De-Escalation Training Presented by Sandy Ortiz Taken from the Crisis Prevention Institute, Inc.

Unit I: The CPI Crisis Development Model Instructional Objectives: Define crisis development in terms of four distinct and identifiable behavior levels. Match each Crisis Development/Behavior Level with an appropriate corresponding Staff Attitude/Approach. Provide the best possible Care, Welfare, Safety and Security for in individuals in our facilities. Taken from the Crisis Prevention Institute, Inc.

The CPI Crisis Development Model – pg. 7 Crisis Development /Behavior Levels 1. Anxiety – A noticeable increase or change in behavior. Staff Attitudes / Approaches 1. Supportive - An empathic, nonjudgmental approach attempting to alleviate anxiety. Taken from the Crisis Prevention Institute, Inc.

The CPI Crisis Development Model – pg. 7 Crisis Development /Behavior Levels 2. Defensive – The beginning stage of loss of rationality. At this stage, an individual becomes belligerent and challenges authority. Staff Attitudes / Approaches 2. Directive - An approach in which a staff member takes control of a potentially escalating situation by setting limits. Taken from the Crisis Prevention Institute, Inc.

The CPI Crisis Development Model – pg. 7 Crisis Development /Behavior Levels 3. Acting out person – The total loss of control, which results in a physical acting-out episode. Staff Attitudes / Approaches 3. Nonviolent Physical Crisis Intervention - Safe, non-harmful control and restraint techniques used only as a LAST RESORT when an individual presents a danger to self or others. Taken from the Crisis Prevention Institute, Inc.

The CPI Crisis Development Model – pg. 7 Crisis Development /Behavior Levels 4. Tension Reduction – A decrease in physical and emotional energy and a return to baseline behavior. Staff Attitudes / Approaches 4. Therapeutic Rapport - Establish rapport. Taken from the Crisis Prevention Institute, Inc.

Unit II: Nonverbal Behavior Instructional Objectives: Raise awareness of nonverbal communication during interventions. Illustrate how personal space or proxemics affects the Anxiety Level of an individual. Illustrate how body posture and motion or kinesics affects the Anxiety Level of an individual. Emphasize prevention and de-escalation of a crisis by fostering awareness of nonverbal communication. Provide the best possible Care, Welfare, Safety and Security for in individuals in our facilities. Taken from the Crisis Prevention Institute, Inc.

Unit II: Nonverbal Behavior pg. 8 Proxemics – personal space Personal space varies from person to person and the context of the situation. For most people it’s 11/2 to 3 feet. Personal possessions are an extension of personal space. Asking personal information is an invasion of personal space. Taken from the Crisis Prevention Institute, Inc.

Unit II: Nonverbal Behavior pg. 8 Proxemics – personal space Factors: Culture Gender Size History Hygiene Rapport/relationship Taken from the Crisis Prevention Institute, Inc.

Unit II: Nonverbal Behavior pg. 8 Kinesics (body language) Facial expressions – eye contact Gestures Posture Body Orientation Approach Appearance Taken from the Crisis Prevention Institute, Inc.

Unit II: Nonverbal Behavior pg. 8 Reasons for CPI Supportive Stance – Communicates respect by honoring personal space. Is non-threatening/non-challenging. Contributes to staff’s personal safety – offers an escape route. Taken from the Crisis Prevention Institute, Inc.

Unit III: Paraverbal Communication Introduction: This section of the course is designed to show that when attempting to defuse a situation, it is essential to be aware of not only what we say to an individual, but how we say it. Only a small percentage of the message we deliver to a person is delivered through words. How we deliver a verbal intervention to defuse a situation is equally, if not more important, than the words we use. This part of communication is called paraverbal communication. It is the link between nonverbal (proxemics and kinesics) and verbal communication. Taken from the Crisis Prevention Institute, Inc.

Unit III: Paraverbal Communication – pg. 8 Definition – The vocal part of speech, excluding the actual words one uses (how you say what you say). Taken from the Crisis Prevention Institute, Inc.

Unit III: Paraverbal Communication – pg. 8 Components and Suggested Approaches Tone: Try to avoid inflections of impatience, condescension, inattention, etc. Volume: Keep the volume appropriate for the distance and the situation Cadence: Deliver your message using an even rate and rhythm. Taken from the Crisis Prevention Institute, Inc.

