Understanding the Impact of Adverse Childhood Experiences

CentraCare is proud to partner with Twin Cities Public Television (TPT MN) to present “Whole People,” a documentary series about Adverse Childhood Experiences (ACEs). CentraCare recognizes the impact ACEs have on the health and well being of Minnesotans and is taking a leading role to support efforts that address this issue. All five episodes of the documentary series are available below.

ACEs Overview

Study Guide

whole people study guide cover
Click here to view the study guide.

Episode #1: Childhood Trauma

Episode #2: Healing Communities

Episode #3: A New Response

Episode #4: Family Solutions

Episode #5: Healing Journeys

5 Questions with a Pediatrician

Dr. Geri Jacobson

Pediatrician, CentraCare Health

  • Are ACEs and its health effects widely understood by healthcare providers?

    More health care providers are becoming aware of ACEs and their effects on health. We still have a long way to go to make sure that ALL health care providers understand the impact of ACEs and how to incorporate this knowledge into the care of their patients.

  • How do you ask trauma or ACEs-related questions in a sensitive manner?

    Trauma informed care involves asking questions in a non-threatening, non-judgmental way. Ask questions in a way to really understand “what has happened to this person” not “what is wrong with this person.”

  • What do you do when a patient reveals their past trauma?

    As we have learned from others who are trauma informed, you can offer a variation of the following two responses: “I’m sorry that happened to you” and/or “thank you for sharing that with me.”

  • What ACEs-related resources are available to you?

    Working in the Child Advocacy Center has exposed me to countless innocent children who have been affected by forms of abuse and household dysfunction. It really is what happened to these children. Not what is wrong with these children. We have also learned to stress and teach resiliency because a high ACE score does not have to define the future for these children.

  • How have you personally been impacted by your experiences working with those who are grappling with trauma/ACEs?

    At the CAC, we use resources provided by the American Academy of Pediatrics, ACEs Connections and others.

5 Questions with a Caregiver



  • How did you first learn about the impact of ACEs?

    I first learned about ACEs from a social worker. They called it our children's invisible luggage. They taught us that we would have to learn how some of their trauma impacts their daily lives. I later learned that the invisible luggage was really called ACEs at a training.

  • What was the first step you took to try and make things better for your child or children?

    To learn about their past traumas and how it could impact their lives. I also took parenting advice from other parents who parent children with extreme traumas too.

  • How does your experiences with trauma/ACEs affect the daily interactions with your child or children?

    I try to interact with them at their pace. I also remind other adults around them that some of their "bad" behaviors is because of what happened to them and not because they are bad children.

  • What advice would you give other caregivers?

    To never give up! To always keep fighting for what is right even if someone tells you it's wrong. To always keep learning, you could always find a better or different way to handle something. Remember to ask for help as needed. Build a village of people who do or are willing to understand what could be going on around you. Just be willing to add people and let people leave as needed. Some unexpected people might be willing to be there for you and your family. And some people might need to leave but they may come back. Welcome them back in. The most important thing is self-care. You can't keep helping people if you have left yourself run empty.

  • What resources do you utilize for support?

    For our children we have done play and art therapy. They also have done occupational therapy. At school we have IEPs with BIPs put into place for them. I also belong to a couple different online support groups and attend an in-person support group that meets once a month.

5 Questions with a Faith Leader

Rev. Randy L. Johnson

The First United Methodist Church of the Saint Cloud Region

  • What place does understanding and addressing ACEs/trauma have within the church?

    What is at stake here is our mission, our goal to follow Jesus in helping to transform peoples’ lives. At one of the recent discussion sessions at our church on ACEs, we sat at tables each with four-six church members. After our discussion it was clear that ACEs is not about us “good church folk” versus “those people out there” who have been damaged by childhood adversity. At my table, one of us had been a child who regularly witnessed violence in their home; one had as a child lost their father to an early and unexpected death; one had had their childhood turned upside down by a nasty divorce which left them torn between two parents; and one had felt unloved and abandoned by a father who was seldom at home and from whom they had never as a child heard the words, “I love you.”

    64% of people, including people in our churches, have experienced at least one ACE in their childhood. This is not about “us” versus “them” but about how we as followers of Jesus can continue his mission to experience the power of God to bring healing in our lives and in the lives of those with whom we minister. The Bible is clear about this: we live in a broken world, we all share its brokenness and we all are called to help make it whole again.

  • How can we as faith communities help people who have experienced ACEs/trauma ?

