The **Neurosequential Model of Therapeutics (NMT)** is a **developmentally sensitive, neurobiology-informed approach** to clinical problem-solving in the context of trauma. Developed by **Dr. Bruce D. Perry**, NMT is **not a specific therapy** but rather a framework that helps professionals organize a child’s (or adult’s) history and current functioning to inform treatment planning. ### Clinical Definition NMT is **a neuroscience-based, stage-sequential approach to clinical assessment and intervention** that recognizes how trauma impacts the developing brain. It integrates principles of neurodevelopment and the sequential organization of brain function to guide therapeutic interventions. The model emphasizes that **the brain develops hierarchically**, meaning that lower, more primitive areas (brainstem, midbrain) must be regulated before higher cognitive functions (cortex) can be effectively engaged. ### How NMT is Employed in Treating Trauma #### Assessment Using the Neurosequential Mapping Process - Clinicians assess a person’s **developmental history**, identifying **adverse childhood experiences (ACEs)** and how they have influenced brain development. - A **functional brain map** is created, highlighting areas of strength and [[Dysregulation]]. #### Sequential and Developmentally Appropriate Interventions - **Regulation First:** Since trauma often affects the **brainstem and limbic system**, interventions start by targeting **sensory and regulatory activities** before moving to cognitive therapies. - **Relational Strategies:** Safe, predictable relationships are essential for healing. - **Higher-Level Therapies (Only When Ready):** Traditional talk therapy is introduced **only after** lower brain regions have been stabilized. #### Multimodal and Individualized Treatment - **Body-based therapies**: Rhythmic activities (e.g., music, dance, movement, yoga) help regulate brainstem function. - **Relational therapy**: Attachment-based interventions provide a safe, nurturing environment. - **Cognitive therapies**: Only after emotional and physiological regulation, techniques like **CBT or EMDR** are used for trauma processing. ### Core Principles of NMT in Trauma Treatment - **“Bottom-Up” Approach:** Healing starts by stabilizing **lower brain areas** before engaging higher reasoning and emotional processing. - **Sequential Developmental Focus:** Therapy should match the person’s **developmental stage**, not just chronological age. - **Multisensory Interventions:** Trauma recovery requires a mix of sensory, relational, and cognitive approaches. - **Neuroplasticity and Repetition:** Repetitive, rhythmic activities help **rewire** trauma-impacted brain circuits. NMT is widely used in **child welfare, juvenile justice, education, and clinical mental health settings** to improve treatment outcomes for trauma survivors.