Behavior Dysregulation Program Overview
According to the CDC, 1 in 20 elementary students are prenatally exposed to alcohol. This is a staggering number that is not being address well. This often presents struggles for the individual that can be overlooked when it’s not understood. Identifying at-risk children includes looking at the prenatal exposure, the stability of their home, traumatic events that they and/or their parents have experience and whether they have positive influence within their circle to help build resiliency. An increasing number of children are experiencing chronic anxiety and depression. This is a significant concern that impacts the children now but could also affect how they are able to navigate their adult lives and the impact on the next generation. We know that children from hard places just grow up to become adults from hard places. This problem expands from the home and into our schools with behavioral dysregulation. We are also seeing an increase of behavioral health patients in our hospitals. The CEO of East Tennessee Children’s Hospital, Matthew Shaeffer, said children’s hospitals across Tennessee have seen around a 60% increase in children seeking mental healthcare during moments of crisis.
Our Behavior Dysregulation Program helps to address these issues. Our goal is to help bridge the gap for children and families in hard places. We want to see lasting impact and understanding that comes with education and treatment of the whole family.
The Behavior Dysregulation Program has its foundation in Trust Based Relational Intervention ® (TBRI) (1). It utilizes the basics of TBRI in a format for therapists to use within a therapeutic setting.
The Behavior Dysregulation Program has a specific intake process, then follows six stages that are to be completed within the 90 days. It is based on 1-2 sessions per week.
Testing is completed prior to starting the program and again around 90 days in the program. Testing is done with the child and primary caregiver.
Tests required: Caregiver- ACE Score
Resiliency Questionnaire
Perceived Stress Scale
Child- Sensory Profile
ADAS-R
BASC-3
ASEBA- CBCL Ages 1 ½ -5
CBCL Ages 6-18
Primary caregiver is required to participate and will complete three brief TBRI education meetings either individually or with a group. This can be done in person or online.
The goal is to see a reduction in caregiver stress and increase in caregiver resiliency, while also seeing a reduction in the child’s anxiety and depression scores.
Additional training regarding FASD or other concerns can be done prior to beginning the program or post the 90 days after second tests are administered.
It is our hope that this will provide a usable outline for therapists who are working with children from hard places to implement TBRI and other strategies to help bring hope and healing to families in crisis.
- Derived or reproduced from Trust-Based Relational Intervention ® resources (Purvis & Cross, 1999-2011).
Behavior Dysregulation Program COHORT
Training and Support provided to cohort participant
Initial training:
Provide education regarding the overall program, including utilizing sensory regulation.
Provide TBRI education, specifically strategies within the three pillars, Connection, Empowerment and Correction.
The base of the program is TRBI (Trust-Based Relational Intervention), however, other techniques are also utilized and reviewed during training.
Training will be providing via zoom format using a PowerPoint presentation.
Estimated time for training 3 hours.
Continued support:
Provide 3 monthly support meetings. (Review of steps and any troubleshooting needed)
Ongoing availability via email.
Overview of Program:
The program is conducted with an intake and six stages. It is front end loaded, with continued review of skills child and parents are learning. The last stage is primarily a review and administering second set of testing.
Each stage is outlined in steps to cover. The following are examples from each stage.
Intake: Assessment of parent’s ability. Initial testing administered.
Stage 1: Client draws a picture of self.
Stage 2: Playful Engagement is introduced, and examples are taught.
Stage 3: Parents are taught the basics of neurochemical imbalance and regulation through connection
Stage 4: Life Value Terms are taught
Stage 5: IDEAL ® Approach is taught
Stage 6: Review of skills learned. Final testing administered
Behavior Dysregulation Program Cohort & Support
Training & Consultation
Total Cost Cohort: $275
Training Date: July 24, 2025 (9am-12pm)
Consultation Dates: August 7, 2025 (12-1pm)
(Choose 3) August 28, 2025 (5-6pm)
September 8, 2025 (12-1pm)
October 16, 2025 (12-1pm)
October 30, 2025 (5-6pm)
All times are in Central Time Zone
Training format via zoom, PowerPoint and conversational education.
Program outline will be emailed in pdf format.
S. Chris Troutt, LMFT 