    While there are times when referring people for professional counseling is the right choice, the church can be a unique and significant partner in addressing the impact of ACEs on peoples’ lives. Research shows that healing from ACEs involves gaining resilience and resilience comes first from having at least one caring adult in a child’s life. Another key is for children (and adults) to feel safe to share their stories of trauma. Churches can address both of these by providing one-one caring relationships between adults and children and by working to provide a supportive community/safe space for children and adults to share stories of pain and to learn and practice the skills of resilience.

    As individuals experience healing from the negative impact of ACEs, faith communities can empower them with new hope and meaning through service and social action: helping transform others’ lives and working to change the broken systems in our society. For example, a woman who witnessed domestic violence throughout her childhood now serves as an advocate at a local shelter for children and women experiencing violence in their homes. Others from her faith community who share similar childhood experiences of trauma now partner with community leaders to affect change in social policies to help create healthy, non-violent families and communities. These peoples’ stories illustrate how individuals who experience their own personal healing from trauma are able to discover and use their gifts and passion to help make a better world for all.

  • What are faith communities doing to educate church leaders about ACEs/trauma?

    There is a growing movement of faith communities and other organizations that are committed to becoming trauma-informed and trauma-responsive (ACEsConnection.com is one online resource to learn more about this global movement and thefaithfulcity.org provides one church example). For our church it began with a group of fourteen congregation members and church staff attending an annual community conference on ACEs. We next developed our TRC (Trauma-Responsive Church) team to coordinate our ACEs/trauma initiative. The goal of this initiative is not to start a new ministry or church program, but, rather to create an environment where all people who enter our church doors feel accepted, wanted, safe and loved by God and the congregation. We learned that the key question as we approach people who have experienced trauma is not “What’s wrong with you?” but, rather, “What happened to you?”

    We next partnered with a community leader on ACEs to provide multiple trainings for all interested church members including those working with children and youth to make sure they understand ACEs and the importance of creating safe spaces within all church programs. Over the next months we began to connect becoming trauma-informed/responsive to every part of our congregational life, e.g., sermon series, personal faith stories shared in worship, devotional booklets with stories and readings of people of faith overcoming adversity, classes on resiliency skills such as mindfulness training, small groups on books such as The Book of Forgiving by Bishop Desmond Tutu, and workshops to develop volunteer “caring listeners” who are available for individuals and for facilitating support groups.

    With each of these steps our TRC team had the full support of the pastoral staff and church leadership. We also benefited from phone interviews with leaders of faith communities across the United States who have been engaged in the Trauma-Informed Church movement for years.

  • Are religious organizations doing enough to address ACEs/trauma?

    The short answer is “no.” We face significant obstacles starting with those within our own faith communities.

    Lyle Schaller, a wise Christian author and church consultant, once wrote, “The greatest gift of the church is denial.” This tongue-in-cheek, critical comment describes the biggest challenge facing faith communities related to addressing ACEs/trauma: moving church professional leadership and congregation members out of the comfort of avoiding openly and intentionally becoming informed about and responsive to trauma. It is encouraging to learn of the hundreds of congregations and thousands of individual faith leaders who courageously choose to engage in this growing movement.

    It is also encouraging to join in partnership with many other local community organizations (e.g., schools, health care organizations, social service agencies) and individual community leaders who seek to develop and work together in a network of trauma-informed/responsive members. Churches cannot do it alone. But churches can provide a unique resource starting with helping congregants to become aware of their own trauma history and its impact and providing unconditional love and spiritual support to move people toward healing and wholeness.

  • How have I personally been impacted by my experiences working with those who are grappling with ACEs/trauma?

    It is a very humbling and rewarding experience to walk alongside people as they find the courage to share their stories of trauma, the impact it has had on their lives, and all the accompanying feelings such as shame, fear, anger, grief and loneliness. I have had this experience as a pastor for forty years and as a Licensed Marriage and Family Therapist for twenty years. In both cases I have relied on the grace of God and the power of God’s unconditional love and acceptance to work through me to help others. While my professional training certainly has given me more confidence and resources to help others facing adversity, research shows that even in the counseling setting it is the caring relationship which provides the sense of safety and trust which people need to share their stories of trauma and experience personal healing. As previously noted, these are the kind of relationships which churches can abundantly and effectively provide if they choose to become trauma-informed and trauma-responsive. As both a pastor and a professional mental health provider, I find that the church and a person’s experience of faith can work either way: it can make things worse through denying and minimizing the impact of ACEs/trauma (or worse yet, blaming the victim) or it can play a powerful role in bringing hope and healing. I currently find profound joy in being a pastor of a church which is seriously engaged in being a healthy congregation through becoming trauma-informed/responsive. My prayer is that this movement will continue to grow among churches and all faith communities who seek to share the transforming love of God.

