3. Crisis Prevention Institute Non-Violent Crisis Intervention Presenters: Ellen Peden, M.C.E.S.A Dan Simonds, Midland Public Schools

4. Before we begin, you should have the following: CPI Workbook Two Day Schedule Corporal Punishment Guidelines Participant Due Care Packet Post Vention Handout Please make sure that you sign in on each day

5. Purpose of this Training a. Ensure the care and welfare, safety, and security of your student and yourself. b. Teaches staff to recognize various stages of a crisis situation. c. Teaches staff the most effective way to respond to a crisis situation. d. Teaches you to sharpen your skills in defusing a crisis before violence occurs. e. This training will make you feel more confident about keeping yourself and others safe when a person loses physical control.

6. Participant Introduction Who are you? Where do you work? What do you do? What do you do to take care of yourself?

7. We can loose control Verbally and Physically Each require a different response from staff In this training you will be learning: a. A set of strategies to use with people who are verbally acting out b. A another set of strategies to use with people who are physically acting out

8. There are levels of behavior an individual experiences when becoming agitated and there are also appropriate staff responses to each of those behavior levels Crisis Development Model AnxietySupportive DefensiveDirective Acting out personUse of non-violent physical crisis int. Tension reductionTherapeutic Rapport “Previous Planning Prevents Poor Performance”

9. Behavioral Escalation Continuum “As behavior excalates so does the intensity”

10. One of the goals of Nonviolent Crisis Intervention is to find positive ways of dealing with crisis so that they are not traumatic (or so that the degree of trauma is lessened) Crisis can be a learning experience for everyone involved and the results can lead to growth and change

12. The overall philosophy and goal of this training is to provide the best possible care welfare safety security for everyone involved in a crisis

13. SS C W Safety Security Care Welfare

14. How CPI training assists with acting out behavior It is when people become agitated and begin to act out that staff may have less confidence in their abilities to handle the situation they encounter We are all agitated individuals at times most of us have some skills to cope with that agitation Our role is to keep them and ourselves safe during such episodes One way we can do this is to recognize the early signs and to intervene early to head off difficult behavior before it escalates. Crisis Development Model

15. “When most of us think of a crisis, we probably think of the moment when a person releases a great deal of verbal or physical energy, such as yelling and swearing or hitting and kicking. BUT almost every crisis begins long before that moment.”

16. Crisis Development Model When we look at nonviolent crisis intervention we need to look at how an individual loses control Verbally or Physically We as staff need two options of intervention for these behaviors -Verbal Intervention or De-escalation Techniques When we look at this model we look at behaviors student’s go through during the escalation process and also the intervention steps that staff can follow The CPI model is a way of understanding how a crisis situation evolves through a series of changes and how our response to each stage has an effect on the outcome -Identifies a student’s behavior and the staff response -If we determine a level it gives us an idea where to begin -We do not have to go through all the levels -Use of Non-Violent Physical Intervention

18. Anxiety:is a noticeable increase or change in behavior Behavior Labels Crisis DevelopmentStaff Attitude/Intervention Anxiety

19. Supportive:An empathic, nonjudgmental approach attempting to alleviate anxiety Behavior Labels Crisis DevelopmentStaff Attitude/Intervention Anxiety Supportive

20. How we support depends on three things: a. The type of support we are comfortable giving Huggers,Listeners, Problem Solvers,Humor b. The type of support the other person responds to Students may need to cry,vent,be held, given space c. The degree of rapport, if any that we share with the student Varies with each student Recognize normal behavior Observe anxiety through nonverbal behavior

21. Key Points: Anxiety/Supportive Recognize normal behavior Notice change in behavior (could be a sign of anxiety) Non-verbal signs could be a good indicator of a potential crisis This is the safest and best opportunity to prevent behavior Avoid overlooking signs of anxiety Be proactive-demonstrate a supportive response

