1. Verbal De-Escalation Workshop Connecting with Kids Through School Health Conference
Eaton RESA
Instructional Services
Micki Fuhrman, Regional School Health Coordinator,
Certified Crisis Prevention Institute Trainer,
Prevention Consultant

2. Introductions Who’s in the room?
Do you ever deal with a person who is upset?

3. Crisis Development Model
Crisis Development Behavior Levels
Staff Attitudes and Behaviors
Understanding these levels of crisis development and the corresponding attitudes and behaviors for staff response can help to de-escalate a potential crisis.

4. Anxiety
Definition: a feeling of worry, nervousness, or unease, typically about an imminent event or something with an uncertain outcome.
Response: Supportive. An empathetic, nonjudgmental approach attempting to alleviate anxiety.

6. Empathic Listening
Definition - An active process to discern what someone is really trying to communicate.
Be non-judgmental
Give your undivided attention
Listen to what the person is REALLY saying
Focus on feelings as well as facts
Allow for silence

8. Brene Brown Empathy What do you take away from this video?
Is there a concept or phrase that will stay with you?

9. Defensive
Definition
Individual may challenge authority and become belligerent
This is the beginning stage of the loss of rationality

10. Closer Look at Defensive Behavior
Questioning:
Rational
Answer question
Challenging
Redirect, or repeat

11. Defensive behavior Refusal--Restate Release--Allow venting
Intimidation--Begin documentation
Tension Reduction—Therapeutic Rapport

12. Acting Out Person Acting Out Person
The total loss of control and rationality which often results in physical acting out behavior.

13. Physically Acting Out Person
What could this look like?
Distinguish between frustration and physically acting out
What is your safety plan and protocol?

14. Safety Plan Where do you meet? Who is near you?
What can be done to support you?
Is there a “panic” signal?

15. Tension Reduction Decrease in physical and emotional energy
Regain rationality
Drop in energy
Examples?

16. Re-establish Connection (Therapeutic Rapport)
An attempt to re-establish communication with an individual who is in the tension reduction stage
Examples

17. Escalating Behaviors

18. Personal Space How do you define personal space?
Average personal space is_______.
Considered an extension of self. (What?)
Influencing factors:
How do you respond when
someone is in your personal space?

19. Nonverbal (or Kinesic) Behavior **even when people can’t see you**
Definition - Non-verbal messages communicated by body postures, gestures or motions. Your kinesic behavior can serve to escalate or de- escalate a given situation

20. Nonverbal Behavior Body Posture and Motion
Communicating with body language:
facial expressions
gestures
posture
movement

21. Supportive Stance Communicates Respect Is non-threatening
Contributes to staff member’s personal safety

22. Paraverbal Communication **How you say what you say**
Tone: Avoid inflections of:
Impatience
Condescension (insincerity)
Inattention
Loudness: Appropriate for the distance and situation; enough to be heard
Cadence: Talk in an even rate and rhythm

23. Paraverbal Communication
I didn’t say you were stupid

24. CPI Verbal Escalation Key Points to Remember!
Don’t take the verbal acting out personally
Avoid getting into power struggles
Be consistent – SET LIMITS

25. Keys To Setting Limits
Simple (limit choices, no technical jargon, acronyms)
Reasonable (consequence fits offence)
Enforceable (you’re able to follow through)

26. Verbal Intervention Tips and Techniques
Do -
Remain calm
Isolate the situation
Enforce limits
Listen
Be aware of nonverbal signs
Be consistent
Watch personal space

27. Verbal Intervention Tips and Techniques
Don’ts
Engage in power struggles
Make false promises
Fake attention
Be threatening
Use sarcasm
Overreact

28. No time to wait for a response?
Pay now or Pay later

29. Tools in your tool belt Be supportive Empathic listening
Answer questions (information seeking)
Re-direct (if challenged)
Set limits (positive choice)
Allow venting
Call for help

30. Precipitating Factors
Internal or external causes of an acting out behavior over which we have little or no control.
Understanding precipitating factors can help: prevent acting out behavior, depersonalize the crisis & avoid becoming a precipitating factor.

