Why it is a good idea for healthcare professionals to ask patients about ACEs
We think that it is important for ACEs to be a part of the conversation between healthcare professionals and adult patients because they are very common and are associated with many adult health problems. However, healthcare professionals often have reservations about the value of asking about ACEs or identify barriers to asking.
Barrier: “You can’t change past events so what am I supposed to do with the information?”
Our response: Learning about a patient’s past experiences can improve their healthcare in several ways. First, being asked about these experiences in a way that feels safe and supportive can improve your treatment alliance. Almost every way that you help your patients depends on that alliance, so this may be the most important benefit of discussing ACEs. It is the reason that we consider asking about ACEs to be an intervention, not just an information-gathering exercise. Second, the information can be useful. For example, it can help you to avoid inadvertently re-traumatizing a patient who is anxious about invasive procedures.
Barrier: “We don’t have enough mental health resources as it is. Why would I want to create more need?”
Our response: Asking about ACEs is unlikely to create a need for mental health resource that wasn’t already apparent. Just because a person has experienced ACEs doesn’t mean they need counseling. Often, nothing further is required after a brief discussion.
Barrier: “There isn’t enough time to add this to the other things we need to discuss.”
Our response: The C.A.R.E. method is designed to take 5 minutes or less. As a one-time investment in a stronger treatment alliance and a better understanding of your patient, we think that is time well-spent.
Barrier: “There is no evidence that asking about ACEs improves health outcomes.”
Our response: That is true. Of course, there is also no evidence that it doesn’t improve outcomes. We lack evidence because the studies haven’t been done yet. That is an important focus of ongoing work.
We think that it is important for ACEs to be a part of the conversation between healthcare professionals and adult patients because they are very common and are associated with many adult health problems. However, healthcare professionals often have reservations about the value of asking about ACEs or identify barriers to asking.
Barrier: “You can’t change past events so what am I supposed to do with the information?”
Our response: Learning about a patient’s past experiences can improve their healthcare in several ways. First, being asked about these experiences in a way that feels safe and supportive can improve your treatment alliance. Almost every way that you help your patients depends on that alliance, so this may be the most important benefit of discussing ACEs. It is the reason that we consider asking about ACEs to be an intervention, not just an information-gathering exercise. Second, the information can be useful. For example, it can help you to avoid inadvertently re-traumatizing a patient who is anxious about invasive procedures.
Barrier: “We don’t have enough mental health resources as it is. Why would I want to create more need?”
Our response: Asking about ACEs is unlikely to create a need for mental health resource that wasn’t already apparent. Just because a person has experienced ACEs doesn’t mean they need counseling. Often, nothing further is required after a brief discussion.
Barrier: “There isn’t enough time to add this to the other things we need to discuss.”
Our response: The C.A.R.E. method is designed to take 5 minutes or less. As a one-time investment in a stronger treatment alliance and a better understanding of your patient, we think that is time well-spent.
Barrier: “There is no evidence that asking about ACEs improves health outcomes.”
Our response: That is true. Of course, there is also no evidence that it doesn’t improve outcomes. We lack evidence because the studies haven’t been done yet. That is an important focus of ongoing work.