The Adverse Childhood Experiences (ACE) Study provided compelling evidence that abuse, neglect, and other ACEs are the most potent risk factors for the development of health, mental health, and substance use problems. Such negative health-related outcomes parallel the cumulative exposure of the developing brain to the stress response, with resulting impairment in multiple brain structures and functions. Collectively, these sequelae can manifest during childhood, adolescence, or adulthood. We and others have posited that counseling and other psychotherapeutic interventions need to address the individual's multilayered ecology (i.e., biological, psychological, social, cultural/contextual). Neurocounseling can provide a heuristic framework to more effectively assess, conceptualize, and counsel people with a history of ACEs. We provide an update of the clinical neuroscience of ACEs and its implications for counseling, including how contemporary interventions (e.g., mindfulness) can potentially have positive benefits for such individuals.

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