Trauma-Focused Care

What does trauma-focused care mean?

Scientific studies have found a link between adverse childhood experiences (called ACEs) and poor long-term physical and emotional health. Trauma experiences are evaluated in three domains, including abuse, neglect, and household dysfunction. While generally the word “trauma” brings to mind a single violent or frightening event, trauma can be the experience of a chronically chaotic, dysfunctional environment.

Trauma-focused care is designed to help clients to understand how early adverse experiences have shaped their behavior, to learn new skills to express/manage emotions, and to develop a sense of competence and mastery for their own lives.

How can early childhood trauma affect long-term physical health?

Many of the health risks associated with early childhood trauma are linked to maladaptive or coping behaviors that lead to poor health outcomes. For example, people who have grown up in an abusive home may use drugs or alcohol or food to numb bad feelings or stresses associated with those experiences. As a result, they are at greater risk for heart disease, liver disease, diabetes, certain kinds of cancers, and even autoimmune disorders.

How much trauma does someone have to experience to have bad outcomes? Can it be measured?

Everyone is different. Some children grow up in a stressful environment, but have a resource that helps them manage that experience. For example, a caring grandparent might help a child build some resiliency even in an otherwise chaotic home. Other children may have few supports to help them.

There is a survey, called the Adverse Childhood Experience (ACE) Survey, which rates the level of trauma a child has experienced on a scale of 1 to 10. The questions on the ACE Survey are about:

  • physical, emotional, or sexual abuse
  • physical or emotional neglect
  • the presence of mental illness or substance abuse in the home
  • loss of a biological parent due to abandonment, divorce, incarceration, or death
  •  violent treatment of mother

There are general findings related to how someone scores on the ACE Survey. Those who score a 4 or more are likely to have some serious health concerns. A lower score does not necessarily mean that a traumatic event is insignificant—a person may score a 1 or 2, but may have that score due to a history of very serious experiences, such as physical or sexual abuse.

In a large study, done in cooperation with the Center for Disease Control (CDC), those with a score of 6 or more have a lifespan that may be 20 years shorter than average, due to poor health. For more information about that study, go to www.cdc.gov/ace.

What can be done about a high ACE Score?

 An ACE score is a picture of the past, part of a person’s story. The ACE survey is one tool that a therapist can use to better understand a client’s experiences and needs. Wellspring therapists are specially trained to help clients understand their past, build on existing strengths, and develop skills for a healthier life.