The ChildTrauma Academy
www.ChildTrauma.org
Neurosequential Model of Therapeutics
Frequently Asked Questions
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. This clinical approach helps professionals determine the strengths and vulnerabilities of a given child and create individualized intervention, enrichment and educational plans for children. Simply, the goal is to find the appropriate set of therapeutic activities that match a child’s current need in various domains of functioning (i.e., social, emotional, cognitive and physical). Patterned, repetitive and developmentally-appropriate activities provided in context of nurturing relationships are the keys to effective intervention. 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 therapeutic, educational and enrichment activities.
How was the Neurosequential Model of Therapeutics created?
Over the last fifteen years, the ChildTrauma Academy (CTA) has developed a neurobiologically-informed framework for working with traumatized and maltreated children. This framework is based on our growing understanding of complex issues facing children in today’s complex, modern world. Using a neurodevelopmental perspective has allowed us the opportunity to generate a common set of concepts and principles based in biology that has helped us better understand the etiology of many of problems seen in children with disrupted development; these disruptions can be from a range of developmental insults ranging from pre-natal drug or alcohol exposure to witnessing violence to intra-familial chaos to outright abuse and neglect. In addition, this perspective has helped us better understand the how to intervene and begin to heal the problems we see in these at-risk, maltreated and traumatized children. With regard to specific clinical work, the NMT approach has been used in CTA clinical work with maltreated and traumatized children for over a dozen years. The specific modification of this approach for special populations has been underway for the last seven years.
The leader in this process has been Dr. Rick Gaskill, a CTA Fellow, and Clinical Director at Sumner Mental Health Center in Kansas (http://www.childtrauma.org/aboutCTA/bio_gaskill.asp). Over the last seven years, Dr. Rick Gaskill and his colleagues in Kansas have been developing a therapeutic pre-school model (TPS) that integrates the NMT. Working with Dr. Perry and the ChildTrauma Academy, Dr. Gaskill developed our current version of the NMT-informed therapeutic preschool. Independent research by Dr. Sharon Barfield at the University of Kansas had documented the efficacy of this approach with high-risk children.
Where is the NMT currently being used?
The CTA is currently working with half a dozen sites interested in the NMT approach. Each of these projects is somewhat different but basically involves integrating NMT into clinical practice and program development. Key institutional partners in direct clinical include the Sumner Mental Health Center, Denver Children’s Advocacy Center, Denver Children’s Home, Kidzone in Philadelphia, and Green County Behavioral Health in Muskogee, Oklahoma. In addition, several large scale partnerships are in place to introduce the core concepts of NMT into existing policy, programs and practice into the child protective system. In Alberta, Dr. Perry and the CTA will be using the NMT staffing and a case-based training model with all of clinical and casework supervisors; in Illinois we are working with Northwestern University and DCFS in a multi-phase effort to bring trauma-informed, NMT-based clinical approach throughout the state through the foster care system. We are in discussion with several other major programs and communities regarding potential partnerships and capacity-building projects using the NMT.
How is the NMT model brought into a program?
Introducing the NMT involves a process of capacity building and training for the primary groups of adults working with the target population of children. Both community building and professional training activities are recommended. While individualized versions of this process are created for each program and community, the primary methods include: an on-sight series of training visits; distance learning opportunities using our online University (www.ChildTraumaAcademy.com), CTA-prepared training curriculum using DVD and prepared supplemental materials, and ongoing case-based and didactic trainings using Web-enhanced audio conferencing. Certification in the NMT model is now possible. Read more about our certification process.
Where can I get more information about the NMT?
A general overview chapter by Dr. Perry is available on the CTA Website (http://www.childtrauma.org/ctamaterials/NeurosequentialModel_06.pdf). Updates will be posted on this site periodically (www.ChildTrauma.org).
Specific project inquiries may be directed to Dr. Christine Dobson, Director of Programs at The ChildTrauma Academy (DrCDobson@sbcglobal.net ).
All other training and general inquiries regarding the NMT or other CTA projects and activities please direct to Jana Lihn Rosenfelt, Executive Director of The ChildTrauma Academy (JLRosenfelt@ChildTraumaAcademy.org; 281.932.1375).
