We can't talk about trauma without talking about adverse childhood experiences or ACEs . It's a very popular study that was done almost 20 years ago and it's often a cornerstone of discussion around trauma and trauma-informed care. But how much is the ACE study benefitting us? And what about going beyond adverse childhood experiences and looking at adverse community environments as well as promoting protective factors and resilience? On today's episode of A Trauma-Informed Future podcast, host Katie Kurtz is in conversation with psychologist and author, Dr. Amy King. Join them on a thought-provoking journey exploring the pressing need for a shift in how we handle childhood adversity and resilience. Dr. King will decipher the complexities of ACE questionnaires, the critical role of nurturing relationships in early childhood, and how to integrate trauma-informed and resilience-focused care into our health systems.

Learn more about Dr. Amy King:

Amy King, PhD, is a licensed psychologist who provides training, consultation and education to professionals and organizations. She specializes in trauma-informed work and resilience building. Dr. King advises organizations around wellness, staff vitality and creating trauma-responsive spaces. Her specialties include working with professionals to help create resilient children, patients, and thriving families, guiding them to heal their stress and trauma through connected relationships.

Dr. King has served as a statewide trainer for the Oregon Department of Human Services, National Head Start Association, Child Welfare, and subject matter expert to promote child wellness in pediatric settings on behalf of the Children’s Health Alliance. Her current work is promoting resilience by training professionals who work with children and families, through partnership and collaboration.

She has a book premiere in June of 2024 with The American Academy of Pediatrics. Dr. Amy & her team serve folks who aim to be champions in connected spaces. When she’s not working to promote resilience, you can find her with her

Connect with Dr. Amy King:

www.doctoramylllc.com
Instagram and Facebook: @doctoramyllc
Pre-order her new book: The Trauma-Informed Pediatric Practice: A Resilience-Based Roadmap to Foster Early Relational Health

Discussed in this episode:

Show Transcript:

Katie Kurtz (she/her): Hi, everyone, and welcome back to A Trauma Informed Future podcast. I am so excited to my dear colleague and friend. You can't see her, but I can, and that's special to me. And to be in conversation with Dr. Amy King. Hi, Amy. How are you? How are you arriving today?

Dr. Amy King (she/her): Oh, Katie, I'm so happy to be here and see your face as well.

I'm actually arriving in a really solid space today, just coming back from vacation. And so, my nervous system, as you can imagine, was like upregulated and then kind of eased into vacay mode. And now I'm back and just trying to honor the fact that I see a very full schedule this week and trying to onboard again.

But mostly I'm just excited to be here.

Katie Kurtz (she/her): Love that. I'm so eager to be in conversation with you. When I started this podcast, I was envisioning who I wanted to talk to, which is so many people, but I was like, Oh, I have to get Dr. Amy King on here because we have [00:01:00] been in these conversations. We've had so many good conversations that we should have recorded just because It's been so good.

And I also send so many people your way and you're such a huge resource to people within healthcare, pediatrics, pediatric psych, to schools, people with children. I just think what you're doing is so incredible and so needed and any way I can amplify you and the work you're doing, is really important to me.

And so I Really want to start sort of from the beginning, but not really. Because this is a trauma informed future. We talk about how we're co creating it, which is an active process, right? But you and I have been in this for a while, this work. Before trauma informed care was even a trend or buzzword, right?

And I'm curious your perspective from, being in health care, being also within kind of health and human services, and then living in Oregon, which is trauma informed Oregon, one of the, The OGs of trauma informed care. So I'm curious, like, [00:02:00] how have you seen trauma informed care evolve? Since the beginning. I mean your beginning. I know this has been a long term process, but because we're talking about like the future like we've leaped so far ahead. Already since I know when I started. I'd be really curious. Your perspective on that.

Dr. Amy King (she/her): Yeah. So kind of the trauma informed evolution of me and of what I'm seeing right now. I was so fortunate Katie and my graduate program to have these stellar female compassionate mentors and my graduate program, who at the time, we would have said we're trauma responsive for sure. And we didn't have a label for that. We didn't necessarily label at the time DEIB work either, but I still remember Dr. Ellen Brantlinger having me read article upon article of Families in Perpetual Chaos, how socioeconomic inequities impact families and children especially. I still remember Dr. Myrtle Scott, [00:03:00] every week we read like 320 pages of articles on developmental trajectories and what that looked like.

If you came from different parts of our world, different parts of our country, even different parts of a neighborhood that were more or less resourced what that meant for your education, what that meant for health care, and just reading these incredible founders of pedagogy around inequity, pedagogy around systemic oppression.

And so early on, it was infused into my training by these incredible people, and I became more aware of it for a couple of reasons. One in writing this book we have to write an acknowledgement section. It was the hardest part of the book for me to write, but I circled back to exactly what you just asked, where was my beginning?

