Meeting Biopsychosocial Needs of Individuals with Histories of Multiple Adverse Childhood Experiences
Master of Social Work (MSW)
According to Felitti and colleagues (1998), a significant portion of the general population has been exposed to adverse childhood experiences (ACEs) with subsequent and persistent, dose-related, negative consequences to physical and mental health. Debilitating disturbances to biopsychosocial well-being are significant and frequently lead to fatality in adulthood. After reviewing the prevalence and severity of ACEs, this thesis presents an overview of the literature outlining the biological, social, and psychological factors contributing to the development and progression of disease in the brain and body. Additionally, current trauma-informed interventions are summarized. Three experienced clinicians share practical advice for implementing evidence-based, trauma-informed mental health services. Suggestions for integrating components of empirical literature with practical advice are provided to meet the biopsychosocial needs of those with histories of multiple adverse childhood experiences. A sample integrated curriculum for middle school students who have been exposed to multiple adverse experiences is included. The proposed, strengths-based curriculum enhances trauma-focused cognitive behavioral therapy (TF-CBT), the gold standard for trauma-informed care, with principles from schema-focused cognitive behavioral therapy (SFCBT; Young, Klosko, & Weishaar, 2003); neurobiological and mindfulness research; motivational interviewing; existential psychology; and, attachment theory. Consistent with new recommendations for children with complex trauma histories (Cohen, Mannarino, Kliethermes, & Murray, 2012), the proposed Building Healthy Core Beliefs curriculum is the skill-building, phase one of a three-phase program. In accord with guidelines from TF-CBT, the skills learned in this curriculum include: (a) recognizing, normalizing, and managing the "fight-flight-freeze" response (b) recognizing, identifying, and managing emotions; (c) differentiating inaccurate thoughts from accurate, helpful thoughts; (d) using positive self-talk; (e) practicing mindfulness and meditative exercises; (f) completing a program with sequenced steps and specific tasks; (g) recognizing and celebrating accomplishments; and, (h) building healthy core beliefs. The four healthy core beliefs promoted are: (a) I am loved; (b) I am lovable; (c) I am worthy; and, (d) I am capable of achieving my goals. This curriculum prepares clients for the second-phase of integrated trauma-informed care, i.e., life-scripting. Sample letters to parents or guardian are provided to maintain communication between therapist and caregiver. Homework is designed to encourage positive parent-child interactions.
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Morgan, Christine G., "Meeting Biopsychosocial Needs of Individuals with Histories of Multiple Adverse Childhood Experiences" (2016). LSU Master's Theses. 1561.