ACE. No, Not the Card

Assessment & Intervention Strategies

A social work practitioner’s main focus area when it comes to understanding ACEs is to assess the family based on their culture and diversity. Many families come to social work practitioners to seek help on a particular moment that happened. However, in order to find out why the ACE occurred, the social worker is going to have to delve into the family’s dynamics. Is the mom or dad the one that enforces the rules? How are feelings discussed inside the household? Do family issues stay within the household or do they reach out for help when necessary? Many of these questions are important to understanding why ACE’s occurred in these families and how a social work practitioner can begin to intervene. Below are a few common assessment methods.

• Child PTSD Symptom Scale (CPSS): This is a self-administered scale from ages 8-18 that uses a diagnostic and statistical method that yields a symptom severity score.
• Violence Exposure Scale for Children – Revised (VEX-R): This one uses drawings, questions, and assesses community violence exposure. VEX-R is another self-administered scale for children ages 4-10.
• Parenting Stress Index (PSI): This one is used for children under 12 to measure parental stress on their child.

It’s good to remember that not a single method will work on every family’s situation. By using well-researched methods, a social worker can quickly see statistical outcomes based on the family’s cultural background and be able to choose the best method for their client.

After carefully assessing the family a social work practitioner can begin to intervene by using a few different methods.

• Eliminating Exposure to Risk Factors: This method goes to the root of the problem by getting the parents the help they need such as medical assistance and/or increasing their educational opportunities. You never know if the parents experienced ACE’s themselves and don’t know how to end the violent cycle.
• Altering the Experience of the Risk Factors: This is done by evidence-based treatment of violence exposure and/or increased caregiver sensitivity.
• Stopping Negative Chain Reactions: The Social Worker can provide the parents additional resources for job opportunities and affordable education which could end the violent cycle.
• Strengthening Protective Factors: This factor includes positive reinforcement of parenting skills, finding child care assistance, and reaching out to the community for parenting help. (It takes a village to raise a child)

On a bigger scale a social worker can speak up for new opportunities and development featuring ACE’s by going to the community, state, and/or national leaders. By educating the people around us and making them aware of those who are suffering, then we can hopefully see positive change someday.

If you are curious about how you would score on the ACE scale¹, click the middle button at the top of this blog post; and if you’re curious about other assessments and interventions click here.

Advocating Change

There are several systemic barriers when it comes to victims and families of ACE. To understand how to start advocating for change, a social worker must know why ACE’s occur. Like I said above, ACE happens when there’s one or more violent occurrences, drug/alcohol abuse, and/or child neglect in the home. There are many other experiences, but those are the main few. These things happen mostly among minority members (low-income, race, ethnicity, etc.). Once we begin to understand where these problems are coming from, we can begin to advocate for change.

Systemic Barriers:

• Minimal Awareness and Understanding: Many people don’t know what ACE’s are and the long term effects of them. I know I didn’t and I, along with many others, have experienced more than a handful of them. In order to start change, Social Workers can begin implementing programs where they work, such as this one.² Since there are so many types of Social Workers and locations where they work, this is an easy way to spread awareness through schools, hospitals, and more.
• Limited Access to Resources: Many low-income households do not have access to a broad range of health care. Making it difficult for those seeking help to actually receive it. This is where advocates step in and voice their opinions, with facts backing them of course. Social Workers such as Ellen DeVoe, Roger Roffman, and Alice Walker have all paved new ways to help minorities. There are also small groups in local areas like Voices for Change in Texas where the community comes together to fight for social justice.
• Stigma Around Mental Health: Some families never discuss their thoughts and feelings with one another. I know mine didn’t. Other families may see mental health as a family matter not to be discussed outside the home. In order to help these families, it is important to acknowledge their roots and help them understand that their mental health is important and reaching out is the first step to getting the help they need.

Approaching ACE’s

In order for a Social Worker to be culturally sensitive and responsive to diverse backgrounds, they will have to adapt to a non “one-size fits all” approach, understand cultural humility, and be self-aware.

Not every client(s) is going to have the same cultural background or beliefs. Therefore, each individual family or person is going to have a personal intervention strategy tailored towards them. This is where a Social Worker can dig into, while being respectful, their cultural background and begin to understand it. Once the Social Worker understands what he/she/they are going through and their background they can begin to research intervention methods that will provide the best results. The ACE Aware team (3rd link at the top of this blog post), has created an entire intervention method to approach ACE.

Another thing to note is how we talk to clients. Being respectful of their culture is the most important part. They are coming to an unknown office where they are trusting a stranger to help them with their ACE. So, even though you might not agree with their beliefs, you have to acknowledge their culture and respect it so they can begin trusting you. This will, I believe, help them get on track to a better life after experiencing an ACE.³

1. I think this was my favorite part of writing this blog. Finding out what I scored was kind of an eye opener to what I had experienced in my own childhood. I remember reading “‘It Will Never Happen to Me!’ Children of Alcoholics as Youngsters – Adolescents – Adults” by PhD Claudia Black, MSW, a few years back and it is such an eye opener to my personality. It also helped me learn to let go of some worries with my parents. It’s a good read if you’re interested. I’m pretty positive I bought it from B&N in Fairbanks, AK. ↩︎
2. I ended up taking this course as a way to familiarize myself with ACE and how it applies to us as future social workers. It’s a very broad way of explaining it and it doesn’t get too far into specific details, but it’s only an hour long and super informative! I highly recommend at least skimming through each section. The website I got this from even has awareness training for teachers so they know what to look out for, which is pretty cool. ↩︎
3. Another thing I thought about after writing this was what if you have no clue about their culture. There’s so many diverse backgrounds out there that it’s not possible to know every single one. I feel like in order to approach a background you are unfamiliar with you might have to use your instincts on whether or not to politely and respectfully ask the family about their culture or if you should just research it after they leave for the day. ↩︎