De-escalating Crisis Situations. Jake Bilodeau Training & Development Coordinator Teaching Family Homes

Similar documents
Assertive Communication/Conflict Resolution In Dealing With Different People. Stephanie Bellin Employer Services Trainer

Open Table Nashville s Guide to De-Escalation

Positive Behavior Support in Inclusion. Taylor Singleton, CTRS and Eric Rueger OPRA Conference February 4, 2019

Overview. Behavior. Chapter 24. Behavioral Emergencies 9/11/2012. Copyright 2013 by Jones & Bartlett Learning, LLC, an Ascend Learning Company

Workplace Violence and Crime Through Environmental Design (CPTED) Sergeant Robert J. Greenlee III DEFINITIONS

Non-Violent Crisis Intervention. Occupational Health, Safety and Wellness 2017

WORKPLACE AND ON CAMPUS VIOLENCE GUIDE

OREGON STATE POLICE CAPITOL MALL AREA COMMAND

Flashpoint: Recognizing and Preventing Workplace Violence Shots Fired: When Lightning Strikes - Active Shooter Training From the Center for Personal

MANAGING RAGE A Summary Review

Assertiveness and Managing Conflict. Julie Molloy NHSBT

Chapter 1. Dysfunctional Behavioral Cycles

COURSE INFORMATION AND INSTRUCTOR PREPARATION. Crisis Intervention EAR Model/Loss Model/Last Model

Anger: Education and Information. Dr. Kevin Raper Compass Point Counseling

Converting change fatigue into workplace success

VERMONT SUICIDE PREVENTION & INTERVENTION PROTOCOLS FOR PRIMARY CARE PROFESSIONALS

OREGON STATE POLICE CAPITOL MALL AREA COMMAND. Oregon State Police 900 Court St Rm 60C Salem, Or (503) Ver

Managing Difficult Patients Increasing Staff & Patient Safety

Behavior Management: Special Topics in TBI

Healing Trauma Evaluation Year 1 Findings

Motivational Interviewing in Healthcare. Presented by: Christy Dauner, OTR

10/20/2014. Supports the couple in learning about boundaries within recovery process. Supports partner s reality of damage and betrayal.

What is stress? Stress is an emotional/ bodily reaction to

Understanding and Preventing Workplace Violence. Alameda County Health Care Services Agency

This training has been in existence for several years, and has been re-written and updated at least annually. The material comes from several

You are the Provider. Behavioral Emergencies

Personal Safety in Clinical Practice. Phil Quinn, Ph.D., Director SSMH, EAP Program Ray Mason, Director SSMH, Metro- Suburban Outreach

WHY LEARN SELF DEFENSE?

Guidelines for Working with People Affected by Trauma

YCS Treatment Planning Guide and Examples

Validation Techniques in a Real World By Alisa Tagg, BA ACC/EDU AC-BC CADDCT CDP CDCS NAAP President

10/9/2015 EMOTIONAL INTELLIGENCE EMOTIONAL INTELLIGENCE

Preventing Workplace Violence

Chapter 3 Self-Esteem and Mental Health

Peer Support Meeting COMMUNICATION STRATEGIES

PRINCIPLES OF CAREGIVING DEVELOPMENTAL DISABILITIES MODULE

Module 2 Mentalizing

ADDITIONAL CASEWORK STRATEGIES

USING ASSERTIVENESS TO COMMUNICATE ABOUT SEX

Creating Trauma Informed Systems of Care

How to Approach Someone Having a Mental Health Challenge

Neurobiology of Sexual Assault Trauma: Supportive Conversations with Victims

MODULE III Challenging Behaviors

AN INFORMATION BOOKLET FOR YOUNG PEOPLE WHO SELF HARM & THOSE WHO CARE FOR THEM

Value of emotional intelligence in veterinary practice teams

Achieving Good Mental Health

Lesson 9 Anxiety and Relaxation Techniques

Hostility Management in the Workplace and Beyond

Disclosing medical errors to patients: Recent developments and future directions

Supporting Youth while providing strength-based, traumainformed supervision for crisis workers TIFFANY WILHELM, MA, LPC-IT

K I N G. mentally ill E N. 38 myevt.com exceptional veterinary team March/April 2012

Key Steps for Brief Intervention Substance Use:

By the end of this educational encounter the nurse will be able to:

De-escalating Anger and Aggression in Aging adults: Strategies to Make It Work!

