Suicide prevention, public health, and the chiropractic profession: a call to action

Cupler, Zachary A.; Daniels, Clinton J.; Anderson, Derek R.; Anderson, Michael T.; Napuli, Jason G.; Tritt, Megan E

doi:10.1186/s12998-021-00372-7

Cited by 5 publications

(3 citation statements)

References 68 publications

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“…As healthcare providers, chiropractors share an ethical obligation with other providers to support patients who have experienced trauma through appropriate identification, treatment, and referral [ 58 , 59 ]. Whilst ACE-awareness and TIC are emerging topics in chiropractic, awareness and application with chiropractic patients impacted by trauma are aligned with recent efforts within the profession to increase awareness of suicide detection, and recognition and referral for intimate partner violence [ 146 , 149 , 150 ]. Our aim is not that chiropractors perform the psychological aspects of their ACE-affected patients' care, but to realize , recognize , and respond to their patients who do have these needs, without re-traumatization .…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Research to inform TIC practices in different healthcare settings, including chiropractic, are necessary. Chiropractors will require additional training to identify psychosocial factors impacting their patients and to recognized the signs of abuse or trauma [52,149,150]. For U.S. chiropractors, SAMHSA guidelines recommend structural changes in 10 domains of healthcare organizations to support TIC, emphasizing implementation at the (1) Governance/Leadership and (2) Policy levels [45].…”

Section: Discussionmentioning

confidence: 99%

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Adverse childhood experiences and trauma informed care for chiropractors: a call to awareness and action

Baca,

Salsbury

2023

Chiropr Man Therap

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Background Trauma is an emotional response to distressing events where coping and subsequent recovery are absent. Adverse Childhood Experiences (ACEs) are traumas, occurring before the age of 18 years, such as child abuse or neglect, caregiver instability, and household dysfunction. Sixty-four percent of the U.S. population report experiencing at least one ACE, with over 1 billion children experiencing abuse and neglect annually worldwide. Chronic exposure to stressful circumstances or multiple traumatic events has negative physiologic impacts. Persons who experience 3 or more ACEs in childhood are at greater risk of poor mental health outcomes and may be more likely to engage in high-risk behaviors, predisposing them to long-term health impacts, such as metabolic diseases, anxiety, depression, substance use, and chronic pain. Trauma informed care (TIC) is a recommended approach to healthcare delivery across professions, especially when a trauma history is suspected. This commentary aims to increase awareness of the impact of ACEs on health outcomes and introduce TIC concepts as they may apply to chiropractic care for adults with a history of ACEs. Discussion This commentary reviews an introductory model (4R's: realize, recognize, respond, resist re-traumatization) as one TIC framework used by healthcare practitioners. Prior trauma can lessen trust, alter perceptions of physical touch, and hands-on examinations and chiropractic treatments may trigger stress responses. Using TIC after appropriate training, includes referrals to multidisciplinary providers to address trauma-related concerns outside the scope of chiropractic, and screening for ACEs if deemed appropriate. Creating safe spaces, communicating clearly, avoiding victimizing language, explaining procedures, asking for consent before physical contact, and giving patients choice and control in their own care may avoid triggering prior traumas. Conclusion Given the high worldwide prevalence of persons experiencing 3 or more ACEs, TIC principles are practical adaptations to chiropractic care for use with many patient populations. As TIC and ACEs are emerging concepts within chiropractic, students and practitioners are encouraged to undertake additional training to better understand these complex and sensitive topics. Exploratory research on the incidence, presentation, and impacts of various trauma types, including ACEs, to support adoption of TIC in chiropractic settings is essential.

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