Unit 4 Crisis Intervention and De-escalation

Module Objectives Define a crisis Differentiate methods of gaining compliance Review elements of effective communication Establishing contact Building rapport Using calming techniques, reflective statements, and active listening

Crisis Any situation in which a youth’s perceived ability to cope is exceeded.

Crisis State Emotions are ruling, not reason Non-verbal communication dominates Safety must come first

Triggers for Adolescents Parents’ divorce or separation Break-up of a relationship Suspension or expulsion from school Sickness, injury, or death Personal or school-related difficulties Loss of health Getting caught in illegal activity Victim of bullying Deterioration of mental health

Working with Youth – What You Can Do

Keys to Successful Crisis Management Intervention/ De-escalation Follow-up Prevention

The best time to intervene in a crisis is before it starts Crisis Prevention The best time to intervene in a crisis is before it starts

Spontaneous crises are extremely rare Spontaneous crises are extremely rare. Often, there are behavioral and environmental cues that indicate a crisis is brewing.

Crisis Prevention Tips (Cont’d) Know the youth. What pushes his/her buttons? What helps him/her calm down? Are there events, interactions, or situations that usually lead to conflict? Being proactive, rather than reactive, can go a long way toward keeping the environment safe for staff and youth.

Crisis Prevention: What You Can Do Are youth safe . . . . . . from other youth? . . . from mistreatment by staff/adults? . . . from hurting themselves? Are clear, simple rules posted? Is structure provided? Set schedules. Announce changes to schedules when they occur.

Crisis Prevention: What You Can Do Be consistent. Set limits appropriately. No violence, yelling, or retaliation. Separate out your anger. Praise and reward youth for positive behavior, including recovery. Model appropriate coping, anger management, and problem-solving behaviors.

Crisis Intervention/De-escalation De-escalation resolves a crisis through problem- solving rather than by force and helps to re-establish equilibrium faster.

Problem Solving, Not Force Get the youth’s attention Gain the youth’s cooperation What does the youth really want? What is the youth really reacting to (disrespect vs. mental health disorder vs. trauma)?

What You Can Do YOU Youth Tension / Stress Be aware of your own feelings Some youth just want to push others’ buttons and get them to react emotionally Be aware of your own posture, voice, and tone Youth Tension / Stress YOU

Nonverbal Communication Body Language Physical Proximity Facial Expressions Eye Contact

The same phrase can communicate totally different meanings depending on volume, tone, and speed Verbal Communication

Tips for Communicating with Youth Use simple age- appropriate language Address youth at eye- level Explain your role – you are there to help Don’t make promises you can’t keep Remove upsetting influences from the scene

Initial Approach If practical, monitor youth’s behavior prior to approaching Assume a calm, non- threatening manner Consider personal space issues Introduce yourself

Introduction “I’m _____, an officer with the ____. I would like to help you.” “My name is ______ and I’m from _____. I’d like to talk to you about what has happened today. I understand there is a problem and I’d like to help.”

Behavioral Change Staircase

Active Listening A powerful skill that can be developed and enhanced Active listening is hearing with engagement, empathy, and understanding Listening is often the key to a successful intervention

Barriers to Active Listening Arguing Criticizing Pacifying Jumping to Conclusion Labeling Derailing Ordering Asking Why Barriers to Active Listening

Active Listening Skills Reflecting – labeling the emotion or identifying the feeling “You sound…” “You seem…” “ I hear…” Mirroring – repeating the last few of the youth’s words to capture the gist of his/her feelings Paraphrasing – putting meaning of other’s statements into your own words.

Establishing a Dialogue Use open- and closed- ended probes Ask clarifying questions Use “I” messages

Open-ended Questions Allow the other person to do more of the talking

Questions and Statements Express empathy Establish rapport Initiate dialogue Questions and Statements

“I” Messages… Are a way of saying how you feel without accusing or blaming anyone Can help de-escalate conflicts and facilitate constructive dialogue

That if you were them, you might be feeling and doing the same things. Communicating that you truly get what they are feeling, expressing, and saying. That if you were them, you might be feeling and doing the same things. Its not all about understanding, its about putting yourself in their shoes and looking through their perspective.

Listen, Listen, Listen That’s a stupid rule! I can’t do that. What would my friends think?!? This sucks. I don’t see what good talking about it now is going to do. TIP: If words fail you, start the dialogue with, “You sound upset.”

Activity Close-ended vs. Open-Ended Questions

Influence: Slow Down Youth are impulsive and often fail to think before they act Slowing down gives youth the opportunity to: Talk about their feelings Think through options Weigh consequences TIP: The passage of time, above any other intervention, tends to de-escalate crisis

Influence: Calming Techniques Modeling Attempt to calm youth by displaying your own calmness Speak slowly and evenly Allow venting Be empathetic Provide actual techniques for calming down Provide reassurance Avoid saying “relax” or “calm down”

Avoiding Roadblocks Let the youth talk without interruptions Do not talk about your own opinions Listen without judging Don’t talk as if the youth is not there Asking “why?” is rarely productive Its important to acknowledge feelings

Additional Guidelines for De-escalation Maintain safety Be truthful Don’t argue about delusions or hallucinations Negotiate/provide choices when possible Help both sides get needs met Increase sense of control Be open to different choices Additional Guidelines for De-escalation

Activity Role Play

Frustrated and Emotionally Distraught Approach: Identify yourself and the purpose of your contact Listen Acknowledge the youth’s frustration Be empathetic Let the youth vent Provide support and alternatives After rapport develops, offer suggestions for the youth to regain internal control

Activity Role Play

Hostile/Aggressive Behavior: Approach Identify yourself and your purpose Isolate Listen Be empathetic Set limits and provide alternatives Maintain eye contact State directives firmly Be ready to be friendly if behavior changes Use diversions Hostile/Aggressive Behavior: Approach

Activity Role Play

Substance-Induced Behavior Approach Youth may have rapidly cycling emotions or maintain either an agitated or despondent state Be cautious, there is potential for impulsive acts and violence Set firm limits Listen and offer alternative behavior suggestions to maintain safety.

Suicidal Thoughts and/or Behavior Approach Inquire directly Get specifics Be empathetic Think together about alternatives Instill hope

Obtaining Collateral Information from Teachers, Family, or School Staff Interview others to determine: History/severity of problem History of mental health care Interventions Medical problems Medications Available supports/resources Ability to keep youth safe

Other Considerations in Working with Family and Staff Treat other adults as part of the solution. Working together will increase compliance. Be observant of relationship indicators. Strategize interventions with this in mind. Be aware that staff and family may have increased expectations of law enforcement and law enforcement interventions.

Intervention/De-escalation Summary Use active listening to develop rapport Reflect feelings/be empathetic Be consistent/firm Use calming/soothing techniques Problem solve Intervention/De-escalation Summary

When a Crisis Escalates Unfortunately, some incidents will still escalate to a crisis Safety is the primary concern Follow departmental or institutional policies regarding progressive levels of intervention, as well as physical and mechanical restraint When a Crisis Escalates

Crisis Follow-up: Learning New Skills Youth are not going to learn new behaviors in the middle of the crisis They may learn from their mistakes after they have calmed down Otherwise, they may keep repeating the same violent, unsuccessful behaviors

The Calm After the Storm Reflect on the event Ask open-ended questions Avoid power struggles Acknowledge mistakes Identify alternatives Express caring and offer support Reward the youth for doing something right The Calm After the Storm

Activity Discussion of De-escalation Techniques