and made sure Bruce was okay before she looked around at her fellow travelers. Her gaze caught that of an older white woman. 

Their smiling at each other gave Avis a little peace. When they arrived at the school and introduced themselves to each other, their collective nervousness seemed to calm down a bit. 

Avis learned her new friend’s name was Mary. And then she went about getting Bruce settled in. 

Avis has some big faith. 

Avis believes in a higher power who loves her deeply. It is a relationship that gets played out in how she is grateful for being able to do things for and at her church. How grateful she is for little things such as finding a vegetarian recipe Bruce likes. Or being paid to play the piano on Sundays, which is something she loves to do whether she is paid or not. Though being paid sure helps out with expenses.

Once they settled into the gym, the waiting began. To be evacuated to a school gymnasium a couple of days before a storm hits is a good news/bad news situation. The good news is you have a place to stay that should be safe. The bad news is that when the storm ends and it’s time to go home, there may not be a home to go home to.

Avis knew she had to put her fears aside. Not only for her own sake, but for Bruce. Bruce laughs when Avis laughs. Bruce gets nervous when his older sister gets nervous. For the sake of Bruce and herself, Avis wanted to stay calm and add to the gratitude and serenity; not compound the stress, fear, and confusion. She prayed for the “courage to change the things she could.”

Hours after they’d settled into the gym and eaten a simple dinner, Avis headed to her cot. She’d checked to see that Bruce had taken his meds and was comfortable. As she lay in the strange bed in the strange place with the strange noises, Avis saw Mary approach her.

“Avis, would you like for me to tuck you in?” Mary asked.

Mary, a white woman Avis figured to be in her mid-eighties.
Avis, a black woman who’d recently turned 60.
Two women who’d experienced the Jim Crow south in what Avis hoped were its worst moments.
One woman who likely went to whites-only schools.
One woman who knew the sting of being called names when schools were integrated, and she was forced to go where she didn’t always feel welcome. 

In fact, as she lay in her cot, Avis was remembering what it felt like to be a black girl in assemblies in a gym that looked a lot like this one. 

For now, though, Avis and Mary and all the others in the gym were safe and sound and dry.

Avis and Mary held each other’s gaze for a few seconds before Avis said, “Yes. I would very much like for you to tuck me in.”

This bedtime conversation became a little ritual for the two women over the next four nights where they would sleep a few cots apart from each other in that big gym protecting them from the wind, rain, and thunder. The thunder and lightening would evoke fear; the wind and rain would leave some with the loss of loved ones, pets, property, a way of life.

A couple of weeks after the storm passed, Avis recalled some of what had happened to her, and remembered being grateful that she’d been evacuated. The old van she drove was fine. She’d driven it home to find her house in good shape, for the most part. Aside from needing to make lots of long calls about roof and air conditioning repairs, it looked as though life was getting back to normal.

When asked to focus for a minute though, on the most memorable aspect of those five nights away from home, Avis paused. And then talked about Mary.

“I don’t know her last name. I have no idea how to be in touch with her. I just know that it was a comfort to me every night when she asked if she could tuck me in,” said Avis.

“I’d like to think it helped her sleep better, too.”

Carey Smith Sipp

carey.pacescommunites@gmail.com

Finding Resilience in the Midst of Hurricane Florence

Carey Sipp Carey Sipp 10/4/187:09 PM

Avis and her brother, Bruce, have seen some hard knocks in their lives. 

At 60, she’s his sole caretaker. She’s taught school, worked as a receptionist, always worked, or wanted to work.

Since she started caring for her brother, full-time work has seemed hard to find. 

He was born with autism 51 years ago.

They share her little house in Pamlico County, North Carolina, where she now hopes to be called in to substitute teach, and he looks forward to her home cooked meals. 

Their lives revolve around family, friends, and church. She plays the piano for Sunday services and writes articles for the congregation’s paper.

