The Hague Protocol: Identifying kids at risk by interviewing parents in the ER

In the summer of 2007, a woman was brought by ambulance to the emergency department of the Medical Center Haaglanden, a hospital that serves an inner city area of The Hague. The woman was drunk and had a severe head injury. Her 8-year-old son was with her.

Hester Diderich, an emergency nurse, and other hospital staff members looked after the boy while they attended to his mother. “We were very nice to him,” Diderich remembers.

After treating the woman’s injuries, they were ready to release her and her son. What happened next led Diderich and her colleagues to realize they needed a better way to protect children and evaluate the risks they face. They created a new process, known as The Hague Protocol, and started a study to evaluate it. The protocol is now in use throughout the Netherlands and is being adopted by other European countries as well.

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Implementation of new Vermont law begins with the appointment of legislators to bicameral, bipartisan ACEs Working Group

After the 2014 Vermont legislative session, Rep. George Till was picking himself up, dusting himself off and reflecting on what he called an “ALE…..or Adverse Legislative Experience” when his ambitious legislative vision fizzled into a tiny bubble of hope to create a trauma-informed state. That bubble was enough to inspire  ACEs-related legislation — No. 43, H. 508, signed by Republican Gov. Phil Scott on May 22 — and policymakers are scheduled to start implementing the law next month. While the law calls for incremental steps, the long-term impact could be substantial.

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States explore trauma screening in the child welfare system

By Jeremy Loudenback, ChronicleofSocialChange.org

As trauma-informed initiatives have multiplied in recent years, more child welfare agencies are now grappling with how to properly screen for trauma.

Along with access to trauma-focused, evidence-based treatments and staff training, screening is a key part of building a trauma-informed system. But that approach has until recently had relatively little traction in the child welfare field.

According to a new paper that looks at the implementation of a recent wave of trauma screening initiatives in five states, child welfare agencies can help steer thousands of children to treatment related to their exposure to traumatic events.

But implementation concerns — such as how to integrate screening into agency practices and ensuring that sufficient trauma-informed services are available to children — are still an issue for most child-welfare agencies.

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Adverse Childhood Experiences Response Team in Manchester, NH, helps children grapple with trauma, violence, addicted parents

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Angela Delyani, community health worker; Mariah Cahill, crisis services advocate; and Sgt. Matthew Larochelle knock on the door of a family with children who witnessed a domestic violence incident just days before.

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An often-overlooked aspect of the opioid epidemic that has exploded across the U.S. in recent years is how often the abuse of heroin or prescription opiates is accompanied by domestic violence. This is tragic enough for the adults involved, but it’s a ticking time bomb for children who are exposed to these adversities, raising their risk for future drug use and multiple health and mental health conditions. Here’s how one community is trying to address the problem.

Police officers and emergency dispatchers are a pretty tough bunch but about three years ago, 911 operators in Manchester, NH, began noticing an uptick of an exceptionally distressing call—from children reporting the overdose of their parents.

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Explaining the symptoms of PTSD or C-PTSD

Author’s Note: It took me over a month to write this because simply describing what it is like to struggle with the symptoms of C-PTSD resulted in triggering fear, anxiety, and flashbacks.  I persisted with this narrative because I want people who have never experienced the complexities of this illness to have a better understanding of what someone with PTSD or C-PTSD might be trying to manage.  If you personally struggle with anxiety, have PTSD or C-PTSD, or you are triggered by descriptions of fear or trauma, you should not read this.  It is hard to read. It was hard to write.

In the car today, a good friend (I rarely leave the house without someone with me) asked me if I had looked at the condominiums in town for potential rentals when I was in the middle of my housing search last year.  I had, and he asked what I had thought of them and why I had not opted to live there. I told him that the basement in one I looked at

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Providers hope trauma legislation will help native children in foster care

By Jeremy Loudenback

Recent federal legislation put forward by Sens. Dick Durbin (D-IL), Al Franken (D-MN) and Heidi Heitkamp (D-ND) proposes to address the issue of childhood trauma through the creation of a federal trauma task force.

The Trauma-Informed Care for Children and Families Act would gather federal officials and members of tribal agencies to create a set of best practices and training to help create a better way to identify and support children and families that have experienced trauma.

In North Dakota, the home state for co-sponsor Heitkamp, advocates are hoping that the bill can have an impact on addressing the needs of Native American children who disproportionately enter the state’s foster care system. According to one report, Native American youth deal with post-traumatic stress disorder at a rate of 22 percent, three times the national average and at the same level as Iraq and Afghanistan war veterans.

At PATH North Dakota, a non-profit child and family services agency, a trauma-informed approach means helping Native American children address historical trauma, as well as contemporary adverse experiences faced by children in foster care.

Jodi Duttenhefer and Heather Simonich, operations directors at PATH, recently talked with The Chronicle of Social Change about the new legislation, the importance of collecting data on the adverse childhood experiences of youth in its treatment foster care program and how the tribal community at Standing Rock is thinking about child trauma.

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Addiction doc says: It’s not the drugs. It’s the ACEs…adverse childhood experiences.

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He says: Addiction shouldn’t be called “addiction”. It should be called “ritualized compulsive comfort-seeking”.

He says: Ritualized compulsive comfort-seeking (what traditionalists call addiction) is a normal response to the adversity experienced in childhood, just like bleeding is a normal response to being stabbed.

He says: The solution to changing the illegal or unhealthy ritualized compulsive comfort-seeking behavior of opioid addiction is to address a person’s adverse childhood experiences (ACEs) individually and in group therapy; treat people with respect; provide medication assistance in the form of buprenorphine, an opioid used to treat opioid addiction; and help them find a ritualized compulsive comfort-seeking behavior that won’t kill them or put them in jail.

This “he” isn’t some hippy-dippy new age dreamer. He is Dr. Daniel Sumrok, director of the Center for Addiction Sciences at the University of Tennessee Health Science Center’s College of Medicine. The center is the first to receive the Center of Excellence designation from the Addiction Medicine Foundation, a national organization that accredits physician training in addiction medicine. Sumrok is also one of the first 106 physicians in the U.S. to become board-certified in addiction medicine by the American Board of Medical Specialties.

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