TBRI Final

Note 3

Caregiver package

Module 1

  • Impact of trauma on development

  • Why TBRI works

    • Founded in research and theory and experience 

    • Developed organically

  • Areas of child development

    • Cognitive

      • Piaget

    • Emotional

      • Erikson

    • Social

      • Bandura

    • Physical

    • Language

      • Brifennbrenner

    • Sensory

    • Sexual

  • Brain growth

    • Greater impact in adolescence and 0-3

    • Experience-expectant

    • Neuroplasticity

    • By age 5 90% of our brains growth has already happened

  • Upstairs vs downstairs brain

    • Hand model

  • Stress response

    • Fight flight freeze or fawn

      • Fawn -meet everyone else's needs 

    • Chronic stress leads to an overreactive stress response system

    • HPA axis

  • Flipping your lid

    • Stress response triggers 

    • Lose access to upstairs brain

    • Focus shifts to survival

    • Impact on children with early stress

      • More frequent lid flipping

      • Lower stress threshold

  • Why brain development matters

    • Caregiver must identify triggers and understand reactions which triggers compassion

    • Stress related behaviors mistaken for mental health disorders

  • Stress

    • Positive stress

      • Activated but responds to calm quickly

    • Tolerable stress

      • Fully activated but temporary

    • Toxic stress

      • Constant activation

  • Trauma types

    • Developmental

    • Relational

    • Historical 

    • Generational

    • Systemic

      • Ex living in a neighborhood in poverty, redlining, racism

    • Race-based trauma

  • 5 B’s of relational trauma

    • Behavior

    • Brain

    • Body

      • In many ways, it alters sensory experience of the world

    • Biology

    • Belief system 

      • Disrupt attachment and beliefs about the self

      • Self-awareness, self-regulation, self-esteem, and self-efficacy

  • Protective factors

    • More factors = higher rates of success

  • TBRI stands for Trust Based Relational Intervention. 

  • For the colors: The three principles of TBRI Strategies, Practices

  • Correcting

    • Proactive

      • Teach skills about healthy relationships 

      • Choices, redos, compromises, life values, behavioral scripts

      • Practice positive social skills (calm, alert), sharing powering and giving yeses, life value terms (with respect, use your words), behavioral scripts (choices, compromises, re-dos)

    • Responsive

      • Address challenging behaviors with the minimal amount of response necessary for the behavior

      • IDEAL response. 

        • IDEAL stands for immediate, direct, action, efficient, action-based, and leveled-at behavior.

      • Levels of response

        • 1 Playful engagement

        • 2 Structured engagement

        • 3 Calming engagement 

        • 4 Protective engagement

  • Empowering

    • Physiological -internal 

      • Empower bodies and help teach regulation 

      • hydration, nutrition, sensory needs, calming techniques, adequate sleep, physical activity, movement, glucose/sugar

    • Ecological -external (environment)

      • Help create an environment of predictability that helps people feel emotional security regardless of physical safety

      • Routines and rituals, calming techniques, adequate sleep, physical activity, transitions, self-regulation, scaffolding self-regulation through activities

  • Connecting

    • Mindfulness 

      • Designed to increase awareness in caregivers of their current states, past events/ triggers, and the state and history of their children and youth

      • Self-care, self-regulation, co-regulation, awareness

    • Engagement

      • Designed to foster connection for children and caregivers through non-verbal forms communication

      • Eye-contact, healthy touch, voice quality, playful interaction, behavior matching.

Module 3

  • 2-way secure and insecure

  • 3-way all but disorganized

  • Avoidant most comfortable exploring not attaching

  • Organized

    • Have patterns 

    • Secure, avoidant ambivalent

  • Disorganized

    • Survival focused behaviors

    • Lack of movement, hesitant approach, contradictory behavior, repetitive movements 

  • Often a reflection of how you were cared for

  • Mindful Awareness

    • awareness of self

    • Awareness of others

    • Awareness of the situation

  • Buttons

    • Triggers 

    • Understand them to help react appropriately in stressful situations

  • Attunement

  • Rupture and repair

    • No caregiver is perfect

  • Module 4

  • Engagement strategies

    • Voice

    • Tone and control

    • Playful engagement

    • Warm eye contact

    • Healthy touch

    • Behavior matching 

  • Parenting styles

    • High structure/ low nurture

    • Obedience, respect for authority

    • Discomfort with emotions, insisting the child shows respect

    • Retaining power as caregiver

    • Child may

      • Not feel safe to express emotions

      • Feel their needs are unimportant

      • Seek control through behaviors (eating and peeing and pooping)

    • To balance

      • Reflect on need for nurturing care

      • Resolve own history around receiving and expressing care

      • Practive emotional attunement and responsiveness

    • authoritarian

  • High nurture, low structure

    • Avoiding conflict, struggle to set limits

    • Child may

      • Struggle with boundaries

      • Lack of growth through challenges

    • Fear of losing connection 

    • Needed to “keep the peace in childhood”

    • Practice setting limits

    • Permissive

  • Low nurture low structure

    • Neglectful caregiving

    • Worse outcomes

    • Value independence over connection, hands off approach

    • Lack of emotionally mature relationships

    • Various mental health issues

    • Child may

      • Feel alone 

      • Struggle in relationships

      • Have unmet needs for affection

    • Reflect on need for more nurture and structure

    • Identify barriers to emotional availability


  • Test review lockdown browser -doesn’t have to go to class

    • 50 questions, 60 min to complete exam, each question is one point

  • How can you help your child recognize progress that has taken place?

    • Small signs of success

  • Example Progress in growth in learning behavioral skills but maybe having a set back

    • Set back is once then they go back to normal 

    • Get back on track and can admit that they were wrong

  • Rember childhood with humor and know that your parents did the best they could and have specific examples your attachment style is likely

    • Secure

  • What are the two tbri strategies for the empowering principle

  • Which of the following is not one of the 5 Bs of relational trauma

    • Broken

    • (beliefs, biology, behavior,,,,,

  • Which describes authoritative voice

    • Appropriate for the situation

  • Healthy touch 

    • Ask the childs permission before offering touch

  • __ are the primary means for communicating and interacting 

    • Engagement strategies

  • What is not a physiological need 

    • Managing transitions