Three years ago this month, the NEAR@Home toolkit went live, aiming to help home visitors talk with families about the wide-ranging and long-term effects of childhood trauma.
Since then, it has been downloaded more than 3,500 times by people from all 50 states, Puerto Rico, District of Columbia, and 11 countries.
NEAR, the acronym for Neuroscience, Epigenetics, Adverse Childhood Experiences and Resilience, represents three decades of scientific research into the power of childhood adversity on biology, behavior and risk – and how these can be passed on to future generations.
“It is one of the largest public health discoveries of our time,” said Quen Zorrah, Thrive Washington’s NEAR@Home Facilitator and a national lead on integrating this work into home visiting programs. “Parents have the right to know the most powerful determinant of their children’s future health, safety and productivity.”
Created, reviewed and tested by home visitors, mental health providers and other experts in Region X (Alaska, Idaho, Oregon and Washington), the NEAR@Home toolkit is a training manual with guided processes to help home visitors learn and practice language and strategies to safely and effectively talk about childhood trauma. It emphasizes safety and reflective support for the home visitor as a critical element in this process. Using this process, home visitors build skills in the therapeutic use of self and discover increased compassion, patience and stamina in their work with families.
Home visitors are uniquely positioned to talk with parents about how their own histories of childhood trauma may be affecting their adult lives and parenting – and being passed on to their children. Because home visiting is relationship based and occurs within each family’s comfort zone, home visitors have the opportunity to ask, listen and affirm. They are highly skilled in building trust and creating safe spaces for meaningful conversations, and they are practiced in the art of family support.
“NEAR@Home has been such a profoundly meaningful tool in my practice. It has opened the door for deeper, more meaningful conversations, insights and understanding,” said Erika, a home visitor in Snohomish County. “One of my clients said, ‘I know those things that happened to me were really bad, but I believe they have made me a stronger and better person.’”
Research finds that parents with a history of childhood trauma will often use this new understanding of their past to begin to heal and learn how to protect their children from trauma.
Because of the success of the toolkit, Region X was awarded a MIECHV federal Innovation Grant in 2017 to pilot a regional expansion. Thrive hired and extensively trained facilitators from each of the four Region X states. This process prioritizes the “do no harm” principle to ensure the success of the intervention with families and protect the psychological, social and moral safety of the of the home visitors themselves. Each facilitator is now piloting this process with at least four programs in their state, helping home visitors learn the NEAR@Home process, sharing best practices and lessons learned with each other and with Thrive. Later this year, a facilitator’s handbook will be completed to scale this work across Region X and the country.
These activities are funded by a MIECHV Home Visiting Innovation Grant which is supported by the U.S. Department of Health and Human Services, Health Resources and Services Administration, through grant #UH4MC30465.