• Florida State launches professional certification in trauma and resilience

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    Florida State University has launched a new online curriculum for a professional certification in trauma and resilience.

    The curriculum was developed by the Clearinghouse on Trauma and Resilience within the Institute for Family Violence Studies at the FSU College of Social Work in conjunction with the FSU Center for Academic and Professional Development.

    “This training addresses a gap in the knowledge base of human services professionals,” said Clearinghouse Director Karen Oehme. “Many professionals do not receive training on the impact of how to provide services to someone who is experiencing the harmful effects of trauma.”

    The course enables professionals to develop the knowledge and skills they need to understand the impact of adult and childhood trauma, along with the keys to resilience. Participants will learn crucial information to improve service delivery to clients, students, human services recipients, patients and other members of the public.

    The self-paced curriculum includes 20 hours of course content and 10 chapters of research-based readings, case scenarios, multimedia materials, assignments and quizzes.

    The multidisciplinary course has been approved for continuing education credits for a diverse range of professionals including licensed counselors, social workers, nurses, dentists and lawyers. Participants outside of Florida can submit their certification to their own licensing board to determine credit awarded.

    “The course is designed for professionals in a wide variety of fields because individuals in all different environments have exposure to trauma,” Oehme said. “We wanted to provide an economical, evidence-based resource to the public for those who want to enhance their professional knowledge, skills and career potential.”

    The curriculum is based on developing an understanding of adverse childhood experiences and the associated long-term negative effects. The training offers a powerful new perspective on trauma-informed approaches to effective service delivery.

    “Florida State University recognizes that professionals from all backgrounds have the ability to help individuals build resilience,” said Jim Clark, dean of the College of Social Work. “But first they have to learn about why resilience is so crucial in treating the negative impacts of trauma.” Clark said that FSU realized the need for such a course as it was developing the Student Resilience Proect.

    “Our community partners have told us time and time again that they need research-informed resources,” Clark said. “It was a natural next step for the Clearinghouse on Trauma and Resilience to develop such a course.”

    Faculty from across Florida State’s campus participated in the review of the new course.

    Mimi Graham at the Center for Prevention & Early Intervention Policy, a leader in trauma-informed education, served as a reviewer, along with 10 other faculty members.

    “FSU is a leader in trauma and resilience education for the public,” Graham said. “This course ensures that crucial information is available to our community leaders, so they can make trauma-informed decisions.”

    Joedrecka Brown Speights at the College of Medicine said, “It’s important for human services professionals to keep up with the new research on brain development so they remember there is always hope for healing after trauma.”

    Chapters in the certification cover the mental and physical effects of trauma, cultural considerations in trauma research, skills for addressing trauma and an interdisciplinary approach to building resilience.

    Professionals are required to review all of the course material and pass the chapter quizzes and final exam. When professionals complete the training, they will receive their professional certification from the Center for Academic and Professional Development.

    Discounts for the 20-hour course are offered for FSU alumni and veterans. For questions about fees and enrollment, contact the FSU Center for Academic & Professional Development at resilience@capd.fsu.edu or (850) 644-7545.

  • Bad news-good news: Each additional ACE increases opioid relapse rate by 17%; each ACE-informed treatment visit reduces it by 2%

    Aopioids2Photo by Ian Sheddan via Flickr Creative Commons
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    It’s no surprise that serious childhood trauma can lead people to use opioids. In the absence of healthy alternatives and an understanding of how experiences — such as living with a parent who’s alcoholic or depressed, divorce, and being constantly yelled at when you’re a kid — can make your adult life miserable, opioids help many people cope with chronic depression, extreme anxiety and hopelessness.

    But a new study has shown the significance of ACEs and ACEs-science-informed treatment: Each additional type of adverse childhood experience increases a person’s risk of relapse during medication-assisted opioid treatment by a whopping 17 percent. And each visit to a clinic that integrates trauma-informed practices based on ACEs science reduced the relapse rate by two percent, which can carry a person perhaps not to zero, but to a minimal risk of relapse.

    “This research clearly shows the lasting impact that ACEs (adverse childhood experiences) can have,” says Dr. Karen Derefinko, lead author and assistant professor in the Department of Preventive Medicine at the University of Tennessee Health Science Center, and director of the National Center for Research of the Addiction Medicine Foundation. “I think it’s the first research to connect ACEs to relapse.”

