Providing Buffers, Solving Barriers: Value-Driven Policies and Actions that Protect Clients Today and Increase the Chances of Thriving Tomorrow

Abstract

Between 1990 and 2018, regions spent between 2.67% (Europe) and 3.6% (North America) of their GDP to treat harmful behavioral, medical, and other effects of significant adverse experience (Bellis et al., 2019 The Lancet Public Health, 4(10), e517-e528). Although dose-dependent exposure to adverse childhood experiences harms long-term medical health (e.g., Anda et al., 2006; European Archives of Psychiatry & Clinical Neuroscience, 256, 174-186, Anda et al., 2008; American Journal of Preventive Medicine, 34(5), 396-403, Dong et al., 2004; Circulation, 110(13), 1761-1766, Felitti and Anda, 2009), six specific buffers (nurturing relationships; nutrition; physical activity; sleep; mental health support; and reducing stress) protect against these harmful health impacts (Purewal et al., 2016, Zero to Three, 37(1), 10-17). However, barriers related to access, information, resources, or behavioral needs prevent many from experiencing the benefits. This article describes an approach in which each buffer area is addressed in the context of its overlap with behavior analytic practice, and supported by related policy suggestions. Providers are invited to adopt an informative buffer policy as an antecedent to client services; establish a collaborative network of providers and resources; and expand buffer promotion beyond clients to other stakeholders including caregivers and staff. The aim of this article is to inspire and empower individuals to use several specific actions: (1) learn about buffers and consider barriers to them; (2) educate others about buffers and barriers to them; (3) scan a client's environment for buffers and barriers; and (4) consider ways to install buffers and resolve barriers for clients or others as appropriate.

Keywords: Adverse childhood experiences; Buffers; Preventive behavior analysis.

Fig. 1

Example conversation to reduce response effort for practitioners new to adopting buffers policy (author original graphic)

Fig. 2

ACES buffers and barriers graphic part 1: Buffers (author original graphic)

Fig. 3

ACES buffers and barriers graphic part 2: Barriers (author original graphic)

Fig. 4

BTRFLS (pronounced “butterflies”): This visual provides a quick glance at some barriers clients may want to discuss related to their engagement in buffering areas