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First Nations adults continue to experience significant health disparities compared to non-First Nations adults in Canada. Ongoing difficulties associated with intergenerational trauma among First Nations peoples may be examined using the adverse childhood experiences (ACEs) model, which measures various forms of abuse, neglect, and household dysfunction. We examined prevalence rates of ACEs and physical and mental health outcomes within a predominately First Nation sample of clients seeking substance use treatment from a First Nations-led treatment facility. The prevalence of ACEs was higher than national averages and previous data collected with broader Indigenous samples in Canada. Descriptive analyses of ACEs and health outcomes for those seeking First Nations-led substance use treatment showed these participants had more chronic health difficulties co-morbid with clinical levels of problematic substance use. To improve ongoing best-treatment options for those seeking substance use treatment, continued assessment and promotion of broader aspects of health and wellbeing are required, including the balance of physical, emotional, spiritual, and mental health and wellbeing across a lifespan.

Adverse childhood experiences (ACEs) have been associated with increased mental health difficulties across a lifespan. Given increased health disparities among Indigenous populations compared to non-Indigenous populations, screening for ACEs is particularly relevant as it can inform future preventative care and treatment approaches. There has been no literature to date about how to best integrate these practices into routine psychological assessment with Indigenous clients. We describe five recommendations for assessing ACEs with Indigenous clients that are based on anecdotal research and clinical practices but aligned with standard evidence-based assessment practices. The preliminary recommendations for ACE assessment are: (1) determine the relevance of the assessment, (2) convey a sense of purpose and meaning during assessment, (3) use therapeutic assessment techniques, (4) use the ACE model for further client psychoeducation, and (5) use culturally relevant measurement techniques. These suggestions may provide a more meaningful and culturally relevant psychological assessment, but research is needed to support them.