1. Unit 4 Crisis Intervention and De-escalation

2. 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

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

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

5. 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

6. Working with Youth – What You Can Do

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

8. 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

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

10. 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.

11. 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.

12. 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.

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

14. 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)?

15. 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

16. Nonverbal Communication
Body Language
Physical Proximity
Facial Expressions
Eye Contact

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

18. 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

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

20. 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.”

21. Behavioral Change Staircase

22. 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

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

24. 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.

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

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

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

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

29. 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.

30. 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.”

31. Activity Close-ended vs. Open-Ended Questions

32. 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

33. 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”

34. 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

35. 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

36. Activity Role Play

37. 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

38. Activity Role Play

39. 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

40. Activity Role Play

41. 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.

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

43. 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

44. 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.

45. 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

46. 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

47. 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

48. 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

49. Activity Discussion of De-escalation Techniques