5 Questions with a Police Officer

Dave Bentrud, Police ChiefCity of Waite Park

  • Why is it important for law enforcement to understand the impact of trauma/ACEs?

    When I started my law enforcement career almost 30 years ago, the job really was more about “law enforcement.” The issues facing law enforcement (and our communities) today are more complex and a strictly “law enforcement” approach to problem solving no longer works as effectively. Law enforcement needs to think outside the box and be creative on the best practices for reducing repeat calls for service particularly for those struggling with mental health issues. We are dealing more and more with persons battling mental illness and related issues like chemical dependency and homelessness. I don’t have a lot of statistical data but my experience tells me that many of our frequent contacts, with individuals suffering from mental illness, have experienced trauma in the past during adolescents and in many cases have a pretty high ACEs score. For police officers to understand the impact of trauma/ACEs on a young person, get them thinking about possible intervention strategies and being able to make an effective referral to help a young person deal with their experiences in an appropriate way could be the first steps in preventing future police contacts, reducing mental health related occurrences and preventing/reducing criminal behavior.

  • How does trauma/ACEs impact people you interact with in our communities?

    I don’t have a lot of statistical data but my experience tells me that many of our frequent contacts, individuals suffering from mental illness, have experienced trauma in the past during adolescents and in many cases have a pretty high ACEs score. We are seeing an increase in homelessness particularly amongst older teens and young adults. Victims of trauma who do not have these events addressed in appropriate ways are more likely to deal with mental illness and/or engage in criminal behaviors in the future. Today’s victims are tomorrow’s abusers – we need to break the cycle!

  • Has law enforcement changed how it approaches individuals who may have experienced trauma/ACEs?

    Yes, I believe law enforcement has taken significant steps forward on this issue but we have a long way to go. We need more training for officers on what ACEs is. One significant issue is the lacking of funding that supports the development of effective referral resources. The emergency room or jail cannot be law enforcement’s only options for individuals they have contact with.

  • How have you personally been impacted by your experiences working with those who are grappling with trauma/ACEs?

    I have been policing long enough now to see us dealing with the kids of individuals I dealt with in the 1990’s who I have no doubt experienced significant trauma/ACEs themselves. The consequence and impact of unresolved trauma is very real. It’s generational.

  • What are other law enforcement agencies doing to address this issue?

    If there is any good news in all of this, it is that while societal issues are more complex, the level of collaboration between police agencies and other disciplines has never been better. The multi-jurisdictional and multi-disciplinary information sharing and strategizing, particularly in our metro area, has been very encouraging. There has been a realization that regardless of our specific discipline that collectively we find ourselves dealing with the same persons albeit from a different perspective. I hear the term Multiple Disciplinary Teams (MDT) all the time now, which is good. MDT is not an acronym I heard 20 years ago.

5 Questions with an Educator

Karli Johnson, Behavioral Interventionist

Sauk Rapids Rice Schools

  • What is the awareness level among teachers and school staff about the effects of trauma/ACEs?

    From my experience in two different local districts, it seems that teachers and school staff want more training around Trauma and ACES. It is clear that they are aware that Trauma and ACEs can contribute to student behavior and there is clearly a desire to learn more. Teachers and staff are always engaged when I have trained around Trauma and ACEs and always ask for more. Having reached out to a few of the local University Education Departments, it is noted that most of these programs provide minimal guidance around mental health and trauma. The education programs also have awareness of the need to provide upcoming teachers with increased data on warning signs regarding mental health and how to infuse trauma-informed practices into the classroom.

  • How does ACEs/trauma affect the education of kids?

    There are so many varied experiences of trauma and each child displays the impact differently. Often students will display behaviors that look a lot like anxiety or ADHD and unfortunately are often misdiagnosed. ADHD, anxiety and trauma look so similar: distracted or difficulty concentrating, "zoned out" or seeming as if they are not paying attention, bounciness/busyness, overthinking problems, misunderstanding social cues etc. It can make paying attention in class so incredibly difficult for these kids. Students that are living in current traumatic situations often display aggression, hypersensitivity or even sleepiness. These students are simply stuck in their survival brain and truly, academics are far from their greatest concern. The other struggle is when students show up with aggressive behaviors in the classroom. This is disruptive to their learning as well as the learning of other students in the classroom.

