Preliminary Recommendations for Assessing Adverse Childhood Experiences in Clinical Practice With Indigenous Clients

Moral Injury and Recovery in Uniformed Professionals: Lessons From Conversations Among International Students and Experts

“…In order to scale up more holistic MI treatment approaches, the impact of key health determinants, such as adverse childhood experiences, need to be measured and accurately assessed. Those affected by PTSD and MI would benefit from access to culturally relevant and personalized treatment approaches that promote resilience, meaning, purpose, hope, and social connection ( 82 – 84 ).…”

Adverse Childhood Experiences (ACEs) and Health Histories Among Clients in a First Nations-Led Treatment for Substance Use

“…Although the current ACE model has been used with First Nations communities, it may not currently incorporate common or culturally-specific experiences shared among First Nations. The way the model is used in both clinical and research settings, including how ACEs are assessed, must be tailored to meet the needs of First Nation communities (Toombs et al, 2021 ). Further research can explore how such processes can do so within a substance use treatment setting.…”

A Challenge to Us or a Challenge for Us? Negotiating Bias and Discrimination in the Consulting Room

“…If we presume that accurate understanding of therapists' implicit assumptions about minority groups is essential to accurate patient assessment, we must simultaneously address the requirement for accurate assessment of adverse childhood experiences (ACEs) in minority patients. As Toombs et al (2021) argue, the dose-response relationship between ACEs and subsequent physical and emotional symptom development is particularly salient in Indigenous populations because they are historically the victims not only of economic and social oppression but also may express intergenerational health concerns that are based on a history of genocidal behavior, such as the deliberate introduction of the smallpox virus into Indigenous groups, an early and shameful example of biological warfare practiced in North America. Toombs and colleagues note that ACE assessments are statistically unlikely to be performed with Indigenous clientele, but argue that all assessments of Indigenous individuals should incorporate a trauma-informed approach in order to accurately conceptualize risk assessment and treatment plans.…”