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BBrruuccee PPeerrrryy''ss IImmppaacctt 
CCoonnssiiddeerraattiioonnss ffoorr 
AArrtt TThheerraappyy && CChhiillddrreenn ffrroomm VViioolleenntt HHoommeess 
GGrreettcchheenn MMiilllleerr,, MMAA,, AATTRR--BBCC,, CCTTCC--SS 
RReeggiisstteerreedd BBooaarrdd CCeerrttiiffiieedd AArrtt TThheerraappiisstt || CCeerrttiiffiieedd TTrraauummaa CCoonnssuullttaanntt SSuuppeerrvviissoorr
Children FFrroomm VViioolleenntt HHoommeess:: 
IImmppaacctt oonn BBrraaiinn FFuunnccttiioonniinngg 
AA cchhiilldd wwhhoo wwiittnneesssseess,, hheeaarrss,, 
aanndd lliivveess iinn aa hhoommee wwhheerree aa 
bbaatttteerreerr iiss eennggaaggiinngg iinn 
aabbuussiivvee,, iinnttiimmiiddaattiinngg,, aanndd 
ccoonnttrroolllliinngg bbeehhaavviioorrss eexxiissttss 
uunnddeerr aa ccoonnssttaanntt ssttaattee ooff ffeeaarr 
aanndd ddaannggeerr.. 
AAss aa rreessuulltt,, cchhiillddrreenn wwhhoo 
wwiittnneessss aanndd lliivvee iinn tthhiiss 
vviioolleennccee rreettaaiinn,, rreeccaallll,, aanndd 
rreeaacctt ttoo tthheeiirr eennvviirroonnmmeenntt iinn aa 
ccoonnttiinnuuoouuss ssttaattee ooff tthhrreeaatt,, 
tteerrrroorr,, aanndd aallaarrmm..
CChhiillddrreenn FFrroomm VViioolleenntt HHoommeess:: 
IImmppaacctt oonn BBrraaiinn FFuunnccttiioonniinngg 
This persistent eexxppeeccttaattiioonn ooff 
eennddaannggeerrmmeenntt aanndd aaddaappttiinngg ttoo 
tthhiiss oonn--ggooiinngg tthhrreeaatt aalltteerrss tthhee 
cchhiilldd’’ss bbrraaiinn ddeevveellooppmmeenntt wwhhiicchh 
ddiirreeccttllyy iimmppaaccttss tthhee cchhiilldd’’ss wweellll 
bbeeiinngg pphhyyssiiccaallllyy,, eemmoottiioonnaallllyy,, 
bbeehhaavviioorraallllyy,, aanndd ccooggnniittiivveellyy..
Children FFrroomm VViioolleenntt HHoommeess:: 
IImmppaacctt oonn BBrraaiinn FFuunnccttiioonniinngg 
“The brain is organized in a 
hierarchical fashion such that all 
incoming sensory input first enters 
the lower parts of the brain.” 
~ Bruce Perry 
Applying Principles of Neurodevelopment to Clinical Work with 
Maltreated and Traumatized Children (2006)
BBrruuccee PPeerrrryy’’ss NNeeuurroosseeqquueennttiiaall 
MMooddeell ooff TThheerraappeeuuttiiccss ((NNMMTT)) 
The brain is responsible ffoorr mmooddeerraattiinngg 
tthhee cchhiilldd’’ss eemmoottiioonnaall,, bbeehhaavviioorraall,, ssoocciiaall,, && mmoottoorr ffuunnccttiioonniinngg.. 
TThheerraappeeuuttiicc iinntteerrvveennttiioonnss ccaann hheellpp bbrriinngg 
cchhaannggee iinn tthhee cchhiilldd bbyy iinnfflluueenncciinngg cchhaannggee iinn 
tthhee cchhiilldd’’ss bbrraaiinn.. 
