Is anyone planning a response to the Finkelhor article?

fyi, David Finkelhor posted a blog here that linked to his article when it came out. I think most of this community has moved so far beyond questioning whether it's a good idea to educate people about ACEs (while screening or not), that it engendered no reaction or response.

and that is exactly the sort of response that has so strangled the effective treatment of these sorts of problems by the American Psychiatric Association for over 30 years, despite challenges by such as the BPS.

By "this community" you refer to only those who subscribe to this forum.

Yes, it's a good idea to "educate people about ACEs"

but how, when, why, and how best to do it -- all valid challenges by Finkelhor -- will NOT go away, despite the best efforts of ill-informed social activists. Their efforts are worthwhile in their contexts but ...

God help poor Colette, who first raised "this question", she has found little here to help her with HER issue in HER context, in medical education, training of nurses, and health care generally -- the major focus of Finkelhor's critique.

Actually, there's quite a bit in this network about this...most specifically about the nascent efforts being done in all three areas, "nascent" being the operative word.

Of course we're all still figuring out how, when and why....and people are making good progress on that front, and sharing that info here, which is terrific. What I was referring to was Finkelhor's POV that people shouldn't be doing it at all until years of research IDs which approach is best, but change based on knowledge of this sort doesn't work very well with that approach.

I too was concerned with an article a year ago (thereabouts) that alluded to the need for lengthy research before any intervention occurs. While we all know the importance of EB studies, to not move forward with what we now know from the ACEs Study and subsequent studies, and the neuroscience of trauma, it would seem like a crime if omission to not act. While I know Finlehors argument is that we do not have the resources to support those screened and need intervention  ( will we ever?), we have to move forward.

Rhonda Hertwig 

To which Finkelhor might reply "to 'move forward' for one group is to move backward for the group whose resources have been reduced" and when there is no real evidence, as yet, that the first group, or elements of it (those responding negatively to being given the ACEsQ?),  have in fact benefitted, how can that be "social justice"?

No easy answers, especially for people involved in trying to bring about changes in the health care system, like Colette 

Finkelhor's article gets at the lack of empirical evidence that shows the benefits of the screening, something I know very little about.**  But I too am finding a lack of empirical research that measures outcomes.  For my own work, I was hoping to find something more than stories (lots of them, yes) that showed the benefits.  I do qualitative research so I know the power of a story.  But academic research requires certain standards that mean doing the work of setting up a study to track and figure out what measures to look for, find a sample...  Seems all the people doing this good work, there'd be somebody out there studying it.

**[I was a little bothered by how little regard (or credit) he was giving people who could take this new self-knowledge and act on their own behalf -- maybe with or without professional mental health help but there are other resources people can and do rely upon.]

Maybe he just needs to read The Deepest Well. As I skimmed through his article I felt like I was watching Fox News. I had to stop.

I think before making such criticisms, or investing too heavily in others' statements of them, they first need to do some homework about Finkelhor's academic history, and his overall contribution to the child protection field. Google Scholar is freely accessible to all after all. Perhaps then they can stay "on point" (perhaps what he sees as being proposed -- but has this been proposed?) -- the pros and cons of use the ACEsQ as the center piece of a public health screening program.  IF this has been proposed, I haven't seen it, but if it has, then his article is a lot more "valid".

Paul Metz posted:

I think before making such criticisms, or investing too heavily in others' statements of them, they first need to do some homework about Finkelhor's academic history, and his overall contribution to the child protection field. Google Scholar is freely accessible to all after all. Perhaps then they can stay "on point" (perhaps what he sees as being proposed -- but has this been proposed?) -- the pros and cons of use the ACEsQ as the center piece of a public health screening program.  IF this has been proposed, I haven't seen it, but if it has, then his article is a lot more "valid".

Yes, he has published many impressive books. That no one can take away from him. Without knowing the author, I can see he has contributed a lot in exposing childhood trauma. I do have legitimate concerns on anyone that might throw a wrench into the motion of ACES. My impression was about the article, not the man.

Then perhaps some more focused comments on the particular arguments advanced in the article would be of value? 

