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The Neurosequential Model of Therapeutics
Abstract and Figures
T he developing child is a miracle of complexity. Billions of dynamic processes, internal (e.g., release of neurotransmitter at the synapse) and ex ternal to the child (e.g., interactions with caregiv ers and family), work together to influence, shape, and create the individual. Each person becomes unique, with his or her collection of strengths and vulnerabilities. In some cases the vulnerabilities can be profound, interfering with the capacity to engage others, participate in, contribute to, and ap preciate the fullness of life. For centuries scholars have known to some degree that the capacity to ex press full human potential is related to the balance of developmental opportunities and challenges. In extreme cases of developmental challenge such as maltreatment-threat, neglect, humiliation, degra dation, deprivation, chaos, and violence-children express a range of serious emotional, behavioral,
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... Additionally, children enrolled in the preschool complete a brain mapping process developed by Perry (2008). The Neurosequential Model of Therapeutics (NMT) is a developmentally sensitive, neurobiologically informed approach to clinical work with children who have experienced trauma. ...
There is a preponderance of evidence that childhood poverty is associated with several mental health disorders later in life including post-traumatic stress disorder, major depressive disorder, and anxiety disorders. In this study, we employed a single-case research design to investigate the impact of Child-Centered Play Therapy (CCPT) on preschool children who have experienced multigenerational poverty and are trauma-affected. Participants demonstrated improvement in interpersonal skills and exhibited fewer behavior and attention problems. Implications, limitations, and recommendations for further research are discussed.
... Research suggests that exposure to family violence has a long-lasting effect on children of all ages and genders with preliminary research suggesting boys may react more with challenging behaviors to attachment stress while girls, on the other hand, may internalize their distress (Powell & Morrison, 2017). How a child's developmental trajectory is impacted depends, in part, on the age and developmental stage when exposure to violence begins, as well as the length and the severity of the family violence (Perry & Hambrick, 2008;Van der Kolk, 2005). For an eleven-year-old boy, as he prepares to navigate adolescence and secondary school, there are important milestones for him to achieve in responsive and reciprocal family relationships such as enabling him to be able to create a reciprocal relationship of meaning-making in the family, and to be able to anticipate another's underlying processes of construction (Kelly, 1991a). ...
This paper introduces the innovative practice of Dynamic Aesthetic Emancipation. It aims to enhance trauma care by emphasizing how the transformative potential of integrated arts and nature-based modalities leads to emancipatory changes for individuals that surpass conventional care and counseling methods. The practice utilizes the aesthetic and experiential aspects of creative and natural modalities to bridge the gap between personal healing and social dynamics. We highlight the necessity of approaches that empower clients to actively engage with art and nature, thereby challenging conventional therapeutic roles.
The assessment for ADHD is particularly challenging in the presence of known or suspected coexisting conditions or presentations, such as other neurodevelopmental conditions, mental health conditions or intellectual disability, but accurate identification of aetiology is vital to ensure appropriate and effective support or intervention is offered. This paper focuses on the assessment for ADHD in the context of possible or known developmental trauma, two presentations with significant overlap and co-occurrence. Using theoretical knowledge and clinical experience we attempt to offer a framework to guide assessment. An overview of each of these presentations is given; similarities and differences in key domains for each presentation are defined; and features in a child’s presentation that may have been attributed to possible ADHD but may in fact be related to developmental trauma are identified. Guidance regarding the approach to assessment of ADHD for a child who may also present with developmental trauma, is woven through the paper.
https://www.routledge.com/Jungian-Counseling-and-Play-Therapy-Classical-Theory-for-the-Digital-Age/McRoberts/p/book/9781032559834
Jungian Counseling and Play Therapy is a textbook for graduate-level counseling students and supervisees. It is both an introduction to Jung’s theory and a practical guide to Jungian-informed practice.
Readers journey through the development of the mental health crisis of the digital age (which Jung foresaw) and are presented with solutions he suggested that are still being met with resistance, despite compelling facts. This book not only advocates for a more widespread integration of Jungian ideas into clinical practice, but for greater acknowledgement of the integrity, creativity, and intersecting identities of clients, professional counselors, and play therapists. Integrating historical theory with contemporary research, this book helps students to weave creative techniques into their online and in-person clinical work.
