Advances in Neurobiology and Neuropsychotherapy in understanding the development of the young brain have demonstrated the need for early intervention to address childhood trauma and subsequent detrimental neural development.

The prevailing paradigms of psychopharmacological and cognitive based interventions as first line interventions for treatment of childhood trauma are confronted with a growing body of neurodevelopmental and neurobiological research that points toward the fundamental development of the right hemisphere during the last trimester pre natally and the first two years post natally.

Violation of basic needs (attachment, orientation and control, self-esteem enhancement and self-esteem protection and pleasure maximization and distress avoidance are explored in terms of neural development and developmental dysfunctions.

Since neurologist Paul MacLean postulated the Triune Brain Theory, research into neural development indicated the key functions of gene expression, synaptogenesis, neural plasticity, neural pruning and enriched environments and the detrimental effects of childhood trauma.

One of the most fundamental aspects of effective interventions (enriched environments) is the facilitation of secure attachment. Violation of secure attachment (especially in the very early stages of neural development) leads to the formation of protective (avoidance) neural loops - implicit memory systems which express especially in the limbic structures, right prefrontal cortex, anterior cingulate and orbito frontal areas.

The implications of these neural facilitations for therapeutic interventions are discussed. Specific reference is made to early intervention and challenges in rural and remote areas to provide effective service delivery. Specific strategies for early intervention are proposed.

Dr Julie Rowse, Ballarat Health Services - will speak at The 4th Australian Rural and Remote Mental Health Conference,in Adelaide on November 19th to 21st 2012

PUTTING PEOPLE FIRST: MENTAL HEALTH NEEDS AND INITIATIVES IN AUSTRALIAN RURAL AND REMOTE COMMUNITIES.