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Trauma and the Neurosequential Model of Therapy™ (NMT)

Defining Trauma

Overcoming Adversity

Emotional and psychological trauma is the result of extraordinarily stressful events that shatter a child’s sense of security, making them feel frightened, helpless, and isolated. Abuse and neglect are obvious sources of trauma, but divorce, lack of financial resources, and loss can also create chronic stress. Children from every walk of life – including those from good, loving homes – can have mental health challenges that our professionals can help overcome.

How does trauma affect brain development?

The brain develops sequentially, from the bottom up and from the inside out. There are four layers in the brain. Basic survival skills originate in the lower region of the brain (brain stem) and complex thinking comes from the top layer of the brain (cortex).

When a child experiences an adverse event, the brain stem is activated. If they remain in their lower brain too long, children can become mentally and emotionally stuck at the age when their trauma occurred. For example, if a child experienced prolonged stress when they were five, their emotional maturity can stay at that age even though their bodies continue to grow.

Kids operating in their brain stem often “act out” by being aggressive, argumentative, impulsive, or irritable. Other symptoms can be a lack of concentration, sleep disturbances, hypervigilance, or flashbacks. They may run away, physically hurt themselves or others, withdraw or become overly emotional.

Neurosequential Model
of Therapeutics™ (NMT)

Dr. Bruce Perry is a psychiatrist and internationally-recognized authority on children in crisis. His research on the connection between trauma and the growing brain in children led him to develop the Neurosequential Model of Therapeutics™. Alexander Youth Network created a model of care based on the science behind Dr. Perry’s evidence-based work. Alexander became the first NMT Flagship Agency in the nation in 2012. NMT is a way to organize a child’s history and current functioning. It emphasizes the importance of positive, supportive relationships and nurturing experiences to help children stabilize, heal and grow. This therapy works on the most disorganized parts of the brain and re-trains the brain to react and process information in healthier ways. At Alexander, NMT is a caring, focused approach that creates a more peaceful environment with fewer physical interventions. We don’t just control kids with challenging behaviors, we give them the respect, empathy, and love to help them learn to self-regulate.

Brain Mapping

A brain map is the product of a highly specialized assessment that tells us precisely what areas of the brain have not yet developed. It is not a diagnostic-imaging procedure.  Brain mapping is conducted by Alexander’s licensed clinicians who are certified by the Child Trauma Academy, an organization founded by Dr. Perry. The map is a colorful depiction of the brain, making it easier for everyone involved in the child’s care to see where trauma has affected the brain. It serves as a blueprint for the experts at Alexander to prescribe individualized treatment and track a child’s progress.  

The 6Rs – How NMT works best


Relationships create change and building trust is key. Family involvement is also vitally important to help kids heal and recover.


Developmentally matched to the individual’s needs, based on the results of the brain map.


The brain needs to experience new things over and over to fully grasp them.


It’s fun but also lowers the brain stem temperature and levels of stress hormones, giving children the peace they crave.


Activities that follow a strong, simple rhythm are most soothing to the human brain.


Of the child, family, culture and experiences.

“Repetitive, big-muscle activities help regulate brain activity, empowering the brain to get back on track so kids can overcome obstacles they faced in the past. We teach kids what it feels like to be in a normal, unaroused state so once they’re in that state, they know how to get back to it. The results of the brain map determine which activities, such as therapeutic drumming, swimming, biking, yoga, pottery, or pet therapy, will be most effective for a child.”

Visit the Child Trauma Academy  to learn more about NMT

Neurosequential Model of Therapeutics™ Training and Consultation

As a Neurosequential Model of Therapeutics™ site, we are able to provide training in the Core Concepts of NMT and interventions that are consistent with the NMT approach. We have provided training to community partners such as Charlotte-Mecklenburg Schools, Cabarrus County Schools, Buncombe County Department of Social Services, Behavioral Health Care, Benchmarks, and others.

Our NMT certified clinicians are also available to conduct NMT assessments and treatment planning consultations for children, families, and agencies nationwide.

To obtain more information about our NMT programs and training and consultation services, please email

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