This is an ideal text for a psychodynamic theory, or methods class, or to support counseling students and supervisors becoming interested in, or familiar with, the work of Carl Jung.
Table of Contents: 1. An Ongoing Journey: Personal and Professional 2. Why Jung? 3. The Structure of the Psyche 4. The Functions of the Psyche 5. The Language of the Unconscious 6. Space and Time Together: The Role of the Counselor 7. Creative Techniques 8. When We Reach the End
Although dysregulated stress biology is becoming increasingly recognized as a key driver of lifelong disparities in chronic disease, we presently have no validated biomarkers of toxic stress physiology; no biological, behavioral, or cognitive treatments specifically focused on normalizing toxic stress processes; and no agreed-upon guidelines for treating stress in the clinic or evaluating the efficacy of interventions that seek to reduce toxic stress and improve human functioning. We address these critical issues by (a) systematically describing key systems and mechanisms that are dysregulated by stress; (b) summarizing indicators, biomarkers, and instruments for assessing stress response systems; and (c) highlighting therapeutic approaches that can be used to normalize stress-related biopsychosocial functioning. We also present a novel multidisciplinary Stress Phenotyping Framework that can bring stress researchers and clinicians one step closer to realizing the goal of using precision medicine-based approaches to prevent and treat stress-associated health problems.
Purpose:
To identify the theory, knowledge, and practical applications that clinical nurse specialists should consider adding to their "toolkit" to support them in caring for people affected by cancer with young children.
Data sources:
Expert opinion and relevant studies on the topic formed the basis of this article.
Conclusion:
A conversation with experts identified five key areas of knowledge important to supporting clinical nurse specialists in caring for people affected by cancer with young children: family-centered and systemic practice, nursing responsibilities and competencies, trauma-informed practice, adult life stages, and stages of child development. Key areas identified have relevance to all healthcare professionals working in cancer care.
Implications for nursing practice:
This article provides a useful overview of psychological theories important to supporting healthcare professionals in caring for people affected by cancer. A discussion on the boundaries and competencies of the nursing role led to agreement about practical advice rooted in theory and knowledge that could benefit clinical practice. Concepts of emotional labor and the wounded healer were identified as important to inform reflection and supervision when caring for a parent affected by cancer who has a young family.
Studies of childhood abuse and neglect haveimportant lessons for considerations of natureand nurture. While each child has uniquegenetic potentials, both human and animalstudies point to important needs that everychild has, and severe long-term consequencesfor brain function if those needs are not met. The effects of the childhood environment,favorable or unfavorable, interact with all theprocesses of neurodevelopment (neurogenesis,migration, differentiation, apoptosis,arborization, synaptogenesis, synapticsculpting, and myelination). The time coursesof all these neural processes are reviewed herealong with statements of core principles forboth genetic and environmental influences onall of these processes. Evidence is presentedthat development of synaptic pathways tends tobe a ``use it or lose it'' proposition.Abuse studies from the author's laboratory,studies of children in orphanages who lackedemotional contact, and a large number of animaldeprivation and enrichment studies point to theneed for children and young nonhuman mammals tohave both stable emotional attachments with andtouch from primary adult caregivers, andspontaneous interactions with peers. If theseconnections are lacking, brain development bothof caring behavior and cognitive capacities isdamaged in a lasting fashion.These effects of experience on the brainimply that effects of modern technology can bepositive but need to be monitored. Whiletechnology has raised opportunities forchildren to become economically secure andliterate, more recent inadvertent impacts oftechnology have spawned declines in extendedfamilies, family meals, and spontaneous peerinteractions. The latter changes have deprivedmany children of experiences that promotepositive growth of the cognitive and caringpotentials of their developing brains.
