Neurosequential Model of Therapeutics

Summer landscape

I am Phase One certified in Neurosequential Model of Therapeutics (NMT).

Founded by psychiatrist and trauma specialist, Bruce Perry, NMT is a developmentally-informed approach that provides a map of client-specific treatment needs. This model sheds light on the intersection between biopsychosocial trauma and neurodevelopment by considering how the unique epigenetic, genetic, and developmental profiles of each client distinctively result in presenting self-regulatory, relational, intellectual, and sensorimotor vulnerabilities and strengths. Backed by years of extensive research, NMT provides a platform for better understanding how the idiosyncratic timing, pattern, and nature of biopsychosocial insults and buffers directly influence brain maturation. NMT emphasizes that neuropsychological change as well as the trauma-mitigating and growth-facilitating development of resiliency occur within the potent matrix of stable, predictable, long-term relationships.

 

NMT is considered a multidimensional assessment tool intended to guide clinical decision-making. For example, a client may present as chronically on-edge and hyperactive. Information gathered during the intake period reveals a history of maternal trauma at the time of the client's perinatal development in addition to an absence of stable, co-regulatory relationships in early childhood. Medically, the client has struggled with insomnia and asthma for years. Collectively integrating this information through an NMT lens, I would hypothesize that lower cortical regions of the client's brain (namely, the brainstem, diencephalon, and cerebellum) are underdeveloped due to autonomic overstimulation and persistent overactivity. Knowing that these areas of the brain are unresponsive to language-based interventions, I would collaborate with the client in co-constructing a treatment plan that initially relied upon heavy use of rhythmic, repetitive sensorimotor activities practiced in the context of safe and predictable relationships (such as with designated family members, friends, etc.).

 

Because the brain is plastic (meaning adaptive and capable of change) the intent of such sensorimotor interventions would be to facilitate the maturation of the noted cortical regions in order to 1) reduce hyperactivity and ideally, improve insomnia and asthma, and 2) provide later treatment access to higher, executive-level, neocortical skill development (such as logically talking oneself through a situation when anxious or pre-planning how to cope with anticipated anxiety in certain circumstances). Given that brain development is sequentially ordered, dysregulation of lower neural regions stalls neocortical regulation; not until the 'bottom' of the brain is nurtured can the higher, more complex areas thrive.