And it was these professors who, early on, talked to me about generational trauma systemic oppression for people, inequities, but then also it was how they [00:04:00] led with me and taught me, both teacher as student and student as teacher, how they taught me to be a woman in psychology how they helped me navigate like having feelings in a mostly white, mostly male. graduate program. And there are just so many stories I could tell you of being a young, female, passionate person who wanted to be in this pediatric space. And these two incredible mentors just continuing to shepherd me and say, yes, you can. And yes, we have feelings. And of course you share things in therapy, which, I mean, there was just so much of that where it was like, no, we don't disclose.

And, we stay very stoic and boundaried and all this kind of stuff. And so early on, it was a dismantling of that system for me. And I think as time has gone on and I've become a veteran psychologist and consultant, what I realized is that I just bring so [00:05:00] much of that into my world now so that when, my private practice was primarily.

Children and families who'd experienced significant trauma, both in my residency and in my private practice. It was a natural segue for me because those were the kids and families I had always been working with. And then, Fast forward, I was able to start doing a lot of training and consultation with people in pediatric and early childhood spaces and then begin to combine my integrated healthcare experience with my trauma experience or experience working with trauma and my own trauma.

Let's be honest, right? It all gets folded in to really create this, I hope, good foundation of being a trauma. Sensitive and responsive consultant and trainer.

Katie Kurtz (she/her): I love that you had that experience in graduate school. That makes me a little weepy. Because I feel like I talk to so many [00:06:00] people whether it's social work, counseling therapy, even psych, or I do a lot of work with med schools, nursing schools, and it's just not there.

And even for me, like I very little, I wish I could say like this person or that, and I definitely have teachers and people I've learned from over the years, but to have those mirrors in, that formative time of developing your practice is so incredible. I love that. I can't wait to read the acknowledgement section of your book.

Dr. Amy King (she/her): Yeah, hardest part to write. And I will be honest, the stories of trauma in graduate school probably, are five, 10 times fold, but luckily I had these buffers for me, these relational buffers that were everything.

Katie Kurtz (she/her): Yeah. All right. So You have this beautiful evolution of trauma informed care.

I'm curious, being somebody in healthcare, and you've been in healthcare in a variety of settings, where are we [00:07:00] at? Let's put our finger on the pulse of where we're at with trauma informed care in healthcare. Because a lot of people, when you do the Google, it'll say, depending on what you read. Trauma informed care started in healthcare. And I'm always just did it? Did it though? And where? And how? And is it now? Because I work in healthcare, I am a caregiver in healthcare, I am a consumer of healthcare, and I've seen it change. I've seen some good steps forward. And also, we are still nowhere near the standard of care in which it should be.

Tell us your thoughts on that.

Dr. Amy King (she/her): Yeah, I think as a consumer, as a patient, as a family member You would be accurate in saying we have a long way to go for trauma informed health care. The experience of most people is not having a trauma informed health care system. If we back up just a little bit, trauma informed care has really become [00:08:00] popularized over the last about 15 years since the ACEs study became really into our popular conscience, and that was done in large part due to Dr. Nadine Burke Harris's famous TED talk that came out. It's had millions of views. You should definitely watch it. But for all of us that were in psychology, mental health, social work, etc.,

And if boots on the ground, that Ted talk made the ACEs study, the adverse childhood experience study famous 15 years after it had been published, that's not uncommon in the world of medicine, right? An infamous study gets published, it doesn't go mainstream until about 10 to 15 years later. And then it's wow, this is really transforming how we practice research to practice takes a long time.

So that philadelphia study. That was done in 1998. The original Kaiser study then became popularized in the early 2000s, kind of 2010 ish with that TED Talk. And, then all of a sudden, these medical practitioners, including the American [00:09:00] Academy of Pediatrics, the American Academy of Family Medicine, began saying, Oh, my gosh, this adverse childhood experience thing it affects long term health consequences or long term health trajectories.

We should know about this. And so that's when I think it became more common to begin talking about early adversity and trauma in the field of health care. And then the question clearly became not just what is trauma, but what do we do about it when we see it? And practitioners, I would say, Katie, still have a long way to go in terms of just, there are a lot of pediatricians and family practitioners and physicians who still aren't, don't even know what the ACEs study is.

And even though, again, the research based folks like the American Academy of Pediatrics have moved beyond the ACE score, the National Child Traumatic Stresses Network even has a paper called Beyond the ACE score, even though we've moved beyond that. And now we're looking at what are the factors that create [00:10:00] resilience, et cetera.

We're still having to catch up our health care systems with that. And there is certainly, no lack of work for those of us who are doing trauma informed trainings in health care systems. and the amount of awakening that happens in kind of awareness when we talk about what trauma is and how it presents in Patients and our colleagues and each other is like this Oh my gosh, it's still, and we're at 2024,

Katie Kurtz (she/her): I'm so glad you brought up ACEs. I think it's a good thing to talk about. I've talked about ACEs on this podcast. I always defer to Dr. Wendy Ellis pair of ACEs because we always think of the infamous tree of. The fruit that bears on the tree is like these adverse child experiences, but kids just don't have these experiences, right?

