How the NFL can stop abuse AND keep its players on the field

A young fan wears an Adrian Peterson jersey.  [Photo: Ann Heisenfelt/AP]

A young fan wears an Adrian Peterson jersey. [Photo: Ann Heisenfelt/AP]

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Many people are happy that the Vikings kicked Adrian Peterson off the team and that Ray Rice can no longer play for the Ravens. Their off-field violence has cascaded into harm and loss for everyone involved – spouses, children, team, league and fans — all because of the consequences of their childhood trauma. And the only way the NFL can stop further abuse, harm and loss is…well…to deal with its players’ childhood trauma.

The severe and toxic stresses in Peterson’s past – or what we in the trauma-informed community count on a scale from one to 10 as adverse childhood experiences or ACEs – aren’t minor. As a child, he lost his father to prison, suffered through his parents’ divorce, saw his brother killed by a drunk driver, and was beaten by his stepfather. Repeating the pattern, he whipped his own four-year-old son with a switch so harshly that he raised welts on the child’s body. And if Peterson is convicted and goes to prison, his son can add another ACE to his trauma-filled life.

Peterson and Rice are two of millions of child and spouse abusers who love their families and can learn from their mistakes, if provided with help early enough. The average child abuser or spouse abuser isn’t dirty, disheveled, reeking of alcohol or stoned on meth. Child and spouse abusers are corporate CEOs, ministers, priests, actors, business owners, teachers, truck drivers, physicians, nurses, basketball heroes, journalists, computer programmers, and your next-door neighbors.

They’re dads and moms who have a hard time controlling their emotions when they’re under stress because they themselves were abused. Nobody helped them when they were kids and nobody’s helping them as adults.

Plain and simple, childhood trauma is the nation’s No. 1 public health problem. The CDC’s Adverse Childhood Experiences Study (ACE Study) – the largest public health study you never heard of — shows that childhood trauma is very, very common. (ACE surveys in 22 states echo the results.) And this childhood adversity causes violence, including family violence, as well as the adult onset of chronic disease and mental illness.

By learning about the science of childhood adversity, and following the lead of many other organizations that are becoming trauma-informed, the NFL could have players whose families are happier and healthier, it could have better players (more focused, less stressed), and it might never have to deal with a Ray Rice or Adrian Peterson situation again.

The NFL has 1,696 players. Of those 1,696 players, probably two-thirds – 1,119 young men – have experienced one type of serious childhood trauma. And it’s likely that 22 percent – about 370 players –

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The Philadelphia story: Education and activism converge in “ACEs epicenter”

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The women and men gathered for a training on trauma and resilience were recovery counselors and social workers, charter-school teachers and prison administrators. But to Stephen Paesani, the child and adolescent training specialist who was leading the session, every person in the room was a potential protective factor in a child’s life.

“When a child experiences adversity or trauma, he goes into the fight-or-flight stance,” Paesani explained. “That’s going to impact brain development. “But no matter what happens, all of you can be the agents for resilience.”

Paesani works for Philadelphia’s Behavioral Health Training and Education Network (BHTEN), which provides training to practitioners and community members, part of the city’s effort to infuse mental health and substance abuse services with principles of recovery, resilience and self-determination.

But BHTEN’s trainings are just one piece of the Philadelphia ACEs story. In this city of 1.5 million—a city rife with disparities of class, education and health, with pockets of multi-generational poverty and trickle-down trauma—the last decade has seen a steady effort to bring understanding of adversity, trauma and resilience to thousands of front-line workers, supervisors and administrators across the map of human services.

This work is not the result of a top-down initiative or a single funder’s vision for change. It is, instead, the gradual flowering of multiple seeds, planted by activist leaders in pediatrics, public health, behavioral health, child welfare, justice and education.

Today, Philadelphia is home to the ACE Task Force, a group of 50 practitioners intent on putting the knowledge of brain development, adversity and resilience to work in pediatric and primary care clinics, child abuse prevention networks and early childhood programs. The social network site ACEsConnection.com recently launched a Philadelphia group whose members share questions, successes and challenges.

And thanks to the Institute for Safe Families, with support from the Robert Wood Johnson Foundation, Philadelphia was the site of the first National Summit on ACEs in May 2013, attended by 160 physicians, academics, social workers and human service administrators. There, speakers called the ACEs movement “a revolution” in thinking about health and illness, human suffering and strength.

In Philadelphia, that revolution began even before the groundbreaking Centers for Disease Control Adverse Childhood Experiences Study (ACE Study) demonstrated the lifelong impact of early adversity.

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Trauma-informed judges take gentler approach, administer problem-solving justice to stop cycle of ACEs

Judge Lynn Tepper hugs Taylor, 11, at his final adoption hearing. Before finding his permanent home, he'd been returned by three families since being removed from his biological mother when he was three years old.

