The Gateway Model

At Gateway Psychology, we aim to facilitate each child’s movement through the challenges or ‘gateways’ faced at a particular time, whether emotional, behavioural, relational or developmental. We recognise that the child or young person exists within a wider, often complex context and are careful to ensure that any ‘problems’ are not seen to be solely located within the child. Our Gateway Model reflects this view.

First and foremost: a firm foundation

Every structure or process needs a firm foundation if it is to stand strong and endure. All children need a safe base from which they can explore their world, both external and internal, and be provided with comfort, protection and delight in their ‘going out’ and their ‘coming back’.

The relationship between the child and their main carer is this foundation and is crucial to support a sometimes unsettling therapy process.

An all-encompassing Arch of Support

For child and carer to feel safe and secure and for the child to grow and develop, they need to be surrounded by a robust arch of support, working collaboratively and without conflict. Like the keystone in an arch, this cohesive approach holds the system and ultimately the child together.

We work closely with the system around the child, including parents/carers, schools, social workers, extended family, support workers and anyone else involved. This cohesive ‘arch’ enables the child to move through the steps of the Gateway Model.

A sequence of steps

The Gateway Model adheres to a sequence of steps in which the child’s brain develops in a ‘bottom up’ or Neurosequential hierarchical order:

  1. The Primitive Brain (brain stem/mid-brain) – concerned with motor and sensory input, and survival (fight/flight/freeze reactions).
  2. The Limbic Brain – concerned with attachment, emotions and behaviour.
  3. The Cortical Brain – concerned with thinking, planning, inhibiting and learning.

The child with early trauma may be ‘stuck’ in survival mode (primitive brain), unable to access the higher brain regions that enable them to form secure attachments, manage emotions and behaviours, and engage in reasoning and reflecting. Therapeutic approaches to address relationships will show limited effect if the first step of increasing regulation is not addressed. In turn, therapy approaches that require reasoning will have limited success if the first two steps are not addressed. These three steps are: Regulate, Relate and Reason.

Step 1: Regulate (the Primitive Brain)

The primitive brain is responsible for survival-related functions, scanning the environment for potential threats and moving the child into a protective fight-flight-freeze state. To move from these heightened anxiety states to a calmer, more cognitive state, children must learn to regulate their fight-flight-freeze system. Typically, children who are emotionally dysregulated struggle to soothe themselves, needing a sense of calm to be facilitated by an attentive carer before a child can learn to soothe themselves. As the carer becomes the child’s co-regulator, the child begins to feel internal calm which leads to a more positive experience of self, others and the world generally. Regulation must be mastered as the first step, before a child can be expected to tolerate and develop relationships on a deeper level, and much later to think, reflect and learn.

The second step, relate, focuses on enhancing the functions within the limbic system: attachment building, memory formation, emotion processing, and spatial navigation. A child is born with almost no limbic programming, relying on attunement and connection from their attachment figure. When a trusted adult attunes to a child, the child learns that love is secure, experiencing a sense of belonging and a sense that their needs are fully met. However, this process is dependent on successful navigation of Step 1.

The final step, to reason, supports the functions within the cortical brain, where more complex cognitive processes occur such as: planning, thinking, imagining, self-monitoring. These processes help children to rationalise, problem solve and reflect in ways that allow them to make sense of themselves and the world around them. Safety and regulation in the context of trusted relationships enables cortical functioning. However, when threat is perceived, the sympathetic nervous system is activated, taking the child back into ‘fight, flight or freeze’ and a narrow focus on survival, much less able to think rationally or be consciously aware of their internal world. This highlights the importance of addressing or revisiting Steps 1 and 2, before attempting therapy requiring reason.

One step forwards, two steps back…

Therapeutic process is not always simple or linear. At times the child may need to take a step back, requiring additional support at a previous level. This may be because the foundations or arch of support are temporarily less secure; life events might be causing additional stress or perceived threat for the child; or the child was not ready for a ‘step up’.

Going through the Gateway – a ‘good enough’ goal

Although therapeutic intervention is often long term, we believe it is important that children and families do not develop a problem-focused identity. We aim for goal-focused interventions, recognising the right time to move on ‘through the gateway’, when therapeutic goals have been met and all agree the child is ready to move on to their next stage of growth (emotional, behavioural, relational or developmental), no longer needing specific therapeutic intervention.

Whilst all difficulties may not have been fully resolved, we would endeavour to equip the child, their parents/carers and ‘arch of support’, to continue the process towards wellbeing. There may be a future time when further specific therapeutic intervention is needed, particularly at periods of increased stress on the child or the system around them, and professional help is needed to renegotiate the steps effectively.

Knowledge used to inform the Gateway Model is accredited to the following experts: John Bowlby, Daniel Hughes, Bruce Perry, Stephen Porges, Bert Powell, Dan Siegel and Bessel Van der Kolk.