Training future counselors to integrate ACEs science in the classroom


Nemia with peacock used in therapy with children. Talking with an animal is often easier than talking with an adult for a child who's experienced abuse.

Toni Nemia, program and clinical director for the University of San Francisco Child and Family Center's School-Based Family Counseling, says that her graduate students are often surprised to hear that ACEs science (adverse childhood experiences) has an international reach. In fact, Scotland is an ACEs-aware nation, and thanks to the efforts of Nemia and others at the USF Center, many schools in San Francisco and in the U.S. are getting closer to integrating ACEs science into their classrooms as well.

The program Nemia directs was established in 1983 within the School of Education at USF, and it places graduate students from the counseling psychology program to provide mental health services in schools. These students must accrue 3,000 supervised hours to become licensed by California as psychotherapists. 

There are 10 trainees in this year’s class; in the last two years, 25 have completed their master’s degree. Nemia says the students are placed in mainly Roman Catholic schools in San Francisco along with one public and one charter school. It is one of the longest-running school-based counseling programs in the United States.

ACEs science was introduced in the program in August 2017. Nemia had learned about ACEs previously but didn’t incorporate the information into the curriculum until she read The Deepest Well:  Healing the Long-Term Effects of Childhood Adversityby California Surgeon General Nadine Burke-Harris, a San Francisco pediatrician and noted spokesperson for integrating ACES science in clinical practice and beyond.

A former high school teacher with two master’s degree—one in literacy and the other in counseling, specializing in marriage and family therapy—Nemia introduces ACEs science during orientation.

“ACEs permeates every training,” she says. “We want our trainees and, by extension, the schools we serve, to become aware of a trauma-responsive approach.”

Using a two-section PowerPoint presentation, she introduces the ten original types of adverse childhood experiences (ACEs) that have been linked to adult onset of chronic disease, mental illness, and violence or being a victim of violence. ACEs, which were described in the landmark CDC-Kaiser Permanente Adverse Childhood Experiences Study, include experiencing physical, sexual, or emotional abuse; living with a family member who abuses alcohol or drugs or who is mentally ill; experiencing divorce; and having a family member who is incarcerated. The second part of the USF training addresses toxic stress and its implications for learning. It emphasizes that students can learn more effectively when their emotional, social, and spiritual needs are met.

That ties in with the mission of the Center for Child and Family Development, which serves “the whole child by encouraging outreach and engagement to families along with case consultation to teachers and administrators.” Counseling services are free to students and families, and the schools pay a modest fee to the center for providing a wrap-around approach.

Nemia points out that integrating ACEs science in schools is part of movement to recognize the importance of social-emotional learning in the classroom. Emotional intelligence is held with the same regard as intellectual intelligence. Social justice tenets are also a strong component of both the counseling and teacher training. That fits USF, which was founded by the Jesuits, who historically have placed great emphasis on the importance of social justice and what that means for humanity.

A newer goal for the center will be to incorporate ACEs science awareness into families. “We need to address how to present this information in a sensitive and culturally relevant way and move the conversation toward ways of staying healthy and becoming resilient,” says Nemia. “This is a major challenge in a city like San Francisco, where so many are poverty-stricken and resources are limited.”

As for the counselors in training, the ACEs science message makes a difference. It takes the blame and shame away from emotional distress and focuses on the context in which people live their lives. Familiarity with a conceptual expansion of ACEs in a child’s life opens a way of understanding what a child’s needs are and what interventions become helpful. Trainees learn what trauma and toxic stress do to the mind, body, and soul. 

“This kind of service is very exciting for us,” says Nemia.

Another goal is to deepen the understanding of ACEs science within a school setting by offering teachers and staff a way to understand student behavior.

“The more we realize that distress is a real barrier to learning, there’s a perfect link between wellness and education,” she adds.

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