O3191: Strength in Adversity: A Trauma Informed Practice to Nurture Resliency

Background: Positive childhood experiences can promote internal protective factors and mitigate the impact of ACEs. Our Child Advocacy Center (CAC) cares for over 1,000 suspected victims of CSA yearly, providing the unique opportunity for a positive experience that can nurture internal protective factors and foster resiliency. Literature has demonstrated the link between character strengths, a pillar of Positive Psychology, and protective factors, supporting the “resilience function” of character strengths (Niemiec, 2018). We designed and implemented an intervention for our patients during the CAC visit and developed an active skill-building tool for the caregiver for continued strength recognition and promotion.

Methods: In order to foster resilience for our patients and families, the goals of this project were: 1) recognize and inform patients of their strengths observed during their visit; 2) provide the caregiver(s) with skills to continue strength recognition and promotion after the visit.
Our multidisciplinary trauma-informed workgroup conducted in-depth reviews of each of the 24 Character Strengths from the VIA Institute on Character (Peterson & Seligman, 2004), followed by several program development sessions. We created the “Strength Card” tailored to our patient population that is provided to patients at the visit’s end with 1-3 strengths identified and the “Caregiver Strength Guide” provided to the caregiver with explanations and concrete suggestions to recognize and promote additional strength. Post-visit surveys and qualitative interviews continue to collect data to assess the impact and utilization of this intervention on the patient, caregiver, and staff.

Results: Staff have reported that the intervention was a positive experience for the patient, caregiver, and themselves 80% of the time. Patients have expressed gratitude and been observed to have strong positive emotions. Caregivers have expressed empowerment to promote their child’s strengths, immediate connection to their child, and gratitude toward staff for seeing their child’s unique qualities. Preliminary data suggests that parents utilize the guide to recognize and discuss strengths with their child after the visit. Additionally, staff reflect a sense of optimism and connection to their patients, serving to mitigate secondary traumatic stress, with 60% of them reporting they felt they had made a difference with the intervention.

Conclusion: Recognition and promotion of patient strengths has a positive impact on patients, caregivers, and staff and has the potential to foster resilience during and after the visit. The CAC visit, almost entirely focused on a traumatic event and its impact, ends on a note of positivity and empowerment. This project can be replicated with minimal cost and training, without significant increase in visit time. Current direction of this work includes expansion to other clinical areas beyond the CAC across the pediatric healthcare setting, aligned with the practice of universal trauma-informed care to nurture resilience for all pediatric patients.