BASIC PROGRAM: Investigator Safety

1/9/2019. The Importance of Body Language in Communication. The Importance of Nonverbal Communication

Look to see if they can focus on compassionate attention, compassionate thinking and compassionate behaviour. This is how the person brings their

Using CPI Strategies (COPING) to Prevent/Respond to Challenging Behavior. Lance L. Hawkins, M.Ed. Harford County Public Schools

Improving Safety through Key Components of Therapeutic Communication with Behaviorally-Challenged. Martin Reinsel, MA, LMHC, Navos Clinical

3.1.2 Change, Loss, and Grief

BASIC VOLUME. Elements of Drug Dependence Treatment

Motivational Interviewing

Reducing Social Threats

Exposures, Flooding, & Desensitization. Anxiety Disorders. History 12/2/2009

TRIANGLE OF CHOICES FOR MANAGING THREATENING BEHAVIOR. STEP #1: First Choices

Distress Tolerance Handout 11 (Distress Tolerance Worksheets 8 9a 5)

Emotional Intelligence

COUNSELING INTERVIEW GUIDELINES

Hard Edges Scotland: Lived Experience Reference Group

The following is a brief summary of the main points of the book.

Rainbow Dots WELCOME! As you enter the room, please take a post-it note. On the post it note please write one of the following:

ANGER MANAGEMENT. So What is Anger? What causes you to be angry? Understanding and Identifying the Cause of your Anger

BASIC HUMAN NEEDS & VALIDATION TECHNIQUES DUSTY LINN, LCSW, CDP, CVW, BC-AC, PAC TRAINER

First, Manage Your Anger. Conflict Management!!! Healthy Anger. Causes of anger 5/14/14. Manage anger first Manage conflict second

PREVENTING WORKPLACE VIOLENCE PRESENTED BY THE SOLUTIONS GROUP

Respect Handout. You receive respect when you show others respect regardless of how they treat you.

Connecting to the Guest. Dr. John L. Avella Ed.D Cal State Monterey Bay

Workplace Violence Prevention. Presented by: Glenn Eiserloh, CHSP Sr. Risk Consultant LHA Trust Funds

Goldsmith. Marshall. FEEDFORWARD Coaching For Your Future. Coaching For Your Future. MMIX ChartHouse Learning. All Rights Reserved. What Is It?

CPRP PRACTICE DOMAIN I: Interpersonal Competencies. Module 4

SELF-CARE: THE OUT USE OF DBT SKILLS IN THERAPIST BURN- Nanci E. Stockwell, LCSW, MBA Chief Clinical & Education Officer

Name Today s Date. 5. True or False: Engagement is based on both physical and emotional safety. (True)

How Post-Traumatic Memories Can Hold the Body Hostage

Gary Duhon, PhD, Professor of School Psychology OSU

Cambridge Public Schools SEL Benchmarks K-12

In the Heat of the Moment

Optimal Health Questionnaire

The Brave Child How to Help Your Child Adapt, Move Forward, and Thrive (Even When They Are Scared)

Chapter Goal. Learning Objectives 9/12/2012. Chapter 31. Behavioral Emergencies & Substance Abuse

Disaster Psychology. CERT Basic Training Unit 7

HANDOUTS FOR MODULE 7: TRAUMA TREATMENT. HANDOUT 55: COMMON REACTIONS CHECKLIST FOR KIDS (under 10 years)

If you have a boring relationship, it means you re not being intimate enough.

BEHAVIORAL EMERGENCIES

Psychological. Psychological First Aid: MN Community Support Model Teen version. April 3, Teen Version

Challenging Behaviour 27/09/2015. Anger and anxiety in the classroom: Higher functioning autism and Asperger s

The Handbook for Campus Threat Assessment and Management Teams. By Gene Deisinger, Ph.D. Marisa Randazzo, Ph.D. Daniel O Neil Jenna Savage SUMMARY

Understanding and Supporting Developmental Growth in Child and Youth Care Practitioners.

Tornado s, Floods, and deadly accidents...

By: Anne Stewart, M.A. Licensed Therapist

Chapter 20 Psychiatric Emergencies Introduction Myth and Reality Defining Behavioral Crisis (1 of 3) Defining a Behavioral Crisis (2 of 3)

Transcription:

De-escalating Crisis Situations Jake Bilodeau Training & Development Coordinator Teaching Family Homes

Training Overview 1. Trainer introduction 2. Crash-course on the Teaching-Family Model 3. Understanding aggressive behavior 4. Phases of verbal escalation 5. Prevention & crisis de-escalation 6. Verbal crisis de-escalation strategies 7. Questions

Introduction Jake Bilodeau Training & Development Coordinator w/ Teaching Family Homes 5 years of Crisis de-escalation work with Teaching Family Homes Completed university coursework at Northern Michigan University Criminal Justice Sociology Law Enforcement Experience in residential treatment, crisis consultation, & family intervention services

The Teaching-Family Model The Teaching-Family Model is an evidence-based model of care that is used internationally The model is recognized as a best practices tool by numerous organizations American Psychological Association National Department of Juvenile Justice National Clearing House Maintaining the highest level of client rights is essential Humane Effective Individualized Trauma-Informed Conducive to CPI techniques

Poll Question Please rate your experience level with prevention efforts related to crisis de-escalation: a. 0 1 year b. 2 5 years c. 5 10 years d. More than 10 years