23. Defensive:The beginning stage of loss of rationality. At this point an individual often becomes belligerent and challenges authority. Behavior Labels Crisis DevelopmentStaff Attitude/Intervention Anxiety Supportive Defensive

24. Directive:An approach in which a staff member takes control of a potentially escalating situation by setting limits. Behavior Labels Crisis DevelopmentStaff Attitude/Intervention Anxiety Supportive Defensive Directive

25. Setting Limits -Setting limits is empowering -Teaches accountability -Gives the student a choice -Helps keep our hands off people -May prevent further intervention

26. Three keys that will assist us that our limits are reasonable 1.Make limits clear, simple and understandable understandable 2.Be Concise 3.Make sure limits are enforceable

27. Key Points: Defensive/Directive Recognize irrational behavior Maintain professionalism-don’t allow students to push buttons Give simple & clear instructions Limits must be enforceable

29. Acting Out Person:The total loss of control which often results in a physical acting out episode. Behavior Labels Crisis DevelopmentStaff Attitude/Intervention Anxiety Supportive Defensive Directive Acting Out Person

30. May use necessary, reasonable physical force upon a pupil: To restrain or remove a pupil whose behavior is interfering with the orderly exercise and performance of school functions if the pupil has refused to cease from further disruption. To act in self defense or the defense of others. To prevent the infliction of harm on the pupil or another. To quell a disturbance that threatens physical injury to any person To obtain possession of a weapon or dangerous object upon or within the control of the student. To protect property

31. Nonviolient Physical Crisis Intervention: Safe, nonharmful control and restraint techniques used to safely control an individual until he can regain control of his behavior. These techniques should be utilized as a last resort, when an individual presents danger to self and others. Behavior Labels Crisis DevelopmentStaff Attitude/Intervention Anxiety Supportive Defensive Directive Acting Out Person Nonviolent Physical Crisis Intervention

32. Key Points: Acting Out Person/Nonviolent Crisis Intervention It is unlikely that the acting out student will respond to a supportive or directive staff attitude. In fact this person may not even hear the words spoken. Verbal intervention may no longer be an option. Physical intervention is used as a last resort and should never be used as a form of punishment. Ensure the care, welfare, security, and safety for the student and yourself. Acting out behaviors should not be taken personally

33. Tension Reduction:Decrease in physical and emotional Energy which occurs after a person has acted out, characterized by regaining of rationality. Behavior Labels Crisis DevelopmentStaff Attitude/Intervention Anxiety Supportive Defensive Directive Acting Out Person Nonviolent Physical Crisis Intervention Tension Reduction

34. Behavioral Escalation Continuum “A drop in normal behavior”

35. Characteristic of Tension Reduction Everyone eventually calms down. Decrease in physical and emotional energy. Often the student feels embarrassed, scared, confused or remorseful. Can be a teachable reachable moment.

36. Therapeutic Rapport:An attempt to reestablish communication with an individual who is in the tension reduction stage. Behavior Labels Crisis DevelopmentStaff Attitude/Intervention Anxiety Supportive Defensive Directive Acting Out Person Nonviolent Physical Crisis Intervention Tension ReductionTherapeutic Rapport

37. If we handled the crisis appropriately throughout the crisis situation it can turn into a productive-learning experience rather than that of a traumatic one. -Therapeutic Rapport gives time for reviewing the crisis situation or the true reason for the acting out behavior: Why it happened What led up to it How can we help the individual deal with it Can we help them alleviate what caused this behavior How can similar crisis be avoided in the future Can we teach them coping mechanisms or skills How can we give them the human dignity that they deserve “We may not be able to eliminate all future crisis, but we can look for ways to make them shorter, less intense, and less frequent”

38. Key Points: Tension Reduction/Therapeutic Rapport Reduction of physical and emotional energy Can be a teachable moment by reviewing the crisis situation An opportunity re-establish trust and respect