A car accident some years ago left her terrified of driving. But in the last six months or so, she’s gotten her courage up and driven alone several times, most recently to the school where she just started getting called in again to help out in the after-school program. This is a good thing, as it could ultimately lead to more work as a substitute teacher. Avis is hopeful.

When her cousin called to say that Hurricane Florence meant she needed to evacuate her home, Avis dutifully packed up her brother and herself.

I can imagine her humming a hymn as she put a few things in suitcases for the two of them. I can imagine that she was praying hard as she drove to the community college where she would have to leave her old van, and feeling nervous as she and Bruce boarded the bus that would take them to the high school gymnasium where they would ride out the storm.

Avis stays in the moment. 

Even though she knew her house could be gone by the end of this “storm of a lifetime,” Avis got onto the bus and made sure Bruce was okay before she looked around at her fellow travelers. Her gaze caught that of an older white woman. 

Their smiling at each other gave Avis a little peace. When they arrived at the school and introduced themselves to each other, their collective nervousness seemed to calm down a bit. 

Avis learned her new friend’s name was Mary. And then she went about getting Bruce settled in. 

Avis has some big faith. 

Avis believes in a higher power who loves her deeply. It is a relationship that gets played out in how she is grateful for being able to do things for and at her church. How grateful she is for little things such as finding a vegetarian recipe Bruce likes. Or being paid to play the piano on Sundays, which is something she loves to do whether she is paid or not. Though being paid sure helps out with expenses.

Once they settled into the gym, the waiting began. To be evacuated to a school gymnasium a couple of days before a storm hits is a good news/bad news situation. The good news is you have a place to stay that should be safe. The bad news is that when the storm ends and it’s time to go home, there may not be a home to go home to.

Avis knew she had to put her fears aside. Not only for her own sake, but for Bruce. Bruce laughs when Avis laughs. Bruce gets nervous when his older sister gets nervous. For the sake of Bruce and herself, Avis wanted to stay calm and add to the gratitude and serenity; not compound the stress, fear, and confusion. She prayed for the “courage to change the things she could.”

Hours after they’d settled into the gym and eaten a simple dinner, Avis headed to her cot. She’d checked to see that Bruce had taken his meds and was comfortable. As she lay in the strange bed in the strange place with the strange noises, Avis saw Mary approach her.

“Avis, would you like for me to tuck you in?” Mary asked.

Mary, a white woman Avis figured to be in her mid-eighties.
Avis, a black woman who’d recently turned 60.
Two women who’d experienced the Jim Crow south in what Avis hoped were its worst moments.
One woman who likely went to whites-only schools.
One woman who knew the sting of being called names when schools were integrated, and she was forced to go where she didn’t always feel welcome. 

In fact, as she lay in her cot, Avis was remembering what it felt like to be a black girl in assemblies in a gym that looked a lot like this one. 

For now, though, Avis and Mary and all the others in the gym were safe and sound and dry.

Avis and Mary held each other’s gaze for a few seconds before Avis said, “Yes. I would very much like for you to tuck me in.”

This bedtime conversation became a little ritual for the two women over the next four nights where they would sleep a few cots apart from each other in that big gym protecting them from the wind, rain, and thunder. The thunder and lightening would evoke fear; the wind and rain would leave some with the loss of loved ones, pets, property, a way of life.

A couple of weeks after the storm passed, Avis recalled some of what had happened to her, and remembered being grateful that she’d been evacuated. The old van she drove was fine. She’d driven it home to find her house in good shape, for the most part. Aside from needing to make lots of long calls about roof and air conditioning repairs, it looked as though life was getting back to normal.

When asked to focus for a minute though, on the most memorable aspect of those five nights away from home, Avis paused. And then talked about Mary.

“I don’t know her last name. I have no idea how to be in touch with her. I just know that it was a comfort to me every night when she asked if she could tuck me in,” said Avis.

“I’d like to think it helped her sleep better, too.”

Carey Smith Sipp

carey.pacescommunites@gmail.com