Unit IV: Verbal Intervention Introduction: This section of the training explores the second level of the CPI Crisis Development Model (the Defensive Level) and introduces strategies to intervene effectively. A model called the CPI Verbal Escalation Continuum is used to guide staff through various behaviors commonly found within the Defensive Level. The purpose of this model is to provide staff with tools to utilize in a verbal intervention. Taken from the Crisis Prevention Institute, Inc.

Unit IV: Verbal Intervention Instructional Objectives: Identify different levels of defensive behavior in the CPI Verbal Escalation Continuum. React to the verbally acting-out person with an appropriate verbal response to defuse the potential crisis situation. Illustrate how inappropriate staff reactions may cause an escalation in behavior. Provide the best possible Care, Welfare, Safety and Security for in individuals in our facilities. Taken from the Crisis Prevention Institute, Inc.

Unit IV: Verbal Intervention -pg.9 1. Questioning: Information-seeking: a rational question seeking a rational response. Challenging: questioning authority or being evasive; attempting to draw staff into a power struggle. Interventions: A. Give a rational response. B. Stick to the topic (redirect), ignore the challenge (not the person), set limits if individual persists. Taken from the Crisis Prevention Institute, Inc.

Unit IV: Verbal Intervention -pg.9 2. Refusal: Noncompliance. Interventions: Set limits. Taken from the Crisis Prevention Institute, Inc.

Unit IV: Verbal Intervention -pg.9 3. Release: Acting out, emotional outburst, loss of rationalization; blowing off steam, screaming, swearing; high energy output. Interventions: Allow them to let off steam, if possible. Remove audience or acting-out person from the area. When the individual begins to quiet done, state directives that are non-threatening. Use an understanding, reasonable approach. Be prepared to enforce any limits you set. Taken from the Crisis Prevention Institute, Inc.

Unit IV: Verbal Intervention -pg.9 4. Intimidation: Individual is verbally and/or nonverbally threatening staff in some manner. Hands-on approach at this time may trigger physical acting-out behavior. Interventions: Seek assistance and wait for team to intervene, if possible. Try to avoid individual intervention. Complete a Threat Assessment and document all threats. Taken from the Crisis Prevention Institute, Inc.

Unit IV: Verbal Intervention -pg.9 5. Tension Reduction: A drop in energy, which occurs after every crisis situation, whether it is after low-level defensive behaviors or after intimidation. Interventions: Establish Therapeutic Rapport – re-establish communication with the individual. This stage will be discussed in greater detail later in the training. Taken from the Crisis Prevention Institute, Inc.

Unit IV: Verbal Intervention -pg.10 Keys to Setting Limits: Simple and clear – be specific, state what behavior is appropriate and why; give choices; avoid professional jargon. Reasonable – are choices fair? Enforceable – if not you lose credibility: use building/district policies and procedures; student rights; give them time and space/ Taken from the Crisis Prevention Institute, Inc.

Taken from the Crisis Prevention Institute, Inc. Unit IV: Verbal Intervention -pg.10 Verbal Intervention Tips and Techniques Do Remain calm Isolate the situation Enforce limits Listen Be aware of nonverbals Be consistent Don’t Overreact Get in a power struggle Make a false promise Fake attention Be threatening Use jargon (it tends to confuse and frustrate) Taken from the Crisis Prevention Institute, Inc.

Unit IV: Verbal Intervention -pg.10 Empathic Listening Empathic Listening is a powerful tool for rebuilding relationships with the individuals under your charge. By taking the time to listen, you not only demonstrate your commitment to them, but you also communicate the message that they are people of value and worth. Empathic Listening is one of the best ways to strengthen trust and rapport with those in your care. Taken from the Crisis Prevention Institute, Inc.

Unit IV: Verbal Intervention -pg.10 Empathic Listening Definition: an active process to discern what a person is saying. Key Elements: Be nonjudgmental Give undivided attention Listen carefully to what the person is really saying (focus on feelings, not just facts). Allow silence for reflection Use restatement to clarify messages. Taken from the Crisis Prevention Institute, Inc.

Taken from the Crisis Prevention Institute, Inc. Unit V: Precipitating Factors, Rational Detachment, Integrated Experience pg. 11 Introduction: This unit is designed to provide insight into the causes of escalating behavior. An individual’s behavior is often affected by factors over which staff have little or no control. By understanding these underlying causes of escalating behavior, staff can project a more professional attitude and minimize personal conflicts with those in their care. It is also important for staff to recognize that their behaviors have an impact on the behaviors of those in their care, and vice versa. This concept, called Integrated Experience, was introduced in the first unit and is further explained in this unit. Taken from the Crisis Prevention Institute, Inc.

