Repair of Trauma

It is never too late, but earlier is better.

The first years of life are a very busy and crucial time for the development of brain circuits. The brain has the most plasticity, or capacity for change, during this time, which means it is a period of both great opportunity and vulnerability. The impact of experiences on brain development is greatest during these years—for better or for worse. It is easier and less costly to form strong brain circuits during the early years than it is to intervene or "fix" them later. However, brains never stop developing—it is never too late to build new neural circuits—but in establishing a strong foundation for brain architecture, earlier is better.

Grant Sinnamon (2013) refers to a six-step neurosequential model of intervention for functional brain deficits resulting from abuse, trauma, neglect, illness & developmental interference. 

  • Regulate
  • Evaluate
  • Present
  • Attend
  • Intervention
  • Re-engage

Regulate refers to regulating the environment and removing any threats.

  • Providing a calm and predictable environment limits the reflexive stress responses from triggers
  • Environment is free from threatening stimuli and triggers.  These are not always obvious and can be things such as physical, psychological and social threats, physiological stress response triggers such as noises, surprises or judgmental commentary.

Evaluate refers to undertaking context-appropriate assessments i.e. understanding what is going on with the young person from psychosocial functioning or neurological functioning.

Present refers to providing loving and stable supports that are present and available.

  • Children need a supportive presence that is not threatening – this relates to both a physical presence and emotional availability (unconditional positive regard)

Attend to immediate needs

  • Do so without expectation of “fixing” the young person.
  • This is inclusive of physical, health, emotional, education and social needs.

Intervene refers to providing formal therapeutic intervention if required

Re-engage refers to reassuring and building resilience


Further Resources