The ChildTrauma Academy
The ChildTrauma Academy Newsletter
July 2010
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BORN FOR LOVE: Why Empathy is Essential and Endangered
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The work of the CTA and our partners continues.  Beta-testing of our web-based Neurosequential Model of Therapeutics (NMT) metrics and brain mapping process started this month; we will feature this project in an upcoming newsletter.   If you aren't familiar with NMT you can read more on our website.  This approach to clinical work often recommends the use of therapeutic and enrichment activities or techniques that may seem atypical or unconventional.  There is, however, clear neurobiological rationale for these recommendations.  One of these therapeutic methods is hippotherapy and equine-assisted therapy).  Although both are emerging fields, they show great promise with dysregulated children (see below). We are also excited to inform you about two upcoming training opportunities with CTA: our Fall 2010 NMT Case-Based Training Series and our second class of Phase I Individual Certification in the NMT.  


     Of all of the hundreds of animal species only a few have been domesticated.  This handful of animal species includes horses and dogs.  Recent research suggests that both species have co-evolved with human populations and have specialized capacity for non-verbal communication and bonding with humans.  This unique feature of their biology allows both species to be used in a range of activities - many of which can have educational and therapeutic benefits.
     The range of emotional, behavioral, social and physiological benefits of human-animal interactions are under-researched. However, emerging research evidence, and a long history of clinical experience, indicates that animals, particularly horses and dogs, have strong therapeutic potential.
      One type of equine assisted therapy, therapeutic riding, is particularly beneficial when a client has experienced a traumatic event affecting his or her ability to form relationships (Yorke, Adams, & Coady, 2008). For example, many people who experience trauma feel a lack of self-efficacy, control, connectedness to others, and acceptance. Therapeutic riding helps them feel capable (because riding is an acquired skill), as if they are in control (because they control the horse and can control whether or not they choose to "tell" their trauma narrative while riding).  Riding also helps them feel connected to another living being (because riding requires a close physical connection and mutual interaction) and feel accepted because the horse accepts them as a rider. The positive somatosensory regulation that can accompany grooming and riding the horse add to this special bonding experience.
      Though therapeutic riding is gaining popularity, Hippotherapy, another type of equine assisted therapy, may have even more benefits to offer. Hippotherapy is provided by occupational therapists, physical therapists, and speech therapists, and it utilizes the sensorimotor aspects of riding to achieve therapeutic gains. Those with developmental delays, sensory integration problems, neurological deficits, speech deficits, and neuromuscular disorders, such as cystic fibrosis, have all shown improvement after receiving hippotherapy.
     How does Hippotherapy work?  It is likely that a primary therapeutic effect of riding is due to the rhythmic and soothing effects. Second, riding is a bit unpredictable and causes the rider to become aware of proprioceptive cues that promote neuromuscular awareness, balance, and strength. Proprioception refers to one's awareness of where his or her body (and specific parts of their body) is in relation to other objects or other parts of the body. People with problems balancing or with other gross motor impairments often have proprioceptive deficits and require practice integrating sensory cues. Without integrated sensory awareness, one cannot plan and execute balanced, fluid motion. Third, riding requires the use of many sensory organs, as one physically feels the horse as they ride, looks to make sure he remains steady, and listens for cues from the instructor, all of which promote sensory integration (e.g., the senses working together). Fourth, riding simulates the pelvic motions necessary for walking and, thus, activates and strengthens muscles that support walking. This stimulation also reduces spasticity, a symptom of many CNS disorders characterized by rigidity in muscles or an inability to fully "relax" and stretch muscles. Fifth, the variable pace of a horse easily lends itself to a gradual progression of a client's therapy.
     Research on Hippotherapy is in its infancy. However, there is emerging evidence that this therapy is more effective at promoting balance, motor control, proprioception, and sensory integration than rocking horses and other inanimate objects, such as barrels (American Hippotherapy Association, 2010). Some insurance providers, such as Aetna, are considering reimbursement for Hippotherapy as evidence increases. As with so many other areas in the field of traumatology, much more research is needed; questions regarding "dosing," duration and targeting specific symptom clusters which appear to be more or less responsive to this approach need to be addressed.
Yorke, J., Adams, C., & Coady, N. (2008). Therapeutic Value of Equine-Human Bonding in Recovery from Trauma. Anthrozoos, 21, 17-30.

Further Reading:

The American Hippotherapy Association Website

Click Here for an annotated bibliography of current research findings provided by Aetna Insurance.

INDIVIDUAL CERTIFICATION in the Neurosequential Model of Theraputics: Phase I
The NMT Individual Training Certification program is modeled after our Program/Institutional Training Certification Program.  Phase I for Individuals offers an introduction to the NMT concepts, metrics and staffing methods. Individuals successfully completing Phase I may continue with Phase II certification which includes a Train-the-Trainer component and advanced training to allow supervision of NMT staffings.
Applicants for Phase I must have at least a master's degree in the social sciences or equivalent, a current license, currently working with children and families, and have participated in at least 1 NMT Case-based Staffing Series (may be waived if clinician has participated in other CTA trainings).
Cost for Phase I is $5,000/per person and includes 10 Individual Certification NMT Case-based Staffings, recordings of 30 NMT Staffings in our Fall, Winter, Spring/Summer NMT Case-based Staffing Series; CTA Videos - Series 1 & 3 and Early Childhood and Brain Development; Series 1 Educators' Package and Reading Materials.  
Click Here to submit an application via our online form.

To learn more about the NMT, visit the NMT page on our website.
Apply now to be part of our 2010 Class!  Applications accepted until July 31, 2010.

Registration Now Open for Fall 2010 NMT Case-Based Training Series
We are currently registering participants for our Fall 2010 Case-Based Training Series -- which begins Friday, October 1, 2010!

The NMT Case-Based Training Series is a clinical case conference series led by Dr. Bruce Perry and attended by participants via the Internet (with audio provided via teleconference). Low cost and convenient format! The Series consists of ten 90-minute case staffings in which Dr. Perry uses the Neurosequential Model (NMT) to conceptualize each case and further illustrate the model. He walks participants through the creation of a brain map for each case and, along with CTA Fellows, teaches on a variety of case-related topics.

During the Fall 2010 Series, we will dedicate one session each to the following five topics:
-- Update on NMT Metrics
-- Play Therapy
-- Psychopharmacology: Dissociation
-- Trauma in Infants
-- Use of the NMT in Adult Populations

Cases are brought forward by the participants in the series. Participants are provided with topic overviews, annotated bibliographies and handouts. Sessions are recorded and available for convenient viewing.

This teaching model has received glowing reviews by participants -- stating it has been extremely useful for helping clinicians and front-line staff better understand the neurodevelopmental principles involved in many of the primary symptoms, as well as strengths, they see in the children they serve.

Enjoy fifteen hours of live instruction/consultation with Dr. Bruce Perry and interaction with professionals throughout the US and the world - without ever having to leave your office! Certificates of completion are available.

Organizational Rate is $1825 for all 15 hours of training with up to 25 participants in a single room. Individual Rate is $650 for all 15 hours of training.

Training Dates:
October 1, 8, 15, 22, 29
November 5, 19
December 3, 10, 17

All trainings to take place on Fridays at 11:30am cst

Register Now via our subscription form!
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Bruce D. Perry, M.D., Ph.D.
The ChildTrauma Academy