    Researchers from the University of Tennessee Health Science Center and the University of Memphis also found that more than half (54%) of people in a rural Tennessee opioid clinic relapsed, and the highest relapse rate was on the first visit. Almost half of the 87 people who participated in the study had an ACE score of four or higher — the average was 3.5, which is remarkably high. The study, “Adverse childhood experiences predict opioid relapse during treatment among rural adults”, appears in the September 2019 issue of the journal, Addictive Behaviors, and was published online last week.

    Derefinko
    Dr. Karen Derefinko

    “This study will help practitioners understand the importance of providing trauma-informed treatment,” says Derefinko. “Because of the stigma associated with drug use, it’s hindered health care workers’ understanding of why people use drugs and has led to an assumption that they’re bad people. This shows that trauma-informed care and providing resources does impact how well people can do. It’s also validating for patients and gives them a lot of hope.”

     

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  • CA announces robust perinatal depression prevention for Medi-Cal recipients

    Melinda Coates experienced a tumultuous pregnancy. “I was really mentally upset literally from day one (of the pregnancy),” she says. (Melinda Coates is a pseudonym. To protect her and her children’s privacy and safety, we are not using her real name.)

    Coates had hoped to get counseling last October, when she was seven months pregnant. That’s when she enrolled in the state’s Medi-Cal program, shortly after she and her abusive husband moved to California, “but nobody was able to get me in that quickly,” she says. “If I had gotten the help that I needed with my mental state, I may not have stayed in my abusive marriage as long,” she says.

    Six weeks after her son’s birth she had one session with a counselor who prescribed an antidepressant. “I was supposed to go back, and I needed to reschedule, but I never heard from her again,” says Coates, who has been living in a domestic violence shelter since the end of June with her eight-month-old son and three-year-old daughter. She is currently separated and filing for a divorce from her husband.

    A new policy in California that went into effect in July now makes it possible for pregnant women like Coates to get the counseling they need, according to a recently-released MediCal bulletin. It will also reimburse providers for up to 20 counseling sessions for the year following childbirth, according to the bulletin. And it specifically states that it will allow any pregnant or postpartum woman in the program to receive that help if they experience “perinatal depression, a history of depression, current depressive symptoms (that do not reach a diagnostic threshold), low income, adolescent or single parenthood, recent intimate partner violence.” The new policy allows practitioners to bill for sessions that occurred from February 2019 forward. The policy is informed by recommendations from the U.S Preventative Task Force.

    AllisonMurphy
    Allison Murphy

    “For women who haven’t had any services in the past, it’s a great benefit,” says Allison Murphy, a psychotherapist and founder and executive director of Mothers Care in Petaluma, Calif. Previously, explained Murphy, women enrolled in Medi-Cal’s comprehensive pregnancy program were only entitled to counseling for up to two months following childbirth.

    There is no question that many families suffer the consequences of perinatal depression and don’t get the help they need. Approximately 15 percent of women in California experience anxiety and depression during or after their pregnancy, according to a recent report by Mathmatica Policy Research. Many do not get treatment, resulting in missed work, and health and mental health consequences — not only for themselves, but also for their children — to the tune of $2.4 billion annually, according to the report, which calculated costs from birth to five years postpartum. (See the attached report below.)

    And untreated perinatal anxiety and depression in mothers translates into adverse childhood experiences (ACES) for their children, says Murphy. “Unfortunately, somebody can be born with already having the vulnerability of a high ACE score, and so it is upstream to start working with someone directly during pregnancy and postpartum.”

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  • The myth of motive in mass shootings

    AElPaso

    Photo: Vernon Bryant, Dallas Morning News

    Almost the first thing you hear out of the mouths of police after a mass shooting is: “We’re looking for a motive.”

    In Gilroy, CA, the FBI is investigating the shooting at the Gilroy Garlic Festival as domestic terrorism. In El Paso, TX, police are describing the shooting as a possible hate crime and act of domestic terrorism, and focusing on the manifesto written by the shooter. Police in Dayton, OH, are still looking for a motive for why 24-year-old Connor Betts murdered nine people in 30 seconds.

    But if we want to prevent shootings, asking about motive will just get you a useless answer to the wrong question. Police might feel as if they have an explanation for why 19-year-old Santino William Legan murdered three people, and why 21-year-old Patrick Crusius murdered 22 people. But motives don’t explain the roots of why those three young men, or any other mass shooters or bombers, foreign or domestic, start their journey as innocent babies and end up on a road to killing people. And in those roots, are our solutions.

