LSCI is trauma-informed care in action! Alex Cameron, Director of Clinical Services, Pressley Ridge
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Trauma-Informed Whitepaper (PDF)

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LSCI & Trauma-Informed Practice

One of the most prominent and promising models for helping children whose brains are affected by stress and trauma is Dr. Bruce Perry’s Neurosequential Model of Therapeutics, also known as NMT (Perry & Szalavitz, 2017). As its name indicates, Perry’s model teaches us that the stressed brain has specific needs that must be met in proper sequence in order to be effective. Regulating, Relating & Reasoning are the three essential (and sequential) steps for assessing and addressing the challenging behaviors of young people. We summarize the 3 R’s as follows:


Before we can be of any real help to a person, we must make them feel safe both physically and emotionally. Regulation is a process that involves calming, or in LSCI terms—draining off—the intense emotions triggered in the brain by a stressful event or memory. Adults help kids become more regulated when we do things like providing a space for them to calm down, encouraging deep, rhythmic breathing, giving opportunities for movement to burn off the neurochemicals associated with the fight/flight/freeze response, offering a drink of water, and reassuring them that they are safe. Similarly, co-regulation is a process through which adults purposefully and skillfully use their own calm demeanor as a tool to create feelings of calm in a child.

Regulation and co-regulation skills are standard practice in the LSCI process. Every LSCI intervention begins with providing the time, space, and place for a young person to become physically and emotionally regulated. In LSCI, we call these practices Emotional First Aid & Drain Off.


Until a child’s brain is regulated, he/she is unable to relate in any meaningful way with a helping adult. Perry’s model and the LSCI approach share the practice that after regulating/draining off a child’s intense emotions, the next priority is connection and relationship. Adults effectively relate to kids when we listen to them, validate their feelings, decode the meaning behind their behaviors, and affirm that we care about their well-being. In the LSCI model, Regulate & Relate skills are standard practice during what we call Stage 1: Drain Off.


Usually when kids are experiencing stress, we observe a high intensity of emotion, along with perhaps loud talking, pacing, crying, defiance, aggressive behavior, self-harm, or other expressions of their feelings. Too often when we see a child seething with emotion after a conflict, we also observe a well-intentioned adult asking them things like, “Why did you do that? What were you thinking? How are you going to fix this? What’s your plan?” We recognize that the adult is trying to be helpful by employing reason with the child. The problem is, of course, that the child can’t process reason, language, and logic at this time because his limbic brain is engaged but his neocortex is not.

Both Dr. Perry and the LSCI approach recognize that real, effective reasoning can only take place after the child is regulated and has established the basis of a trusting relationship with an adult. Once these prerequisites are in place, the child can engage in the higher-level, thinking brain functions of perspective-taking, reflection, and problem-solving.

Stage 2 of the LSCI process, called the Timeline, is a systematic process of helping kids reason by putting language to emotion, telling their stories, and feeling heard and understood. The subsequent LSCI stages extend the reasoning process by fostering insight into troubling patterns of behavior, building pro-social skills, and setting the conditions for long-term behavioral change.