Category: Health Psychology / Behavioral Medicine - Adult


Developing and Delivering a Primary Care Treatment for Adults Who Were Exposed to Adverse Childhood Experiences: A New Strategy

Friday, November 17
12:00 PM - 1:30 PM
Location: Sapphire Ballroom I & J, Level 4, Sapphire Level

Keywords: Treatment Development | Trauma | Prevention
Presentation Type: Symposium

Since the publication of Felitti & Anda et al.'s (1998) Adverse Childhood Experiences (ACE) study, there has been growing awareness of the strong relationship between exposure to childhood emotional, physical and sexual abuse and/or household dysfunction and subsequent elevations in health risk behaviors, addictions, and disease in adulthood.  More recent research has further defined the relationship between childhod adversity and adult physical and mental health (e.g., Bellis, Lowey et al., 2014).  Unfortunately, the emerging understanding of the longterm effects of child maltreatment has not readily led to efforts to identify and treat adults who have experienced childhood trauma.   This gap between scientific knowledge and clinical practice is important to correct, especially when it becomes clear that a) ACEs are ubiquitous (it is believed that about two-thirds of the adult population has been exposed to at least one type of ACE, and 16% of the population has been exposed to 4 or more types of ACEs; Pusch & Dobson, 2016), and b) ACEs may be the strongest predictors of risk for the main problems threatening the sustainability of the health care system - mental illness, addictions, and chronic disease.

Not surprisingly, adults with a history of childhood adversity have been found to be particularly frequent consumers of services in primary care clinics.  However, very little effort has been expended on developing treatment options for these adults in an effort to help offest the possible development of future health problems.  In this presentation, participants will learn about a treatment developed in Calgary, Canada specifically for adults with childhood exposure to trauma.  The new treatment was the product of a group of mental health clinicians who work in integrated primary care settings, combined with input from family physicians and a group of patients with lived experience of trauma who served in an advisory capacity.   The work of the group members was informed by their own years of clinical training and experience in treating trauma, in addition to a comprehensive literature review that covered both skills-based and reprocessing approaches to the treatment of trauma (Korotana et al., 2016), as well as consultation with external experts in the field of trauma.  The resulting treatment is largely based on CBT, ACT, and mindfulness techniques, and is specifically intended to increase resilience, capacity for emotional regulation, and interpersonal connectedness in participants.

This innovative 6-session treatment has already been offered in 12 primary care settings in Calgary in an open trial, with a total of 105 patients completing the treatment to date.  The chance to screen patients for ACEs and to provide the treatment in primary care settings was made possible in large part due to a robust integrated care model that has developed in Calgary over the past 17 years, and which currently features weekly working relationships between approximately 60 mental health clinicians and over 1,000 family physicians in the greater Calgary area. The process used in developing the ACEs treatment will be presented in detail, and participants will have the chance to learn about the content of the treatment in both didactic and experiential formats.  The presentation will conclude with a review of feedback provided by both primary care providers and patients.

David Whitsitt

Alberta Health Services


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Chantelle Klassen

ALberta Heath Services


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Developing and Delivering a Primary Care Treatment for Adults Who Were Exposed to Adverse Childhood Experiences: A New Strategy

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