Implementation of an adverse childhood experiences screening protocol for adults at an outpatient medical psychology practice

Abstract

Objective: Despite an abundance of evidence supporting screening adults for adverse childhood experiences (ACEs), the gap between this knowledge and screening persists. Evidence suggests that screening is warranted, feasible, and desired by patients. This feasibility study aimed to educate and train staff and providers on ACE screening and implement an ACE screening policy and protocol at an outpatient medical psychology practice. The two expected outcomes of this project, provider knowledge after ACE training and provider compliance with the ACE screening protocol, were measured to determine if a clinical practice change occurred.
Methods: A quasi-experimental design with a pre-test/post-test was used to determine increases in provider knowledge following an ACEs training intervention. Additionally, post-intervention only data collection was used to determine compliance with ACE screening protocol, to determine practice change and feasibility of continued protocol use.
Results: The project results indicated that the implementation of the ACE screening protocol was feasible. Thirty-three adult clients new to the practice completed the ACE screening. Of the 33 clients screened during the 12-week study, 26 clients had an ACE score of three or higher, and 14 (42%) received therapy referrals based on their ACE score after education and discussion by the intake therapist. Weekly chart checks revealed that 100% of clients screened received, at a minimum, the educational packet regarding the impact of ACEs on physical and mental health. The protocol encouraged providers to promote evidence-based interventions to mitigate the potential untoward outcomes associated with ACEs.
Conclusions: These findings reflected a change in knowledge based on education and indicated that educational intervention was effective.