39. Crisis development is an integrated experience -What you say and what you do affects others and visa-versa Anxious peopleneed support Defensive individualsrequiredirection and limits A person who loses control and acts out physically needs Someone to physically maintain control to prevent harm to themselves and others A person experiencing tension reduction needs therapeutic rapport

40. Key Points: Crisis Development Model Crisis DevelopmentStaff Attitude/Intervention Anxiety Supportive Defensive Directive Acting Out Person Nonviolent Physical Crisis Intervention Tension ReductionTherapeutic Rapport The CPI model is a way of understanding how a crisis situation evolves through a series of changes and how our response to each stage has an effect on the outcome. The CPI Crisis Development model identifies the student’s behavior and the staff attitude or response. a. If we can determine a level--it gives us an idea where to begin b. We do not have to go through all the levels

41. Break

42. Nonverbal behavior Despite our highly developed language skills, as much as 80% of our communication is estimated to be nonverbal In the context of intervening with a person experiencing anxiety, an acute awareness of nonverbal messages becomes essential

43. Proxemics (personal space) Proxemics or personal space varies depending on who is approaching and what the context of the situation is. Personal space on the average is 2-3 feet Personal space varies based on the level of rapport

44. Proxemics exercise

45. Proxemics Many factors effect the amount of personal space one may need. Gender, size, culture, background, authority, appearance, hygiene, environmental moods, eye-contact

46. Kinesics (Body posture and motion) Kinesics include: facial expressions, gestures, posture, and movement. The way we move and position our body in relation to another person has a direct impact on the message we deliver.

47. Supportive Stance 1. Communicates respect by honoring personal space (2-3 feet is the recommended guideline) 2. Is nonthreatening, nonchallenging, and offers an escape route (by standing off to the side). 3. Contributes to the staff’s personal safety if attacked (provides a margin of safety of at least 2-3 feet). By turning sideways you are keeping the most vulnerable areas of your body, such as your groin, chest,stomach, knees and shins, protected.

48. Tips for supportive stance 1. Keep hands close to the body 2. Palms up rather than palms down 3. Keep hands out in the open

49. Kinesics (body posture) Your body posture can escalate or deescalate a situation increase or defuse anxiety avoid the need for higher level intervention or invite it

50. Kinesics A staff member has the option during a potential crisis to defuse the situation simply by taking the time to And Check Yourself

51. Key Points Personal space can effect anxiety levels. Body posture and motion effect anxiety levels. Awareness of nonverbal communication can de-escalate anxiety

53. PARA VERBAL COMMUNICATION Para verbal communication is “how we say what we say”. The manner in which we alter our tone, volume, and rate. “How does Para verbal communication assist us with dealing with disruptive behavior?” People in crisis situations begin to lose rationality. When this occurs, they respond to more basic levels of communication.

56. THREE COMPONENTS OF PARA VERBAL COMMUNICATION Tone:A sound of distinct pitch and quality Volume: The amplification or loudness of a sound or word(s). Cadence:How fast or slow a message is delivered

57. We want to demonstrate control We are not trying to control the individual’s behavior but we are telling our students that we have professional control especially over ourselves.

58. If we graph out an individual’s verbal behavior in the defensive stage it would be erratic with highs and lows

59. We have no more control than they do..so how can we possibly help them? If the staff’s verbal behavior is similar, what are we telling the student?

60. 7 simple words that we can keep in the same order but we can make that statement say several things I didn’ttellTomwereincompetentyou

61. The words are the same but the meaning is different Paraverbal along with nonverbal communication will help get our messages through

62. Key Points “Para verbal communication is “how we say what we say” -Your voice, including its tone, and rate of speech, significantly affects the meaning behind your words. Think about how we sound -This can contribute to how we can de-escalate a behavior -We don’t want to contradict Para verbals with nonverbals -Nonverbal and Para verbal communication should be consistent with the message you want to deliver. Coupled with non-verbal communication Para verbals “package” your verbal intervention

