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Treatment for Adverse Childhood Experiences (ACES)


Abstract

This literature review examines treatment options developed for those affected by Adverse Childhood Experiences (ACEs). Three peer-reviewed articles explore the question. Schauss et al. (2019) found that integrating social, interpersonal, and biological methods, a model for a holistic treatment for the psychological effects of ACEs, show promising outcomes. Burkey, Ali, Hobson, Despins, and Sze (2020) explore how medical doctors can be integral in mitigating and preventing the ACEs’ physical effects. The study finds that by integrating trauma-informed practices and educating caregivers about childhood trauma prevention, the effects of ACEs are minimized or, in some cases, avoided. Thompson and Kaufman’s (2019) research discerns that although psychological and physical treatment options have advanced, the deeper, more systemic causes of ACEs warrant further action. Their study asserts that systemic change is needed at the national level to address the factors that cause the environmental factors for ACEs to occur. Overall findings suggest that there are good treatment options in specific fields of study, but a more holistic approach to treatment and societal change is needed.

Keywords: adverse childhood experiences, ACEs, holistic, treatment, interdisciplinary, retrospective recall, literature review.

Treatment Options for ACEs

Adverse Childhood Experiences (ACEs) are harmful, traumatic events that occur during an individual’s childhood experience. Examples of ACEs vary from physical, sexual, or emotional abuse to witnessing familial violence and paternal negligence. A landmark epidemiological study led by Dr. Vincent Felitti et al. (1998) proved a strong correlation between adverse childhood experiences and significant health problems that develop into adulthood. The more adversity a person experiences as a child, the more likely they are to develop substance addiction, mental illness, heart disease, and a myriad of other health-related issues. Since the study was released, psychologists, medical doctors, sociologists, and leaders from various fields have attempted to determine successful treatment options for subjects with this traumatic history. The past twenty years have shown significant advancement in the treatment and prevention of ACEs.

The most recognizable implications of ACEs are both interpersonal and psychological; therefore, treatment must encompass a range of approaches. In their study, Schauss et al. (2019) integrate social, interpersonal, and biological methods to create a model for a holistic treatment for the effects of ACEs. By integrating neuroscience and counseling techniques, mental health counselors can suggest an alternate perception of traumatic events. In addition to combining the sciences of neuropsychology and mental health counseling, Schauss et al. (2019) explore the dynamic relationship between the person, behavior, and environment, including physical environment, attachment, and genetic expression. Combining other disciplines with mental health counseling while holistically treating the consequences of ACEs provides a myriad of positive outcomes. These outcomes include improved sleep patterns, successful interpersonal relationships to diminishing aggressive behaviors. Schauss et al. (2019) represent a fraction of the noteworthy developments in ACEs' psychological treatment over the past two decades.

Felitti et al. (1998) discovered that the consequences of ACEs were not only psychological but extended to physical ailments such as obesity, diabetes, heart disease, maladaptive sleep patterns, autoimmune disorders, and inflammation, among others. Exposure to ACEs leads to the prolonged activation of the stress response system in the body, causing long term changes in cortisol and immune function (Felitti et al., 1998). These physiological changes also affect brain structures, which are essential to learning and memory. In response to these findings, Burkey, Ali, Hobson, Despins, and Sze (2020) explore how medical doctors can help to mitigate the physical effects of ACEs by integrating trauma-informed practices and educating caregivers about childhood trauma prevention. Understanding the implications of childhood trauma on brain development is essential for all medical doctors to recognize as they pursue treatment. For example, Felitti et al. (1998) found a dose-response relationship between the number of ACEs experienced and the likelihood of physical repercussions. Burkey et al. (2020) concluded that by promoting cross-sectoral leadership, fostering resilience in pediatric patients, strengthening overall policy, and implementing trauma-informed training across all fields, whereby lessening the implications of ACEs. In less than a quarter-century, researchers have discovered various treatments for ACEs' psychological and physical effects, but further action is needed.

Thompson and Kaufman’s (2019) research indicated that as beneficial as it is to treat and prevent ACEs, the roots of the phenomenon delve much deeper into systemic issues affecting communities. People suffering from the effects of ACEs produce a significant burden on society in the form of drug sales and acquisition, addiction, juvenile crimes, incarceration, and poor psychological health. Thompson and Kaufman (2019) found that the genesis of the environmental factors which cause ACEs to originate with systemic issues such as poverty, discrimination, community disruption, lack of opportunity, inadequate housing options and violence. There are several strategies suggested to mitigate the societal effects of ACEs. One of these strategies is to increase the minimum wage. Another strategy is to create job opportunities for people with felony convictions, whereby breaking the cycle of crime. Decriminalizing addiction is yet another strategy suggested to prevent ACEs. By decriminalizing addiction, treatment becomes the goal instead of incarceration (Thompson and Kaufman, 2019). Finally, addressing police misconduct in at-risk communities, and nation-wide, remains a struggle ultimately affecting the population in negative ways. Addressing the root of the problem is vital to extinguishing circumstances that lead to adverse outcomes. There is work to be done in this field of study.

Over the past twenty years, scientists from various fields of study have combined their efforts to treat ACEs' effects. Psychological treatments have become mainstream as well as interpersonal therapeutic strategies. With the inclusion of medical professionals, progress toward prevention and treatment of the factors that cause the ACEs are advancing. The past two decades have been successful in treating the symptoms of the disease but not the base cause of it. Society must make systemic changes to eliminate the factors that cause the prime conditions, which give rise to abuse, addiction, violence, and the other causes of ACEs.

References

Burkey, M. D., Ali, T., Hobson, B., Despins, L., & Sze, S. (2020). Addressing adverse childhood experiences (ACEs) in BC: Practical approaches. British Columbia Medical Journal, 62(1), 14–17. https://www.bcmj.org/sites/default/files/public/BCMJ_Vol62_No1_ACEs.pdf

Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. P., & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine, 14(4), 245–258. https://doi.org/10.1016/S0749-3797(98)00017-8

Schauss, E., Horn, G., Ellmo, F., Reeves, T., Zettler, H., Bartelli, D., Cogdal, P., & West, S. (2019). Fostering Intrinsic Resilience: A Neuroscience-Informed Model of Conceptualizing and Treating Adverse Childhood Experiences. Journal of Mental Health Counseling, 41(3), 242–259. https://doi-org.proxy.ccis.edu/10.17744/mehc.41.3.04

Thompson, E., Kaufman, J., & Abell Foundation. (2019). Prevention, Intervention, and Policy Strategies to Reduce the Individual and Societal Costs Associated with Adverse Childhood Experiences (ACEs) for Children in Baltimore City. The Abell Report. Volume 32, No. 11. In Abell Foundation. Abell Foundation. https://eric-ed-gov.proxy.ccis.edu/contentdelivery/servlet/ERICServlet?accno=ED601987