Attachment & Trauma Center of Houston

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TBRI® Trust Based Relational Intervention

What is TBRI® Trust Based Relational Intervention?

Developed by Dr. Karyn Purvis and Dr. David Cross at the TCU Child Development Institute. It has been successfully used for children with a wide range of behavioral challenges for whom other interventions have failed. TBRI® consists of three sets of harmonious principles: Connecting, Empowering, and Correcting. It is a holistic approach that is attachment-centered and flexible for challenging behaviors.

Therapy for Children
TBRI® Trust Based Relational Intervention

How TBRI® Helps?

Most children are treated through the traditional medical model—consisting of visits to a practitioner’s office, with caregivers playing a superficial role in the child’s treatment. TBRI® includes caregivers and may be more effective because treatment occurs in the child’s environment where challenges occur. Our center involves parents in the treatment to provide the parent with the necessary strategies to respond to the behavioral challenges. Relationship-based trauma can only be resolved through loving, stable relationships such as can be offered by nurturing caregivers.


Children who have experienced relationship-based trauma or early childhood trauma due to medical interventions need to feel safe and secure in order to respond appropriately. Traditional discipline triggers the child’s fight or flight response and behaviors escalate rather than decrease.

Parents and caregivers learn to look for the causes behind the behavior and create a safe environment for the child based on those needs. The phrase “A Scary Child is a Scared Child” describes the cause frequently pushing the extreme behaviors seen in children with attachment and trauma challenges.

Our therapists provide the support and education needed to implement this program in a strategic manner for your child’s needs. We understand change is hard and provide a team therapist approach to enable a successful implementation of this program for your family.

Regardless of their ages, all children and teens require the need to feel safe and secure with their caregivers. Providing nurturing support allows children to openly discuss their feelings with their parents resulting in a healthy relationship. Dysfunctional behaviors can create barriers that block the development of healthy relationships. Targeting the causes or feelings behind the behavior allows for healthy open conversation about those feelings.