ACES and COMPLEX TRAUMA

In my previous post, I talked about the Adverse Childhood Experiences Study (ACEs) and how this is beginning to shake the foundation of how we view mental health problems.

Take the ACEs test here

The ACEs study points to a powerful connection between stressful childhood experiences and how it can create lifelong difficulties for people in health, relationships, education, and employment.

ACE researchers have mapped out the connections.  They say that accumulated ACEs lead to the following steps:

  • Disrupted Brain and Nervous System Development which leads to
  • Social, Emotional, and Cognitive Impairments which leads to
  • Adoption of Health Risk Behaviours (e.g. smoking, alcohol, drugs, high risk activities) which leads to
  • Disability, Disease, and Social Problems which leads to
  • Early Death

These findings dovetail perfectly with what is being learned about the effects of complex trauma on children.  The key connection I’d like to make is how ACEs and stressful, overlapping traumatic experiences have a profound effect on the development of brain architecture (please see link here for further information:  http://developingchild.harvard.edu/resources/wp3/

Traumatic experiences and toxic stress produce a multitude of issues for the developing brain.  Simply put, stress produces cortisol which is toxic for brain growth.  Experiences of heightened stress change the brain making it highly reactive and oversensitive to new stresses.  A child’s over-reactive nervous system moves the child quickly along the Fight, Flight, Freeze continuum and very challenging behaviours result.

As a psychologist and clinical supervisor working within Child and Mental Health, I have often received referrals of foster or adoptive children who were displaying a wide range of extremely problematic behaviours. These youth frequently arrived with a bewildering array of assessments, a long list of diagnoses, multiple medications, and a frustrated and confused Care Team.  From a mental health perspective, we often felt overwhelmed as well since the evidence-based therapies in which we were trained were usually not effective with this population.  When we began to learn about complex trauma we saw the difficulties of these children and teens in a completely new light.

Our Approach

The CTR Clinical Team has developed a cutting-edge approach to the effects of Complex Trauma in children and youth.  Our approach arises from the recognition that complex trauma and persistent maltreatment often affect children’s development in fairly consistent ways. Regardless of the type of maltreatment, its severity and frequency create profound, personal, and developmental effects for the children who experience them. We start with assessing the way that trauma may have interfered with development in the following CTR Developmental Domains:

Neurological and Biological Maturity

Over-reactive Stress Response

Emotional Regulation

Attachment Style and Relationships

Identity Development

Behavioural Regulation

Cognitive and Language Development

This comprehensive assessment is completed as a structured interview with the Care Team. Our model is non-diagnostic in that we do not use ineffective and inappropriate DSM-V diagnostic categories to describe the difficulties resulting from trauma.  Instead, we use language reflecting developmental needs and compare the child’s areas of strength and maturity vs areas of developmental lag. The assessment leads us to intervention strategies which provide what the child needs to overcome the effects of complex trauma.  It is our belief that the most important therapeutic experiences a child can receive occur in the day to day moments of their lives with their main attachment figures.  We dedicate ourselves to building the knowledge and skills necessary for caregivers to respond to the child’s needs – first at a neurological level, and then at a relational level. All of our approaches are geared to giving simple and practical strategies that address the core needs of the child at a physical, emotional and relational level.

Our very positive results for children and youth over the past seven years indicate that this trauma-centric approach can begin to change the trajectory of children’s lives and reverse the affects of ACEs.  We’ve been fascinated to see that on average the children and teens in our program see developmental catch-up compared to their peers on all seven of the developmental domains!  Brain science works in our favour –  the best time to help a person’s brain rewire and avoid the effects of ACEs is during childhood and early adolescence.

An argument can be made that Child Welfare systems which do not address ACEs or Complex Trauma and the resulting brain and body challenges are not meeting the needs of the children and families they serve.

For a more detailed article outlining some of our approach at CTR as well as a case example that can be applied to this model, please see the sidebar free offer.

Note: The CTR 7 Developmental Domains are adapted from the work of the National Child Traumatic Stress Network and other researchers. For further information on Complex Trauma, please read the following article produced by NCTSN:  http://pathwaysrtc.pdx.edu/pdf/fpW0702.pdf.

About the author

Dr. Chuck Geddes

Dr. Chuck Geddes is a registered psychologist and the Clinical Director of Complex Trauma Resources. To learn more about him click here

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