Voices’ Blog

Trauma-Informed Approaches from Practice to Policy

Posted:  -  By: Ashley Airington

By Ashley Koski

What are ACEs?

ACEs. Toxic Stress. Early trauma. These are the popular buzzwords that seem to be the subject of every discussion surrounding child development and well-being. So, what do these terms mean and how do they differ? Each term refers to adverse circumstances that many children experience during their first few years of life. Although these experiences may vary drastically and trauma can manifest in numerous ways, toxic stress typically refers to instances of frequent, prolonged adversity, such as: physical/emotional/sexual abuse, extreme poverty, exposure to violence, and neglect. The detrimental impact of these experiences on the developing brain was made salient by the popular CDC-Kaiser Adverse Childhood Experiences (ACEs) Study, which revealed a clear correlation between a list of negative childhood experiences and the increased risk of negative health outcomes throughout the life course. In order to combat these adverse experiences, many child-serving systems now aim to become “trauma-informed” and put measures into place to strengthen the resilience of the youth they impact. However, these systems cannot implement trauma-informed practices without supportive legislative policies in place. Therefore, as a policy organization, Voices is interested in advocating for preventive efforts that aim to reduce trauma and/or assist youth that have been exposed to trauma. We want to support initiatives that will translate trauma-informed practices and the aforementioned ACEs research into state-level policies that can build resiliency and improve outcomes for children from early childhood education to schools to foster care and the juvenile justice system.


State Level Policy Change to Support Trauma-Informed Systems

So, how do we begin to form a policy agenda that addresses ACEs in our state? Overall, we found that different states are using a variety of techniques in their efforts towards building these “trauma-informed” policies and that becoming a trauma-informed state is by no means a uniform process. The methods chosen vary depending on the needs of the state, the amount of support given by state government leaders, the state budget, the strength of connectivity between state departments, and numerous other factors. However, despite the array of methods being taken, we found that most of the work around creating trauma-informed policies falls into one of the following major categories: local endeavors, creation of trauma screening tools, transformations of state agencies, interagency efforts, the passage of legislation, and the formation of public-private partnerships.

We are going to highlight just a few of these examples. For a broader overview of each method—check out the Presentation from the RVA ACEs Summit- State Level Trauma-Informed Policies.


Local Efforts Become an Example

One way to make strides towards becoming a trauma-informed state is to begin with local-level efforts. In the city of Camden, New Jersey, individuals are working to make their region trauma-informed through a project called “The Healing 10”. This is a an approach that aims to certify the police, education, medical, and non-profit communities of Camden in the Sanctuary Model curriculum so that all sectors are using one, cohesive method to address toxic stress. These various sectors work together as a cohort and then participate in a “Community of Communities” that is tasked with training future organizations so that their work spreads and eventually reaches the rest of the state. Overall, this approach aims to impact the city, organization, and individual levels of Camden. To do so, the “Healing 10” aims to spark a cultural change in the city, create communities centered on self-care and safety, promote awareness of vicarious trauma, and spread knowledge about the impact of traumatic history on workplace relations. Though this is a very concentrated effort, local initiatives like this have the ability to spark long-term policy change if they are supported by the rest of the state.


Agency Transformations

While these local efforts are extremely important, the implementation of policy is heavily influenced by the work done at state level departments. Across the country, many state agencies are working to transform their daily work by implementing established trauma-informed methods and creating new trauma-informed practices. Some agencies (like this one) have enacted these changes through passing formal legislation, while others have sparked internal changes. For example, Rhode Island has completely transformed its public child-welfare system by: 1) implementing new resources (such as a trauma-informed child welfare toolkit, a trauma readiness tool, and a trauma-informed training curriculum), 2) training case workers to screen children for trauma, 3) developing a Wellness committee to focus specifically on children who have experienced trauma, 4) forming focus groups in the department to discuss trauma issues, and partaking in numerous other intervention strategies. Because state agency employees often work closely with advocacy organizations and legislators, changes at this level signify a big step towards implementation of trauma-informed policy in a state.


Public Private Partnerships

In addition to these examples, some progressive states have begun to establish widespread change by establishing partnerships between public agencies and the private sector (such as non-profit organizations). Public-private partnerships (PPP’s) offer a unique way to influence trauma-informed policy because they bring together diverse levels of influence, various funding streams, and allow for the dispersion of innovative ideas. An example of this type of coalition that has gained a lot of traction is Washington State’s ACEs Public-Private Initiative. The partners in this team evaluate approaches aimed at reducing ACEs and spread awareness/ knowledge about best practices across the state. Similarly, both Oregon and Tennessee are making great strides utilizing this partnership method. With the vast diversity that exists across our state, this would also be an interesting effort to emulate here in Virginia!


Further Information

Though this post covers a variety of different steps towards state level, trauma-informed policy, it is by no means a comprehensive overview. For more information, be sure to follow the #ResilientRVA hashtag on Twitter to be updated on the RVA ACEs Summit which will take place on August 3rd-4th. Also, be sure to check out the following resources to stay on top of everything ACEs-related in both Virginia and across the country:





Ashley Koski is our summer intern and an upcoming 2nd year MPH student at Columbia University where she is pursuing a graduate degree in Sociomedical Sciences with a concentration in Health Policy and Practice. Here at Voices she is currently focusing on researching state-level trauma-informed policies, editing indicators in our Kids Count Data Center, and working on awareness around the upcoming Richmond City Mayoral Election.

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