31. What is trauma?
Trauma is defined by the American Psychological Association (APA) as the emotional response someone has to an extremely negative event.
While trauma is a normal reaction to a horrible event, the effects can be so severe that they interfere with an individual’s ability to live a “normal” life.

32. ACEs (adverse childhood experiences) have a powerful correlation to adult health outcomes later in life. As the number of traumatic experiences increases, so does the risk of an array of social and health problems experienced in adulthood, such as:
social, emotional and cognitive impairment;
adoption of health-risk behaviors;
Disease
Disability
Social problems;
and early death

33. ACE’s-Adverse Childhood Experiences
— Physical, sexual and verbal abuse.
— Physical and emotional neglect.
— A family member:
depressed or diagnosed with other mental illness;
Addiction
in prison.
Witnessing a mother being abused.
Losing a parent to separation, divorce or other reason.

34. Adverse Childhood Experiences Include:
Physical/Emotional/Sexual neglect or abuse
Alcohol/Drug use/abuse in the home
Incarcerated household member
Household member who is chronically depressed, mentally ill, institutionalized, or suicidal
Domestic violence
Absent Parent

35. ACE’s Data
46% of all children in the United States have at least one ACE.
35% of children in Michigan have ACE’s.
14% of children in Michigan have 3 or more.
The most common ACE in the country is economic hardship.

36. ACE’s Data (continued)
Most common ACE’s in Michigan(in order)
Divorce/Separation
Economic Hardship
Alcoholism
Mental illness

37. Behavioral and Developmental Effects of Trauma: Biologically based challenges:
Problems with movement and sensation
Hypersensitivity to physical contact
Insensitivity to pain.
Problems with coordination and balance
Unexplained physical symptoms
Increased medical problems (asthma, skins problems, autoimmune disorders
Body reactions such as racing hearts, churning stomach or sweatiness.

38. Behavioral and Developmental Effects of Trauma-Children may have difficulties with mood regulations as demonstrated by difficulty:
Knowing/identifying their feelings
Describing feelings and internal states
Describing their wishing and desires to others
Utilizing coping skills.

39. Behavioral and Developmental Effects of Trauma
Attachment difficulties characterized by:
Difficulties with boundaries.
Feeling distrustful and suspicions of others.
Becoming socially isolated and having difficulty relating to and empathizing with others.

40. Behavioral and Developmental Effects of Trauma Cognition and Self- Concept challenges
Difficulties focusing and completing tasks.
Problems planning and anticipating the future.
Understanding their own role in their own life.
Disturbed/distorted body image.
Low self esteem
Shame, guilt
Dissociation

41. Behavioral and Developmental Effects of Trauma Children may demonstrate:
Poor impulse control
Self-destructive behaviors
Verbal and physical aggression towards others.
Excessive amounts of energy.
Incongruent emotions (crying, laughing, etc.)
Yelling
Name calling
Provocative behaviors

42. Rational Detachment Staff’s ability to maintain
professionalism and not take
acting out behavior
personally -
To stay in control of one’s behavior and not take it personally
Maintain a professional attitude
Find positive outlets to relieve negative energy

43. Integrated Experience
The concept that staff’s attitude, action and behavior directly influences a client’s response, attitude and behavior.
Can I control someone’s behavior?

44. Debriefing Why is it important? How do you do it?
Who do you do it with?
Is there an office protocol?

45. COPING Control – Rationality returned Orient – To the basic facts
Patterns – Of behavior
Investigate - Alternatives
Negotiate – Agree to changes
Give – Support, encouragement, THE RETURN TO COMMUNITY

47. “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 de-escalated and a child humanized or dehumanized.”
- Haim Ginott

48. THE END
THANK YOU FOR PARTICIPATING