Trauma Increases Risk for Health and Wellness Problems
It is estimated that 2 out of 3 youth will be exposed to trauma before the age of 16. Traumatic childhood experiences such as abuse, neglect, loss of a loved one, domestic violence, parental substance abuse, natural disasters and other life-altering events impact how a child views him or herself and responds to the world. Trauma impacts important regions of the brain responsible for problem-solving, emotion regulation and memory. Years and years of research show that some of the worst health and social problems arise from traumatic childhood experiences.
One of the largest investigations into this connection was conducted from 1995 to 1997 at Kaiser Permanente’s Health Appraisal Clinic in San Diego. More than 17,000 individuals participated in the Adverse Childhood Experiences (ACE) Study which involved completing a standardized physical exam along with a confidential survey that contained questions about childhood abuse, neglect and family dysfunction. The ACE Study revealed that 67% of the participants had at least one adverse childhood experience, and 20% of participants had experienced three or more. Participants also detailed their current health status and behaviors and as the number of ACEs increased, the risk for health problems also increased in a strong and graded fashion.
An important shift in perception and treatment of individuals who have experienced trauma occurred when Dr. Sandra L. Bloom worked in a psychiatric hospital. She and her unit made the observation that all of the individuals receiving inpatient treatment were trauma survivors. It was during a team meeting that Bloom’s colleague Joseph Foderaro introduced an important shift that needed to happen in the mental health field – change the fundamental question from “what’s wrong with you?” to “what happened to you?” By understanding the connection between traumatic childhood experiences and life-long health and wellness outcomes, recovery and prevention efforts can be improved.
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Integrating Trauma-Informed Care into Child Welfare and Related Systems
KVC Health Systems is a national leader in behavioral healthcare and child welfare. Each year, the organization supports tens of thousands of children involved in the child welfare system in Kansas, Missouri, Nebraska, Kentucky and West Virginia. Many of the children, particularly those temporarily removed from their homes for their own safety, have been abused, neglected or abandoned and require support from highly-trained professionals and caregivers such as foster families.
In 2009, KVC partnered with New York University and Dr. Glenn Saxe, Director of the NYU Child Study Center, to adapt and implement his Trauma Systems Therapy (TST) throughout KVC’s continuum of care in child welfare. TST is an empirically supported model for treating traumatic stress in children and adolescents, and guides children and families to heal from trauma by building skills to manage difficult emotions, process trauma and move beyond those experiences. All KVC staff in Kansas, as well as foster families, were successfully trained in TST in order to understand and help children heal from trauma and improve their wellbeing long into adulthood. KVC has also trained national and international public agencies including Washington, D.C. and Singapore on implementing TST.
The partnership between KVC and Dr. Saxe also led to the creation of the NYU/KVC Midwest Trauma Training Center, an innovative training center that provides expertise to professionals throughout the Midwest, promoting the use of effective trauma treatment and services for children, adolescents and families. Thousands of professionals working in physical and mental health, child welfare, and the education and juvenile justice systems have all benefited from an increased understanding of what childhood trauma is and how they can help youth who have experienced it. The Center is connected to the National Child Traumatic Stress Network through a grant funded by the Substance Abuse and Mental Health Services Administration (SAMHSA).
KVC’s leadership in integrating trauma-informed care into child welfare and related systems led to a new initiative funded by the Annie E. Casey Foundation to bring the combined knowledge and experience of NYU and KVC to public child welfare agencies and caregivers across the country. A new foster parent training curriculum was written by Kelly McCauley, LSCSW, Associate Director of the KVC Institute for Health Systems Innovation. KVC representatives have since traveled to several states to train agency staff how to, in turn, train relative families and foster families how to help children who have experienced trauma. The training, which has been tested in Ohio and Maryland, emphasizes interactive, hands-on activities that will ensure caregivers learn and practice skills that are critical in family moments ranging from the mundane to crisis situations.
Addressing and treating childhood trauma improves outcomes not only for individuals and families; communities as a whole also benefit from healthy citizens and reduced healthcare costs. We already have the tools to address the life-long effects of childhood trauma, but we need to commit more resources toward treatment and prevention. It will require creating infrastructure and environments that give all people better, healthier options. KVC is involved in a three-year collaborative working with 14 other U.S. and Canadian nonprofit organizations to infuse the most recent neuroscience research into practice, policy and public decisions. Learn more about the initiative at www.kvc.org/brain.