63. Break

64. Key Points 1. Staff may not be able to control precipitating factors, but they can control their own response to the acting out behaviors which result. 2. A professional attitude must be maintained so that we may control the situation without overreacting or acting inappropriately 3. Staff need to find positive outlets for the negative energy absorbed from acting out individuals

65. Questioning

66. Questioning is one of the first behaviors we see in a person who is escalating in the defensive level There are two types of questions that are apparent at this level 1. INFORMATION SEEKING 2. CHALLENGING

67. Information Seeking 1. A rational question seeking a rational response. A legitimate question seeking information, clarification or satisfying curiosity. 2. Do not assume that the person understands why your directive is being issued. Intervention: Give them an answer to their question.

68. Challenging Questions These questions are to question authority or to be evasive. These questions: Challenge authority are used to manipulate people and situations, and are used to take the focus off the student. Intervention: Assist the student to refocus, stay on the topic, (broken record technique), negotiation (we’ll talk about that later).

69. Questioning Refusal

70. The next stage commonly observed in a person who is verbally escalating is refusal Characteristics of Refusal are: 1. Noncompliant behavior 2. Defiance 3. Tempting you to engage in a power struggle. 4. Button pushing

71. Interventions for Refusal !. Ask the student “Why won’t you do that?” 2. Set Limits: Clear, Simple, Reasonable,and Enforceable 3. Allow time: We all need time to make a competent decision, back off and release some pressure.

72. Questioning Refusal Release

73. Acting out, emotional outburst, loss of rationalization venting, screaming,swearing, High energy output Interventions for Release, 1, Allow venting, if possible, 2.Remove audience or acting out individual from the area 3.When individual begins to calm down state directives that are nonthreatening. 4.Use an understanding reasonable approach 5. Be prepared to enforce any limits you set.

74. Questioning Refusal Release Intimidation

75. Characteristics are: Individual is verbally and/or nonverbally threatening staff in some manner. Hands on approach at this time may trigger physical acting out behavior. Interventions: 1. Seek assistance and wait for team to intervene, if possible. 2. Try to avoid individual intervention as this is more likely to jeopardize the safety and welfare of both staff and student. If a person displays aggressive behavior that jeopardizes the safety of you, others or property, then, nonviolent physical intervention may be used as a last resort.

76. Questioning Refusal Release Intimidation Therapeutic Rapport

77. Tension Reduction There is a drop in energy that follows every crisis situation Interventions: Establish therapeutic rapport-- reestablish communication with the individual.

78. Questioning Refusal Release Intimidation Therapeutic Rapport

79. Verbal Intervention Tips and Techniques Dos Don’ts 1. Remain Calm Overreact 2. Isolate the situation Get in a power struggle 3. Enforce Limits Make false promises 4. Listen Fake attention 5, Be aware of nonverbals Be threatening 6. Be consistent Use jargon that confuses the student.

80. EMPATHIC LISTENING 1. BE NONJUDGEMENTAL 2. GIVE UNDIVIDED ATTENTION 3. LISTEN CAREFULLY TO WHAT THE PERSON IS REALLY SAYING (FOCUS ON FEELINGS, NOT JUST FACTS 4. ALLOW SILENCE FOR REFLECTION 5. USE RESTATEMENT TO CLARIFY MESSAGES

81. Lunch

82. Precipitating Factors The internal or external causes of an acting out behavior over which a staff member has little or no control. We as staff have very little control over these factors

83. Behavioral Escalation Continuum “Events and/or experiences that occur before the behavior ever begins”

84. Precipitating Factors “Antecedent of Behaviors” Precipitating factors come in many different forms. (Insomnia or hunger or pain) Think of how your behavior changes when you don’t get enough sleep or when you have a severe headache. For a person with limited coping skills these factors may be enough to cause an episode of acting out behavior.

85. Understanding precipitating factors can positively affect a staff person’s attitude and action

87. Lack of Sleep Hunger Pain Loss of personal power Divorce DeathLow self-esteem Physical Abuse Attention Seeking Displaced Anger Psychological Physiological Change Substance Abuse Peer Pressure Academics Communication Difficulties Money Hormonal Changes Health Lack of supervision/discipline The list is endless because people are so different!