Who has a link to this particular Finkelhor article?  I'm familiar with his work and have followed him for a number of years.  He seems to be the type who thrives on self-restraint and not drawing obvious conclusions.  I frankly do not understand why ANYONE would hesitate to talk about ACEs any more than we talk about Genograms (which outline trauma, violence, addictions, etc.) in family histories.  These are just facts.  We present them as such and we hand power over to our clients by showing them connections between trauma and the future impact on lives.  It's like saying we can't talk about someone's drinking history and show the facts about alcoholism or alcohol addiction.  Perhaps I am missing something?  I'd like to read this article (where was it published?)

My overview of what I find unsettling goes back to what Dr. Felitti stated and the CDC's original publication. I watched a video of Dr. Felitti in Alaska and he tells how healthcare costs could be reduced by as much as one-third. The CDC's ACES report showed a reduction of heath care cost with only one hour of therapy. They saw a reduction in ER visits, Dr office visits, hospital stays and reduced use in pharmaceuticals. No one takes notice of a new trend until it cuts into their market share.  We must keep diligent to the voices of naysayers.

Here's a link to David Finkelhor's post. He attached a copy of his paper there.

https://www.pacesconnection.com/...-aces-in-health-care

The bizarre thing is that it still doesn't seem to have been "published" yet, so it is still open to being changed - - I get access to a number of papers this way with this understanding. When it is copyright then usually resides with the publisher not the author.

In any event I go back to the question of what is meant by "used as a screening measure" - - something Finkelhor himself isn't clear about. There's a world of difference between my using the ACEsQ as a clinician, with my knowledge and experience, and it being used as something like a chest X-ray for TB but without "medical" review.  In the former case I can build into my practice things which would be much more difficult than in the latter; and it is in the latter cases that his cautions are most valid.

In the end the basic rules apply: people shouldn't rush into using any clinical measure without proper prior knowledge of its limitations. Perhaps before the article is actually printed this could be made plain: Jane Stevens and others on this forum have said much about what cautions need to be in place for it to be used effectively. 

I screen for ACEs and have convinced two local counseling services in my county to do so too. We aren’t stopping because too many kids and parents are dying. Thank You. 

Well, I read David Finkelhor's paper from top to bottom. I even clicked on a few of the resources. I ran into this same precautionary "baby steps" approach with  Trauma Informed Initiative of Western New York a few years ago. (University of Buffalo sponsored) In just three short years UB has produced "Champion Collaborative" which has produced the insight for it's graduates in the use of ACES in the Developmental and Intellectual Disability Services. How ACES effects this population.  There is a quote from the Resilience movie that gives me the breath to continue on. "If you can get the science into the hands of the general population, they will invent very wise actions." 

Peter Chiavetta posted:

 "If you can get the science into the hands of the general population, they will invent very wise actions." 

and that is precisely where you and Finkelhor are in total agreement.

Instead of relying on specious, aspirational claims for "technology" one needs to carefully evaluate the validity of the evidence (data) used to make the claim (that the hypothesis is supported). He merely asks us to evaluate the evidence, in the face of highly emotive arguments being offered by some: "we need to do this or else people will die!" Really?!  One needs to remember (hard in some political climates) that the grander the claims, the more solid the evidence must be to justify their being acted on, to the inevitable "neglect" of other priorities.

But how many of us have done the training, are continuing to build on the training they received, in order to gather, evaluate and present evidence "scientifically" -- sadly, from what I've seen, precious few -- here's one recent article for your convenience (open access). 

Paul, I had all the intentions in the world in reading "Degrees in Freedom..." After reading the first two pages at my dyslexic snails pace, I had to stop. I would never get that part of my life back. It reads like a legal document. 

I think Finklehor's points are valid when taken into the context of generalization. I believe he is speaking to a larger model. If you wanted to screen everyone in the United States medical system tomorrow for ACE's you would not have the resources, educated staff (that have addressed their own ACE's), and standardized questionnaire to do it. You would also have pandemonium. I think his article is taken harshly here because you are taking for granted that you already have groups of educated practitioners in community doing this work. But those here are maybe forgetting what it took to get where you are. And what Finlehor is bringing some awareness to is that it's going to take a lot of work to get this to EVERYONE. Which is the goal.