The current diathesis-stress model of schizophrenia proposes that a genetic deficit creates a predisposing vulnerability in the form of oversenstivity to stress. This model positions all psychosocial events on the stress side of the diathesis-stress equation. As an example of hypotheses that emerge when consideration is given to repositioning adverse life events as potential contributors to the diathesis, this article examines one possible explanation for the high prevalence of child abuse found in adults diagnosed schizophrenic. A traumagenic neurodevelopmental (TN) model of schizophrenia is presented, documenting the similarities between the effects of traumatic events on the developing brain and the biological abnormalities found in persons diagnosed with schizophrenia, including overreactivity of the hypothalamic-pituitary-adrenal (HPA) axis; dopamine, norepinephrine, and serotonin abnormalities; and structural changes to the brain such as hippocampal damage, cerebral atrophy, ventricular enlargement, and reversed cerebral asymmetry. The TN model offers potential explanations for other findings in schizophrenia research beyond oversensitivity to stress, including cognitive impairment, pathways to positive and negative symptoms, and the relationship between psychotic and dissociative symptomatology. It is recommended that clinicians and researchers explore the presence of early adverse life events in adults with psychotic symptoms in order to ensure comprehensive formulations and appropriate treatment plans, and to further investigate the hypotheses generated by the TN model.
The enduring effects of abuse and related adverse experiences in childhood. A convergence of evidence from neurobiology and epidemiology . Anda R.F., Felitti V.J., Bremner J.D., Walker J.D., Whitfield C., Perry B.D., Dube S.R. & Giles W.H. ( 2005 ) European Archives of Psychiatry and Clinical Neuroscience , ePub, posted online 29 November 2005 .
Background Childhood maltreatment has been linked to a variety of changes in brain structure and function and stress–responsive neurobiological systems. Epidemiological studies have documented the impact of childhood maltreatment on health and emotional well-being.
Methods After a brief review of the neurobiology of childhood trauma, we use the Adverse Childhood Experiences (ACE) Study as an epidemiological ‘case example’ of the convergence between epidemiological and neurobiological evidence of the effects of childhood trauma. The ACE Study included 17 337 adult HMO (Health Maintenance Organization) members and assessed eight adverse childhood experiences (ACEs) including abuse, witnessing domestic violence, and serious household dysfunction. We used the number of ACEs (ACE score) as a measure of cumulative childhood stress and hypothesized a ‘dose–response’ relationship of the ACE score to 18 selected outcomes and to the total number of these outcomes (comorbidity).
Results Based upon logistic regression analysis, the risk of every outcome in the affective, somatic, substance abuse, memory, sexual, and aggression-related domains increased in a graded fashion as the ACE score increased (P < 0.001). The mean number of comorbid outcomes tripled across the range of the ACE score.
Conclusions The graded relationship of the ACE score to 18 different outcomes in multiple domains theoretically parallels the cumulative exposure of the developing brain to the stress response with resulting impairment in multiple brain structures and functions.
Child and mother outcomes are reported for the Abecedarian Project, an early childhood education, pediatric healthcare, and family support program for high-risk children and their mothers. Three randomized intervention conditions for at-risk participants were compared to a control condition. Randomized control group participants received family support social services, low-cost or free pediatric care, and child nutritional supplements but no additional educational program beyond what the parents and the local school system provided. The local community was generally affluent and well educated; disadvantaged families represented a small minority whose welfare was a high social and educational priority.
The neuroarcheology of childhood mal treatment: The neurodevelopmental costs of adverse childhood events
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The Neurosequential Model of Thera peutics: Applying principles of neuroscience to clinical work with traumatized and maltreated children
- B D Perry
Perry, B. D. (2006). The Neurosequential Model of Thera
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Implementing the Neurosequential Model of Therapeutics© (NMT) with Filial Therapy in a thera peutic preschool setting: Implications for work with children with serious emotional disturbance
- S Barfield
- R Gaskill
- C Dobson
- B D Perry
Barfield, S., Gaskill, R., Dobson, C., & Perry, B. D. (submit
ted). Implementing the Neurosequential Model of
Therapeutics© (NMT) with Filial Therapy in a thera
peutic preschool setting: Implications for work with
children with serious emotional disturbance.