Table Of ContentMAKING SENSE OF THE 70%: AWARENESS OF THE ADVERSE CHILDHOOD
EXPERIENCE (ACE) SCORE AND TRAUMA-INFORMED PRACTICES OF SERVICE
PROVIDERS IN BUTTE COUNTY
____________
A Thesis
Presented
To the Faculty of
California State University, Chico
____________
In Partial Fulfillment
Of the Requirements for the Degree
Master of Social Work
____________
by
© Kate Maren Scowsmith
Spring 2017
MAKING SENSE OF THE 70%: AWARENESS OF THE ADVERSE CHILDHOOD
EXPERIENCE (ACE) SCORE AND TRAUMA-INFORMED PRACTICES OF SERVICE
PROVIDERS IN BUTTE COUNTY
A Thesis
by
Kate Scowsmith
Spring 2017
APPROVED BY THE INTERIM DEAN OF GRADUATE STUDIES:
________________________________
Sharon Barrios, Ph.D.
APPROVED BY THE GRADUATE ADVISORY COMMITTEE:
________________________________ ________________________________
Dr. Jean Schuldberg, Ed.D. Patty Hunter, LCSW, MSW, Chair
Graduate Coordinator
________________________________
Celeste Jones, Ph.D.
___________________________________________
Judy Vang, Ph.D.
PUBLICATION RIGHTS
No portion of this thesis may be reprinted or reproduced in any manner unacceptable to the usual
copyright restrictions without the permission of the author.
iii
DEDICATION
To all the resolute dreamers, thinkers, conceivers, organizers and believers that step outside their
comfort zone for the betterment of others, communities, and the world.
iv
ACKNOWLEDGEMENTS
I am forever humbled and amazed by the incredibly supportive community I have found
at Chico State: my cohort, within the Social Work department, and those through my internship
at Student Health Services. Without their unconditional support, hugs, and listening ears writing
this thesis would not have been so substantial.
I wish to thank my thesis committee: Patty Hunter, Chair, Dr. Celeste Jones, and Dr. Judy
Vang. I extend my warmest regard and gratitude for your expertise, encouragement, and humor
throughout this journey. In addition, I also wish to recognize the brilliant support of Dr. Susan
Roll and Dr. Sue Steiner. I am thankful for each one of these instructors and members of my
committee who have been incredibly generous with their time, wisdom, compassion, and skill in
offering an enriching, approachable educational experience.
My gratitude extends to Dr. Deborah Stewart and Lauri Evans at CSUC Student Health
Services. Both Deborah and Lauri have been a tremendous source of knowledge and support
during my internship and have been thoroughly receptive to hearing out and considering my
ideas. Dr. Stewart has afforded me numerous opportunities for my personal and professional
growth; her encouragement has been invaluable and has made me feel brave. Lauri has always
had an open door and heart throughout the year; I cannot thank her enough for her advice and
understanding. It has been inspiring to work with Deborah and Lauri, and bear witness to their
commitment and contributions towards a thriving, healthy campus culture.
Immense gratitude to my parents, Greg and Ann, and my sister, Hannah: for nurturing
and cultivating my interests, encouraging my creativity, and wanting me to succeed...also, the
laughs and the spontaneous excursions. Thanks to my grandparents for enriching my life in all
v
their unique ways, and especially to my grandmothers, Millicent and Geraldine, for exemplifying
the exciting possibilities of being strong women.
Lastly, love and appreciation to Julie Scalet and the entire Scalet family for the best of
times and hanging through the worst of times. Our friendship has been a consistent source of joy,
compassion and support that have helped make this thesis possible. Thank you for being you.
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TABLE OF CONTENTS
PAGE
Publication Rights ....................................................................................................... iii
Dedication ................................................................................................................... iv
Acknowledgments....................................................................................................... v
List of Tables .............................................................................................................. x
Abstract ....................................................................................................................... xiii
CHAPTER PAGE
I. Introduction ............................................................................................... 1
Background ................................................................................... 1
ix
Statement of the Problem .............................................................. 4
Purpose of the Study ..................................................................... 5
Definition of Terms....................................................................... 6
II. Literature Review...................................................................................... 9
Introduction ................................................................................... 9
Trauma in the United States ...................................................................... 9
Adverse Childhood Experiences Study ........................................ 10
Medical and Health Challenges .................................................... 11
Social and Emotional Challenges ................................................. 13
Cognition and Neurodevelopment ................................................ 13
Vulnerable Populations ................................................................. 16
Lasting Impacts of Trauma ........................................................... 19
Interventions for Trauma .............................................................. 21
ACEs, Trauma and Butte County ................................................. 23
Theoretical Bases and Organization ............................................. 24
III. Methodology ............................................................................................. 27
Research Design............................................................................ 28
Selection of Survey Participants ................................................... 29
Instrumentation ............................................................................. 29
Data Analysis ................................................................................ 30
Limitations .................................................................................... 24
x
IV. Findings and Results ................................................................................. 34
Introduction ................................................................................... 34
Quantitative ................................................................................... 36
Qualitative ..................................................................................... 36
Themes .......................................................................................... 46
V. Discussion ................................................................................................ 34
Quantitative ................................................................................... 34
One-Way Analysis of Variance (ANOVA) .................................. 36
Qualitative ..................................................................................... 36
VI. Conclusions and Recommendations ......................................................... 49
Conclusion .................................................................................... 49
Recommendations ......................................................................... 50
Implications for Social Work ........................................................ 52
References ..................................................................................................................... 54
Appendices
A. ACEs Pyramid .......................................................................................... 71
B. Trauma-Informed Integrated Care ............................................................ 73
x
C. Survey Instrument ..................................................................................... 75
D. Research Questions ................................................................................... 79
E. Trauma-Informed Practice:
Approaches and Values............................................................................. 81
x
Description:Trauma informed care (TIC) is a strengths based approach that is rooted in an understanding of trauma Working in a trauma-informed environment puts theory into practice, a way to see the great possibilities that .. toward accounting for adverse environmental factors (Larkin & Read, 2008).