You just don't have trauma under the age of 18. They come from something else and there's root causes and we can't, just what you talked about earlier, we need to talk about the systemic collective oppression and the systems and contexts we live in that can [00:11:00] cause and generate these environments.

But I love that you talk about beyond ACEs. This is a really important thing, I think, to consider. It's always ACEs is so important. That study was monumental. It, for a lot of reasons, is why we're at where we're at today. And also, it's not the end all be all. And there's more to it. And we should be discerning.

I find it so fascinating when I talk about ACEs in the trainings I do, I very purposefully don't go too in depth with it because unless I'm there to do an in depth trauma responsive, like I'm working with trauma professionals, I really don't go too in depth because what happens, and I'm curious if this happens to you too, because we do such similar work, people in that audience likely haven't heard of it.

And then they start to see it and I have watched people awaken to their own childhood trauma before my eyes. They're like, I never knew I've had [00:12:00] people break down. I've had to stop and support people. It's a very, and I tell people, I'm like, this is not a BuzzFeed quiz.

Like you don't just Google it and take it and see what your number is. That's not what this is. And I've sat in meetings at hospitals and large healthcare systems where we need to screen everyone for ACEs. And I'm in the corner, like how many times? Will you be screening them and are you training the people who will be facilitating the screening?

Because when someone realizes they have an ACE score of eight and then you're like, thank you for your time and you leave. What are you doing for them?

Dr. Amy King (she/her): Yeah.

Katie Kurtz (she/her): And when they learn that their ACE score may be tied to chronic health related issues, social, emotional issues like you just literally open the biggest can of worms.

And then. I will dare say that's harmful. You're creating a pathway of harm or creating direct harm when we screen without intention and then what are we doing with that data? What story are we telling? [00:13:00] And are you using it to advocate for funding to get resources?

Because how many times have we screened people for interpersonal violence or suicide prevention, any of those things, but we don't have resources to give those people if they say yes, I am in an unsafe relationship. Like all of these things, I have a lot of strong feelings about screening.

And the way the intention and all of that, but especially with aces, like it is a monumental thing to awaken. And also like Nadine Burke Harris says it is not a death sentence. I think we've popularized it to the point of heightened fear mongering. And. That's why I think our work is so important because we help okay, let's bring it back.

Yes, there's trauma. Yes, it has this impact and there's healing and there's resilience of building the capacity. There's so much more. And. It's not just for kids, I loved [00:14:00] working with some hospital systems who are giving these a screenings to parents and caregivers and like, how are we looking at, because kids just don't hurt kids. It's, there's other people involved. Sorry, that was my long, like tangent. I tried to keep it brief, but I just would love to hear your thoughts. On our hyper focus on ACEs and how we can honor it while also maybe looking at it through a different lens that can be more healing informed, more resilience focused.

Dr. Amy King (she/her): Yeah. There's so much I could say about the ACEs. Let me highlight a few things I was noting when you were chatting. First of all, for any of you listening that are familiar with the ACE study, let's remember that it was a study done in 1998. CDC in combination with Kaiser Permanente on a mostly white, mostly insured population, period, right?

So, that's number one. The second thing is that the ACE study was done on, the outcomes were on population health effects. So large groups of [00:15:00] people, we could say, based on these ACE scores, we could determine or predict long term health consequence. There's a lot of shortcomings. To screening or questioning someone about their ACE score.

It's not meant to be predictive. Medicine loves data and that's why so many people are starting to quote unquote screen for ACEs. Let's define something really important. A screen in healthcare means that I'm identifying something, Katie, in you, that you didn't know about before.

So I could give you a diabetes screen or a thyroid screen, or I could screen Or colorectal cancer, breast cancer, right? You wouldn't know until we got the results of the screening. That's not the case with trauma. So actually we have to start calling it a questionnaire instead of a screener because the person who's experienced the trauma knows that they've experienced the trauma.

Like they know what their lived experiences. The second thing that's really important [00:16:00] in terms of the shortcoming of doing any kind of questionnaires around ACEs is those of us that especially work With kids and families in trauma are beginning to refer to those 10 ACE questions as intrafamilial traumas.

Those are traumas that happen during those critical caregiving years. And then when we look beyond the ACE score, we're looking at like Dr. Wendy, Dr. Ellis's study, right? What are some systemic oppressions? What are the other historical and generational traumas that people have experienced? What are other things that are happening in their community?

What are other things that are happening to them in terms of. Deportation or immigration status, sex traffic. There's just so many things and the National Child Traumatic Stress Network did a great job of expanding beyond the ACE score to look at other traumas that children and families experience.

The American Academy of Pediatrics actually has a very clear statement that they do not support ACE questionnaires. in and of themselves because it can do [00:17:00] harm. So when Dr. Gillespie, R. J. Gillespie and I talk about ACEs, ACE questionnaires, we're really trying to shift the language to taking a relational health history to really look at not just what are some adversities that you may have experienced or you experienced as a caregiver but also what are the positive strengths that are happening in your life?