AAppppllyyiinngg PPrriinncciipplleess ooff NNeeuurrooddeevveellooppmmeenntt ttoo CClliinniiccaall WWoorrkk wwiitthh 
MMaallttrreeaatteedd aanndd TTrraauummaattiizzeedd CChhiillddrreenn ((22000066))
State Dependent Functioning 
Child Trauma Academy- Seven Slide Series 
https://www.youtube.com/watch?v=1uCn7VX6BPQ
PPhhyyssiiccaall IImmppaacctt 
 HHoorrmmoonnee ccoorriittoossaall iiss rreelleeaasseedd bbyy tthhee 
bbrraaiinn ttoo rreessppoonndd ttoo iimmppeennddiinngg tthhrreeaatt 
 CCaauusseess iinnccrreeaassee iinn aaddrreennaalliinn, hheeaarrtt 
rraattee, bblloooodd pprreessssuurree, mmuussccllee tteennssiioonn 
 SSlleeeepp ddiissttuurrbbaanncceess 
 HHeeiigghhtteenneedd ssttaattee ooff aarroouussaall 
 HHyyppeerr vviiggiillaannccee // SSttaarrttllee rreessppoonnssee
EEmmoottiioonnaall IImmppaacctt 
 DDeepprreessssiioonn 
 IIrrrriittaabbiilliittyy 
 AAnnggeerr 
 FFeeaarrffuullnneessss 
 AAnnxxiieettyy 
 LLaacckk ooff aaffffeecctt
BBeehhaavviioorraall IImmppaacctt 
 AAggggrreessssiioonn 
 RReeggrreessssiioonn 
 NNiigghhttmmaarreess 
 SSeeppaarraattiioonn 
AAnnxxiieettyy 
 OOppppoossiittiioonnaall 
 RReeppeettiittiivvee ppllaayy
CCooggnniittiivvee IImmppaacctt 
 DDeeccrreeaassee iinn aatttteennttiioonn ssppaann 
 DDiiffffiiccuullttyy ccoonncceennttrraattiinngg 
 CCoonnffuussiioonn aarroouunndd ttrraauummaattiicc eevveenntt 
 MMeemmoorryy IImmppaaiirrmmeenntt 
 PPeerrssiisstteenntt iinnttrruussiivvee tthhoouugghhttss && iimmaaggeess 
 PPoooorr sseellff iimmaaggee aanndd sseellff eesstteeeemm
CCoonnssiiddeerraattiioonnss ffoorr IInntteerrvveennttiioonnss 
 Appropriate ddeevveellooppmmeennttaall lleevveell 
 PPrroovviiddee aa sseennssee ooff ssaaffeettyy && pprreeddiiccttaabbiilliittyy 
 RReeppeettiittiioonn 
 RReellaattiioonnaall eennrriicchhmmeenntt 
 EExxppeerriieennccee ooff rreewwaarrdd 
AAppppllyyiinngg PPrriinncciipplleess ooff NNeeuurrooddeevveellooppmmeenntt ttoo CClliinniiccaall WWoorrkk wwiitthh 
MMaallttrreeaatteedd aanndd TTrraauummaattiizzeedd CChhiillddrreenn ((22000066))
TTrraauummaa IInnffoorrmmeedd GGrroouupp WWoorrkk:: 
Group ssttrruuccttuurree iiss ddeessiiggnneedd ttoo ffoosstteerr:: 
 CCoonnssiisstteennccyy 
 PPrreeddiiccttaabbiilliittyy 
 SSaaffeettyy aanndd aabbiilliittyy ttoo mmaakkee cchhooiicceess 
 RReellaattiioonnaall iinntteerraaccttiioonn 
 AApppprroopprriiaattee rroollee mmooddeelliinngg
AArrtt EExxppeerriieennttiiaallss 
Sensory bbaasseedd aaccttiivviittiieess tthhaatt eexxpplloorree:: 
-- AAcccceeppttaannccee aanndd ttrruusstt 
-- VVaalliiddaattiioonn ooff eexxppeerriieennccee 
-- EEdduuccaattee && nnoorrmmaalliizzee ttrraauummaa rreeaaccttiioonnss 
-- PPrroommoottiinngg eemmoottiioonnaall eexxpprreessssiioonn 
-- CCooppiinngg aanndd sseellff--rreegguullaattiioonn
Gretchen Miller, MMAA,, AATTRR--BBCC,, 
CCTTCC--SS 
EE--mmaaiill:: ggrreettcchheennmmiilllleerr@@ccooxx..nneett 
OOnn tthhee wweebb:: ggrreettcchheenn--mmiilllleerr..ccoomm 
BBlloogg:: ggrreettcchheennmmiilllleerrwwoorrddpprreessss..ccoomm

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Bruce Perry's Impact: Considerations for Art Therapy & Children from Violent Homes

