Understanding and Addressing the Impact of Adverse Childhood Experiences ACEs in Behavioral Health

Childhood should be a time of joy, growth, and exploration.  However, for many, it’s marred by traumatic experiences, also called toxic stress, that can leave adverse marks that last a lifetime.  

Adverse Childhood Experiences, or ACEs in behavioral health, can include violence, abuse, and growing up in a family with mental health or substance abuse problems. Thankfully, behavioral health treatment centers have served as crucial resources in the journey toward healing from ACEs.  At C4 Consulting, we have delved deep into the profound effects of ACEs on behavioral health and are shining a spotlight on the critical importance of early intervention. 

In this blog, we will explore how you can provide comprehensive care and support to individuals seeking to overcome the challenges posed by their traumatic past.

What Exactly Are ACEs in Behavioral Health?

ACEs are potentially traumatic events that can have negative, lasting effects on one’s mental and physical health and well-being throughout their life.  They broadly fall under three categories.

  • Abuse:  This can be physical, emotional, or sexual.
  • Neglect:  Neglect can be either physical or emotional in nature.
  • Household Dysfunction: This could be due to family members with mental illness (many of whom have ACE mental health-related issues themselves), substance abuse issues, incarcerated relatives, witnessing domestic violence, or facing parental separation or divorce.

According to a study by the Centers for Disease Control and Prevention (CDC), exposure to ACEs increases the risk of several leading causes of death, including heart disease, cancer, respiratory diseases, and diabetes.  Moreover, individuals with a high ACE score are more likely to grapple with behavioral health issues like depression and substance abuse. 

ACES behavioral health

How Can You Determine the Level of ACEs?

Screening for ACEs can be accomplished by using the ACEs and Toxic Street Risk Assessment Algorithm created by Kaiser Permanente and the Centers for Disease Control and Prevention (CDC).  With it clinicians can assess a patient’s risk for toxic stress.  Taken together, ACE scores and ACE-associated health conditions can indicate where a patient is on the ACE scale based upon whether their ACE score is low, intermediate, or high.  The higher the score, the greater the impacts typically are on physical and mental health.  

ACEs Aware, an effort initially led by the California Department of Health Services (DHCS) and the Office of the California Surgeon General (CA-OSG), was formed in 2021 as part of Governor Gavin Newsom’s California For All Initiative.  They offer a library of ACEs Aware core trainings, including ACEs and resilience training, and other supplemental training.  

ACES Aware offers a free, two-hour online core training that educates clinicians and their teams about how to provide trauma-informed care, screen for ACEs, assess health conditions related to ACEs, and how to identify evidence-based interventions.

Despite receiving a high score, some patients live relatively healthy and productive lives.

“There are people with high ACE scores who do remarkably well,” said Jack Shonkoff, a pediatrician and director of the Center on the Developing Child at Harvard University.  “But that’s not typical for most who score high.” 

Adverse Childhood Experiences (ACEs) in behavioral health and Toxic Stress Risk Assessment Test Algorithm

What Are the Physical and Mental Health Risks Associated with ACEs?

The health risks associated with ACEs in behavioral health are staggering. The more ACEs a child experiences, the more likely he or she will suffer from the impacts of diseases such as heart disease and diabetes, as well as poor academic achievement and substance abuse as adults.  

If a child has four or more ACEs, they are 12 times more likely to attempt suicide.

There is a 2-times higher likelihood they will suffer from chronic diseases like heart disease or cancer.

The risk of developing depression increases by 4.5 times for ACE sufferers than for those who haven’t experienced a high level of toxic stress in their childhood. 

Plus, children who often act out, bully their peers, or become abusive or substance-addicted adults have been exposed to one or more forms of ACEs.

kids arguing behavioral health

Behavioral Health Treatment Centers Play a Pivotal Role in Minimizing Health Risks Due to ACEs.  

Depending upon the severity or frequency of ACEs a child experienced, the most prudent pathway to wellness can lead to a behavioral treatment center.  They provide all the elements of care needed to get an ACE-affected individual on the road to recovery as part of an intensive outpatient mental health program.

It all begins with assessment and diagnosis.  The ACEs and Toxic Street Risks Assessment Algorithm we discussed earlier is one tool.  But therapists, psychologists, and psychiatrists have the training and the experience to determine the level of ACEs encountered, and use comprehensive evaluations to pinpoint how it has affected someone’s mental health.  This insight leads to a healing-centric, personalized treatment plan.  

Trauma-informed care is another important tool behavioral health professionals use.  This style of care turns the clinical setting into one of safety and support, where patients are encouraged to share their experiences and how they make them feel. Their feedback is met with compassion and understanding and is a safe place for many to talk about the unimaginable injuries they have faced.  Trauma-informed care often incorporates group therapy and peer support, where ACEs sufferers learn that they are not alone, which in and of itself, empowers them to seek recovery.  