What are those? Supportive things that are happening in your community, in your culture, in your family that we know mitigate stress and harm. So anytime we're doing a questionnaire in a pediatric setting, in any setting, really, but we want to ask, what am I looking for? Why am I looking for it?

And what will I do when I find it? To your point, right? For instance, I'm working with a hospital system right now, Katie, who is getting a large grant to do ACE questionnaires. They have spent 50 hours with me preparing. to do these questionnaires. [00:18:00] So that when a patient comes in and is asked to fill this out, and they look at it, and it's not in their language, or they don't know why are you asking me about whether or not I experienced emotional abuse before the age of 18?

The patient service representative at the front desk can say, I'm so glad you asked. If you have more questions, your provider is happy to talk to you about this. You don't have to fill it out at all. It's absolutely your choice. So we talk about giving autonomy. We talk about, providing, a context for why the questionnaire is taking place.

We're letting them know that they can discuss it further with their practitioner. There's so much that goes into asking someone about their And by the way, you're absolutely right. We should not be asking if we don't have appropriate resources. With every organization that I work with, We start with that care management team also and say, okay, what are your local, walkable, within a mile of your clinic, because otherwise a lot of patients without transportation will never [00:19:00] be able to access it.

What are your local resources for anything that you're going to ask questions about? So if you're going to ask about domestic violence, if you're going to ask about parental harm, if you're going to ask about emotional abuse, if you're going to ask about substance abuse, we need to have some resources available in the community.

So that if there's a positive endorsement, we have some things to do. Otherwise we are doing harm. And one of the number one things in medicine is do no harm.

Katie Kurtz (she/her): Yeah.

Dr. Amy King (she/her): Okay. That was a lot for me too, Katie, but

Katie Kurtz (she/her): I was like, I'm so happy you exist in this world. I love to hear that. I never specifically worked in peds, and that's why you and I connected many years ago was to be able to refer people within pediatrics.

Because I was working primarily in pop health in, around SDOH and trauma in relation to mostly adults. And I am so grateful to hear this movement and love that, [00:20:00] that is trauma informed care, 50 plus hours of good quality training with an overly qualified team of trainers, and then learning not just what it is we're doing, why we're doing it, the impact of doing it, and then skills to ensure we're not causing further harm, but instead elevating potential safety.

Embedding that into the culture that's it. That's trauma informed care, and it needs to be consistent. And that's why yeah, grants are great to get these things off the ground. But this is why we need health care systems to invest in this as a part of their standard, operating procedures which I'm always a little judgy of healthcare.

I hold healthcare to a very high standard. I hold a lot of systems to a very high standard. I will always Look critically and ask for more where I know more can be offered [00:21:00] while at the same time Celebrating the small wins and how far we've come I know you and I have both shared stories of being invited into spaces. I've been getting invited in more and more into resident fellowship education med schools like working long term within healthcare systems, seeing people start to understand the connection of, addiction, mental health, trauma, like people still see it as very delineated things.

It's all interconnected, right? And I love this idea of a relational health. Kind of lens because trauma informed care is relational care. It's inclusive care. It's all of that. And I think that makes me so hopeful because I get so fired up about, I'm glad you talked about screening versus, I get very fired up about them.

I, myself, have had to ask questions or do assessments where I feel very uncomfortable even doing it because, and I have to, but I'm just always like why [00:22:00] do we need this information? And what are we going to do with it? And also, I'm not going to ask people questions when I know there are no resources in our community for them. And so I'm grateful that we're moving slowly towards that norm. Because it's so essential.

Dr. Amy King (she/her): And can we also just acknowledge that if you're in healthcare and you're asking questionnaires about trauma and you're a mandatory reporter, can you imagine the situation that puts you in with a family that you're trying to build trust with?

And so the other thing is that we 100 percent have to disclose what we're asking and what we're going to do with the information to the patient. Because otherwise we could do harm and continue. To have this patient experience medical oppression from medical systems,. It's hey, I would like to ask you about adversities that your child might be experiencing.

And oh, by the way, some of them that you report, I'll have to report you to Child Protective Services. Hang on. [00:23:00] That's harmful. And so we have to make sure that we are acknowledging autonomy, giving opportunity to say no thank you to any questionnaire making sure we have appropriate consent. I was talking about a group that I'm working with right now, and every group that I work with we create little scenarios where we make up a mini medical home,

the person who first greets you to the person that's going to send you a billing statement, I want to make sure every single person in that organization, front to back, top to bottom, knows what is my role in being trauma responsive to our patients. How will I embody, place, Where if our mission and vision says that we're a compassionate, holistic healthcare space am I walking that talk?

And so I have groups create elevator pitches and a couple sentences that they can communicate to patients so that they know that they're integrating what their mission and vision is and doing it in a way that is sensitive to trauma that [00:24:00] people have gone through.

Katie Kurtz (she/her): Yeah. Yes. Love this so much.

