Reply to "Distress after ACE training"

The timing of your question is great as I am in Finland at the Interpersonal Violence Conference (IPV 2017) doing two presentations on the intersections between domestic violence and ACEs based on research I did with domestic violence shelters here in Finland and in Alaska!  As an aside, there are a number of participants from the U.K. here!

I appreciate that you are addressing what I consider to be a critical gap in the ACEs work--bringing domestic violence and ACEs together.   Our population-based data in Alaska mirrors what we have seen in the national data; childhood exposure to domestic violence is the strongest predictor of other ACEs. My experience in the U.S., Canada and several other regions is that the domestic violence movement and the ACEs movement, which are so different in their origins and orientation, have remained separate and there is a pressing need to bring information about the intersections between DV and ACEs to DV advocates and service providers.

With regard to your question, I have many thoughts and will share a few here. My first comment is only relevant if the ACEs questionnaire is provided during the training.  Informed by our work with home visitors and developing ACEs curricula for other types of frontline service providers, we learned that whatever your position is on assessment for ACEs, it should not be done during training.  There is a lot of groundwork on trauma-informed practices and support that needs to be in place before asking questions about ACEs. While in the right circumstances with appropriate support, answering these questions can be useful, in a training it can be highly stressful and push people into survival brain mode, feeling traumatized and unable to focus and learn.   

 I do talk about and provide validated assessment tools for resilience (for adults and for children) as I have found that often people are not aware of these tools and we stress the importance of identifying strengths.  In settings where ACE assessment is being done, I think we have a duty to also ask about strengths/protective factors given what we now know about resilience.

In developing curriculum and resources on DV and ACEs, we have learned to be very sensitive, trauma-informed in our approach and the language we use.  As someone who specializes in the neurodevelopmental implications of trauma, I have seen the damage done when people perceive the information on toxic stress as ACES=damaged brain forever.   Emphasizing that we are talking about potentially traumatic events, that neuroplasticity continues across the lifespan and the amazing capacity of the brain to heal, discussing the growing sciences of post-traumatic growth and hope and using a resiliency framework that highlights the fourth generation of resilience research and clearly communicates that DV and ACEs do not define our destiny are some key points.

In closing, here are a few additional thoughts based on the training we do on ACEs for domestic violence service providers and advocates:

  • Start and end with resilience--build a "resiliency sandwich" including content to interactively practice resilience promoting skills
  • Focus on the ACEs data that is relevant to the DV community--the intersections between DV and ACEs
  • Facilitate group discussions about implications and concerns about the ACEs data, identifying culturally relevant factors that buffer the effects of ACEs and opportunities regarding how DV advocates and organizations can use ACEs information in their work to support clients, build partnerships, seek new funding streams etc.
  • Incorporate simple strategies for self-care and healing