Putting the pieces together: RISing community collaboratives for ACE-informed programs & communities Heather Larkin, PhD, LCSW-R Beth Gerlach, PhD, LCSW Amanda Barczyk, PhD, MSW

Goals Brief ACE overview RIS model Cross-sector ACE Response Whole person approach: programs, community Cross-sector ACE Response HEARTS Initiative case example ACE-informed pediatric healthcare Austin needs assessment Next steps – locally

Source: http://www. rwjf

ACEs and Negative Outcomes Source: www.cdc.gov/violenceprevention/acestudy

Managing activating material Self-Care Managing activating material

Implications: Preventing ACE consequences Connection to self-care: ACE backgrounds of providers, community leaders Promoting community resilience Fragmented service silos vs. comprehensive, integrated services ACE research as policy advocacy tool BRFSS

Implications (continued): Preventing ACE consequences ACE-informed programs & communities Identify ACEs Integrate resilience & recovery knowledge Transform systems Empower people Whole person approach

Whole person approach: Body / mind / spirit Self / community / nature Breaking the trajectory: people more than the sum of their problems

Intergenerational & Community perspectives Comprehensive, “whole family” approach Address ACEs in parents, prevent ACEs in children Integrated services enhanced through social networks Involves the whole community

The Integral Quadrants Individual Thoughts Feelings Strengths/ capacities Behaviors Physical health Physical characteristics Larger culture Sub-culture Family culture (includes cultural values) Family & other relational systems Service systems Work, economic system John, top first person (UL is first person subjective, UR is first person objective, LL is collective intersubjective, LR is collective interobjective) Collective

Integral Perspective: Causes of Trauma Individual Perception of trauma Impact on developing self (overwhelming feelings and activation of defense mechanisms) Physical Injury Health risk behaviors Medical problems (both short and long term) Changes in developing brain Family meanings Social networks Cultural values Rugged individualism Social taboos Victim blaming Adverse interactions or events Social Violence Natural disasters Service Access Policies Heather, looking this and applying to ACEs Collective

Restorative Integral Support Individual Support strengths Mobilize resilience & recovery Enhance coping skills Resolve trauma Restore development Build other life skills “Evidence-based behavioral practices” (i.e. CBT) Medical model Body-oriented interventions Physical exercise Social networks Therapeutic milieu Peer supports Culture of Recovery and Transformation Policies and procedures Infrastructure Recovery-oriented systems of care Systems Transformation Collective

The HEARTS Initiative a coalition of Capital Region service providers strengthening social networks within and across agencies building community capacity workforce development Policy advocacy Educational presentations Website: www.aceresponse.org

Mobilizing Action for Resilient Communities (MARC) Project Health Federation of Philadelphia Robert Wood Johnson Foundation & California Endowment One of 14 communities nationally Collective Impact ACEs and resilience

Recovery & Transformation “Some of the healthiest people I know are those who have had to heal from the most challenging situations, and in the process, have gained insight and wisdom far beyond what a ‘comfortable’ life would ordinarily provoke.” - Joan Borysenko, Fire in the Soul John, Heather adds

Next Steps in Travis County

The Pediatric Trauma-Informed Research and Care Collaborative Needs Assessment Assess the familiarity and experience of healthcare providers with Adverse Childhood Experiences (ACE) informed care. Assess the value and feasibility of implementing ACE-informed care. Assess the comfort and confidence of healthcare providers exploring ACEs with patients and their families.

Graphic Source: The Kirwan Institute for the Study of Race and Ethnicity

Discussion Questions What actions can you take to raise awareness of ACE consequences and the potential for recovery? What are some ways to expand your ACE Response community? What resources would support you and others contributing to healthy social networks? How can systems be brought together for comprehensive ACE Response? Reference: http://aceresponse.org/img/uploads/file/RIS_Exercises_4_WPS_copy.pdf