I. Want to shift a little bit because I think what also happens. which I'm sure you can attest, is that when we talk about ACEs, or any type of trauma developmental trauma, any type at all, we can't compartmentalize our humanity. I always, tell people when I'm teaching about trauma and trauma informed care, be aware that you may be here for professional reasons, but we can't separate the personal and professional.

And I honor that everyone in this room likely has some form of trauma, lived experience, toxic stress. And you may feel something throughout this, so be gentle and nurture yourself, and that's where we infuse trauma informed care in the experience. What I see happen is, yes, some people become a little, like their eyes become a little more wide, they see their own lived [00:25:00] experience.

But if I'm working with people who are parents or caregivers, I then start to see the anxiety rise and the fear. And Of people saying, I don't want to cause my child harm. I don't want to cause the person I'm caring for harm. And I think this is where, because we forget the nuance and the complexity of understanding adverse child experiences.

And we focus so much on that adversity rather than also the. Resiliency, and I want you to talk about resiliency because I think some people just think resiliency is like the bounce back. And we know yes, and also kids shouldn't have to be resilient. No one should be. But I'm curious for parents or caregivers listening who may hold this anxiety.

Can you talk a little about the work you're doing? Within pediatric settings and especially looking at the developmental. Aspects and also just [00:26:00] around, with you do so much with an education and I know with parents. Whenever I talk to you and hear about your work, I just get this nice, Big exhale and I want people to know you through this podcast and feel that exhale because I think again It can get dark and scary out here, but there is a lot of hope we know healings possible Neuroplasticity goodness all these things we have to hold the end both.

Dr. Amy King (she/her): Yeah. Yeah. Thanks for asking that question So we actually have an entire chapter in our book called not without resilience. I will not train about trauma, stress, and adversity without also talking about hope, and I will not talk about adversity without talking about how we can heal intergenerational trauma, because we can.

Study after study, by the way, has supported this, which is, yes, adversity happens, trauma and stress happens, and there are things that ameliorate stress and trauma, mostly relational health, connectedness. And so, whether you [00:27:00] look at studies by Christina Bethel and Robert Sagie with the Positive Childhood Experience Study, I could go on and on Bruce Perry and Ken Ginsberg and all these incredible authors Bottom core principle is that it comes back to this despite adversity and or trauma that you've experienced when you have experienced connected positive relationships over the course of your life, it buffers it.

And so the American Academy of Pediatrics has actually come out with a policy statement that says, That the policy around trauma and adversity will shift from assessing adversity, in quotes, to building buffering mechanisms. And what we're really focused on with this relational health history is looking at not just what happened, but what are the strengths and supports that are available in your life?

So when we look at things like the Positive Childhood Experience Study, we ask parents and caregivers things like Is it okay to talk about feelings in your family? Are there other adults outside of [00:28:00] your family that take an interest in your child, right? Like mentors and helpers and, people that are in your village, do you celebrate your culture in your community?

Do you take part in community traditions? Does it feel like you have a sense of belonging in school and in your growing up spaces? If you look at it. Anybody's research, over and over is connection. So resilience is built in relationship, right? So when we look at social emotional health, when we look at early relational health, which is the little zero to five experience with relational health it happens in those caregiving spaces.

It happens with moms and dads and grandmas and grandpas and incredible foster parents and aunties and uncles and all the villages that we create for kids and families. And even when I'm talking to adult patients, I say to them, you can still create connectedness now for you. And I have this really

amazing exercise that I've been doing since I was in graduate school as part of my dissertation called Creating Circles of Support, where we just pause and we [00:29:00] say, let's just look at, who are the people in your village? And it is, if we know that adverse childhood experiences could have a long term health impact on you, and we also know that having positive, buffering, nurturing relationships of connectedness in your life mitigate that.

Then doesn't it become critically important to build those buffering relationships like now, before anything else happens in that adult's life, in that child's life, in that family's support system to just pause and say, I know that stress and adversity can affect your health. But I also know that relationships heal it.

So let's look at the relationships in your life. Let's build those relationship structures and supports out. Let's see where there are gaps, where we can fill in some gaps, where we can get some more supports, systemic supports, friendship supports, community, culture religious, whatever supports feel genuine to your family.

Because when families are barely surviving, They're not [00:30:00] thinking about building out all of those systems. So we have to help them do that. We have to say, who are your people that you can call at 2 o'clock in the morning when you feel like you can't do this anymore? And who are the people you can call the next day?

And who are the systems that are in your life? But what I have seen over and over again, Katie, is I sit with a parent or a caregiver and you can imagine, right? Like you said this, we'll use a mom for example. She's so scared of having this baby. Pregnancy becomes a trigger right away for so many women. Because they think, Oh my gosh, I don't want to mess up my kid like I was messed up. And now I know about this ACE study. I'm sure to mess them up. When we pause and we say, no, we can address generational patterns of behavior. And we can shift and you can create new relationships of connectedness and secret care attachment with your kids.

