ACEs and Trauma-Informed Care

ACEs are adverse childhood experiences that may have lasting, negative effects on health and well-being both in childhood and in adult life.

While there is currently not a definitive list of ACEs, the original list included exposure to child abuse, substance abuse, mental illness and suicide, incarceration, and violence. Recent additions included in a study of ACEs conducted by Child Trends are parental separation/divorce, death of parent, and economic hardship. The following information summarizes the study and there is a link to the study at the end of this post.

Key findings:

  • Economic hardship and parental separation/divorce are the most common ACEs reported nationally
  • 45% of children in the U.S. have experienced at least one ACE
  • 61% of black children, 51% of Hispanic children, 40% of white children, and 23% of Asian children have experienced at least one ACE
  • One in nine children has experienced three or more ACEs

ACEs can result in toxic levels of stress hormones that alter normal mental and physical development.  This can lead to alcoholism, drug abuse, depression, suicide, poor physical health, lower educational attainment, unemployment, and poverty. Not all children who experience ACEs have negative outcomes but multiple ACEs substantially increase the risk of negative outcomes.

Protective factors can reduce negative outcomes.  The most significant protective factor is a positive, supportive relationship with one or more adults.  Children who experience ACEs but who can manage their emotions have more positive outcomes.  Resilience can be cultivated through self-care routines and through strengthening social and emotional skills such as empathy, self-regulation, and self-efficacy.

An understanding of ACEs has been accompanied by an increase in the development and application of trauma-informed care.  Trauma-informed care includes a variety of approaches that acknowledge the impact of trauma, recognize its systems, respond with appropriate treatment, and prevent further traumatization. It should be noted that screening for ACEs does not replace comprehensive trauma screening and assessment.

All federally-funded programs and many state programs require that programs and services be trauma-informed.  In response to these mandates, the National Family Preservation Network developed one of the first tools for assessing family trauma.  The tool measures symptoms and indicators of trauma in both children and parents.  In the field study one of the most significant findings was the effect of past trauma in parents involved in abuse/neglect of their children or family conflict.  The tool also measures post-trauma well-being following services.  The field study showed dramatic improvement in post-trauma well-being with services primarily consisting of Intensive Family Preservation Services.

For more information on the Trauma/Post-Trauma Well-Being tool visit

To read the field study report on trauma visit

To read the full report on ACEs visit


Posted by Priscilla Martens, NFPN Executive Director


Resources for the Opioid Epidemic

Did you know that 21 million Americans struggle with substance addictions annually – more than the total number of people who have all cancers combined!  Someone dies every 19 minutes from an opioid overdose—there were 64,000 overdose deaths from opioids in 2016.  A new research study correlates opioid overdose deaths with increases in reports of child abuse/neglect, substantiated reports, and foster care entries.

The National Family Preservation Network (NFPN) is starting the new year by addressing the opioid epidemic.  NFPN’s perspective is different from many other organizations in that we view family, not the individual, as the focus of assistance and treatment.  We believe that families can be preserved even in the midst of an epidemic that is targeted to destroy families.

NFPN is embarking on a Rural Opioid Project to better understand and more effectively address rural opioid use.  Rural sites in 5 states will be participating in the project and one of the goals is to develop a model response to opioid use in rural areas.

How can we achieve keeping families together that are involved in substance abuse?  It’s helpful to recall that during a previous epidemic in the 1980’s, Intensive Family Preservation Services kept families safely together in one of the highest concentrations of crack cocaine use:  the Bronx, New York.  IFPS is an evidence-based practice that continues to be used today to keep families involved in substance abuse safely together.

NFPN has numerous resources available on IFPS. Here are two of the most popular to start with for use in developing or strengthening IFPS programs:

IFPS ToolKit : Comprehensive Resource Guide for the development and maintenance of strong and effective IFPS services

IFPS Nationwide Survey (2014): Comparison of high-quality IFPS programs in 12 states

Research indicates a close relationship between trauma and addiction.  About a third of all trauma survivors develop an addiction.  For those who experience trauma as children, two-thirds develop an addiction as an adult.  Thus, it’s critical that trauma be identified and treated as part of prevention and treatment of addiction.  NFPN has a tool specifically designed to assess trauma (note that this tool is used in conjunction with either the NCFAS-G or NCFAS-G+R assessment tools).  NFPN’s assessment tools have been tested and found reliable with families involved in substance abuse.

Trauma/Post-Trauma Well-Being Assessment Tool:

To view all assessment tools visit

With substance abuse moving to the front burner of child and family-serving agencies, NFPN offers a video training on substance abuse and in-home services.  The video is designed to help train practitioners on interventions for families involved in substance abuse.  Highlights of the video include effective therapeutic techniques and an interview with a mother recovering from substance abuse and reunifying with her children.  A list of 25 supplemental materials for training is also included.  Pricing begins at $275.

For more information and to order, email or phone 888-498-9047.

Posted by Priscilla Martens, NFPN Executive Director


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