Adverse Childhood Experiences (ACEs) are “negative, stressful, traumatizing events that occur before the age of 18 and confer health risks across the lifespan” (Alberta Family Wellness, 2020; retrieved from https://www.albertafamilywellness.org/what-we-know/aces). Examples of ACEs include physical or emotional abuse or neglect, sexual abuse and household dysfunction. The more ACEs experienced, the greater the chance of poor outcomes later in life, including increased risk of substance use and mental health conditions, such as depression.

In-depth, ongoing process to inform the therapeutic approach. The practitioner collaborates with the individual and in consultation with them establishes the presence or absence of a challenge, identifies strengths and barriers to engagement, and areas of resilience, and determines whether there is a need for crisis intervention or specialist practitioner support, intervention or treatment.

A combination or co-occurrence of a substance use condition and a mental health condition Examples of concurrent substance use and mental health conditions are:

• Harmful use of alcohol and an anxiety disorder
• Cannabis dependence and schizophrenia
• Heroin dependence and borderline personality disorder