I can actually show you how. Hope comes up. This [00:31:00] feeling of my gosh, this is not a sentence for me to duplicate what I experienced as a person. The people that are in those caregivers lives, pediatricians, nurse practitioners, early headstart, early intervention teachers, Nurse home visiting programs if they're not aware of not just like what is trauma, but what do we do about it, right?

How do I support that? Caregiving environment and how do I empower that parent the resource parent the grandparent whomever it is To create more connection with this child because it is everything for their health and when we do it and when we see families feel empowered and supported and They start to do these like shifts in behavior of connectedness, right?

All the pediatricians I work with, all the early educators that I work with, we prescribe special time. Just uninterrupted play time with kids. But you can imagine a lot of caregivers never experienced play. [00:32:00] And so we have to teach them, we have to show them that, we have to model that. But we can do that in about five or ten minutes.

It doesn't take, it doesn't have to be like therapeutic intervention it can just take a couple of moments to model play based interactions, and now all of a sudden you have this parent who came in pretty hopeless. And doing a lot of like maybe corporal punishment or behavior management with their kid.

And now we prescribe, 10 to 15 minutes a day, a few days a week, right? Doesn't have to be hours, doesn't have to be right for that single mom or working dad or whomever it is. And all of a sudden they come back and they say to me, Oh my gosh, he's not acting out. I think meeting these needs of connection are what they needed.

And It feels magical to the parent, but it's not, it's really intentional. It's about shifting how we're caregiving in a connected space. And we're creating, what you and I might call a co regulated space for that family system. But really it's about teaching [00:33:00] connection sometimes to people who've never experienced it before.

Katie Kurtz(she/her): Yeah. I always say resilience is relational and a hundred percent. I. often tell people when I bring in, cause I'm the same way. I've always infusing hope. I will not, not talk about hope. And I always tell people we have this incredible power at any moment to be a safe, healthy, nurturing person in someone's life, not just kids, but in all of our lives.

And it's all connection centered. And when I. learned about you and your work and you showed me your cards for connection. I was like, Oh my God. And you were saying like, we prescribe playtime. When we think of healthcare, we think of prescriptions, like a pill for, a pill will solve anything or.

We have 15 minutes to get everything solved in, a very short primary care visit, and there's a lot of obstacles based on the system we're working within, but the cards for connection, curriculum and the [00:34:00] physical cards you have are incredible. And this emphasis on relationship building . We think of trauma healing as like years of therapy, which, yeah, absolutely it can be.

And I think something we often miss in trauma healing, which Would be the thing I say in every podcast episode is we could create a whole podcast on this is the fact that we often think we're missing in trauma healing modalities is the connection piece the community care piece, the building relationships founded in trust and safety.

Can you share a little bit about your cards for connection and the other tools you have for. Sharing with anyone who's listening, who provides care.

Dr. Amy King (she/her): Yeah. So the cards for connection are meant for any professional who's child and family facing and adult facing. And it really is what I call 100 small doses of connection, right?

So whether you're an early educator or in family practice or [00:35:00] pediatrics, any kind of primary care or education, you have this opportunity. To be therapeutic. You don't have to go to therapy to be therapeutic. And I know you share that sentiment, Katie. But there's such a need right now in our communities for bridging some mental health gaps.

And we can do that. And so I created the Cards for Connection originally with a group of pediatricians through the Children's Health Alliance who had come to me and said, Hey, we found out about this ACE study. This seems like bad news. What do we do about it? And I'll never forget. One of the physicians said, what I'd really like is for someone to make a curriculum, like for every well child visit that I have.

And so I naively at the time said, Oh, sure. I could do that. And what it's come to in the last 10 years is this curriculum around relational health, connectedness, relationships, resilience within relationships and helping caregivers, helping adults, helping kids as. [00:36:00] they get older address stress and trauma in a really positive strength based way, often in those relationships.

And at every stage, whether you're a provider or you're a teacher, these cards are meant to be the first model of the connected relationship, right? Between the educator and the parent or the nurse home visitor and the parent or the pediatrician and the parent. And then you're modeling for the

caregiver in the child, or the caregiver in their partner or spouse even. And so what they do is they just talk about why relational health is important, why social emotional health is important for the long term parts of health trajectories, and then they just teach one small tool, like it might be the circle of support, or it might be prescribing special time, or it might be how we can talk about kids feelings in a more strength based way, or it might be How we manage worry.

And again, these are all little doses of resilience building intervention that these very busy child and family facing people can do in about [00:37:00] five minutes. That was my goal in creating the Cards for Connection because the great thing about being in education or in healthcare is that you have so many opportunities.

You don't have to quote unquote fix them in one visit, right? There's no pill. You're going to do this over several times. And what we're seeing now is parents who come back to their pediatrician and say things like, do you have the next card? I'm so excited. Like I got my husband to do it and now he's doing special time too.

Can you show him or these nurse home visitors who go into families homes and they teach them one of these strength based interventions and they're like, Amy, You should see like the parents sit up a little straighter. They feel more competent. They feel more confident. They feel like they actually have a tool now to use.