    If you use the lens of the science of adverse childhood experiences, the answer reveals itself, and usually pretty quickly.

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  • Medical students’ ACE scores mirror general population, study finds

    national survey published in 2014 revealed a disturbing finding. Compared to college graduates pursuing other professions, medical students, residents and early career physicians experienced a higher degree of burnout.

    Citing that article, a group of researchers at University of California at Davis School of Medicine wondered whether medical students’ childhood adversity and resilience played a role in their burnout, said Dr. Andres Sciolla, an associate professor of psychiatry and behavioral sciences at the University of California at Davis Medical School. Sciolla is the lead author of a recent study in the journal Academic Psychiatry that investigated those questions.

    Their query was based on the landmark CDC-Kaiser Permanente Adverse Childhood Experiences Studythat showed a remarkable link between 10 types of childhood trauma — such as witnessing a mother being hit, living with a family member who is addicted to alcohol or who is mentally ill, living with a parent who is emotionally abusive, experiencing divorce — and the adult onset of chronic disease, mental illness, being violent or a victim of violence, among many other consequences. The study found that two-thirds of the more than 17,000 participants had an ACE score of at least one, and 12 percent had an ACE score of four or more. (For more information, see ACEs Science 101.)

    The ACE Study and subsequent research shows that people with an ACE score of 4 are twice as likely to be smokers and seven times more likely to be alcoholic than someone with an ACE score of 0. Having an ACE score of 4 increases the risk of emphysema or chronic bronchitis by nearly 400 percent, and attempted suicide by 1200 percent. An ACE score of 6 or higher is associated with a 20-year shorter lifespan than someone with an ACE score of 0. However, subsequent research has shown that social buffers, such as having just one caring adult in a child’s life, can mitigate the impact of ACEs.

    For the UC Davis study, 86 third-year medical students completed an ACE survey. Of those, 49% had an ACE score of 0, 40 % had ACE scores between 1-3, and 12 % had ACE scores of 4 or more.

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  • Personal stories from witnesses, U.S. representatives provided an emotional wallop to House Oversight and Reform Committee hearing on childhood trauma

    William Kellibrew's grandmother receives standing ovation

    Room erupts in applause for the grandmother of witness William Kellibrew during July 11 House Oversight and Reform Committee hearing.

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    The power of personal stories from witnesses and committee members fueled the July 11 hearing on childhood trauma in the House Oversight and Reform Committee* throughout the nearly four hours of often emotional and searing testimony and member questions and statements (Click here for 3:47 hour video). The hearing was organized into a two panels—testimony from survivors followed by statements from experts—but personal experiences relayed by witnesses (including the experts) and the members of Congress blurred the lines of traditional roles.

    Chairman Cummings
    Chairman Elijah Cummings
    Ranking Committee member Jim Jordan (R-OH)
    Ranking member Jim Jordon (OH)

    Chairman Elijah Cummings (D-IL) set the tone early in the hearing by recalling his childhood experience of being in special education from kindergarten to sixth grade, and being told he would “never be able to read or write.”  Still, he “ended up a Phi Beta Kappa and a lawyer.”

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  • Talking ACEs and building resilience in prison

    WA-Penitentiary_Exterior

    They’re the forgotten, the 2.3 million people in US prisons. The overwhelming majority of them have experienced significant childhood trauma. Before you click out of here, this isn’t another boo-hoo story, as some of you might describe it, about the dismal state of our corrections system, for inmates and guards alike. (Oh, yes, it is profoundly dismal.) This is a story about how one tiny part of it isn’t so dismal, and actually addresses head-on the fact that most (91 percent) of the approximately 2.3 million prisoners will finish their sentences and go home. To your neighborhood. So….wouldn’t you want the prisons to help these guys and gals so that they, and by definition, we, come out happier and more well-adjusted than when they went in?

    Well, yea-uh.

    Ok. Just in case you glossed over it, let’s go back to that sentence about childhood trauma. It is precisely why the 2,300 inmates at Washington State Penitentiary in Walla Walla, Wash., ended up there. Over the last 20 years some profound, intense research revealed that people who have a lot of childhood adversity have seven times the risk of becoming an alcoholic, 12 times the risk of attempted suicide, twice the risk of cancer and heart attacks. They’re more violent, more likely to be victims of violence, have more broken bones, more marriages, and use prescription drugs more often than people who have no childhood adversity. And those are just the few drops in the bucket of how childhood trauma affects people’s lives.

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