Poll Question Please rate your experience level with verbal crisis de-escalation techniques: a. 0 1 year b. 2 5 years c. 5 10 years d. More than 10 years

Understanding Aggressive Behavior Nature of aggression: Desire for power & control Needs must be met (food, sleep, safety, security, etc.) Response to intense feelings (trauma) Rewarding consequences ( I ll get my way ) Environmental Risk Factors Absent support networks Drug/substance abuse Poverty Domestic violence Peer influence Complex trauma

Phases of Verbal Escalation

Prevention Use Proactive Teaching as a prevention tool Preparation Transparency Teaching Rationale Our clients are able to thrive off of predictability Prevention items to consider: How often do we avoid telling people things due to fear? Can we avoid verbal or physical escalation if we are more predictable? How can we use our own experiences as a teaching tool for our clients?

What can we control? Having control over your surroundings can be your greatest asset when addressing crisis situations Things to consider prior to interacting with volatile clients: Who is involved? Where will you be in relation to the client? Do you have support nearby? If you are driving, where are you parked? Are their weapons nearby? What is the client s history?

Maintaining Self-Control Positive mind set Understand the impacts of trauma related to client behavior Depersonalize If they weren t saying or doing it to me, it would be the next person working Gentle teaching/quality components Create a nurturing, safe, and trusting environment Control body signals Stance, posture, gestures, reactions, etc. Know your buttons Do you know what they are? Avoid content and stick to your de-escalation tools Be creative in your approach to dealing with challenging behavior Practice self-reflection Listen to feedback, process emotions, commit to improvement

Controlling Client Behavior We can only control client behavior with our words, presence, and overall attitude Negative comments, threats, or intimidation will result in counter aggression We must understand what is being gained by engaging in a certain behavior Safety, food, security, etc.? Power or control? Status? We cannot promote self-control when we are not in control of our own bodies Crisis de-escalation is focused on both worker and client behavior

Crisis Intervention Crisis intervention can not be effective without using the following intervention strategies: Empathy statements Avoiding content Reality statements Rationales Offering options Praising approximations Coupling statements What do these strategies look like?

Empathy Statements Empathy statements are not focused on relating your own experiences to those of the client, but should be focused on acknowledging the challenging circumstances the client is experiencing I can see that you are really upset It sounds like this is pretty difficult It can see that you are getting angry Statements to use with caution: I understand I know

Avoiding Content Avoiding content is essential to de-escalating situations more efficiently & effectively When we are dealing with crisis situations, our focus is on deescalating our client Often times the client s goal is to draw their worker into content Engaging a worker in content results in power & control We can avoid content by saying things like: If you are able to talk calmly we can discuss your concerns. If you are able to have a seat, we can talk about what is bothering you.

Reality Statements Reality statements should be used to explain the reality of a situation, not as a threat Effective Reality Statements: It is going to take longer to discuss your concerns if you continue to raise your voice Making threatening statements can lead to further consequences. Ineffective Reality Statements: If you don t stop yelling, I am going to report your behavior to the judge. If you keep doing this, you will never get anything you want.

Rationales Rationales should be client-focused and encourage a change in behavior If you are able to take some deep breathes, it is more likely that you might feel less angry. If you can stop screaming, it is more likely that people will be able to understand what you are saying. When you can stop making threats, we can talk about what it is that you want.

Coupling Statements Coupling statements are used to describe the behavior that is being exhibited while providing a more appropriate option Effective Coupling Statements: It looks like you are thinking about hitting something, a better choice might be to have a seat. Instead of yelling and swearing, a better choice might be to practice some deep breathing. Ineffective Coupling Statements You are making some comments, a better choice would be not to talk. You are making some threats, a better choice would be to shut your mouth.

Offering Options It is important that we offer our clients options during difficult situations. Sometimes it is difficult to make healthy choices when emotions are elevated. Offering alternative options can relieve stress. When offering alternative options, you might say: Why don t you think about having a seat on the couch or in this chair? You might feel less angry if you go take a drink of water or take some time to yourself.

Praising Approximations Praising approximations focuses on positive behaviors. These positive behaviors are likely coupled with inappropriate or even destructive behaviors Thank you for sitting down. Thank you for unclenching your fists. You are doing a really good job of lowering your voice. You are doing a very good job of taking some deep breaths.

Testing for Self-Control Look for physical indications Deep breathing Making eye contact Beginning to open posture Starting to respond to some prompts Be sure that the client is willing and able to discuss alternative options Ask them if they are ready Level of commitment should be obvious based on demeanor In order to move forward from an escalation in behavior, we need to know that the client is in control of their behavior

Teaching It is okay to help our clients to learn something from an escalation in behavior Each client is an individual with regards to their openness to learning How can we help them to stay calm in the future? What was gained from the escalation in behavior? Is there anything we can do differently as professionals? We do not need to be therapists with our clients, but in many cases we can offer assistance based on our education and experiences

Questions?