It's one thing to talk about trauma and resilience up here on an esoteric level, but what practitioners really want are these tools. And so this curriculum has really been my life's work, Katie, of taking what I [00:38:00] know to be trauma responsive intervention in little doses, across the course of a child's life and a caregiver's life and a patient's life if they're adults to decrease the effects of stress and trauma because we know that it happens in connected relationships.

Katie Kurtz (she/her): Yeah, I love it so much. I love the Cards for Connection. I hope an adult version comes out soon. I was recently at the doctor right after my wedding in the end of 2023. And. I've mentioned before I'm a caregiver and my mom was in the hospital for six weeks. My dad has a lot of health issues. It's just a lot.

Didn't even process the grief of my mom, not being at my wedding. And I'm also managing a lot of additional stressors related to that. And my doctor's well, you have these, symptoms like, You really need to manage your stress. And I'm like, yeah, [00:39:00] I have stress. I'm the first to tell you I have this stress.

Unfortunately, a lot of it is not within my control. The response and I offer a lot of grace to people, but it was just like, well, you just can't think about it. Oh, great. Good talk. What is that? What we're telling people just don't think about it. Like I am not expecting you to be an expert.

However, language matters, and it's our catalyst to either bridge connection or disconnect and sever connection. And although I'm good, I think I laughed when she said that. I was like, really? Okay I won't go back and see that practitioner.

I'm just like, I don't have time for this, but most people don't know they can say no or they have choice. In their health care and there's so much pressure and authority that occurs and assume trust, which, yes, we have to hold that nuance that like we need to assume trust in health [00:40:00] care providers.

Especially within emergency settings. There needs to be an element of being like, I'm handing you my health, I hope you can help me. And also, we have to be aware of the power dynamics that occur within a health care doctor's visit, because that can also shut people down. They may not disclose certain symptoms.

They may be in some sort of nervous system response where maybe they're frozen and they forget. Or, you might be kidding or you might say something you're not thinking, cause you're thinking about a million other things. So you're not present. And instead of reconnecting people to a sense of felt sense of safety or trust, you're disconnecting them.

And that's why I love the cards for connection because they're so simple. and powerful. I've read them. I love them. I use them. They're practices that we can utilize and use specifically for children and families. I love how intentional around like the [00:41:00] developmental stages.

So it meets, it truly meets people where they're at, but this is something that's accessible to anyone. That's right. And it's the part of trauma informed care. I think We need to remember, it isn't just all trauma all the time., we never talk about people's trauma, usually it's none of your business, quite frankly, it's more about using your understanding of trauma to inform.

That's right. But you and I know you and I do this, is that when we're teaching about trauma, we're also teaching about healing. And the power of healing, what healing looks like in all its modalities and forms, and resilience, and the capacity building, and co regulation and connection, it's all baked in and that's informing the trauma informed care.

And that's a piece we need to really remind people of. We're talking about a trauma informed future. We're talking about a healing informed future and our role in that

Dr. Amy King (she/her): absolutely our role in that. [00:42:00] And, I want to just back up to this experience that you had, and a little bit of compassion for healthcare providers who go through medical school and all they are told to do is have answers, right?

They have to have answers. They have to make decisions in split seconds, sometimes life or death. And so when I train medical professionals. Often the term that they use is unlearning medical school. I have to unlearn what I've been taught so that when Katie comes in and says, I'm so stressed and blah, blah, blah, blah, they don't say, well, just don't think about it.

That they say something else. And sometimes it means I'm not sure what to do. I want to help, but I'm not sure how, or would you like me to just listen for a moment? Even though medical providers are taught to listen to so many other health care symptoms. Again, there's an entire chapter in our book called the art of listening.

And part of listening is being present to whatever comes up in the room. And sometimes [00:43:00] saying, I don't know, but I will find out, I'll find out, I'll find some more information. Let me look for some more resources to support. Can I get back to you? And as we do this, infusion of what it really means to be trauma responsive to a patient and I watch These physicians and nurses and healthcare providers or educators, whatever group I had a physician at one point who, by the way, was a fellow for a trauma informed organization, like in medicine, and yet still, he didn't have some of the actionable tools and he kind of stopped in the middle of my training and he was like, All the other things that are on my checklist in Epic, all the other things that are in the electronic health record they don't matter.

And he said, this is the most important medicine, just talking about relationships and healing relationships. And I was like, yes, that's it. It's the most important medicine. And it was so exciting. And. I think about [00:44:00] multiple Katie's who enter a primary care space. And I'm thinking about my friend Denise, who's a family practitioner.

And she was doing one of the interventions called worry pie. And she was just drawing it on an exam piece of paper, right? Just like the white paper that's on the bed that you go into. And she was drawing it. And one of the things we carve out in the worry pie is our right now versus past future and out of control worries.

Wouldn't it have been so lovely for you or anybody else in that moment to say, you know what, Katie, there is so much future worry right now. What if we just focused on what you could do today? Is there anything that you feel like you could just do today to help your stress, to know that you're doing incredible caregiving for your parents, right?

