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Teaching about ACEs

An Interview with Master Resilience Trainer Deborah Bock, MSW, LCSW

The Alaska Children’s Trust Resilience Trainer Program began in the summer of 2014. Twenty-six individuals from six Alaska communities (Anchorage, Wasilla, Fairbanks, Juneau, Cordova and Homer) were selected to attend a two-day workshop given by Dr. Robert Anda and Laura Porter of ACE Interface, and supported by Rasmuson Foundation, Mat-Su Health Foundation, Alaska Mental Health Trust Authority, and Alaska Children’s Trust.

Participants learned about the impact of Adverse Childhood Experiences (ACEs) on lifelong health and well-being, the effects of toxic stress on brain development, and promising approaches to reducing and reversing the impact of childhood trauma and building resilience in children, families and communities. Participants were given resources and guidance on how to teach about ACEs and resilience. In turn, they made a commitment to share this information with their community by giving presentations free of charge.

We sat down with one of the trainers, Deborah Bock, who is based in Anchorage, and asked about her experiences as a resilience trainer.

Q: Why did you want to be a resilience trainer?

R: In 2014 I jumped at the opportunity to join a community of people working to educate our state about the damaging effects of child abuse and neglect. Eight years earlier I had read about the findings of the Adverse Childhood Experiences (ACE) Study, and it made a powerful impression on me. The ACE Study provided scientific confirmation for what I had observed in my work and in my family, that someone who has a stressful childhood is at increased risk for both emotional and physical health problems later in life.

Q: How would you describe your experiences as a resilience trainer with Alaska Children’s Trust?

R: I find it extremely rewarding. I’ve been invited to present to professional groups, including social workers, public health nurses, domestic violence advocates, addiction treatment counselors, and nursing students at the University of Alaska Anchorage. Because of my background in school social work, I feel at home among teachers and school counselors. I have presented to teachers ranging from preschool to college. My favorite audience is Head Start parents; many of them survived a very difficult childhood themselves, and they want better for their children.

At the end of every presentation I invite participants to complete a feedback form. In response to the question, “How will you use this information in your work and in your life,” I have received comments such as, “I will be more compassionate toward homeless people,” “I will be more compassionate toward my students,” and “I will be more compassionate toward myself.” When I read comments like that, it makes it all worthwhile.

Q: You are clearly passionate about this work. Where does that passion come from?

R: After I graduated from college I worked in a group home for teenage girls in San Francisco. During the two years that I worked there, I can’t remember a day when all nine girls went to school. The girls missed a tremendous amount of school due to illness. They had migraine headaches and asthma attacks. When a girl caught a cold, it dragged on and on. It often led to an ear infection or bronchitis. I remember thinking to myself, “I guess if you don’t get enough love as a child, you don’t develop a normal immune system.” Twenty-five years later, I came across an article about the Adverse Childhood Experiences (ACE) Study, which confirmed my hunch.

The ACE Study demonstrated that chronic childhood trauma increases the risk for headaches, asthma, high blood pressure, arthritis, diabetes, heart disease, kidney disease, stroke, and cancer, and much more. ACEs also increase the risk for school failure, teen pregnancy, homelessness, divorce, mental illness, suicide, and many other personal and social problems. It confirmed what many of us have suspected for a long time, that our homeless shelters, prisons, juvenile halls and mental hospitals are largely filled with people who have a history of child abuse and neglect.

Q: What types of adversity were included in the ACE Study?

R: The original ACE Study was a collaboration between Kaiser Permanente in San Diego and the Centers for Disease Control and Prevention. The researchers asked over 17,000 adults about stressful experiences they had before the age of 18. The researchers then divided the responses into 10 forms of adversity: three forms of abuse (physical, emotional and sexual), two forms of neglect (physical and emotional), and five forms of household dysfunction (parental divorce/separation, growing up with someone who abused alcohol or drugs, growing up with someone who was mentally ill, or having a household member go to prison). From this they developed an ACE Score (0-10), which is a measure of the cumulative toxic stress of a person’s childhood.

Awareness of the impact of ACEs has developed into what is being referred to as the trauma-informed movement. Trauma-sensitive practices are being instituted in medical settings, addiction treatment programs, homeless shelters, police departments and courts, juvenile and adult corrections facilities, preschools, K-12 schools, universities and so on. At this point it seems like the sky’s the limit.

Q: Do other adversities, like bullying or historical trauma, that were included from the study have the same impact on a child?

R: At present, ACEs data has been collected on almost half a million people. The original ACE Study was conducted almost 20 years ago; since then the study has been replicated many times in many places, including in Alaska. This has led to a growing recognition that events that occur outside of the home and even trauma experienced by a child’s parents and grandparents can have direct and lasting impact on a child’s development.

Being the victim of bullying and growing up in a violent community have emerged as significant stressors. The intergenerational transmission of suffering, shame and grief (also known as historical trauma) is beginning to be understood, including how trauma can be transmitted from one generation to the next by way of epigenetic programming of the DNA in our cells.

Research continues to expand. Researchers in Washington state are measuring levels of adversity among young children. The World Health Organization is developing the ACEs International Questionnaire, which will include questions about witnessing war, being a child bride, or being recruited as a child soldier.

Q: What has been the greatest challenge for you as a resilience trainer?

R: Talking about trauma can be a “downer.” I want people to walk away feeling hopeful, and inspired to take action. In every presentation I share information about trauma-informed practices that are making a difference in schools, prisons, clinics and social service programs. I want people to know that the presence of a caring, competent adult in a child’s life can make all the difference. The resilience researcher Dr. Ann Masten calls it “ordinary magic.” We all have the opportunity to be magicians, by spending quality time with a child.

Q: What do you want your audiences to remember after a training?

R: I want audiences to remember that ACEs are common, and that there is a “dose-response relationship” between childhood adversity and later physical, social and behavioral health problems. That understanding provides a clear and urgent call for us to prevent childhood adversity, heal trauma, and build resilience in children, families and communities. It takes a lot of work, but we can break the intergenerational cycle of child abuse and neglect.

Interested in becoming a resilience trainer or scheduling a training for your organization? Contact Laura Avellaneda-Cruz at 907-248-7676 or lavellanedacruz@alaskachildrenstrust.org!

You can support efforts like these and make a positive statewide impACT for Alaska’s children and families when you Pick. Click. Give. to Alaska Children’s Trust!

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Deborah Bock, MSW, LCSW, lives in Anchorage for the past 18 years. She has worked as a bilingual (Spanish-English) school social worker and as a university Spanish instructor. Deborah is a self-proclaimed “ACEs fanatic.” She says that is it dangerous to get seated next to her on an airplane; if you put down your book you are probably going to get an earful about ACEs.

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