Healing From Past Wounds – A Proposal to Give ACEs Training to Psychiatrists and Therapists in San Diego
This grant proposal aims to train mental health providers on how to talk to their patients about Adverse Childhood Experiences (ACES). We will educate the public in this county about ACEs and we will improve the trauma-informed skillsets of psychiatrists and therapists. The field of psychiatry now focuses mainly on biological causes for psychological complaints, at the expense of helping patients deal with the psychological and social problems in their lives (“Bio-Psycho Social-Spiritual Model,” n.d.). Since a majority of psychiatrists report not talking about their patient's past trauma or life stressors, it’s clear that psychiatrists are not treating the root causes of their patient's suffering (Westly, n.d.). Research has shown the ineffectiveness of antidepressants and their harmful short-term and long-term side effects (Simons, 2018); furthermore, the CDC reported that suicides increased in the U.S. by 30% between 1999 and 2016 (Whitaker, 2018). It’s safe to say that there is a mental health crisis in our community. An intervention to raise trauma awareness will help people find true and lasting relief.
Trauma-Informed Principles
This program will train both providers and organizations according to the SAMHSA guiding principles of trauma-informed care(“Infographic,” 2018). A few prominent guidelines are listed below:
Safety – We encourage recipients of the Healing Together training to assess their workplaces for physical and psychological safety. We want their location to be conveniently-located and for it to not add additional stress to patients! For example, a building with limited parking in a neighborhood with a history of violence wouldn’t be a good match for ACEs treatment! To assure psychological safety, all staff members at SAMHSA certified organizations are encouraged to be trained about ACEs. Since there is the risk of patients feeling heightened depression and anxiety after an appointment that explores ACEs, we teach providers to recommend soothing routines that we encourage patients to use when feeling overwhelmed. One such acronym is ACCEPTS – Activities, Contributing, Comparison, Emotions, Push Away, Thoughts, Sensations(Center, 2017).
Peer Support and Mutual Self-Help – Since we know that dealing with our past traumas leads to positive mental health(McAleavey et al., 2019), we want our participating organizations to offer to patients a receptive ear, either to use interviewing skills to listen, reflect, and provide support for what has happened to their patients, or to refer them to therapists who may be better able to assist. In certain situations where a foundation of trust has been created with others, we encourage employees to be open to talking about their past traumas, if they so choose.
Trustworthiness and Transparency AND Collaboration and Mutuality – We will be transparent about our data findings with the community partners whom we assist with training, and we encourage members of Heal Together to follow the same standards of openness. In the battle against past ACEs, it’s essential that we view patients as partners in our growth and development. Members of Heal Together are taught how to train staff members to be trauma-informed and trauma-sensitive.
Cultural, historical and gender issues – As part of the staff training, this includes broadening the mental horizons of providers to consider racism, sexual orientation prejudice, and other ideas never cognized by most psychiatrists.
Levels of the Social Ecological Model
In reference to the McLeroy, Bibeau, Stechker, & Glanz Social Ecological Model, we are targeting the Community, Organizational, Interpersonal, and Individual levels (“An ecological perspective on health promotion programs. - PubMed - NCBI,” n.d.). We’re making an impact at the Community level by planning Trauma Informed Care (TIC) Awareness Meetings, where mental health professionals will eat lunch together, share useful information, and provide social support in order to make San Diego more trauma-informed. When people from different organizations come together to talk about ACEs, the community benefits overall.
That leads us next to the organizational level, where our “TIC Change Specialists” are teaching staff and providers to make their organizations SAMHSA trauma-informed, thus helping both patients and employees. Perhaps most importantly, we reach out to psychiatrists directly and provide research evidence on how they can help heal patients with better listening skills. Our marketing efforts to patients and their peers encourages their conversations to be about uncovering the trauma-based source of their unhappiness. We’re proud to be able to address so many levels of the sociological model in one intervention. The levels reciprocate across levels, e.g. organizational changes may lead to more resiliency programs for employees, which encourages individual and interpersonal benefits arising from more therapy and more open communication, which leads to more healthy relationships, more meditation/mindfulness training, all of which help to build resiliency for people with ACEs.
Public Health Framework
This intervention focuses on the secondary and tertiary levels of mental health treatment. We’re data-driven in that we will be tracking the effectiveness of our training using surveys, and we’ll be tracking the number of organizations and providers who receive our training, in addition to the number of people reached by our marketing efforts.
Adverse Childhood Experiences are an incredibly sensitive topic and a source of immense suffering for a lot of people. This program will give useful knowledge to those who are most qualified to help people with ACEs, as well as to those who are afflicted by trauma. By improving mental health treatment and by raising awareness of the subject of ACES, we will help to reverse this terrible crisis.
References
Ahn, W., Proctor, C. C., & Flanagan, E. H. (2009). Mental Health Clinicians’ Beliefs About the Biological, Psychological, and Environmental Bases of Mental Disorders. Cognitive Science, 33(2), 147–182. https://doi.org/10.1111/j.1551-6709.2009.01008.x
An ecological perspective on health promotion programs. - PubMed - NCBI. (n.d.). Retrieved April 20, 2019, from https://www-ncbi-nlm-nih-gov.l...l.edu/pubmed/3068205
Bio-Psycho Social-Spiritual Model. (n.d.). Retrieved April 20, 2019, from University of Nevada, Reno School of Medicine website: https://med.unr.edu/psychiatry...cial-spiritual-model
Gøtzsche, P. C., Young, A. H., & Crace, J. (2015). Does long term use of psychiatric drugs cause more harm than good? BMJ, 350, h2435. https://doi.org/10.1136/bmj.h2435
HASDIC_CHNA_2016_Executive_Summary_June_2016-rev.pdf. (n.d.). Retrieved from https://hasdic.org/wp-content/...ry_June_2016-rev.pdf
Infographic: 6 Guiding Principles To A Trauma-Informed Approach | CDC. (2018, December 19). Retrieved April 20, 2019, from https://www.cdc.gov/cpr/infogr...ples_trauma_info.htm
McAleavey, A. A., Youn, S. J., Xiao, H., Castonguay, L. G., Hayes, J. A., & Locke, B. D. (2019). Effectiveness of routine psychotherapy: Method matters. Psychotherapy Research, 29(2), 139–156. https://doi.org/10.1080/10503307.2017.1395921
Mental Health By the Numbers | NAMI: National Alliance on Mental Illness. (n.d.). Retrieved April 20, 2019, from https://www.nami.org/learn-mor...ealth-by-the-numbers
SAMHSA News - Guiding Principles of Trauma-Informed Care. (n.d.). Retrieved April 20, 2019, from https://www.samhsa.gov/samhsaN...ding_principles.html
Simons, P. (2018, April 30). Antidepressant Use Leads to Worse Long Term Outcomes, Study Finds. Retrieved April 20, 2019, from Mad In America website: https://www.madinamerica.com/2...utcomes-study-finds/
Treatment (US), C. for S. A. (2014). Trauma-Informed Organizations. Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK207204/
Westly, E. (n.d.). Psychiatric Drugs Replacing Talk Therapy. https://doi.org/10.1038/scient...americanmind1208-14b
Whitaker, R. (2018b, August 6). Suicide in the Age of Prozac. Retrieved April 20, 2019, from Mad In America website: https://www.madinamerica.com/2...n-the-age-of-prozac/
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