Taken from the Crisis Prevention Institute, Inc. Unit V: Precipitating Factors, Rational Detachment, Integrated Experience – pg. 11 Instructional Objectives: Identify underlying factors which precipitate escalating behavior. Maintain professional attitudes during a crisis intervention by rationally detaching. Understand the reciprocal relationship between the behavior of staff and the behavior of those in their charge, especially during crisis intervention. Provide the best possible Care, Welfare, Safety and Security for in individuals in our facilities. Taken from the Crisis Prevention Institute, Inc.

Unit V: Precipitating Factors- pg. 11 Definition: internal or external causes of acting-out behavior over which a staff member has little to no control. Examples: Loss of personal power Need to maintain self-esteem Fear Failure Attention seeking Displaced anger Psychological/physiological causes Taken from the Crisis Prevention Institute, Inc.

Unit V: Precipitating Factors- pg. 11 Understanding Precipitating Factors can help staff to: Prevent acting-out behavior by being proactive. Depersonalize crisis situations by recognizing that we are seldom the cause of the acting-out behavior. Avoid becoming a Precipitation Factor ourselves. If we are not able to rationally detach from a potential crisis situation, we become a part of the problem and may actually precipitate acting-out behavior from an individual. Taken from the Crisis Prevention Institute, Inc.

Unit V: Rational Detachment pg. 11 Definition: ability to stay in control of one’s own behavior and not take acting-out behavior personally. Key points: Before Crisis Develop a plan: pre-planed and rational Rehearse the plan: role play to breed confidence. Develop a team: provides safety During Crisis Use plan Use team Positive self-talk Post Crisis Debrief with those involved – staff and student Staff need to find a positive outlet for the negative energy absorbed during a crisis Taken from the Crisis Prevention Institute, Inc.

Unit V: Integrated Experience pg. 11 Definition: the concept that behaviors and attitudes of staff impact behaviors and attitudes of those in their care, and vice versa. Key Points: Individuals do not act out in a vacuum. If we stay in control when we encounter a disruptive individual, we can display a positive action which will not escalate the person’s behavior: imbalance = escalation and balance = de-escalation Taken from the Crisis Prevention Institute, Inc.

Unit VI: Staff Fear and Anxiety Introduction: This unit will allow you to deal with a very common factor in a crisis situation: fear. It is a natural – and sometimes beneficial – emotion. Anxiety is a form of fear in which we anticipate what might happen in a crisis situation. Fear results from a lack of knowledge and understanding. It can affect us in many ways. In this unit, we will learn about the unproductive, as well as the productive, reactions to fear and anxiety. It is important to remember that you can never eliminate your own fear; however, you can learn to control fear and use the energy it creates to your advantage. Taken from the Crisis Prevention Institute, Inc.

Unit VI: Staff Fear and Anxiety Instructional Objectives: Understand the causes of fear. Identify the productive and unproductive behaviors caused by fear. Learn how to make fear/anxiety work for you in a crisis situation. Provide the best possible Care, Welfare, Safety and Security for in individuals in our facilities. Taken from the Crisis Prevention Institute, Inc.

Unit VI: Staff Fear and Anxiety Unproductive Freezing – inability to react to a situation Overreacting – Psychologically: perceiving a situation as worse than it really is. Physiologically: motor skills do not function normally. Responding inappropriately – Verbally: saying things that are not pertinent to the situation; using offensive or inappropriate language. Physically: striking out at someone; not being able to control our actions. Productive Increase in speed and strength – increase in adrenaline causes superhuman speed and strength. Increase in sensory acuity – special alertness or sharpening of our senses. Decrease in reaction time – we take less time to react than we would under normal circumstances. Taken from the Crisis Prevention Institute, Inc.

Unit VI: Staff Fear and Anxiety Ways to control fear and anxiety: Understand what makes us afraid. Learn techniques to protect both ourselves and acting-out individuals in a crisis. Use a team approach – don’t respond alone. Learn physical intervention techniques to manage acting-out individuals, if necessary. Taken from the Crisis Prevention Institute, Inc.