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Family & Children Services Joins Community-Wide Effort to Break Generational Cycle of Adverse Childhood Experiences

December 14, 2017

It’s no secret that childhood traumas – also called Adverse Childhood Experiences or ACEs – can lead to behavioral and social problems in adolescents and teens. But scientific evidence demonstrates that ACEs also increase the risk of experiencing serious physical, mental, and behavioral problems later in life. Further, adults who had ACEs tend to have children with ACEs.

This transfer of childhood trauma from one generation to the next is considered to be the most powerful determinant of the public’s health. Yet, health experts say, a widespread approach to raising awareness of ACEs and reducing their impact on both children and adults has lagged.

“Preventing ACEs and their intergenerational transfer is the greatest opportunity we have to improve the well-being of our communities’ public health,” says Diane Marquess, director of behavioral health services at Family & Children Services.

Marquess is part of a community cross-sector workgroup of medical providers, mental health and social service professionals, educators, criminal justice experts, faith leaders, and others across the Kalamazoo region convened by United Way of the Battle Creek and Kalamazoo Region and ISAAC.

Their goal is to raise awareness of ACEs and the toll they take on our community, increase communication and collaboration across community treatment and service sectors, bring a “trauma-informed” approach to treating people affected by ACEs, and “build resilience” to families and communities in order to break the intergenerational transmission of ACEs.

“Family & Children Services believes in contributing to a thriving community.” Marquess says. “We want to help change our community perspective from ‘What’s wrong with you?’ to ‘What happened to you?’”

When Four Aces Are Not Good

Adverse Childhood Experiences disrupt children’s neurodevelopment and cause social, emotional, and cognitive impairment. They lead children to adopt risky behaviors – smoking, alcohol and drug use, sexual activity – that can damage their health and wellbeing.

The accumulation of “toxic stress” from these ACEs shows up in students as lack of focus, truancy, low grades, aggressive behavior, high suspension rates, and low graduation rates. They also contribute to the “school-to-prison pipeline.”

The first large-scale epidemiological study about the effects of ACEs in adults was the Centers for Disease Control-Kaiser Permanente Adverse Childhood Experiences Study, conducted in the mid-1990s with more than 17,000 participants.

Ten ACEs in three categories were studied: abuse (emotional, physical, or sexual), neglect (emotional or physical), and household dysfunctions (witnessing domestic violence against mother, parental death or abandonment, incarceration of household member, mentally ill or suicidal family member, drug or alcohol addicted family member).

“The study confirmed that the higher the number of ACEs, the higher the risk for negative health outcomes a person would have as an adult,” Marquess says. “For example, a person with four or more ACEs is twice as likely to smoke, three times more likely to have cancer, seven times more likely to be an alcoholic, and twelve times more likely to attempt suicide. Six or more ACEs could cut 20 years off a person’s life.”

Research also demonstrates that the higher the number of ACEs, the higher the likelihood of experiencing adult homelessness, unemployment, poverty, disability, learning problems, incarceration, and other negative outcomes. “ACEs are highly interrelated which calls for a collective community response,” Marquess says.

Trumping ACEs at Family & Children’s Services
Experts have identified three core protective systems that help children and adults overcome the effects and intergenerational transfer of ACEs: 1) increase individual capabilities in people; 2) improve the attachment that children have with caring and competent people; and 3) build a protective community that fosters empowerment.

Family & Children Services has a long history of accomplishment in these areas.

Therapists in The Counseling Center (including several who are embedded in Kalamazoo-area public schools) work with students identified by schools and parents as struggling with nonacademic issues linked to ACEs, including emotion regulation which manifests in anger and aggression anxiety, depression, grief and loss, and other problems.

The Agency’s therapists also help adults struggling with depression, anxiety, and other fallout from their own adverse childhood experiences.

The Agency’s Foster Care & Adoption and Family Preservation & Parental Support programs focus on building healthy family-child relationships. This adheres to one of the main findings of ACE research that one of the best ways to reduce the effects of ACEs in children is to have at least one loving, supportive adult in a child’s life.

Here are just three of many such programs at the Agency:

  • Families First serves Kalamazoo families whose children are at-risk of out-of-home placement due to abuse or neglect and children in foster care being reunited with their families. In this intensive four-week voluntary program, families receive an average of ten hours of face-to-face contact per week focusing on crisis intervention and safety planning, parenting education, communication and conflict resolution skills, life skills, linking families to community services, and more.
  • Families Together Building Solutions (FTBS) serves families who are experiencing issues related to child and family well-being and are in need of supportive assistance. In this three- to six-month program in Kalamazoo and Calhoun counties, families receive an average of three hours of face-to-face contact per week. Services focus on enhancing family functioning through safety planning and crisis intervention, parenting education, life skill education, communication and conflict resolution skills, building positive relationships, and community resource navigation and advocacy.
  • Foster Care Supportive Visitation/In-Home Education provides intensive, individualized parent skill coaching and education to families whose child or children have been in out-of-home placement for less than eight months. The program utilizes evidence-based approaches to replace old patterns of thoughts and behaviors with newer, healthier ones.