That's the right now slice of the pie. And so I think about really we're creating A shift that I'm super excited about where those stories make me feel so sad, actually, when I hear about caregivers or parents coming into spaces and feeling alone when [00:45:00] in 30 seconds, 90 seconds, we could be connected with them.

And. Then when I see the hope of these educators and professionals who are learning I just, I think there'll be less aloneness in the world. Because nobody should go into an appointment and feel the way that you felt. Nobody.

Katie Kurtz (she/her): Yeah. Saying I don't know is one of my most favorite things, and I love that you teach that, I do the same exact thing.

And I think it's so powerful. And I know it feels funny because we are supposed to know, right? We're taught no matter what profession, we're authority. We need to know everything. And it's no, I actually feel more trust build with someone when they tell me they don't know than when I'm given lip service or something happens.

And I think you're so correct in 30 seconds. Three different words could have shifted my perspective. And again I work with healthcare professionals. I have a ton of compassion and grace. I love [00:46:00] working within healthcare and it's a big system. It's a big culture shift.

Culture shift takes time. This is a long game. And the good news is I went to a new doctor and I am in healthcare all the time. I talk about my life as a caregiver all the time. I'm good, but if you're going to ask me, why are you so stressed? I'm like, well, I have this going on.

Would you be? And I shared my typo I'm a caregiver, this is the thing. And he goes, wow that's a lot. He said, Oh, are you controlling your anxiety all the time? Are you like choosing to be anxious all the time? And I'm like, no, he's so of course you're not, this isn't something that's wrong with you.

He said, this isn't something that's wrong with you. It's happening to you. And I was like, okay, I'll stick around. And I'm very privileged that I know right away To scan my environment. I know what to say. I speak medical, right? Like I can speak it, I can interpret, and I have a level of confidence in my [00:47:00] ability to be like this person, providers for me, this person's not.

And then I, advocate and move on. What a concept. A few different words turned into listening and validation. And I always like to remind people that, we can validate people and not agree with them. Validation is letting people know you've been seen and heard. And that's being human and honoring people's humanity.

You might not agree. That's fine. But, can we still just validate that we've heard and see people and that we're listening? It's so powerful and I just adore the work you're doing and I love seeing what you're doing and, It gives me so much hope. I love being able to refer people your way.

Again the future is trauma informed because we're here and we're in community doing this work. Like you said, there's enough to go around. And so it's so nice to know, too, that Because this is a long game and we are working in these mega systems that will take time to shift, though that's where our resilience, this kind of connection, [00:48:00] right?

Being connected with other trauma informed leaders is so essential because it helps nurture our own resilience in this work. I'm so grateful for you. Can you tell everyone about your book?

Dr. Amy King (she/her): Yeah, absolutely. Well, first of all, I would be remiss to say I'm not Equally as grateful for you and everything you're putting out into the world and into the space.

Katie is beautiful and compassionate and responsive to, the needs of people's hearts and souls. So, back at you. Yes, the book is called A Trauma Informed Pediatric Practice, A Resilience Based Roadmap to Early Relationships. And it really is focusing on relational health, how to prepare your organization to be trauma responsive, what to do, to mitigate stress and harm and how to build those early relationships of support.

Katie Kurtz (she/her): Love it. I will link everything, including the connection cards, your podcast, everything. I leave our conversations feeling so nourished. , [00:49:00] it's like I just drank a whole cup of coffee. I'm so grateful for you. I would love to close with our little soft spray, gentle spritz of questions if you're ready for them.

Dr. Amy King (she/her): Ready for them.

Katie Kurtz (she/her): All right. So if you could describe trauma informed care in one word, what would it be?

What is your current go to for nervous system care?

Dr. Amy King (she/her): I love that you asked this question. I have a couple of go to's, reading a book, I read murder mysteries and love it, , being outdoors in any capacity, and laughing with my family, with my husband, with my girlfriends, with my kids, just being in connected spaces is like what my heart always needs.

Katie Kurtz (she/her): Love that. And what does a trauma informed future look like for you?

Dr. Amy King (she/her): This, conversations, leaning into curiosity, wondering more about how we can help, how we can lean [00:50:00] into, hurt and then provide hope and healing in connected spaces. This is it.

Katie Kurtz (she/her): Thank you so much for being here. Anything else before we close today?

Dr. Amy King (she/her): No, just thank you for creating this space. I love envisioning, not just where did we come from, but where are we headed? And I do think a trauma informed future is possible. I think we're getting there. I think it's going to take a lot of brave conversations like this.

Katie Kurtz (she/her): Thank you so much.

Dr. Amy King (she/her): Thanks, Katie.Katie Kurtz (she/her): Hi, everyone, and welcome back to A Trauma Informed Future podcast. I am so excited to my dear colleague and friend. You can't see her, but I can, and that's special to me. And to be in conversation with Dr. Amy King. Hi, Amy. How are you? How are you arriving today?