Nonviolent Crisis Intervention® Training Program Luzerne Intermediate Unit #18

CARE WELFARE SAFETY SECURITY

The CPI Crisis Development ModelSM Unit I The CPI Crisis Development ModelSM

The CPI Crisis Development ModelSM Crisis Development/ Behavior Levels Anxiety Staff Attitude/ Approaches Supportive Integrated Experience

The CPI Crisis Development ModelSM Anxiety: A noticeable increase or change in behavior e.g., pacing, finger drumming, wringing of hands, rocking, etc… Supportive An empathetic, nonjudgmental approach attempting to alleviate anxiety

The CPI Crisis Development ModelSM Crisis Development/ Behavior Levels Anxiety Defensive Staff Attitude/ Approaches Supportive Directive Integrated Experience

The CPI Crisis Development ModelSM Defensive: The beginning stage of loss of rationality Noncompliance, verbal venting, accuse or blame others Directive Manage a potentially dangerous situation by setting limits

The CPI Crisis Development ModelSM Crisis Development/ Behavior Levels Anxiety Defensive Acting Out Person Staff Attitude/ Approaches Supportive Directive Nonviolent Physical Crisis Intervention Integrated Experience

The CPI Crisis Development ModelSM Acting Out Person: The total loss of control which often results in a physical acting out episode Nonviolent Physical Crisis Intervention Safe, nonharmful controls and techniques used to safely manage an Acting Out Person Last Resort

The CPI Crisis Development ModelSM Crisis Development/ Behavior Levels Anxiety Defensive Acting Out Person Tension Reduction Staff Attitude/ Approaches Supportive Directive Nonviolent Physical Crisis Intervention Therapeutic Rapport Integrated Experience

The CPI Crisis Development ModelSM Tension Reduction: a decrease in physical and emotional energy which occurs after a person has acted out Regaining control Therapeutic Rapport Reestablish communication Learning opportunity Give closure Build relationships

Unit II Nonverbal Behavior

Proxemics

Proxemics (Personal Space) Personal Space Varies 1 ½ to 3 feet Factors: Gender Size Personal relationship Age Context of situation

Proxemics (Personal Space) It is respectful to observe individuals personal space Announce when and why you need to invade an individual’s personal space Personal space can extend to family, friends and belongings Invasion of one’s personal Space can increase anxiety

Kinesics

Kinesics Messages we communicate with our body posture and motion Our body language should be nonthreatening Includes: Stances Facial expressions Gestures

CPI Supportive StanceSM About a leg length away On an angle Hands visible

Reasons for using the CPI Supportive StanceSM Safety Respectful Nonthreatening

Paraverbal Communication Unit III Paraverbal Communication

Paraverbal Exercise “______________, I am glad you came to school today, why don’t you get to your locker.”

Paraverbal Communication The vocal part of speech excluding the actual words one uses How you say what you say

Paraverbal Communication 3 Key Components Tone Supportive, understanding and comforting Volume Appropriate to situation and person Cadence Even rate and rhythm Total Voice Control

Unit IV Verbal Intervention

The CPI Verbal Escalation ContinuumSM Part of the Defensive stage of the CPI Crisis Development ModelSM The goal of staff is to deescalate the individual

The CPI Verbal Escalation ContinuumSM Defensive = Directive 1. Questioning

The CPI Verbal Escalation ContinuumSM Questioning a. Information-seeking: a rational question seeking a rational response b. Challenge: questioning authority, being evasive, attempts to draw staff into power struggle

The CPI Verbal Escalation ContinuumSM Interventions Give Information- be a resource Stick to the topic (redirect), ignore the challenge (not the person), avoid the struggle

The CPI Verbal Escalation ContinuumSM 2. Refusal 1. Questioning

The CPI Verbal Escalation ContinuumSM Refusal Noncompliance, no-mode, drop and flop

The CPI Verbal Escalation ContinuumSM Intervention The process of setting limits Choices/options Incentives/consequences Space and time (planned ignoring-extinction)

The CPI Verbal Escalation ContinuumSM 3. Release 2. Refusal 1. Questioning

The CPI Verbal Escalation ContinuumSM Release Verbal venting, tantrums, screaming, yelling

The CPI Verbal Escalation ContinuumSM Intervention Let child vent Isolate the situation Team approach Enforce limits

The CPI Verbal Escalation ContinuumSM 3. Release 4. Intimidation 2. Refusal 1. Questioning

The CPI Verbal Escalation ContinuumSM Intimidation Individual is making threats Verbally or nonverbally

The CPI Verbal Escalation ContinuumSM Intervention Take all threats seriously (document and inform or exit room) Take a team approach

The CPI Verbal Escalation ContinuumSM 3. Release 4. Intimidation 2. Refusal 5. Tension Reduction 1. Questioning

The CPI Verbal Escalation ContinuumSM Tension Reduction Decrease in Emotional and Physical energy

The CPI Verbal Escalation ContinuumSM Intervention Establish Therapeutic Rapport Reestablish communication

The CPI Verbal Escalation ContinuumSM 3. Release CARE WELFARE 4. Intimidation 2. Refusal SAFETY SECURITY 5. Tension Reduction 1. Questioning

