What are buffers?
Buffers are 6 areas of living: healthy nutrition, exercise, and sleep; having a nurturing relationship; getting mental health care, and using skills that work to calm down. Mounting medical research suggests that as we engage in these buffers, we can prevent, and protect against, the medical and other harms that ACES (adverse childhood (and conditioning) cause. Behavioral research has addressed these 6 areas for decades, but we often forget to put them first, in our rush to document what behaviors a client needs to be “reduced”.
Peer-reviewed article on Buffers
Dr. Kolu’s peer reviewed article describes buffers, the barriers to them, and related behavioral research, urging practitioners to screen for buffers and put them first in our proactive plans to support caregivers, clients, staff and ourselves. This publication includes a flowchart for getting started having conversations about buffers, graphics to communicate about them with others, and describes an assessment tool for talking about buffers and the barriers to them.
Link to the article
Kolu, T. C. (2023). Providing Buffers, Solving Barriers: Value-Driven Policies and Actions that Protect Clients Today and Increase the Chances of Thriving Tomorrow. Behavior Analysis in Practice, 1-20.
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.
Read the blog about buffers and grab resources
Intersections with the SAFE-T Model
Dr. Kolu teaches how to document and work with various trauma-related risk factors in the SAFE-T model and related tools (see CuspEmergenceUniversity.com for the course on this topic). How are Buffers related to the SAFE-T model?
First, buffers have always been a part of the SAFE-T Assessment. If you took the SAFE-T course in the past, you might have noticed the section called the “Buffer/Resilience Score”: In Section E, The Nurturing Environment, there are 6 items referenced in multiple publications (including Dr. Nadine Burke Harris’ work reported with pediatric patients) that can help individuals who have been through trauma. The highest score a client could receive is a 6 in this area, if all 6 items are present for a client.
As research continues to mount in this area, we are moving the buffers to a place of prominence in our work going forward, because of their preventive potential. We have noticed that solving barriers related to a caregiver’s engagement in buffers can actually prevent some of the so-called “behavioral problems” their client or family member was experiencing before the family, household or team became more resourced.
If you are interested in being a part of our research on integrating buffers preventively in practices, please reach out any time. We will be posting more formal opportunities in the future.
Help us by sharing the article with your team or friends. It’s open access as we value removing barriers to getting others the help they need. It’s all about how we operationalize and provide access to active nurturance for ourselves and those we care about.
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