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PACEs in the Criminal Justice System

Discussion and sharing of resources in working with clients involved in the criminal justice system and how screening for and treating ACEs will lead to successful re-entry of prisoners into the community and reduced recidivism for former offenders.

Action steps using ACEs and trauma-informed care: a resilience model (


The prison system is an example of the ways undigested trauma from early childhood experiences can join with the conditions of harshness and violence in many of our U.S. prisons and contribute to reinforcing a cycle of reactivity in both Correction Officers and prisoners. The correctional system is rife with challenges to the health and well being of Correction Officers (COs) as well as prisoners. Suicide rates of COs are more than double that of police officers as well as for the national average (Steele 2009) and their average life expectancy is 59 years old (Cheek and Miller 1982; Steele 2009). How much is due to adverse childhood experiences? How much is due to our system of incarceration, which can create a culture of violence in which both the imprisoned and those in charge of them must operate in a perpetual state of hypervigilence and wired-in reactivity? Practices throughout the criminal justice process can benefit from information from neuroscience as well as the skills that are based on this information to create environments and approaches that enrich rather than deplete the ability of both COs and inmates to self-regulate as a core practice. Practical self-regulation skills that are based on neuroscience research belong in police and CO training academies, and with other first responder groups as a tool to build resilience and decrease reactivity during stressful situations.

The ACE Study and Trauma-Informed Care have made a strong and positive contribution to understanding the powerful role and negative health effects of adverse events in childhood. The effects of early negative childhood experiences are found to carry on throughout adulthood, even affecting life expectancy. The two contributions have helped sensitize service providers to the risk factors that shape behaviors and health, have helped policy makers and service providers shift away from a characterological lens of human behavior to one that recognizes the impact of early and traumatic experiences, and have highlighted the importance of early childhood prevention programs and family support.

The unintended consequences, however, have contributed to an over-focus on negative events to the neglect of protective and positive factors. This over-focus, while not characterizing all policies and programs, is still too common, nevertheless. It has shaped research as well as social programs. During service delivery, collection of the adverse details about people’s lives is often necessary but it is not sufficient. A focus on individuals’ strengths and competencies is essential. And, Trauma-Informed Care is also necessary but not sufficient. Policy makers and providers must know what to do with the information, what actions are needed. Action-oriented interventions will facilitate evaluation studies of outcomes. This will advance the field of TIC.

Current neuroscience-based information (“neuroeducation”) has an important role to play in the field of criminal justice including 1) redesigning information gathering processes to decrease re-traumatization, 2) decreasing the use of labels such as “anti-social” that do not take into account the neurobiological effects of trauma on the nervous system, 3) the incorporation of self-regulation skills training for providers and clients, and 4) facilitating outcome evaluations of trauma and resilience oriented skills-based programs. Drawing on neuroeducation about nervous system activation and calming as well as slow and fast systems of information processing can decrease the potential of both data collection and social programs to re-traumatize clients and research subjects and can help reinforce nervous system stabilization.

To read more of Health and Justice's Study Protocol, please click here.

The 10-page report is also attached.


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I am not working in the criminal justice community, but this is really powerful and I see use for my work with educators and family physicians.  What particularly resonated for me from a day to day implementation viewpoint is the Resilience Zone and queuing up activities that vary from activating to calming and back, rather than just pushing them all together in no particular order. I think it is both obvious, but only in retrospect, and profound, looking forward. Thanks, Ellen

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