  • 1. BBrruuccee PPeerrrryy''ss IImmppaacctt CCoonnssiiddeerraattiioonnss ffoorr AArrtt TThheerraappyy && CChhiillddrreenn ffrroomm VViioolleenntt HHoommeess GGrreettcchheenn MMiilllleerr,, MMAA,, AATTRR--BBCC,, CCTTCC--SS RReeggiisstteerreedd BBooaarrdd CCeerrttiiffiieedd AArrtt TThheerraappiisstt || CCeerrttiiffiieedd TTrraauummaa CCoonnssuullttaanntt SSuuppeerrvviissoorr
  • 2. Children FFrroomm VViioolleenntt HHoommeess:: IImmppaacctt oonn BBrraaiinn FFuunnccttiioonniinngg AA cchhiilldd wwhhoo wwiittnneesssseess,, hheeaarrss,, aanndd lliivveess iinn aa hhoommee wwhheerree aa bbaatttteerreerr iiss eennggaaggiinngg iinn aabbuussiivvee,, iinnttiimmiiddaattiinngg,, aanndd ccoonnttrroolllliinngg bbeehhaavviioorrss eexxiissttss uunnddeerr aa ccoonnssttaanntt ssttaattee ooff ffeeaarr aanndd ddaannggeerr.. AAss aa rreessuulltt,, cchhiillddrreenn wwhhoo wwiittnneessss aanndd lliivvee iinn tthhiiss vviioolleennccee rreettaaiinn,, rreeccaallll,, aanndd rreeaacctt ttoo tthheeiirr eennvviirroonnmmeenntt iinn aa ccoonnttiinnuuoouuss ssttaattee ooff tthhrreeaatt,, tteerrrroorr,, aanndd aallaarrmm..
  • 3. CChhiillddrreenn FFrroomm VViioolleenntt HHoommeess:: IImmppaacctt oonn BBrraaiinn FFuunnccttiioonniinngg This persistent eexxppeeccttaattiioonn ooff eennddaannggeerrmmeenntt aanndd aaddaappttiinngg ttoo tthhiiss oonn--ggooiinngg tthhrreeaatt aalltteerrss tthhee cchhiilldd’’ss bbrraaiinn ddeevveellooppmmeenntt wwhhiicchh ddiirreeccttllyy iimmppaaccttss tthhee cchhiilldd’’ss wweellll bbeeiinngg pphhyyssiiccaallllyy,, eemmoottiioonnaallllyy,, bbeehhaavviioorraallllyy,, aanndd ccooggnniittiivveellyy..
  • 4. Children FFrroomm VViioolleenntt HHoommeess:: IImmppaacctt oonn BBrraaiinn FFuunnccttiioonniinngg “The brain is organized in a hierarchical fashion such that all incoming sensory input first enters the lower parts of the brain.” ~ Bruce Perry Applying Principles of Neurodevelopment to Clinical Work with Maltreated and Traumatized Children (2006)
  • 5. BBrruuccee PPeerrrryy’’ss NNeeuurroosseeqquueennttiiaall MMooddeell ooff TThheerraappeeuuttiiccss ((NNMMTT)) The brain is responsible ffoorr mmooddeerraattiinngg tthhee cchhiilldd’’ss eemmoottiioonnaall,, bbeehhaavviioorraall,, ssoocciiaall,, && mmoottoorr ffuunnccttiioonniinngg.. TThheerraappeeuuttiicc iinntteerrvveennttiioonnss ccaann hheellpp bbrriinngg cchhaannggee iinn tthhee cchhiilldd bbyy iinnfflluueenncciinngg cchhaannggee iinn tthhee cchhiilldd’’ss bbrraaiinn.. AAppppllyyiinngg PPrriinncciipplleess ooff NNeeuurrooddeevveellooppmmeenntt ttoo CClliinniiccaall WWoorrkk wwiitthh MMaallttrreeaatteedd aanndd TTrraauummaattiizzeedd CChhiillddrreenn ((22000066))
  • 6. State Dependent Functioning Child Trauma Academy- Seven Slide Series https://www.youtube.com/watch?v=1uCn7VX6BPQ
  • 7. PPhhyyssiiccaall IImmppaacctt  HHoorrmmoonnee ccoorriittoossaall iiss rreelleeaasseedd bbyy tthhee bbrraaiinn ttoo rreessppoonndd ttoo iimmppeennddiinngg tthhrreeaatt  CCaauusseess iinnccrreeaassee iinn aaddrreennaalliinn, hheeaarrtt rraattee, bblloooodd pprreessssuurree, mmuussccllee tteennssiioonn  SSlleeeepp ddiissttuurrbbaanncceess  HHeeiigghhtteenneedd ssttaattee ooff aarroouussaall  HHyyppeerr vviiggiillaannccee // SSttaarrttllee rreessppoonnssee
  • 8.
