Regional VP (Special) Conference: Nov 2013 The Six Stages of a Crisis: The importance of stage 6 Post Incident Learning (PIL) Colin Campbell. Asst. Advisory Officer, BST, SEELB Joe Duffy, Senior Ed. Psychologist, SEELB/QUB 22/11/13

Six Stages of a Crisis Time Crisis Defensive / Escalation Recovery Adapted from Kapler and Wheelan 1980 Time Crisis Defensive / Escalation Possible need for Restrictive Physical Intervention appropriate for the service user Recovery Anxiety / Trigger Depression Follow Up Need for coordinated letting go. Support, reassurance Need for diversion, reassurance, clear limits, boundaries and choices Need for observation, support and monitoring - recovery and repair Need for positive listening and learning Need for diversion, support and reassurance Risk Restraint Reduction Risk Restraint Reduction CORE

Stage six of a crisis The objective of Stage 6 of the Stages of a Crisis is for the child to understand that the reason why staff sometimes need to hold them is because they care about them. This will involve staff listening to the child, linking their feelings to their behaviours and giving them the opportunity to learn from what they have done

Positive Listening and Learning. Post Incident Support. Positive Listening and Learning. CORE 4

CRISIS Outcomes of a Crisis Staff – Child/Client Staff – Child/Client Relationship Damaged Staff – Child/Client Relationship Unchanged Staff – Child/Client Relationship Improved CORE 5

Why Three Ls? Listen Link Learn What happened? How did that make you feel? Learn The next time you feel that way what could you do?

Why Three Ls? Listen Link Learn To the child’s view first Feelings to behaviours Learn Find better ways for next time CORE

Conflict Spiral CONFLICT Learn Link Listen Reactions Behaviours Feelings Listen Experiences

T E L L PIL - TELL ime nvironment isten earn Cannot rush it – only when they are ready nvironment Comfortable and private isten Hear the individual’s view first earn Find better ways for next time E L L

H E L P PIL - HELP ear xplain ink lan To their side of the story first Why staff took the action they did ink To show how feelings drive behaviour lan Together to find better ways E L P

Pupils with communication difficulties Ref: Cotton (2012)

Three Ls LISTEN LINK LEARN Communication Recognising Learning style feelings style

Any info regarding situation e.g. triggers: What we did to rebuild our relationship Pupil: ______________________ Staff: ______________________ Date: ______________________

Comic strip Pupil: ______________ Staff: ______________ Me I felt… This happened… If I feel like this again I will… Pupil: ______________ Staff: ______________ Date: ______________

When I was feeling sad or angry I showed this by ____________________ This was because ____________________ If I feel like this again I will _________________________ (strategy to de-escalate) To help others know and to help make me happy Pupil: ______________________ Staff: ______________________ Date: ______________________

Behaviour Feelings ExperiencesE Experiences

What does the research say? [1] The impact of training staff in special schools in safe handling: In one study involving 4 schools, all schools saw a reduction in physical interventions post training. One school however witnessed more significant reduction Why? pupils were given the opportunity for listening & learning following incidents; the school had a dedicated staff member with overall responsibility for behaviour management; the entire staff was trained. Source: www.team-teach.co.uk/casestudies/SEBDA_Article.pdf 

What does the research say? [2] Perkins & Leadbetter (2002) in an evaluative study of aggression training management in a special school found that, following training, the lack of supporting action by the school was identified as key inhibiting factor. They recommended: the development of systems for auditing behaviour & assessing its underlying function [see next slide]; ensuring that IEPs contain a behavioural management component clear management support & leadership; supporting staff through formal review of practice ( e.g. debriefing)

Assessing the function of behaviour In relation to pupils with SLD functional assessment has been identified as a factor which is able to improve the efficacy of numerous treatments (Hasting & Noone, 2005)

The Process for Staff Support? Module Eight: After a crisis staff need support during the recovery period. A member of staff usually requires:- support, space, reassurance & guidance. As with the child, as soon as possible after the incident. Support meeting with staff(s) involved & line manager.

Objectives of the Process for Staff Discuss what happened in a non-blaming, supportive, caring manner. Use crisis situation to clarify underlying causes, issues and feelings. Examine what techniques were used to de-escalate and/or physically manage the situation. Develop a strategy for the next time the child/client begins to lose control. All items discussed concerning professional practice issues should be documented

References Cotton, D. (2012). What communication strategies can be used to support the mental health of children with classical autism? Kidderminster: BILD Perkins, J. & Leadbetter, D. (2002) An evaluation of aggression management training in a special educational setting. Emotional & Behavioural Difficulties, 7, (1), 19-34 Hastings, R.P. & Noone, S.J. (2005) Self-injurious behaviour & functional analysis: ethics & evidence. Education & Training in Developmental Disabilities, 40, (4), 335 -342