Trust-Based Relational Intervention (TBRI) is a therapeutic model that trains caregivers to provide effective support and treatment for at-risk children -- particularly those who have experienced complex developmental trauma stemming from attachment disorders such as reactive attachment disorder (RAD). 

TBRI is widely used by foster care and applied in top-tier orphanages, courts, residential treatment centers, therapeutic boarding schools, and group homes. 

TBRI is a dynamic treatment widely used by a myriad of different schools and therapeutic professionals alike. In the following article, we will discuss its applications and list examples of how it is applied. 

The Origins of TBRI 

Trust-Based Relational Intervention was developed by the late Dr. Karyn Purvis and Dr. David Cross at the TCU Institute of Child Development in 1999. 

Dr. Purvis coined the term “children from hard places” to refer to those whose young lives are touched by hardship and trauma. Along with abuse, neglect and catastrophic events, it’s now recognized that normal development can be compromised as early as in the womb by unhealthy conditions or adversity in a pregnant woman’s life. So can difficult birth, and necessary medical procedures during infancy and early childhood – all of these are risk factors for developmental trauma and can result in the same kind of damage as intentional harm.

What began as a summer camp for adopted and orphaned children. TBRI was soon adapted to expand its focus by training professionals who work in the troubled teen industry, including foster homes, therapeutic boarding schools, and residential treatment centers.

Per the Karyn Purvis Institute’s official TCU website:  

“By the end of the first week and into the second week of camp, they saw dramatic changes in attachment, social competency with peers, and in language. These outcomes formed the empirical foundations for Trust-based Relational Intervention (TBRI)®, a model for children from “hard places. Since the days of the first Hope Connection® Camp, which focused on families who adopt children from hard places, the Institute has expanded its focus by training professionals who work in a variety of caregiving contexts, including foster homes, residential settings, courtrooms, and classrooms.”

Who is TBRI for? 

While the treatment was initially used to treat the maladaptive symptoms of orphans and foster care children suffering from reactive attachment disorder (RAD) and other related disorders, TBRI has since been clinically proven to treat underlying issues in children who have experienced disorders such as: 

  • Toxic stress
  • Post-traumatic-stress-disorder (PTSD) 
  • Adversity stemming from early childhood

TBRI is provenly successful in treating children who have difficulty trusting, respecting, or even loving adults because of their traumatic histories. Moreover, this treatment provides caregivers, parents, and therapeutic professionals the tools to see “disenfranchised” and misunderstood children as a “whole child” -- allowing said children to reach their highest potential in the process.  

Why is TBRI Necessary?

When it comes to certain types of traumatized children -- such as those suffering from reactive attachment disorder -- regular therapeutic interventions are ineffective. Due to their past traumas, certain types of children experience emotional and even physiological changes that affect their behaviors, brain chemistry, and even bodily functions. Even with the right parenting strategies, medications, and traditional psychiatric methods, children with early-onset traumatic histories are in need of alternative care. TBRI is a treatment that is able to address the complexities and deep-seated, underlying issues that traditional psychiatric methods are not able to.

“All children need to know they are precious. Children from hard places need to know it more desperately.” – Dr. Karyn Purvis

What are the Empowering Principals of TBRI? 

The TBRI model can be broken down into two empowering principles. These empowering principles are classified into two groups, physiological strategies, and ecological strategies. Both strategies work to address all the needs of a child and ser4ve to help children learn important life skills and strategies pertaining to self-regulation. 

The two types of empowering principles are:

  • Physiological principles consist of strategies that focus on a child's physical necessities, including feeding, hydrating, blood sugar, and other sensory requirements.  
  • Ecological principles, which consist of strategies focusing on the child’s external environment, include transitions, scaffolding (guided support appropriate to a child’s level that facilitates learning), routines, and daily rituals.

Using TBRI to Treat Underlying Issues of Troubled Youth 

Teens with Reactive Attachment Disorder (RAD) suffer from deep-seated, underlying issues that traditional therapy oftentimes cannot properly address. This means that teens with RAD are especially prone to developing unhealthy and self-destructive coping mechanisms and behaviors that negatively impact their lives.

That said, experts recommend that parents of a RAD-afflicted, troubled teen seek out the services of a program that offers Trust-Based Relational Intervention. It is only through treatment models like TBRI that teens with RAD can effectively learn to cope with and eventually overcome past traumas. 

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