Erin Calhoun, MACPC LPCC-S is NMT™ Phase II Trained

Because a child’s brain is still developing, it is highly sensitive and reactive to experience. Abuse, neglect, trauma, chaos, and stress that occur during childhood have a particularly profound impact. Children are NOT resilient, in fact, they are incredibly vulnerable in extraordinary ways. Children are impacted by adversity in a profoundly more powerful way than even adults are. 

Childhood adversity may lead to developmental trauma and developmental trauma has the potential to impact every aspect of the individual's brain and body in very profound ways. Complications are enduring and can continue being problematic in adulthood, which is why NMT™-directed services are helpful for children, adolescents, and adults. Symptoms of developmental trauma can include fine and gross motor issues, sensory issues, speech issues, medical problems, social-emotional problems, behavioral problems, and difficulty with learning. Often, developmental trauma gets misdiagnosed as Attention-Deficit Hyperactivity Disorder, Oppositional Defiant Disorder, Conduct Disorder, depression, substance abuse, dissociation, and psychosis (Perry, B.D., p. 695). Inattention, hyperactivity, impulsivity, distractibility, defiance, aggression, mood issues, difficulty with relationships, guilt, shame, and poor self-image and self-esteem are often reported.

Unfortunately, many parents, teachers, doctors, and even clinicians do not understand the way stress, trauma, and childhood adversity impact brain organization and development. Traditional therapy and behavior-based interventions seldom work. Why? Because brain-based problems require brain-based interventions. Counseling at Brainwork Healing Center™, LLC uses interventions that target the systems or networks of the brain causing problematic symptoms in a way that is reparative and sequenced. This brain-based protocol in turn fosters healing and helps improve functioning. 

NMT™ is an evidence-based, developmentally sensitive, trauma-informed model guiding case conceptualization and intervention. It is not a specific therapeutic technique; rather, it uses concepts of traumatology, neurobiology, and developmental psychology to identify effective sequencing of intervention that provides reparative experience to the brain and thus tangible progress in social-emotional-behavioral-physical functioning (Perry and Dobson 2013).

Individuals may request a full NMT™ Assessment as needed. The NMT™ Assessment process involves the use of NMT™ Metrics, which create a visual image of the individual's current brain organization and functioning. The NMT™ Assessment is most helpful with complex cases, when there are multiple presenting problems, and/or when treatment has not been successful in the past. The NMT™ Assessment provides a neurobiological approach to understanding the individual's history and the impact both relationships and adversity have had on their unique neurobiological development and current functioning. This trauma-informed, neurobiological, developmentally sensitive lens helps identify and sequence effective, individualized intervention. 

NMT™ Metrics show the individual's developmental risk, a combination of their adverse experiences and buffering factors; sensory integration functioning; relational functioning; regulation functioning; cognitive functioning; cortical modulation ratio, and current relational health status. Results identify strengths and vulnerabilities in 32 brain-related areas of central nervous system functioning (e.g., cardiovascular, autonomic regulation, attention/tracking, dissociation, hyperarousal, gross motor, fine motor, coordination, expressive/receptive communication, speech/articulation, concrete cognition, abstract cognition, values and beliefs, etc.).  This identifies the individual's developmental age compared to chronological age expectations in each of the 32 anatomical areas of the brain represented (Cox et. al., 2019, p.188).

Typically, NMT™ Metrics are completed at intake in order to generate recommendations, every six months to review treatment effectiveness, and at discharge to show outcomes; however, initial recommendations may very well be sufficient. Detailed information is gathered related to the individual’s history and current level of functioning. During this phase, it is helpful to collaborate with the individual and their family, teachers, and providers (as applicable). An NMT™ Assessment is completed after sufficient information has been gathered. 

Once the assessment is complete, a session is scheduled to review the Metric Report and in-depth clinical recommendations.  Recommendations include both clinical recommendations and strategies for the classroom and school environment, if applicable. Results identify the neurobiological path necessary for sequenced, reparative experience needed in order for intervention to be effective. They may also identify underlying patterns contributing to a complex presentation unresponsive to intervention thus far. 

                                                                                                                                             References

CBS Mornings. (2018, March 6). Oprah explores “life-changing question” in treating childhood trauma [Video]. YouTube. 

          https://www.youtube.com/watch?v=gqu54ZlhINc

Cox, A., Perry, B.D., Frederico, M. (2019). Resourcing the System and Enhancing Relationships: Pathways to Positive Outcomes for Children  

          Impacted by Abuse and Neglect. Child Welfare Journal: Journal on Policy, Practice and Program, Vol. 98 (No. 6), 177-201.

Perry, B. D. (n.d.). The Neurosequential Model of Therapeutics: NMT as an Evidence-Based Practice. bdperry.com. Retrieved June 30, 2023,    

          from  https://www.bdperry.com/_files/ugd/5cebf2_008b61d5565846b48b494dffe35f51eb.pdf

Perry, B.D. (2017) Trauma-and stress-related disorders. In (T.B. Beauchaine & S.P. Hinshaw, Eds.) Child and Adolescent Psychopathology: 

          Third Edition, Wiley, New York, pp. 683-705.

Perry, B.D. & Dobson, C. (2013) Application of the Neurosequential Model (NMT) in Maltreated Children. In (J. Ford & C. Courtois, Eds)

         Treating Complex Traumatic Stress Disorders in Children and Adolescents, Guilford Press, New York, pp. 249-260.