Keys to Setting Limits Clear and Concise Reasonable Enforceable Simple and easy to understand Use their communication Reasonable Fair, incentives, buy-in Enforceable Remember space and time Follow through

Verbal Intervention Tips and Techniques Do and Don't

Verbal Intervention Tips and Techniques DO Remain Calm Isolate the situation Enforce limits Listen Be aware of nonverbals Be consistent Ignore challenge questions Be nonthreatening DON’T Overreact Provide an audience Change them Ignore Communicate emotion Make false promises Get in a power struggle Be threatening

Empathetic Listening

Empathetic Listening An active process to discern what a person is truly saying

S I L E N T Empathetic Listening Be nonjudgmental Give undivided attention Listen carefully to what the person is really saying (feelings, not just facts) Use restatement to clarify message Allow silence for reflection S I L E N T

Precipitating Factors, Rational Detachment, Integrated Experience Unit V Precipitating Factors, Rational Detachment, Integrated Experience

Precipitating Factors Internal or external causes of an acting out behavior of which staff has little or no control

Precipitating Factors EXAMPLES

Rational Detachment Ability to stay in control of one’s own behavior and not take acting out personally A professional and calm approach

Rational Detachment Why? How?

Integrated Experience The concept that the behaviors and attitudes of staff impact on those in their care and vice-versa

Remember The CPI Crisis Development ModelSM Crisis Development/ Behavior Levels Anxiety Defensive Acting Out Person Tension Reduction Staff Attitude/ Approaches Supportive Directive Nonviolent Physical Crisis Intervention Therapeutic Rapport Integrated Experience

Unit VI Staff Fear and Anxiety

Fear Is a natural human emotion Produces physiological and psychological responses

Reactions to Fear and Anxiety Unproductive Freezing Overreacting Physiologically Psychologically Respond Inappropriately Saying things Doing things Productive Increase of speed and strength Increase in sensory acuity Decrease in Reaction time

How do we manage fear? Acknowledge and understand Learn personal safety skills Use a team approach Learn controls to safely manage and Acting Out Person

A Famous Quote from Between Teacher and Child I've come to a frightening conclusion that I am the decisive element in the classroom. It's my personal approach that creates the climate. It’s my daily mood that makes the weather. As a teacher, I possess a tremendous power to make a child's life miserable or joyous. I can be a tool of torture or an instrument of inspiration. I can humiliate or humor, hurt or heal. In all situations, it is my response that decides whether a crisis will be escalated or deescalated and a child humanized or dehumanized. -Haim Ginott

CPI’s Personal Safety TechniquesSM Unit VII CPI’s Personal Safety TechniquesSM

CPI’s Personal Safety TechniquesSM

CPI’s Personal Safety TechniquesSM STRIKE GRAB Punch Bite Kick Pinch Spit Hair Pull Throw Objects Choke SIB

Definitions STRIKE Grab A weapon coming in contact with a target The attempt to control or destroy part of one’s body

Principles of Personal Safety Strike Block or deflect the weapon Move the target

Principles of Personal Safety Grab Gain a physiological advantage Weak point Leverage Momentum Gain a psychological advantage Remain calm Have a plan Use element of surprise or distraction

Principles of Personal Safety Response to the Strike Natural and instinctive Response to the Grab Not natural and instinctive

Nonviolent Physical Crisis Intervention and Team Intervention Unit VIII Nonviolent Physical Crisis Intervention and Team Intervention

Nonviolent Physical Crisis Intervention (pg 15) Use a team approach Use as a last resort Used for protection, not punishment Intent is to calm a person down Nonharmful in design

RISKS OF RESTRAINTS (pgs 12s 13s 14s) What one needs to breathe Open Airway Gas Exchange Movement of Ribcage and Diaphragm

Control Dynamics Reduce upper body strength by controlling arms as weapons Turn palms up Raise arms above shoulders Anchor arm to your body (hip area)

Control Dynamics Reduce lower body strength by controlling the back line Lower shoulders below hips

Control Dynamics Reduce mobility by close body contact Move hips close to individual’s body Move the individual’s center of gravity forward, bring him onto his toes (ball of foot)

Team Intervention (pg 20) WHO? HOW? WHEN?

Team vs. Solo Intervention Safety Litigation Professionalism

Team Leader The first person on the scene Competence and confidence in handling crisis situations Good rapport with the Acting Out Person

Team Leader Duties Assess situation Plan intervention Direct or cue team members Communicate with the Acting Out Person

Auxiliary Team Member Duties Check Address Recognize Engage in

Situational Role-Plays Unit IX Situational Role-Plays

Unit X Postvention

The CPI COPING ModelSM ontrol rient atterns nvestigate egotiate ive

For Individuals COPING Emotional and physical control Orient yourself to the feelings and views of the individual Look for patterns of past behaviors of individual and triggers Investigate alternatives to behaviors Negotiate a contract Give back control COPING

For Staff COPING All staff are in control Orient the team to the facts of the crisis Look for patterns of staff behavior Investigate ways to strengthen staff Negotiate and agree to changes that will take place in future interventions Give support and encouragement COPING

POST-TEST EVALUATION The End