This week’s guest speaker was Susan L. Hess. She is a senior guest lecturer at the USC School of Social Work. Her primary areas of expertise include intimate partner violence and trauma-informed care. Professor Hess is promoting research and clinical approaches to trauma-informed practices. She is currently furthering her efforts by launching a Trauma-Informed Care Task Force across all systems of care in Los Angeles. Professor Hess’s presentation was about the largest public health study that no one has heard of. The public health study is on the Adverse Childhood Experience (ACE).
Professor Hess began by asking the class if anyone has heard of the ACE study. Surely enough, no one in the class had heard of it. She opened up her presentation by asking the question, “What is trauma?” According to Judith Herman, trauma is experiencing intense fear, helplessness, loss of control, and threat of annihilation. A few examples of traumatic experiences include: domestic violence, emotional abuse, war, immigration, racism, educational neglect, incarceration, mental illness, and child maltreatment. There can also be complex trauma, which describes the experience of multiple, chronic, and prolonged developmentally adverse traumas. Some responses include: dissociation, hyperarousal, intrusion, constriction and avoidance, and somatic complaints.
The ACE study is a survey of ten questions with categories of: abuse (emotional, physical, sexual), neglect, and household dysfunction (mother treated violently, household substance abuse, household mental illness, parental separation/divorce, and incarcerated household member(s)). The amount of questions you answer “yes” to gives you an ACE score (one point for each category). The higher the score, the greater the exposure, and therefore the greater the risk of negative consequences. The ACE score then shows a strong, graded relationship between adverse childhood experiences and subsequent health-related behaviors and outcomes. Professor Hess then poses the question, “How could services be different if this was implemented in systems?” There would be a lot more prediction, prevention, and intervention at an earlier age. Trauma is an important study because people with childhood histories of trauma, abuse, and neglect make up almost the entire criminal justice population in the United States!
If you would like to see the consequences of lifetime exposure to violence and abuse you can go to coleva.net. If you would like to know your ACE score you can go to http://acestudy.org/ace_score and help spread the word about the largest public health study on the Adverse Childhood Experience.