All child welfare programs at Family & Children Services are based on Strengthening Families, a research-based framework developed by the Center for the Study of Social Policy to enhance child development, reduce abuse and neglect, and increase family strengths. It’s “Five Protective Factors” help parents who might otherwise be at risk of abusing their children to find resources, supports, or coping strategies that allow them to parent effectively, even under stress.

“Nurturing relationships and environments are crucial to preventing child neglect and abuse, and helping children reach their full potential,” Marquess says. “This, in turn, builds stronger families and stable communities for the next generation. It lies at the heart of what we do as an agency and what the community-wide effort to combat ACEs is all about.”

A Trauma-Informed Provider
Family & Children Services also takes a “trauma-informed” approach to its ACE interventions, says Marquess. Trauma-informed care is an organizational structure and treatment framework that runs throughout the entire organization. Such care understands the widespread impact of trauma and potential paths for recovery; recognizes the signs and symptoms of trauma in clients; fully integrates knowledge about trauma into policies, procedures, and practices; and works hard to avoid re-traumatizing clients.

The design of the new Family Center – the hub of Family & Children Services’ child welfare programs, opened in 2016 – integrates trauma-informed practices so that family visits will relieve stress, not add to it. Both indoor and outdoor spaces provide mandatory staff observation that doesn’t get in the way of family interaction. Children are able to share successes, play, visit with siblings, and discuss adjusting to foster care – all in a supportive, caring, nonthreatening environment.

The Agency worked closely with Western Michigan University’s (WMU) School of Social Work and other organizations to become a trauma-informed organization. The Counseling Center offers children’s specialty trauma services, including trauma consultations with foster parents and evidence-based trauma treatment to children.

“Being a trauma-informed provider is about more than how one therapist interacts with a specific client,” Marquess says. “It’s about how the entire organization serves all its clients. Our direct care and support staff, administrators, and clinicians receive coaching on how to create a safe, supportive, welcoming, and respectful environment, and how best to employ trauma-informed screening, assessment, and treatment tools and procedures to treat traumatized children and adults, particularly ones with serious or multiple ACEs.”

“Resilience” in the Community
Helping kids, adults, and families recover from their traumas lies at the center of the ACEs issue. So, too, does helping them build resilience to trauma, tragedy, and stress they are likely to meet in the future. Having a protective, nurturing community that helps them build this resilience is vital, says Marquess.

“Being able to reach out to a trusted member of your community – perhaps a doctor, school counselor, teacher, therapist, or church leader – can make all the difference to someone who has been traumatized,” she says. “Making sure these community members have the knowledge and awareness to understand those affected and then respond in a supportive manner is equally important.”

That’s why building a protective and resilient community is a top goal of the cross-sector workgroup addressing the ACEs issue in the Kalamazoo area. The group, she says, is engaged in a multipronged effort to raise awareness and foster communication about ACEs and trauma-informed care throughout the community.

The Michigan Aces Initiative and local United Way have also supported the effort to show Resilience: The Biology of Stress & Science of Hope, a documentary film about the ground-breaking ACE study and how groups and individuals across the country are creating programs to prevent and build resilience to ACEs in their communities. Directed by filmmaker James Redford (son of actor/director Robert Redford), the film made its world premiere in 2016 at the Sundance Film Festival.

“Resilience” has been shown four times in Kalamazoo to groups of educators, health care and social service providers, policy makers, and other community stakeholders. More screenings will be scheduled in 2018.

“The screenings and the conversations that follow them are a call to action for our community to work together to ensure that everyone has an opportunity to reach their full potential, regardless how many ACEs they’ve been dealt,” says Marquess.

“Family & Children Services is well aware of the impact that ACEs have on children, adults, families, and our community,” Marquess says. “We’re glad to contribute to the larger community in its effort to reduce the generational transmission of ACEs.”

Family & Children Services Director of Behavioral Health Services Diane Marquess and United Way of the Battle Creek & Kalamazoo Region Associate Director of Community Impact Jennifer Nottingham were recently on the WMUK radio (102.1 FM) program WestSouthWest to discuss Adverse Childhood Experiences (ACEs), local efforts to prevent them, and the film “Resilience.” Listen to their interview with WMUK Morning Edition Host Earlene McMichael.