TBRI Therapy, or the Trust-Based Relational Intervention Therapy, is a caregiver-based therapy. It’s an alternative to the traditional model of providing therapy in a practitioner’s office to at-risk children. Caregivers are taught to properly support and treat the children. Its low cost and effectiveness are making this therapy popular among caregivers of at-risk children.
TBRI Therapy is for children of all ages that deal with the major issues that stem from experiencing complex developmental trauma. This refers to that when multiple incidents have occurred, such as frequent physical abuse. Many therapies address issues stemming from only a single incident. Children placed in an orphanage or in foster care frequently experience complex developmental trauma. According to the Child Welfare Information Gateway, there were 427,910 children in foster care in the United States in 2015. It’s likely that a large number of these children will need therapy.
This principle focuses on creating a solid foundation by providing for the child’s physical needs. One component is to create a safe environment, both physically and cognitively. Another is meeting all the child’s sensory needs. Traumatized children often have sensory disorders that can have an impact on social and motor skills as well as behavior. Providing sensory activities allow for children to organize their emotions and mental thoughts. Another component is ensuring that the child has adequate nutrition. Significant changes in behavior can occur as blood sugar changes. A goal is to stabilize the child’s blood sugar.
This principle is concerned with providing for the child’s attachment needs. One component is observational awareness where caregivers analyze a child’s anxiety and comfort level, including their non-verbal cues. Through attentive responsiveness, caregivers can prevent negative behavioral episodes. Self-awareness by the caregiver is another component. The caregiver becomes aware of their emotions and attachment style. Steps are taken to create a secure attachment relationship with the child. Playful engagement is another component which cultivates warmth and trust in the relationship. If this part of the relationship doesn’t exist, then therapeutic play activities are recommended. The last component is attunement which deals with the degree a caregiver is participating in creating a harmonious relationship with the child. This area analyzes the verbal and non-verbal communications in the relationship and seeks to improve the needed areas.
This principle deals with the child’s behavioral needs. The goal is to build the child’s social abilities. The components are based on cognitive behavioral therapy (CBT). The proactive behavioral strategies, such as role-playing and verbal reminders, are taught in a way that would prevent behavioral problems. Responsive behavioral strategies are taught for when a child has exhibited unacceptable behavior. Two approaches were developed for this type of therapy called the Level of Response and the IDEAL Approach. These approaches instruct caregivers how to deal with the misbehaviors.
Implementing this therapy is suitable in a wide variety of settings such as foster homes, orphanages, adoptive homes, schools, and treatment centers. The low cost, the ability to begin treatment immediately, and the greater variety of treatment settings make TBRI Therapy more accessible and likely to have greater gains in the well-being of at-risk children than traditional therapeutic models.