Judge Lynn Tepper hugs Taylor, 11, at his final adoption hearing. Before finding his permanent home, he’d been returned by three families. [Photo: Edmund D. Fountain, Tampa Bay Times]

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Three years ago, Judge Lynn Tepper of Florida’s Sixth Judicial Circuit Court in Dade City, FL, learned about the CDC-Kaiser Adverse Childhood Experiences (ACE) Study The ground-breaking research links childhood abuse and neglect with adult onset of chronic disease, mental illness, violence and being a victim of violence.

It was like flipping a switch.

“I suddenly had this trauma-informed lens, as we call it. I see it everywhere,” she says, giving an example of someone in front of her on child abuse charges for whom she might recommend counseling and/or anger management. “I have discovered the reality is that when I start asking a few questions, that parent or partner has experienced ACEs,” she says.

The 10 types of childhood trauma measured in the ACE Study are: physical, verbal and sexual abuse, and physical and emotional neglect; a family member who abused alcohol or other drugs, who was depressed or mentally ill, or was in prison; witnessing a mother being abused, and loss of a parent through separation or divorce.

Tepper, a veteran of 37 years on the bench, realized that childhood trauma experienced by the people who ended up in her courtroom was much worse than their paperwork showed. “When you dig down deeper, you wonder how these people get up in the morning,” she says. “I remember thinking at one point, ‘Oh boy, did we blow it all these years on these delinquents.’ ”

Most judges in the United States are unfamiliar with the ACE Study and the research on the neurobiology of toxic stress that has emerged over the last 15 years. But that’s beginning to change in courtrooms across the U.S., due to a number of educational programs aimed at producing trauma-informed judges—and courts. As a result, trauma-informed judges have made three big changes:

  • They’ve modified their courts to be safer and less threatening to defendants with histories of childhood trauma and who are often already traumatized.
  • They recognize that trauma is passed from one generation to another, and take a two- or three-generational approach in child abuse and neglect cases.
  • Because, they say, the traditional approach in criminal justice continues the traumatization of children, youth and families, they’re taking a solution-oriented approach.

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Mindfulness protects adults from physical, mental health consequences of childhood abuse, neglect

Aeye2Fact #1: People who were abused and neglected when they were kids have poorer physical and mental health. The more types of ACEs (adverse childhood experiences) – physical abuse, an alcoholic father, an abused mother, etc. – the higher the risk of heart disease, depression, diabetes, obesity, being violent or experiencing violence. Got an ACE score of 4 or more? Your risk of heart disease increases 200%. Your risk of suicide increases 1200%.

Fact #2: Mindfulness practices improve people’s physical and mental health.

Now, says Dr. Robert Whitaker, a pediatrician and professor of pediatrics and public health at Temple University, there’s one more important fact: People who are mindful are physically and mentally healthier, no matter what their ACE scores are.

This study, to be published in the October issue of Preventive Medicine, is the first to look at the relationship between ACEs, mindfulness and health. And it has implications for anyone, and especially those who take care of children– teachers, parents, coaches, healthcare and childcare workers.

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Dr. Robert Whitaker

Many people think of mindfulness as sitting around and saying “Ommmm.” There’s actually more to it, and it’s worth explaining. People who aren’t mindful don’t regulate their own emotions very well. Situations that trigger traumatic memories may cause people who aren’t mindful to lose focus on what’s happening currently, and lead them to make snap judgments and have knee-jerk reactions of anger, frustration, or fear, which can further the spread stress and trauma. They also ruminate on situations they can’t control, and can’t let go. And they may not even be conscious that they’re doing any of this. They just think it’s part of their personality.

Here’s what it’s like not to be mindful:

  • “My co-worker’s angry today. I must have done something wrong. She’s JUST like my mother: moody, angry, a screamer. Well, I’d better get my defenses up and give her a piece of my mind before she attacks me.”

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Florida study confirms link between juvenile offenders, ACEs; rates much higher than CDC’s ACE Study

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Juvenile offenders in Florida have starkly higher rates of adverse childhood experiences (ACEs) than the population as a whole, according to a study conducted by the state’s Office of Juvenile Justice and Delinquency Prevention and the University of Florida.

The study — The Prevalence of Adverse Childhood Experiences (ACE) in the Lives of Juvenile Offenders — is the first in the U.S. to look at the extent of ACEs among youth offenders. In the 64,329 Florida juvenile offenders surveyed, only 2.8 percent reported no childhood adversity, compared with 34 percent from the original Adverse Childhood Experiences (ACE) Study conducted by the Centers for Disease Control and Prevention and Kaiser Permanente, San Diego, in 1998 . The CDC’s groundbreaking epidemiological study discovered a link between childhood adversity and the adult onset of chronic disease , mental illness, violence and becoming a victim of violence.

