Administering ACE questionnaire in a clinical setting

Hi Christy,

I'm going to set up a 'group' via regrouptherapy.com I'm waiting to hear
back from others as to the time that would work between 11 and 1 PST. I'll
let you know as soon as I know.

On Thu, Feb 11, 2016 at 10:36 AM, ACEsConnection <
communitymanager@acesconnection.com> wrote:

Hi guys,

I'm planning on participating, but I'm a bit confused about the time slot.

We could perhaps do a Doodle (http://doodle.com/) to help us coordinate more explicitly?

Also, as you probably know by now from my posts, I am working on online open source, privacy-first ACE screening and reporting tools (delivered through smartphones, apps, PCs, websites (also embedded) and on paper), and I should be able to demonstrate a prototype next week as well.

I don't want to hijack the agenda for this particular meeting, but one of the most important factors to me in being able to deliver value to the ACE community with my project is that it addresses the actual needs and supports the real-life processes that you guys engage in with your clients, users, students, etc. It's also a huge personal motivation to me.

If you would like it, I could do a short live demo via a YouTube stream, and engage with the community via the ACEsConnection chat either during the meeting or at some other time next week?

Best,
Thomas

Robbyn Peters Bennett posted:

Very interested in participating. Amy Bryant and I have developed a flyer we are distributing to local pediatricians that offers a resiliency questionnaire and also offers a free online webinar, free closed parenting Facebook groups, and an online parenting class that they may want to sign up for. The idea is to help prevent ACEs by teaching parents about their own resiliency and how to parent using co-regulation which helps regulate both the parent and child.

Many parents' lives are too hectic to find a sitter and drive somewhere once a week, so we are offering it online. I'm attaching our flyers.

thanks for sharing the flier!

I'm also a bit confused. I thought there was a need to host this conversation on the ACE chat function? I guess we need to make two decisions: first, the format and second, day and time. I can make time available Monday through Friday between 9am and 5pm EST as long as I have a week or two notice.

We're going with a chat on ACEsConnection first, Keith. And we'll continue doing chats about this as long as people are interested, probably featuring people from different types of organizations that are implementing taking ACEs history, and in some cases, using it as a screening tool. Stay tuned for day/time....I hope to figure that out today. It'll be no sooner than next Thursday.

This is very exciting and I would love to be part of the chat - this is also a topic of great interest among the MARC communities and others.  I just participated in a webinar conducted by a FQHC (Community Based Health Center) in Colorado that has integrated ACE screening into their process.  I am still interested in creating a directory on ACEs Connection of everyone who is using the ACE questionnaire - or a modified version of it - in practice.

We are working with Family Voices on ways they can communicate with their families.  This is so helpful.  

Might there be interest in framing ACEs screening in a broader positive health and healing frame?  I am worried about what seem to me to be artificial debates about screening for ACEs vs. promoting healing and positive health and resilience.  I can chat Thursday morning but 11am-9pm booked that day!!

Hello Christy,  As my organization does not use the tool I ask the questions but put them in to the three catetories physical, mental, and Family dysfunction. Ad B. Vander Kolk points out in his book, may people in dysfunctional families don't realize they are. One of the SW I works with argues that the question should be asking people if there were any experiences they Perceived as traumatic, the emphesis being on the perception of the patient. That however would mean that the patient consciously recognized it and many times they do not.

 

I agree that it is trauma perceived that engages the bodies reaction and chronic stress.  As such, I have wondered about using a consequences-based vs event based assessment.  Yet, seems the ACEs items cover the range of likely sources of more extreme trauma.  For me, the unique aspect is trauma associated with loss of safety and nurturing from primary caregivers and those we needed to trust, etc.  much to discuss

I've also heard people, when educated about ACEs, say that they didn't understand that being verbally abused or experiencing neglect or divorce, or living with an alcoholic parent, could do damage. They just thought they themselves were "bad" people (or even bad children or born bad) and it took that education about ACEs to open the door for them. If people experience neglect, for example, as normal, then often they think they're responsible for the  consequences of neglect. Over and over, people when hearing about ACEs, say: "This explains my life." i.e.....if you don't know what safety feels like, then "loss of safety" feels normal.

Keith Haas posted:

Hello all,

Also, I am considering administering the resilience questionnaire as well. Any thoughts on this would be appreciated as well.

 

 

Keith,

What resilience questionnaire are you talking about? I'm interested in the topic and have some reservations about it, as well. One of them is the limitations in the field of instruments to measure resilience. To wit: 

concepthttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC3042897/ 

Best of luck with the call, I won't be able to attend but look forward to the "proceedings" on such important issue.

Andres

Hello Andres,

I am referring to the attached questionnaire. It is my understanding that some programs administer this alongside the ACE questionnaire as a way to capture the presence/absence of known protective factors and contributors to resilience. I am not aware of the statistical validity of this measure.

Keith

Keith—

There was no attachment. Please resend.

Thank you,

Andres

Andrés F. Sciolla, MD
Associate Professor of Clinical Psychiatry
Medical Director, Northgate Point RST
University of California, Davis
Department of Psychiatry & Behavioral Sciences
2230 Stockton Bvld.
Sacramento, CA 95817
Tel 916-567-4222
Fax 916-567-4220

So Jane, and all those experienced in ACE understanding and possibly administration of to clientele, would you use or advocate the use of the Resilience history score?

I don't think I'll get the definitive answer I am looking for...!

All the best with the call.

Hi, Mem -- These pediatricians do, and it helps them understand their families, and it seems to help the parents understand their life course.

Hello Mem,  Yes, I would definately use it. To me the is no point digging up problems if you can't help supply solutions. Resiliency history helps you identify this and direct patients to resources. I just found out about this place yesterday and have sent an inquiry asking directory of practitioners with these unique skills that I can refer patients to. http://www.lisaferentz.com/workshops/     Based on the recent seminar I went to taught by Dr. B. Vander Kolk I have a new preference for referring people to those practitioners who use therapies that appeal to the visceral senses rather than just talk therapy. 

 

Keith, now I see the attachment and the questionnaire. Do you (or Jane) know who is the author, and whether it has been validated?

Diane Iverson posted:

Hello Mem,  Yes, I would definately use it. To me the is no point digging up problems if you can't help supply solutions. 

 

Dear Diane,

From a provider-centered perspective, I understand your point. None of us likes to feel helpless. From a client- or patient-centered perspective, however, research shows that clients want their providers to ask about exposure to traumatic experiences and respond with empathy to their disclosure.  For clients, disclosure in the context of empathy can be therapeutic in itself. In addition, the disclosure and the response they receive may deepen the trust and feelings of safety with their provider. In order to bring about behavioral change towards recovery and reduce health risks, mental and physical healthcare relationships require that foundation of trust and safety. There's a beautiful piece on a recent issue of JAMA, "Responding To Suffering" by Ron Epstein and Anthony Back that I think conveys this point.

Best,

Andres

PS: The article is attached, but please do not post it in the public domain, as I believe it would be an infringement of copyright. 

Andres,

I am not aware of the author, or whether or not it has been validated. Anyone else on the list know these things?