Bruce Perry’s Neurosequential Model of Therapeutics

As we wind down this lengthy series of posts on trauma in children and adults, it is important that we look at some of the therapies that give us promise to recover from trauma and its consequences. We are very blessed at Lakeside to have Bruce Perry as one of our resources for trauma information.

NMT: A promising approach to treating trauma

Dr. Bruce Perry
Dr. Perry and his staff at the Child Trauma Academy have developed an innovative, promising approach to treating trauma.

Dr. Perry and his staff at the Child Trauma Academy have developed an innovative, promising approach to treating trauma based on neurobiological wounding. This approach is called Neurosequential Model of Therapeutics (NMT).

Basically, Dr. Perry and his staff have designed a process for creating brain maps of children who have experienced chronic or complex trauma. The maps can identify specific areas of the brain that have not been adequately nurtured and, in fact, may have been wounded. 

Once each segment of the brain map is coded, and those areas in need of somatosensory attention have been identified, the therapy involves systematically engaging each brain area with appropriate sensory activities, beginning with the areas deepest and lowest in the brain’s hierarchy in order to promote healing and recovery.

child abused

The maps can identify specific areas of the brain that have not been adequately nurtured and, in fact, may have been wounded.

A team approch is used in which clinicians take a neurosequential trauma history to create a map for a child. Then in addition to clinical therapy, those who have relationships with the child will partner in providing neurosequentially respectful interactions, especially whenever outward behaviors indicate a specific brain area’s traumatic wounding has been activated.

Note: The following has been excerpted from the Child Trauma website. Family professionals who are interested in learning more are encouraged to visit this Web site to discover more information about the nature of NMT. [http://www.childtrauma.org/index.php/services/neurosequential-model-of-therapeutics] 

What is the Neurosequential Model of Therapeutics?

The Neurosequential Model of Therapeutics (NMT) is a developmentally-informed, biologically-respectful approach to working with at-risk children. The NMT is not a specific therapeutic technique or intervention; it is a way to organize the child’s history and current functioning to optimally inform the therapeutic process.

scared child watches from closet

The NMT is not a specific therapeutic technique or intervention; it is a way to organize the child’s history and current functioning to optimally inform the therapeutic process.

The NMT integrates several core principles of neurodevelopment and traumatology into a comprehensive approach to the child, family and broader community. The NMT process helps match the nature and timing of specific therapeutic techniques to the developmental stage of the child, and to the brain region and neural networks that are likely mediating the neuropsychiatric problems. 

The goal of this approach is to structure assessment of the child, the articulation of the primary problems, identification of key strengths and the application of interventions (educational, enrichment and therapeutic) in a way that will help family, educators, therapists and related professionals best meet the needs of the child.  Active participation of caregivers and other adults in the child’s life is important to the success of the NMT; indeed, by weaving various activities throughout the child’s various relationships and environments, the majority of “therapeutic” experiences are provided outside of the actual context of conventional therapy.

The model has three key components: assessment, staffing/training and the array of recommended therapeutic, educational and enrichment activities (see Perry, 2006; Perry and Hambrick, 2008; Perry, 2009).  A related approach, the Neurosequential Approach to Caregiving (NAC) incorporates the same principles but the practical application informs parenting, early childhood education, education and a range of other settings where focus of the work is not specifically “clinical” in nature. This application of neurodevelopmental principles, the NAC, is a powerful complement to the use of NMT in clinical populations.

The many benefits of NMT

Boy on chair screaming

While clinicians may be involved in the most serious cases of trauma and in designing the specific strategies for an individual child, the general theories of NMT might prove extremely beneficial to all professionals and caregivers who interact with the child, from Early Childhood Education staff to parents.

NMT appears to have many potential benefits because it is so specific in terms of the neurobiology behind it and the respect for the need to address the most primitive brain issues first before sequentially moving up the brain to address each new area in need of repair. It is also exciting to think that while clinicians may be involved in the most serious cases and in designing the specific strategies for an individual child, the general theories might prove extremely beneficial to all professionals and caregivers who interact with the child, from Early Childhood Education staff to parents.

Lakeside’s IPED Program, the Institute for Family Professionals, is planning to have this model as a part of our training soon as we have joined with the United Way of Southeastern Pennsylvania to bring Dr. Perry to Philadelphia. Dr. Perry will train our regional clinicians and other professionals how to utilize NMT to help children recover from trauma.

The NMT has exciting potential for all children who have experienced trauma. If we can add this model to the information we already have learned and understand, we can achieve new and unprecedented success in treating childhood trauma.

Gerry Vassar, President/CEO, Lakeside Educational Network

Some information is taken from Applying Trauma Principles, Diane Wagenhals, 2010. Licensed materials. All rights reserved.

3 Responses to Bruce Perry’s Neurosequential Model of Therapeutics

  1. Joe Hesh says:

    Fantastic!!!!

  2. Dorothy Gladsjo says:

    So this approach is not for community members to learn and give to PTSD kids?

    • Gerry Vassar says:

      Hello, Dorothy,

      Thank you for your question and for reading Lakeside Connect.

      Dr. Perry’s Neurosequential Model of Therapeutics has been designed primarily for clinicians. However, two more versions are being designed, one for educators and the other for caregivers. You may check on the status of these courses on the Child Trauma Academy web site.

      Thank you,
      Gerry