ALBANY
Study planned of homeless, neglect Professor to
do research on 2 coasts
BY SARA FOSS Gazette Reporter
In
1998, a groundbreaking study of middleclass adults linked childhood neglect and
abuse to death and disability decades later.
Researchers looked at the effects of traumatic
events such as sexual abuse, domestic violence, and living with household
members who were substance abusers, mentally ill or suicidal. They found that
people who experienced these sorts of things when they were young were more
susceptible to disease, addiction and depression, less likely to seek early
treatment for their problems, and more likely to engage in risky behaviors such
as smoking and unprotected sex.
Now a researcher
at the University at Albany is planning to do the same study with homeless
adults in Albany and in the northern California town of Petaluma. She expects
that childhood neglect and abuse will be more common, and the traumatic effects
even more pronounced, among homeless people than the middle-class population
that was the subject of the original study.
“From working with the homeless, we know that
the number of adverse childhood experiences they’ve had is very high,” said
Heather Larkin, the assistant professor of social work at UAlbany’s School of
Social Welfare who heads the study.
Larkin will
partner with the Committee on the Shelterless, Petaluma’s primary homeless
services agency, where her research will be used to refine a treatment program
developed by COTS Executive Director John Records.
The treatment model, called Integral Restorative
Processes, tries to recognize the effects of childhood trauma among homeless
people and help them recover. The idea is that it’s not enough for agencies to
work with clients to meet basic needs such as food and shelter; they also need
to help them deal with trauma that occurred years earlier. Otherwise, these
clients will continue to have difficulty rebuilding their lives.
CONNECTING THE DOTS
“I believe we can
design a more comprehensive approach to offering services,” Larkin said. “Up to
now, it’s been pretty piecemeal. This fragmented service delivery system doesn’t
work [with the people who are most vulnerable].”
“We want to connect the dots,” Records said.
Larkin said she hopes the study will help reduce
the stigma attached to being home- less. She said
once people understand the horrible experiences that are often at the root of
the problems homeless people have, such as being unable to keep a job, they may
view them with more understanding and sympathy.
“I think it could be a real eyeopener,” Larkin
said. “There is a higher rate of substance abuse and mental illness among the
homeless. Adverse childhood experiences appear to underlie [these problems].”
The Committee on the Shelterless, which provides
emergency and transitional housing, has some unique programs.
One of them involves getting clients to create
an “explicatory narrative” — tell the story of their life.
People who do this learn that they have the
power to change their story, from something like ‘I’m a screw-up’ into something
different, Records said.
Telling stories about
traumatic events, he said, can help people begin to process what happened to
them and rebuild their lives.
Larkin is in the
process of identifying homeless agencies in Albany that might be willing to
participate in the study.
It was easy to find
the Committee on the Shelterless, where she once did an administrative
internship, and she plans to travel there this month to train the staff on how
to survey clients. She said she hopes to get 300 people in Petaluma to
participate in the study, and 100 in Albany.
Data collection, she said, will take about a
year.
COPING MECHANISMS
“I think it’s
really cool that we can have a coast-to-coast partnership,” Records said.
The 1998 study, by the Kaiser Permanente Medical
Care Program in San Diego and the Centers for Disease Control and Prevention in
Atlanta, looked at the childhood experiences of 440,000 adults.
It was the largest study of its kind ever done
examining the effects of “adverse childhood experiences” over the course of a
person’s life.
A surprisingly high number of
respondents — more than half — reported experiencing at least one of the 10
categories of adverse childhood experiences surveyed. Sample questions — ones
which Larkin will also use — include “Did a household member go to prison?” “Was
a biological parent ever lost to you through divorce, abandonment or other
reason?” or “Did a parent or other adult in the household often or very often
swear at you, insult you, put you down or humiliate you?”
About 22 percent of respondents had suffered
sexual abuse, 26 had lived in a house with a substance abuser, and 23 percent
had suffered the loss of a parent.
RESULTS OF TRAUMA
The researchers found that traumatic childhood
experiences result in poor physical and emotional health in adulthood, and
concluded that adverse childhood experiences are at the root of the 10 leading
causes of death in the United States, a list that includes heart disease,
cancer, chronic lung and liver disease and injuries.
The more adverse childhood experiences someone
has had, the more likely they are to experience problems.
Though smoking, promiscuity, drug use and other
behaviors are typically viewed as public health problems, the researchers
suggested that they are often coping mechanisms for people who have had adverse
childhood experiences.
Larkin's study will be
one of the first to apply the ACE research to homeless people.
It will include additional questions querying
homeless people on what services, such as a doctor or social worker, they’ve
recently used.