Beyond ACEs: A Holistic Approach to Trauma-Informed Support

Trauma-informed approaches are central to our professional practices – and with good reason. So many of us have experienced some form of trauma or adversity in our early lives and continue to be affected well into adulthood. This is true not only for the individuals we support, but also for our staff teams.

ACEs, or adverse childhood experiences, can have an enduring impact on our physical, emotional and mental health, which is perhaps why we often use the ACEs list as a basis for determining the trauma-informed approaches we use in our settings.

However, ACEs are just one part of a much bigger puzzle, and to successfully meet individuals’ needs, we need to think more broadly than just ACEs and take a more holistic approach to trauma-informed support.

Why we need to think beyond ACEs

The list of ten adverse childhood experiences is undoubtedly a useful starting point when thinking about trauma in children, young people and adults. It includes many types of adversity that can impact a person in childhood and beyond:

1. 1. physical abuse

1. 1. sexual abuse

1. 1. psychological abuse

1. 1. physical neglect

1. 1. emotional neglect

1. 1. witnessing domestic abuse

1. 1. having a close family member who misuses drugs or alcohol

1. 1. having a close family member with mental health problems

1. 1. having a close family member who served time in prison

1. 1. parental separation or divorce on account of relationship breakdown

Using this list as a guide to inform our practice goes some way to helping us make sense of a person’s feelings, beliefs, values and behaviour, and can even help us understand certain physical and mental health conditions they may experience.

However, we need to be discerning when using it to shape trauma-informed approaches to behaviour support. Here are some of the reasons why we need to think more broadly:

1: It is not an exhaustive list

There are many types of adversity that affect children in both the short and longer term, not all of which are on the list. These include things like bereavement, bullying, racism, disability, poverty and moving house.

A person in residential care, for example, may have moved multiple times throughout their childhood and adolescence, potentially leaving them with deep-rooted issues around abandonment and attachment. There can be little doubt around the associated trauma that moving regularly can cause, and yet it is not on the ACEs list.

2: It doesn’t account for different responses to trauma

Trauma is not a diagnosis or a condition; it’s a response to a single event or series of events that threaten our physical, emotional and psychological safety.