Therapeutic Crisis Intervention Edition 6 Residential Child Care Project Cornell University 2009

A young person’s inability to cope results in a change in behaviour A Crisis Occurs When A young person’s inability to cope results in a change in behaviour THE STRESS MODEL OF CRISIS: A TYPICAL CRISIS 9

The Goals of Crisis Intervention Are To Support: environmentally and emotionally to reduce stress and risk. Teach: children better ways to cope with stress THE STRESS MODEL OF CRISIS: A TYPICAL CRISIS 10

Stress Model of Crisis THE STRESS MODEL OF CRISIS: A TYPICAL CRISIS11

Recovery Phase THE STRESS MODEL OF CRISIS: A TYPICAL CRISIS 12

Skills Building Pyramid:LSI THE LIFE SPACE INTERVIEW 63

Stress Model of Crisis PROTECTIVE INTERVENTION 50

Elements of Potentially Violent Situation A potential trigger to violence A target A weapon Level of stress of motivation PROTECTIVE INTERVENTION 51

Remove the Potential Trigger to Violence By Never touching an angry and potentially violent person Avoiding any aggressive moves and provocative statements Avoiding the conflict cycle and counter aggression Removing others who might trigger the violence _ Body language is critical _ PROTECTIVE INTERVENTION 52

Remove the Target By Asking the targeted person to leave If it’s you, reminding they young person of your relationship or leaving the situation and asking a “neutral” staff to mange the incident - The target may shift during the episode - PROTECTIVE INTERVENTION 53

Avoid the Weapon By Discreetly removing objects Manoeuvring away from weapons Staying a safe distance away PROTECTIVE INTERVENTION 54

Decrease the Level of stress or Motivation By Using your relationship Actively listening to identify feelings Removing the audience Using co – regulation strategies (reactive aggression) Offering alternative, nonaggressive ways to achieve goals( proactive aggression) PROTECTIVE INTERVENTION 55

Skills Building Pyramid: Crisis Co-Regulation HELP ME HELP MYSELF CRISIS CO-REGULATION 56

Stress Model of Crisis HELP ME HELP MYSELF CRISIS CO-REGULATION 57

Objective of Crisis Co- Regulation To provide support in a way that reduces stress and risk HELP ME HELP MYSELF CRISIS CO-REGULATION 58

What to think (Self Awareness) Ask yourself the four questions Use positive self talk. HELP ME HELP MYSELF CRISIS CO-REGULATION 59

What To Do (Nonverbal Strategies) Take a deep breath Use protective stance Step back Give the situation time Sit sown if appropriate Remember the importance of body language and facial expression HELP ME HELP MYSELF CRISIS CO-REGULATION 60

What to say (Verbal Strategies) Very little Understanding responses “ I can see….”(validate feelings) “ When you …”(encourage positive behaviour) “ I know we….” ( emphasise desirable outcomes) “ I am sorry….” (offer an apology) Remember the importance for tone of voice HELP ME HELP MYSEL: CRISIS CO-REGULATION 61

What to Do When It is Over It’s over when the ……………. Prepare to discuss the situation in a LSI HELP ME HELP MYSELF CRISIS CO-REGULATION 62

Skills Building Pyramid: LSI THE LIFE SPACE INTERVIEW 63

THE LIFE SPACE INTERVIEW 64

The Life Space Interview ( LSI) Is A therapeutic, verbal strategy for intervening with a young person “ The clinical exploitation of life events” - Fritz Redl THE LIFE SPACE INTERVIEW 65

Goals of the LSI Return the young person to normal functioning Clarify events Repair and restore the relationship Teach new coping skills Reintegrate the young person back into the programme THE LIFE SPACE INTERVIEW 66

Steps to the LSI I – Isolate the conversation E – Explore the young person’s point of view S – Summaries the feelings and content C – Connect feelings to behaviour A – Alternative behaviours discussed P – Plan developed / Practice new behaviour E – Enter young person back into the routine THE LIFE SPACE INTERVIEW 67

Caveat (Warning) Participate only if physically and medically able Offer no resistance in the role of the young person (unless the trainers instruct you otherwise) Remove objects that might cause injury Be appropriately dressed Practice only the techniques demonstrated PROTECTIVE INTERVENTIONS 49