To Assess Tusla Social Care Leaders and Social Care Workers Working within the PPFS: Childhood Trauma/ Adverse Childhood Experiences (ACEs) Thesis, QUB,

Thesis Title:

‘To assess Tusla social care leaders and social care workers working within the PPFS knowledge and understanding of ACEs in supporting children and families in Co Mayo’

Research Questions:

1. What are staff members understanding or knowledge of Queen’s University Belfast as Trauma-Informed Practice?

2. What training is available within Tusla with regard to Adverse Childhood Experiences as Trauma-Informed Family Support Practice?

3. Have staff members availed of this training?

4. Do staff members feel confident in adopting Adverse Childhood Experiences as a Trauma-Informed Practice?

5. Do staff members perceive the need for training in Adverse Childhood Experiences as an approach to Trauma-Informed Practice? Include a method for literature research. summarise key messages from the literature review at the end.

Introduction

In this chapter, I will navigate through the extensive literature on Adverse Childhood Experiences (ACEs). This chapter will chart the origins of the concept, ACEs and Family Support in literature, the link between ACEs and attachment through relevant literature from Patricia McKindsey Crittenden; Raising Parents book.

It is well established globally that adverse childhood experiences are a significant public health concern. According to research carried out by Queens University Belfast (2019), ‘the occurrence of adverse childhood experiences (ACEs) such as abuse, neglect, household dysfunction, and peer and community violence, to be high in young adults in Northern Ireland’.

Research from the Queens University Belfast has shown that over 26% experience at least one ACE, and the most common adverse experience, reported by 34% of the sample, was growing up the mental illness in the family. One-quarter of young people reported growing up with four or more ACEs, and these young people were found to be at significantly increased risk of engaging in health-harming behaviours, psychopathology and lower educational attainment.

Adverse Childhood Experiences (ACEs) have a dose-respondent, multi-layered and developmentally pervasive impact on the young developing child (Anda et al, 2005, D’Andrea et al, 2012; Fisher, 2003, Cook et al, 2005).

The Origins of ACEs

The Kaiser Permanente Appraisal Clinic in San Diego California in collaboration with the US Centres for Disease Control and prevention carried out the original ACE study (Felitti et al., 1998). The focus of work originally was on the apparent inability of patients to sustain weight loss. During interviews with patients as to why this might be, there was a recurring theme of a long term impact of having experienced significant adversity in their early lives.

Complex Trauma and Trauma-Informed Care

The trauma of any kind is serious, and its effects are damaging and need to be addressed. Courtois and Ford, (2014) define complex trauma `is a subset of the full range of psychological trauma that has as its unique trademark a compromise of the individual’s self-development’ (p.16). Kezelman and Stavropoulos, (2012) define complex’, as distinct from `single incident’, trauma is not well understood or addressed by governments and health systems. Herman, (1992) described complex trauma (also known as “complex post-traumatic stress disorder” or “type 2” trauma) is a term that describes psychological harm arising from repeated or prolonged trauma, including abuse or neglect during childhood.

ACEs and Family Support

As a Social Care Worker on the Prevention, Partnership and Family Support in Tusla carrying out weekly home visits to families dealing with a traumatic incident in their lives that they are struggling with sometimes parents who had difficult lives growing up which is preventing them from moving forward and children who have dealt with some difficult situations recently.

Existing ACEs Models of Practice

According to Garza, Rich and Omilian, (2019), trauma-informed care (TIC) has become a growing trend sweeping the nation’s mental health, education, medical, child welfare, family court, and criminal justice systems with TIC being advocated as a universal precaution approach to service delivery across all settings and disciplines.

ACEs and Attachment

Patricia McKinsey Crittenden provides a unique perspective on the relationship between events that occur as children progress through different developmental periods and the attachment patterns that they exhibit in her book Raising Parents: Attachment, Parenting and Child Safety. The book examines parents who exhibit problematic and/or abusive parenting behaviours and treatments that may be applicable to improving the situation of families where parenting has not been optimal. Raising Parents describes the Dynamic-Maturational Model of attachment, a model that includes references to the works of John Bowlby, Mary Ainsworth, and Urie Bronfenbrenner.