CARP project builds resilience

Carpinteria Children's Project executive director Maria Chesley, PhD. (left)
 and Dr. Peggy Dodds MD of the Carpinteria Health Care Clinic
 have been instrumental in launching CARP.

by Dennis Tivey, Maria Chesley, and Barbara Finch

Under a new pilot project in Carpinteria, doctors are screening patients for Adverse Childhood Experiences (ACEs) and offering referrals to family-strengthening services. Known as the Carpinteria ACEs and Resilience Project or CARP, the program can serve as a countywide model for how organizations can collaborate to detect, treat, and prevent childhood trauma. Read on to learn more.

Adverse Childhood Experiences (ACEs) include traumas such as abuse, neglect, parental incarceration, and divorce. These events are highly stressful for children, and researchers have found that chronic exposure to high levels of stress hormones can disrupt physical, mental, and emotional development, a condition known as toxic stress. This can result in long-term negative impacts on learning, behavior, and health—such as elevated risk of heart disease, depression, and addiction in adulthood. The more ACEs a child accumulates, the greater the risk. Every demographic in our community is affected: approximately 44% of adults in Santa Barbara County have experienced one to three ACEs and 13% have experienced 4 or more..

However, by screening for ACEs and intervening to help families build protective factors—such as parenting knowledge, concrete support, and social connections—it is possible to increase child and family resilience, buffering against the impact of ACEs. That’s where CARP comes in.

Carpinteria Health Care Clinic

CARP marks a significantly expanded integration of formal care across organizations. Since February 2019, the visiting nurses of Maternal Child Adolescent Health (MCAH) and pediatricians at the Carpinteria Health Care Clinic (CHCC) screen parents and infants up to age 24 months for ACEs (using tools adapted from the Center for Youth Wellness, founded by California’s newly named Surgeon General, Dr. Nadine Burke Harris). If screening reveals that a parent has two or more ACEs or an infant has one or more, the parent will be given the opportunity to engage in interventions provided by the local Family Resource Center (FRC) operated by the Carpinteria Children’s Project, and partner agencies including CALM and the Family Service Agency (FSA).

Practitioners received training on ACEs and resilience

All interventions are designed to support parents' efforts to improve their own resilience and improve their ability to reduce and buffer their child's exposure to toxic stress. Interventions include psycho-educational lessons, a structured assessment of the parent’s strengths and areas for growth, and referrals as indicated for parenting classes, mental health counseling, and other needs. Initial training for all CHCC and FRC staff, and FSA and CALM staff as appropriate, began in November 2018 and so far has included viewing of the documentary RESILIENCE and training on motivational interviewing by CALM.

Ultimately, the aim is to create a more holistic system of care for children that integrates medical, behavioral health, and social services to prevent ACEs and promote healthy development across our community. This pilot, improved by lessons learned, will spread the integration of pediatric care with community-provided behavioral health and social services to other Public Health clinics and social service providers in our county. Furthermore, by educating medical and FRC staff about ACEs science, their own ACEs, and the need to care for themselves, patient care can be made more trauma-informed and resilience-focused.

KIDS Network, one of the community networks administered through DSS, is leading efforts to organize and coordinate the cross-sector countywide ACEs movement known as Resilient Santa Barbara County. The Carpinteria project is linked with these efforts and backed by First 5, Cottage Health and the Bower Foundation.

Through CARP and other efforts to teach children and their parents about ACEs and toxic stress, as well as the hope of resilience and the range of practices that can foster it, we can help children get a healthier start in life and help adults heal.