1. Nonviolent Crisis Interventions
Why and how I found CPI-NCI.
Describe and give website information about CPI.
Amy Boecker, Director of Special Services
Cordell Public Schools

2. What is a crisis? cri•sis /ˈkrīsis/ noun
A time of intense difficulty, trouble, or danger
emergency, disaster, catastrophe, calamity
A time when a difficult or important decision must be made
Critical point, turning point, crossroads, moment of truth
The turning point of a disease when an important change takes place, indicating either recovery or death

3. Joey's story: The science of trauma
Students comes to use with baggage with we cant imagine.
Some people live in a constant state of crisis.
Concept of Trauma Informed Care – physical, psychological, emotional safety.

4. Crisis Development Model
Integrated Experience
Crisis Development/Behavior Levels
Staff Attitudes/Approaches
1. Anxiety
1. Supportive
2. Defensive
2. Directive
3. Risk Behavior
3. Physical Intervention
4. Tension Reduction
4. Therapeutic Rapport
Explain and describe the levels.
Explain that different people have different symptoms. Relationships are important in order to identify the behavior level accurately.
Behavior influences behavior.
Behavior cannot be controlled by staff – it is a choice of the student even if the student may not be in total control either.

5. Nonverbal Communication

6. Nonverbal Communication
Proxemics – Personal Space
Kinesics – Body Language
Haptics – Communication through Touch
Consider: Posture, Position, Proximity
Beware that each of these can increase anxiety – use with caution
Demonstration activity. Ask for volunteers from the crowd.

7. Paraverbal Communication

8. Paraverbal Communication
The vocal part of speech excluding the words. “HOW we say what we say.”
Tone – Inflection of voice
Volume – Range of soft and loud
Cadence – Speed
Be aware of how your communication is being perceived.
Volume – Mrs. Hull, Mrs. Ogle
Cadence – Mrs. Reimer

9. Verbal Communication

10. Verbal Intervention

11. Verbal Communication

12. Verbal Interventions

13. Keys to Limit Setting
Remember: they have lost rationality so they may not be able to process much information. Keep repeating, remain calm and be patient.

14. Approaches to Limit Setting

15. Limit Setting Steps
Explain which behavior is inappropriate. Be specific.
Explain why the behavior is inappropriate. Don’t assume they know.
Give reasonable choices with consequences. Avoid the power struggle.
Allow time for decision making. The person may need more time than usual.
Be prepared to enforce your consequence. Consistency is key.
If you clean up your work area, you’ll be able to attend the special assembly today. If you don’t clean up your work area, then you’ll have to stay behind. It’s your decision. Remember, keeping your work area clean is your responsibility.
Remain calm and in control of your emotions, Avoid making threats or ultimatums.
Controlling your own emotions is crucial!

16. Why is building a relationship with individuals in our care important?

17. Empathetic Listening
An active process to discern what a person is saying.
Nonjudgmental
Undivided attention
Listen carefully (focus on feelings and facts)
Allow silence for reflection
Restate and paraphrase
Don’t tell them what they need. It will help them more to say it out loud so they can process the situation.

18. Empathy
They don’t need you to feel sorry for them. Recognize their story as their truth. Your words won’t fix it – relationships!

19. Precipitating Factors
Factors that influence behavior.
Recognize that we are seldom the cause of the risk behavior.
Address factors that lead to crisis situations.
Avoid becoming a Precipitating Factor ourselves.

20. Precipitating Factors

21. What things contribute to stress?

22. Rational Detachment
The ability to manage your own behavior and attitude.
Stay calm.
Maintain professionalism
Do not take it personally.
Find positive outlets

23. How do you relax or decompress after a stressful situation or a difficult day?

24. Integrated Experience
Behavior influences behavior.
Consider how behavior impacts others.
Treat others respectfully.
Make objective decisions.
Remain calm.
Staff response must match the individual’s behavior. Otherwise, you risk increasing the behavior.

25. Staff Fear and Anxiety

26. Staff Fear and Anxiety
Fear: Lack of knowledge or understanding             Anxiety: Anticipation of results of fear
Unproductive Responses – freeze, overreact, respond inappropriately
Productive Responses – increased speed & strength, increased sensory acuity, decreased reaction time
Maximizing Productive Responses
Learn to keep self and others safe
Use appropriate interventions
Understand your own fears and how it drives your decisions
Be honest with yourself about your fears.

27. Decision Making Key Legal and Professional Considerations Key Themes
Accreditation & Regulation
Professional Codes of Conduct
Benchmarks for good practice
Criminal/Civil Law
Key Themes
Duty of care
Best interests
Reasonable & proportionate
Last resort & least restrictive
Human rights
These should be some of the driving forces behind your decision to intervene.

28. Physical Interventions
Physical interventions should only be used by specially trained staff members. These skills are never to be used as punishment or to enforce rules but only when the individual is no longer responding to reason AND presents a risk to self or others.
Factors that Influence Touch Zones
Cultural & Social Norms
Religion
Gender
Intimacy
Safety
Vulnerability
Sensitivity
Potential Risks of Restraints
Psychosocial Risks
Soft Tissue Risk
Bony or Articular Risks
Cardiovascular & Respiratory Risks
Physical interventions should ALWAYS be the last resort, reasonable and proportionate to the level of behavior.

29. The Aftermath
When the crisis is over and all parties are in control of their physical/emotional selves, it is best practice to debrief and document the event.
Provides the student and staff with the “whole picture”
Allows for student and staff to investigate and address any patterns in the behaviors and responses of both parties.
Student and staff can determine how to impose consequences that fit the situation.
Without this step, it is likely the individual will repeat the behavior with similar outcomes.
Consequences are not the same as punishment. Consequences are important for learning, otherwise the behavior may continue to repeat. Imposing consequeces will only be effective if all parties are calm.
If it isn’t written down then it didn’t happen. Don’t forget to document all physical interventions!

30. Integrated Experience
Review
Integrated Experience
Crisis Development/Behavior Levels
Staff Attitudes/Approaches
1. Anxiety
Change in typical behavior.
Supportive
Empathic and nonjudgmental attempt to
address the individual’s anxiety.
2. Defensive
Beginning to rationality. Questioning, refusal,
release, and verbal intimidation.
2. Directive
Remain calm. Set Limits. Simple, clear, &
concise directions.
3. Risk Behavior
Physical Intimidation, running away, harm to
self or others.
3. Physical Intervention
Only to be used by individuals with specific
training.
4. Tension Reduction
Release of physical/emotional energy.
4. Therapeutic Rapport
Reestablish communication. Support the
individual’s efforts to prevent future problem
behaviors.

31. Final Thoughts Crisis intervention does not have to be complex.
Intervening in a crisis is not a race.
Crisis intervention is more about managing your own behavior and less about managing the behavior of others.
The most successful crisis intervention situations are the ones you never hear about.
Crisis intervention is everyone’s responsibility.