Implementing the Neurosequential Model of Therapeutics in Tennessee: Parent and Clinician Perspectives (Child Wefare)

Child Welfare publication, Child Trends, September 25, 2020.

^{The QIC-AG is a five-year project working with eight sites that implemented evidence-based interventions or developed and tested promising practices which, if proven effective, can be replicated or adapted in other child welfare jurisdictions. Effective interventions are expected to achieve long-term, stable permanence in adoptive and guardianship homes for waiting children as well as children and families after adoption or guardianship has been finalized.}

The NMT is not a specific treatment protocol; rather, it provides a structured, neurobiologically informed approach for organizing a child’s developmental history
and current functioning to inform the clinical decision making and treatment planning.

The Quality Improvement Center for Adoption and Guardianship Support and Preservation (QIC-AG) recently completed its evaluation of an enhanced approach for Adoption Support and Preservation (ASAP) services in Tennessee. Specifically, the Tennessee Department of Children’s Services (DCS), in collaboration with a private agency (Harmony Family Center, or Harmony), implemented the Neurosequential Model of Therapeutics (NMT) in the eastern area of the state.ⁱ The QIC-AG compared outcomes for families served in that part of Tennessee (the treatment group) with families that received services as usual (the comparison group) in the remainder of the state. A second private agency under subcontract with Harmony—Catholic Charities—served the comparison group.ⁱⁱ Across four outcome measures (child behavior problems, staff satisfaction with their delivery of ASAP services,ⁱⁱⁱ familial relationships, and caregiver commitment), the QIC-AG observed gains for treatment and comparison groups, on average, in all four fields. However, the only statistically significant impact that emerged—that is, the only area in which progress was greater for the treatment than for the comparison group—was for behavior problems, and the effect size was small. 

Copied from attached brief:
“It’s a lot that these kids have gone through, and you’re parenting blind. You don’t know what their triggers are, what fully happened to them. It’s like putting a blindfold on and try[ing] to parent and walk through the world. It’s hard. I was underwater, except for my nose. That was the only thing allowing me to breathe, that my nose was above water.” –Comparison group parent

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