  • 9. EEmmoottiioonnaall IImmppaacctt  DDeepprreessssiioonn  IIrrrriittaabbiilliittyy  AAnnggeerr  FFeeaarrffuullnneessss  AAnnxxiieettyy  LLaacckk ooff aaffffeecctt
  • 10.
  • 11. BBeehhaavviioorraall IImmppaacctt  AAggggrreessssiioonn  RReeggrreessssiioonn  NNiigghhttmmaarreess  SSeeppaarraattiioonn AAnnxxiieettyy  OOppppoossiittiioonnaall  RReeppeettiittiivvee ppllaayy
  • 12. CCooggnniittiivvee IImmppaacctt  DDeeccrreeaassee iinn aatttteennttiioonn ssppaann  DDiiffffiiccuullttyy ccoonncceennttrraattiinngg  CCoonnffuussiioonn aarroouunndd ttrraauummaattiicc eevveenntt  MMeemmoorryy IImmppaaiirrmmeenntt  PPeerrssiisstteenntt iinnttrruussiivvee tthhoouugghhttss && iimmaaggeess  PPoooorr sseellff iimmaaggee aanndd sseellff eesstteeeemm
  • 13.
  • 14. CCoonnssiiddeerraattiioonnss ffoorr IInntteerrvveennttiioonnss  Appropriate ddeevveellooppmmeennttaall lleevveell  PPrroovviiddee aa sseennssee ooff ssaaffeettyy && pprreeddiiccttaabbiilliittyy  RReeppeettiittiioonn  RReellaattiioonnaall eennrriicchhmmeenntt  EExxppeerriieennccee ooff rreewwaarrdd AAppppllyyiinngg PPrriinncciipplleess ooff NNeeuurrooddeevveellooppmmeenntt ttoo CClliinniiccaall WWoorrkk wwiitthh MMaallttrreeaatteedd aanndd TTrraauummaattiizzeedd CChhiillddrreenn ((22000066))
  • 15. TTrraauummaa IInnffoorrmmeedd GGrroouupp WWoorrkk:: Group ssttrruuccttuurree iiss ddeessiiggnneedd ttoo ffoosstteerr::  CCoonnssiisstteennccyy  PPrreeddiiccttaabbiilliittyy  SSaaffeettyy aanndd aabbiilliittyy ttoo mmaakkee cchhooiicceess  RReellaattiioonnaall iinntteerraaccttiioonn  AApppprroopprriiaattee rroollee mmooddeelliinngg
  • 16. AArrtt EExxppeerriieennttiiaallss Sensory bbaasseedd aaccttiivviittiieess tthhaatt eexxpplloorree:: -- AAcccceeppttaannccee aanndd ttrruusstt -- VVaalliiddaattiioonn ooff eexxppeerriieennccee -- EEdduuccaattee && nnoorrmmaalliizzee ttrraauummaa rreeaaccttiioonnss -- PPrroommoottiinngg eemmoottiioonnaall eexxpprreessssiioonn -- CCooppiinngg aanndd sseellff--rreegguullaattiioonn
  • 17. Gretchen Miller, MMAA,, AATTRR--BBCC,, CCTTCC--SS EE--mmaaiill:: ggrreettcchheennmmiilllleerr@@ccooxx..nneett OOnn tthhee wweebb:: ggrreettcchheenn--mmiilllleerr..ccoomm BBlloogg:: ggrreettcchheennmmiilllleerrwwoorrddpprreessss..ccoomm