The 10 adverse childhood experiences measured in the Florida research and the CDC’s ACE Study were: emotional, physical, and sexual abuse; emotional and physical neglect; and five types of family dysfunction: witnessing a mother being abused, household substance abuse, household mental illness, losing a parent to separation or divorce, and having an incarcerated household member.

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Half of the Florida juveniles reported four or more ACEs, compared with 13 percent of those in the CDC’s ACE Study. This is significant because, compared with people with zero ACEs, those with four ACEs are twice as likely to be smokers, 12 times more likely to attempt suicide, seven times

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Patrick Kennedy builds connections among diverse sectors to change healthcare

(l to r) Patrick Kennedy, Bill Emmet, Kennedy Forum executive director, and Mike Thompson

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Former U.S. Congressman Patrick Kennedy is building a “Community of Mental Health,” by making connections that are needed for mental health to be fully integrated into our understanding of overall health. To achieve this goal, the son of U.S. Senator Edward M. Kennedy has created the Kennedy Forum—so named to evoke the memory of President John F. Kennedy and employ the family name to inspire, motivate, and unite advocates and policymakers around a shared vision of what healthcare should be. The Kennedy Forum is focused on the development, implementation, and dissemination of mental health and addiction policy and standards—with the first order of business being the implementation of the new mental health and addiction parity law.

The Kennedy Forum is providing this leadership by convening people with diverse interests and perspectives in a variety of formats including one-on-one meetings, national summits, locally focused seminars and forums being held venues as diverse as Chicago and Cape Cod. The goal of the Forum is to help shape the service delivery and payment system of the future—one that encourages prevention, early intervention, and coordinated care for all who need it.

Patrick Kennedy (center) addresses gathering at the Kennedy compound in Hyannis Port, MA

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The premier meeting of the Kennedy Forum was held at the Kennedy Library in Boston in the fall of 2013 (the second such meeting will be held in June 2015). Earlier this summer, a series of small gatherings took place at the Kennedy compound in Hyannis Port, on Cape Cod in Massachusetts. A meeting is scheduled for November 13 in Chicago to address local issues. Part of that meeting will address prevention and early intervention in mental health, including the traumatic impact of community violence on the city’s children.

Arthur Evans

Arthur Evans at Philadelphia “I Will Listen” event

The gatherings at the the family home on Cape Cod brought together leaders from a variety of fields to share experiences and expertise and learn from each other, often for the first time. Here are several examples of participants who illustrate different perspectives on improving health in the broadest sense of the word:

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Massachusetts “Safe and Supportive Schools” provisions signed into law, boosts trauma-informed school movement

Massachusetts Gov. Deval Patrick

Massachusetts Gov. Deval Patrick

Massachusetts Governor Deval Patrick today signed into law provisions to create conditions for “safe and supportive schools” intended to improve education outcomes for children statewide, and giving momentum to the state’s trauma-informed schools movement. They were included in The Reduction of Gun Violence bill (No. 4376). This groundbreaking advance was achieved when advocates seized the opportunity to add behavioral health in the schools to the options under consideration as state officials searched for ways to strengthen one of the nation’s more restrictive gun laws in the aftermath of the tragic shooting of schoolchildren in Newtown, CT.

House Speaker Robert DeLeo saw the connection between reducing gun violence and school achievement and was instrumental in the bill’s passage. When the original sponsor of a Safe and Support Schools Act, Katherine Clark, left the state legislature for the U.S. House of Representatives, some advocates were concerned the void would not be filled. Their fears were assuaged when Rep. Ruth Balser of Newton and Sen. Sal DiDomenico of Boston became lead sponsors.

The schools act supporters were jubilant that the legislation they labored on for years was incorporated in the gun violence bill now signed into law, and expressed deep relief and excitement about the achievement. They also said the hard work of statewide implementation now begins.

The law requires the state education department to develop a framework for safe and supportive schools, first developed by a task force established by the legislature in 2008, that provides a foundation to help schools create a learning environment in which all students can flourish. The framework is based on a public health approach that includes fostering the emotional wellbeing of all students, preventive services and supports, and intensive services for those with significant needs.

Within the framework, schools are encouraged, but not mandated, to develop action plans that will be incorporated into the already required School Improvement Plans. The law also provides a self-assessment tool to help in the creation of the plans.

Under the leadership of the Trauma and Learning Policy Initiative (TLPI), a coalition of the Massachusetts Advocates for Children and Harvard Law School, the “Safe and Supportive Schools Coalition” was formed to move the legislation

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