There are also evidence-based therapies that can help alleviate an ACEs victim’s suffering.  Cognitive-Behavioral Therapy (CBT) is a great method of addressing this pain, and then teaching the patient how to modify their behavior and thought patterns to lessen its impact.   Dialectical Behavior Therapy (DBT) helps ACEs patients better regulate their emotions and look inward to find the strength to deal with their hurt. Finally, Eye Movement Desensitization and Reprocessing (EDMR) is especially effective helping those with ACEs better process trauma-induced memories and reduce the emotional toll they take on their lives.  

Kids in a behavioral health setting

ACEs can lead to very severe health conditions, such as depression, anxiety disorders, and even post-traumatic stress disorder (PTSD), that require pharmaceutical intervention.  When administered and monitored by professionals, these medicines can drastically reduce symptoms and encourage better mental health.  

Behavioral health centers can also utilize holistic approaches like yoga, meditation, art or music therapy, and exercises to stimulate the body and the mind to move in positive directions.  

ACEs effects are often a family’s trauma as well.  Treating the whole family can lead to greater empathy, communication, and healing for all affected.  

ACEs Behavioral Health and Physical Health Issues Can Be Mitigated By Others In The Community

With early intervention, at-risk families can participate in programs that help prevent the destructive effects of ACEs.  

Training educators and caregivers to recognize and address signs of trauma early on can be pivotal in a child’s life.

Offering trauma-informed care and therapy can be healing for both children and adults.

Community initiatives create a supportive environment that understands and tackles the impacts of ACEs on their citizens.

Group of girls studying to combat ACES in behavioral health

Educating Parents and Giving Them Strategies to Regulate Toxic Stress from ACEs Can Be Beneficial  

First of all, it’s crucial that parents understand that their children aren’t merely small adults.  They process and manifest stress differently than their parents do.  By incorporating some key practices into their daily routine, parents can help regulate stress in their children through proven habits and practices.

Serving a Balanced Diet

It’s no secret that what children eat has a direct effect on how they feel.  A balanced diet plays a vital role in regulating mood and stress.  It should include healthy portions of:

Whole grains, like brown rice, quinoa, and oats.  These foods release energy slowly, preventing sugar spikes that can affect mood. Omega-3 fatty acids found in fish like salmon have been shown to reduce symptoms of anxiety and depression. Limited sugary snacks can help children avoid energy crashes, which can affect mood and increase feelings of lethargy.

Encouraging Regular Physical Activity

Physical activity isn’t just for physical health. It can also significantly reduce stress and anxiety in children.

Sports are a great way to help children build social skills and confidence.

Dance is another fun way to be active and express creativity.

Simple play can also be beneficial.  Just running around the park or playing tag can be good for emotional health.  

Mindfulness and Meditation

Introducing children to meditation and mindfulness can give them lifelong tools they can use to handle stress.  These practices teach children to focus on the present moment, and be intentionally still and reflective.

Guided meditation can be practiced even by very young children.  There are many apps like Smiling Mind and online resources to show parents and caregivers the way.

Deep breathing is another way to help children take their mind off the stress they are feeling.

Mindful coloring is actually a form of meditation and a creative way for children to relax.

Nature and Fresh Air

Spending time in nature has been clinically proven to reduce stress, increase creativity, and improve attention spans in children. 

Nature walks, even if a short walk in the park, can have far-reaching benefits.

Gardening can be therapeutic because it gives children a sense of accomplishment and also teaches patience.

Picnics combine outdoor time with mealtime for a refreshing change of scenery.

Nature and Fresh Air Impact on ACEs

Treatment May Play An Important Part of Early Intervention

If a child’s stress or anxiety seems chronic or is affecting their daily life, it is a good indication that it may be time to seek professional help. 

Whether it’s counseling from a trained therapist, art or music therapy that can be an important form of expression and healing, or family therapy that addresses the family dynamic, treatment is a viable and effective option for giving children and families the tools they need to de-stress their lives.

Daughter struggling with behavioral health issues

Reducing the Effects of ACEs Is Everybody’s Responsibility

Anyone who plays a role in a child’s life, whether it is a parent, teacher, caregiver, healthcare provider, friend, or family member, has a moral obligation to let children grow and develop as unencumbered by stress as possible.  

Achieve Sustainable Success In Treating ACEs in Behavioral Health (and Other Mental Health Challenges)

At C4 Consulting, we are helping providers develop the programs and the delivery methods across multiple platforms to help these stakeholders raise and care for healthy, happy, secure children who ultimately result in empowered adults. 

The addiction and mental health treatment industry is a highly complex and regulated business. Not only do you need to be looking out for the best interests of the people you serve but you also have to continue generating quality stakeholder returns and profit.
You don’t have to do it alone with our behavioral health consulting services. C4 Consulting is your collaborative partner in optimizing your business, building, growing, buying, or selling your business, or translating critical strategic data into actionable planning.