20-599 Help Patients with ACEs Reduce Toxic Stress
Date: 08/31/20
Use these strategies to treat patients with secondary stress from ACEs and care for yourself in the process
Adverse childhood experiences (ACEs) like abuse, neglect and household dysfunction can have a cumulative effect. Some stress can be positive, but built-up, chronic or “toxic” stress can result in negative physical and emotional health outcomes.
Adult patients with a history of significant childhood trauma can be at higher risk of experiencing health and behavioral problems during times of stress. California Health & Wellness Plan encourages providers who care for such patients to educate them on how to deal with stress and ways to protect children and adolescents from trauma.
Support protective factors
You can help patients reduce factors that lead to ACEs for children and adolescents. Encourage awareness of protective factors like:
- Concrete support: Families who can meet their basic needs and know how to access care are better able to ensure the safety and well-being of their children.
- Social and emotional competence: Children who are nurtured and develop positive relationships with caring adults will experience improved behavior and development.
- Resilience: Parents with coping skills and resilience are better equipped to handle everyday stress.
- Social connections: It’s easier to care for children when parents are connected to a network of friends, family and neighbors.
- Knowledge of parenting and child development: Parents provide a safe space for children to grow independently by listening, communicating well, and setting appropriate rules and expectations.
- Nurturing and attachment: Research shows that children who consistently receive affection and nurture do better academically, behaviorally and have the ability to cope with stress.
Promote self-care for patients
Educate patients to reduce stress by taking care of themselves in simple ways. Talk with them about:
- Supportive relationships: Staying in touch and connecting with loved ones, friends and community or faith-based groups can reduce isolation and relieve stress.
- Daily exercise: Sixty minutes of activity can help burn off stress.
- Healthy sleep: Ensure enough sleep by going to bed and waking up at the same time. Avoid caffeine and electronics near bedtime.
- Good nutrition: A healthy diet will help the body combat stress.
- Behavioral health care: Reach out to a mental health professional to schedule an appointment for supportive care.
- Mindfulness: Engage in mindfulness practices, like meditation, yoga or prayer to help regulate the stress response.
Care for yourself
Stay aware of your own well-being and know how to recognize secondary traumatic stress when working with traumatized adults and/or adolescents. Studies show that providers who work directly with traumatized patients are at higher risk of secondary traumatic stress, or the related conditions of post-traumatic stress disorder (PTSD) and vicarious trauma.
Empower yourself by recognizing indirect trauma and the effects of secondary traumatic stress. It may also be helpful to explore strategies to enhance your own resiliency and reduce your risk of traumatization.
Preventive strategies like the following can build resiliency:
- Use supervision to address secondary traumatic stress.
- Increase self-awareness of secondary traumatic stress.
- Maintain healthy work-life balance.
- Participate in a self-care accountability or buddy system.
- Develop and implement plans to increase personal wellness and resilience.
- Continue individual training on risk reduction and self-care.
ACEs training and self-attestation requirements
Starting July 1, 2020, Medi-Cal providers who have completed the two-hour online ACEs training and submitted their self-attestation to the Department of Health Care Services (DHCS) can continue or begin billing for ACEs screenings. If you missed the deadline, you can still complete the training, self-attest and begin billing the month of completing the attestation.
Take these steps:
1. Register for the two-hour online training at training.acesaware.org/.
2. To self-attest, complete the DHCS Trauma Screening Training Attestation form.
Provider resources
Visit the Health Care Toolbox. The toolbox was created by the Center for Pediatric Traumatic Stress (CPTS) to increase awareness of medical traumatic stress in children, provide information and evidence-based recommendations for health care providers, and guide parents and families to resources.
References
www.ounce.org/cap/Six_Protective_Factors_Infographic.pdf
www.nctsn.org/trauma-informed-care/secondary-traumatic-stress/introduction