What is TBRI? 

Trust-Based Relational Interventions (TBRI) is what behavioral experts describe as an attachment-based and trauma-informed intervention. TBRI is designed and mainly used to help vulnerable children overcome past traumas. 

TBRI uses what its proponents refer to as Empowering Principals, Connecting Principals, Correcting  Principals to address a vulnerable child’s physical needs and disarm their fear-based behaviors that stem from trauma. 

TBRI was developed by Karyn Purvis and Dr. David Cross, who utilized their attachment-based treatment to assist foster and adopted children and their adoptive families. As Dr. Purvis states, “ I look at children and their adoptive families from a holistic perspective, keeping relationships at the heart of the work I focus on.”

What Are The Empowering Principals of TBRI?

Empowering Principals are the foundation of TBRI. What’s more, it is a term that describes attention to addressing a child's physical needs to make them feel safe and secure after experiencing trauma that has caused them to develop emotional and mental health-related issues, such as PTSD. 

As Dr. Pruvis and Cross describe, Empowering Principals to assist vulnerable children in developing essential skills and self-regulation. These Principals are split into two types of treatment strategies, Physiological Strategies and Ecological Strategies. 

Physiological Strategies focus on meeting the internal physical health of children. These strategies include meeting essential needs such as hydration, feeding, regulating blood sugar, and sensory needs. 

Ecological Strategies are defined as actions that address a child’s external environment, including helping them through transitions, establishing routines and daily rituals. 

So, What is TBRI and Empowering Principals Used for? 

As we briefly discussed, TBRI is designed to treat children who have complex needs and mental health-related issues. While it was created to reach foster and adopted children, it effectively treats any child who has experienced trauma, toxic stress, early harm, and other damaging adversities. 

Children who have suffered early traumas typically have extreme challenges with bonding with others, especially adults, regardless of how loving they happen to be. This disconnection and inability to trust adults commonly results in the child displaying odd, out-of-control, or otherwise abnormal behaviors. Enter TBRI. Trust-Based Relational Interventions provide parents or caregivers of a child with trauma the tools to see the “whole child” so that they may help them overcome their trauma-related issues and reach their full potential.

Why Should Parents and Caregivers Use TBRI? 

Children who have suffered trauma, especially during their formative first few years of life, deal with issues most of us adults can’t begin to process. These children’s trauma has not only affected their psyche but has caused physical changes in their bodies, brains, behavioral patterns, and their trust in humanity. In other words, whereas typical parenting strategies may work for a child who does not have PTSD, children with a traumatic past require more hands-on and intensive therapeutic strategies that meet their unique and complex needs. 

This is where TBRI and utilizing its Empowering Principals come in. Parents and caregivers that utilize the tools of TBRI can better reach the child who otherwise would find it immensely difficult to accept their caregiver’s nurturing support or doting love. As we all know and children with PTSD have shown us, any child can and will benefit from a nurturing, trusting relationship with those who are in charge of keeping them safe and making them feel loved.

Ecological Strategies

It is essential to understand the difference between "being safe" and "feeling safe" as caregivers. This distinction helps caregivers recognize when a child's out-of-control or strange behaviors are more than just childish defiance or belligerence. Take hunger, for instance. While the parent or caregiver obviously knows they will never let their child go hungry, the child in their care does not. In other words, while the child's safety isn't in question, whether they feel or are even able to accept that truth is another issue entirely. Fear-based behavior can come from this. Ecologically we can empower our children by creating an environment of felt safety through routines and rituals.

Below is a small list of rituals and routines that can help a child better understand and consciously appreciate the fact they are safe: 


  • Secret handshakes
  • Bedtime rituals that involve safe touch (bedtime rituals can also help with sleep issues)
  • Nicknames
  • Funny way to greet the child
  • Dinner together (and involving a child in planning)
  • Family traditions
  • I love your rituals


  • Keeping a weekly journal that documents the child's behaviors to understand what behaviors need to be addressed.
  • Make a schedule that the child will easily learn to trust and depend on (eat, hydrate, activity every 2 hours)
  • Do things together, such as going shopping, the park and eating healthy snacks and bonds.
  • Bedtime rituals that involve safe touch (bedtime rituals can also help with sleep issues)
  • Create calendars, schedules, behavior charts that empower the child to know what is to be expected and when changes will occur
  • Roleplay and/or discuss when changes will occur or how to respond appropriately

Physiological Strategies

Managing glucose levels, hydration, and nutrition (quality – quantity – frequency)

  • Small, regular snacks every 2 hours
  • Balance protein and complex carbs to help keep blood sugar stable
  • Avoid high sugar content foods, caffeine, and deep-fried foods
  • Consider organic
  • Consider allergies and sensitivities
  • Keep a water bottle available

Touch- Loving, healthy touch is so important!  It helps us to connect and reduces stress.  Cortisol levels drop with touch. So it is important to make it part of our routines and rituals.

  • Weather report massage (ask permission first)
  • Cuddling, bedtime routines
  • High Fives, special handshakes, and silly games involving healthy touch