The Neurosequential Model of Therapeutics™
The Neurosequential Model of Therapeutics™ (NMT) is not a specific therapeutic technique or intervention; it is a developmentally sensitive, neurobiologically informed approach to clinical work. NMT integrates several core principles of neurodevelopment and traumatology into a comprehensive approach to the child, family, and their broader community. The process helps match the nature and timing of specific therapeutic techniques to the child’s developmental stage and brain region and neural networks mediating the neuropsychiatric problems.
According to Dr. Perry, the creator of the model, The Neurosequential Model of Therapeutics maps the neurobiological development of maltreated children. Assessment identifies developmental challenges and relationships which contribute to risk or resiliency. Once identified, formal therapy is then combined with rich relationships by trustworthy peers, teachers, and caregivers.
The Goal of NMT
The goal of this approach is to structure the assessment of the child, articulation of the primary problems, identification of key strengths, and application of interventions (educational, enrichment and therapeutic) in a way that will help family, educators, therapists, and related professionals best meet the needs of each child. Active participation of caregivers and other adults in the child’s life is important to the success of the NMT, by weaving various activities throughout the child’s various relationships and environments.
3 Stages of NMT
Stage 1: Assessment
Make an assessment of where the child has been, a review of child's past experiences.
Stage 2: Observation
Identify where the child is now and their current functioning strengths & deficiencies.
Stage 3: Treatment
Direct where the child should go with application of interventions.
In the Assessment phase, the NMT process examines both the past and current experience and functioning, including a review of the history of adverse experiences and relational health factors to help create an estimate of the timing and severity of developmental risks that may have influenced brain development. Once determined, the information collected is plotted on maps to generate an overall risk assessment and then are compared to a “normal”/stable individual, to determine areas of focus. Based on the findings, and treatment plan, specific therapies and behaviors are modified in order to more closely align the child within clinical norms.
Above is an example of a functional brain “map” produced by the web-based NMT Clinical Practice Application. The left image (with the red squares) corresponds to a client (each box corresponds to brain functions mediated by a region/system in the brain. The map is color coded with red indicating significant problems; yellow indicates moderate compromise and green, fully organized and functionally capable). The right image is a comparative map for a “typical” same-aged child. The graphic representations allow a clinician, teacher, or parent to quickly visualize important aspects of a child’s history and current status. The information is key in designing developmentally appropriate educational, enrichment and therapeutic experiences to help the child. This clinical approach helps professionals determine the strengths and vulnerabilities of the child and create an individualized intervention, enrichment and educational plan matched to his/her unique needs. The goal is to find a set of therapeutic activities that meet the child’s current needs in various domains of functioning (i.e., social, emotional, cognitive and physical.