Leitch Laurie
Threshold GlobalWorks, New York, NY, USA.
Health Justice. 2017 Dec;5(1):5. doi: 10.1186/s40352-017-0050-5. Epub 2017 Apr 28.
This paper 1) discusses two important contributions that are shaping work with vulnerable and under-resourced populations: Kaiser Permanente's (1998) Adverse Childhood Experiences Study (ACE) which includes the impact of adverse experiences in childhood on adult health and health behaviors and the more recent advent of what has come to be known as Trauma-Informed Care (TIC), programs which incorporate knowledge of the impact of early trauma into policies and programs. 2) Despite many positive benefits that have come from both contributions there are unintended consequences, described in the paper, that have an impact on research and program evaluation as well as social policies and programs. 3) Three key neuroscience concepts are recommended for inclusion in Trauma-Informed Care programs and practices in ways that can enrich program design and guide the development of practical, resilience-oriented interventions that can be evaluated for outcomes. 4) Finally, a resilience-oriented approach to TIC is recommended that moves from trauma information to neuroscience-based action with practical skills to build greater capacity for self-regulation and self-care in both service providers and clients. Examples from criminal justice are used.
本文1）讨论了对弱势群体和资源匮乏人群工作产生影响的两项重要贡献：凯撒医疗集团（1998年）的儿童期不良经历研究（ACE），该研究涵盖儿童期不良经历对成人健康和健康行为的影响，以及最近出现的所谓创伤知情护理（TIC），即将早期创伤影响的知识纳入政策和项目的计划。2）尽管这两项贡献带来了许多积极益处，但本文描述了一些意外后果，这些后果对研究和项目评估以及社会政策和项目都有影响。3）建议将三个关键的神经科学概念纳入创伤知情护理计划和实践中，以丰富项目设计并指导开发注重恢复力的实用干预措施，并可对其结果进行评估。4）最后，建议采用一种注重恢复力的创伤知情护理方法，从创伤信息转向基于神经科学的行动，并运用实用技能，以增强服务提供者和客户的自我调节和自我护理能力。文中使用了刑事司法领域的例子。