  • Do you associate disruptive behaviors with kids who have experienced some form of traumatic situation in their lives? How do you deal with disruptive behaviors?

    Absolutely we have to ask ourselves what the disruptive behavior is trying to tell us. I often say to our staff, "All behavior is communication, what is the child trying to say?" We also often ask the students about basic needs, "Have you had breakfast? Did you sleep well last night? Do you need a nap?" I often have students napping in my office because they simply need better rest than they are able to get at home. All of our classrooms (K-5) have a safe space set up in a quiet corner of the classroom. Students are trained on the purpose and use of this space and can utilize this space without question if they are needing a break. If this space is not enough to meet the student need, we have our entire core staff team on walkies and we are able to respond to calls to the classroom- anything from full aggression to students who might simply need someone to talk to, or they just need that nap. This is followed up by some 1:1 teaching about behaviors or how to better meet basic needs/ survival skills.

  • Why is Social Emotional Learning (SEL) an important piece of understanding trauma/ACEs?

    In our school, we provide every single classroom with SEL lessons every week. We review our behavior data to inform our teaching and what our needs are within the school. These lessons are just as much for the adults in the school as they are for the children. Our adults need to provide appropriate examples of social skills to our students throughout the day to reinforce what we have taught in social skills. Our students with trauma often are unable to accurately identify emotions they are experiencing, how they feel them in their body and how to appropriately respond to those emotions in a useful way. These are the types of skills that we are directly teaching every week. We also begin each day at our school with a breathing exercise for the entire school- this helps to calm all of us and center adults and students to be ready for learning.

  • How have you personally been impacted by your experiences working with those who are grappling with trauma/ACEs?

    Certainly as a licensed professional clinical counselor (LPCC) doing therapy and now having worked in the schools, it is clear that students/families that are impacted by trauma can be difficult to serve as the entire family may be in survival mode. Often times, these are the families and students that we want to help the most. As teachers and staff in schools, there are so many big, caring hearts, that we often over tax ourselves and begin to "burn out" as we try to rescue these families. I have found there is incredible need for direct guidance, instruction and permission for adults to engage in self-care. When I have provided professional education opportunities about adult self-care, these sessions have been full immediately and there is always full engagement (and sometimes even tears.) This shows me that we so often neglect our own needs and it makes it difficult to serve these kiddos that we adore so much. Increased community understanding, increased support for our adults who are serving and increased permission for adults to care for themselves will significantly support the impact of working with these families and students.

5 Questions with a Mental Health Professional

Dr. Steven Loos

Psychologist, Central Minnesota Mental Health Center

  • How does awareness about trauma/ACEs change how you practice?

    Central Minnesota Mental Health Clinic (CMMHC) has two guiding philosophies that shape all aspects of service delivery. Trauma Informed Care (TIC), based upon the ACEs research, is one of those philosophies. We have adopted Sandra Bloom’s three levels of trauma by changing the way we deliver services to clients (client trauma), how we provide support to staff (staff trauma), and how we treat our colleagues (organizational trauma).

  • How do you identify clients that have experienced trauma/ACEs?

    CMMHC follows the National Council for Behavioral Health’s recommendation to assess early and often for trauma experiences across many formats. We ask questions through screening instruments, during the initial therapeutic service, and throughout treatment. This is critical as clients often are more open to disclosure once the therapeutic alliance has been established.

  • What kind of impact have you been able to have on people who have experienced trauma/ACEs?

    CMMHC has improved in all 7 domains of the Organizational Self-Assessment, developed by the National Council for Behavioral Health, since implementing TIC. We believe this has had a significant impact on our clients, community, and staff. CMMHC has also been asked to provide TIC and ACEs trainings to schools, law enforcement, county workers, and the community.

  • Where can I find more resources and information about trauma/ACEs?
  • How have you personally been impacted by your experiences working with those you are grappling with trauma/ACEs?

    Vicarious trauma is a significant factor that impacts all staff who work closely with individuals that have a lived experience of trauma. I have had to be mindful of my own self-care strategies, limit trauma intake through news/entertainment, and be open to feedback from colleagues or loved ones about blind spots. Despite all of this, I continue to value being a small part of creating sanctuary for our clients, community, and staff.

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