From ACEs to early relational health: Implications for clinical practice

Access: FREE/Open Access

Download the full text: Williams_2023

Publication year

2023

study description

Commentary

core topic(s)

Early Relational Health , Pediatric Primary Care

Population Characteristics

Medical Providers

Exposures, Outcomes, Other

Clinic-Based Programs and Interventions , Parent-Provider Relationships/Interactions

objectives

This statement describes how clinicians can bring a relational health approach to any medical encounter.

exposure

Initiatives promoting relational health in clinical practice

outcomes evaluated

What toxic stress is and how it can affect the developing brain, family relationships, and child development; how positive relationships, experiences, and behaviours can help buffer such effects and build resilience; observable signs of relational health and risk in parent–child interactions; the attributes of trustful, therapeutic relationships with families; and how to optimize these benefits through conversation and clinical practice.

methods

TOPICS DISCUSSED: 1) INTRODUCTION: FROM FAMILY DEFICITS TO RELATIONAL STRENGTH 2) BIOPHYSICAL EFFECTS OF TOXIC STRESS AND POSITIVE RELATIONSHIPS 3) HOW CHILDHOOD EXPERIENCES AFFECT PARENTING 4) EFFECTS ON CHILD DEVELOPMENT 5) ASSESSING RELATIONAL HEALTH IN CLINICAL PRACTICE 6) BUILDING RELATIONAL HEALTH THROUGH GUIDANCE, TREATMENT, AND PRACTICE CULTURE 7) RECOMMENDATIONS

measures

Review

results

This statement describes how clinicians can bring a relational health approach to all medical encounters by: Understanding what toxic stress is; how it can affect the developing brain, family relations, and child development; and how positive relationships, experiences, and behaviours can help buffer such effects (10). Watching for signs of relational health—and risk—in parent–child interactions. Appreciating the attributes of trustful, therapeutic relationships with families, and optimizing these benefits through conversation and practice. Identifying each family’s needs and referring them to community supports.

conclusions

In advocating for a strength-based approach to addressing adverse childhood experiences (ACEs), the article underscores the pivotal role of pediatricians and primary care providers. Over time, healthcare professionals are encouraged to assess and build on family strengths as a preventive and mitigative measure against the impact of ACEs. Emphasizing the importance of early relational health (ERH) and child development, the approach focuses on fostering safe, stable, nurturing relationships, supporting parental well-being, and encouraging positive parenting practices. The article also highlights the significance of community connections and outlines specific strategies for healthcare settings, medical education, and health policy to integrate a strength-based perspective in tackling ACEs.

limitations

Not discussed