Advancing Clinical Practice

Applying universal ACEs screening in the pediatric clinic.

The Bayview Child Health Center (BCHC)-Center for Youth Wellness integrated pediatric care model was created to recognize the impact of Adverse Childhood Experiences (ACEs) on health, and seeks to treat toxic stress in children. We do this by routine screening, which allows for early detection and intervention, paired with a multidisciplinary approach focused on addressing the neuro-endocrine-immune dysregulation of toxic stress.

Through our partnership with BCHC, the Center for Youth Wellness has developed a comprehensive suite of trauma-informed services. Delivered in partnership with the patient’s primary medical home, the services are aimed at treating children, adolescents and their caregivers.

By identifying and assessing risk in children and youth with an ACEs screening tool, we can offer more effective interventions that prevent long-term health and behavioral problems. Screening for childhood adversity is also an opportunity to educate families about the link between adversity and negative health outcomes and to make appropriate referrals for prevention and treatment.

Center for Youth Wellness Clinical Services

  • Adverse Childhood Experiences Questionnaire (ACE-Q)

    We developed an ACEs screening questionnaire and accompanying user guide as an ACEs screening tool and protocol for pediatric care providers to administer and interpret the screening, as well as discuss treatment options with children and their caregivers. If you are a health care professional interested in using the CYW ACE-Q, click here.

  • Care Coordination

    Our care coordinators are embedded in the pediatric clinic and offer education to children, youth and caregivers about the impacts of ACEs and toxic stress on health. They can provide brief interventions, information and referral resources, and coordinate care among internal and external providers for families receiving multidisciplinary treatment.

  • Multidisciplinary Treatment

    Child, adolescent, and young adult patients of BCHC who have been exposed to four or more ACEs, or who have one to three ACEs plus significant symptoms, are referred for multidisciplinary treatment. Families receive care coordination services and may also receive a combination of psychotherapy, psychiatric care, and biofeedback based on their individualized care plan.

  • Psychotherapy

    We provide a variety of evidence-supported treatments and promising practices that share core principles of culturally competent, trauma-informed therapy that are appropriate for children and families from diverse cultural backgrounds. These include Child Parent Psychotherapy (CPP), Infant Parent Psychotherapy (IPP), Trauma Focused Cognitive Behavioral Therapy (TF-CBT), Dialectical Behavioral Therapy (DBT), and Cue-Centered Therapy. We do this in partnership with the Child Trauma Research Program at the University of California San Francisco, led by Dr. Alicia Lieberman, and the Early Life Stress and Pediatric Anxiety Program at Lucile Packard Children's Hospital, led by Dr. Victor Carrion.

  • Psychiatry

    Psychiatric services are offered through a partnership with the Department of Psychiatry at University of California San Francisco. Psychiatrists provide medication evaluations of children and caregivers, psychotropic medication management, and clinical consultation to BCHC primary care providers and Center for Youth Wellness Clinical Programs staff.

  • Biofeedback (Peripheral and Neurofeedback)

    These services build awareness and control over body processes such as muscle tension, blood pressure, and heart rate to help patients recognize and better regulate their fight or flight response. Neurofeedback is a form of biofeedback in which individuals learn to regulate their neurological function, or brainwave activity. With both bio- and neurofeedback, our main objective is to raise the brain’s threshold to toxic stress by increasing resiliency, flexibility, and stability.

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The Center for Youth Wellness (CYW) is not a crisis center and cannot provide professional resources or clinical consultation to individuals who are not our patients. Individuals experiencing urgent medical or psychiatric concerns should call 911 or their local emergency service agency for immediate assistance.

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