89. As staff members we have very little control over many of these factors. Sometimes we don’t even know which factors are at work in a given situation. Sometimes we are seen as a safe and convenient target for the person who is disruptive or even assaultive. KNOWING THESE BEHAVIORS AND THE BIG PICTURE ALLOWS US TO SHOW SOME COMPASSION, HOWEVER THIS DOES NOT JUSTIFY BEHAVIOR

90. Knowledge of Precipitating factors assist us in building a positive staff attitudes 1. Prevent acting out behavior by being proactive 2. Depersonalize crisis situations 3. Avoid becoming a precipitating factor ourselves (Rational Detachment)

91. Behavioral Escalation Continuum “Events and/or experiences that occur before the behavior ever begins”

92. 1. Knowledge of Precipitating Factors allows us to anticipate when a student might become agitated 2. This anticipation allows us to be prepared 3. By feeling prepared staff will feel more confident and less desperate 4. Allows staff to understand where the student is coming from or their aggression 5. Assists us in depersonalizing the situation Being Proactive Attempting to eliminate or elevate precipitating factors

93. 1. We are seldom the cause of acting out behavior 2. We want to avoid taking an acting out behavior as a personal attack 3. Another name for depersonalizing is rational detachment Depersonalizing Understanding precipitating factors can help us recognize that we are seldom the cause of acting out behavior

94. 1. The ability to control your own feelings 2. The ability to stay calm, objective and professional 3. We can prepare to rational detach ourselves from stressful situations by taking good care of ourselves Rational Detachment The ability to stay in control of one’s behavior and not take acting out Behavior personally

96. Key Points 1. Staff may not be able to control precipitating factors, but they can control their own response to the acting out behaviors which result. 2. A professional attitude must be maintained so that we may control the situation without overreacting or acting inappropriately 3. Staff need to find positive outlets for the negative energy absorbed from acting out individuals

97. UNIT IV: STAFF FEAR AND ANXIETY Fear and anxiety are universal emotions. Our response to them is both psychological and physiological Nonproductive reactions to fear/anxiety include: A. Freezing- inability to react to a situation (i.e. stage fright) B. Overreacting 1. Perceiving that a situation is worse than it really is C. Responding Inappropriately 1. Verbally-saying things that are not pertinent to the situation, using obscene or vulgar language 2. Physically- striking out at someone, not being able to control our actions.

98. Productive reactions to fear and anxiety include: 1. Increase in speed and strength additional adrenaline in the bloodstream can induce super human strength. 2. Increase in sensory acuity - special alertness or sharpening of our senses. 3. Decrease in Reaction Time we respond more quickly, than in normal situations.

99. Ways to control fear/Anxiety 1. Understand what makes us afraid. Learn techniques to protect everyone. Use a team approach, don’t respond alone. Learn techniques to control acting out individuals.

100. Fear and Anxiety Our goal is not to make you fearless, but to use the energy produced from fear in a positive way by improving our responses to crisis situations.

101. Break

102. DUE CARE FOR PARTICIPANTS * We will treat each other as peers. * We are all responsible for each other’s safety. * You are responsible to gauge for yourself any past/current injuries and your comfort level. If you have any concerns, please see us. * Horseplay will not be tolerated. * In all exercises, you will act only on my command/direction. * You must report all injuries to me immediately. * Cooperate, don’t compete. (No points for style). * Take off all jewelry.

103. Personal Safety Techniques There are two types of personal attacks: A STRIKE & A GRAB a weapon coming in contact with a target Strike: Examples: hit,punch, kick, shove, spitting, throwing objects, use of weapons Grab: any strike that holds on the control or destruction of a part of one’s anatomy Examples: wrist grab, hair pull,chokes,bites, pinching,tackle “Every attack usually falls in these two categories (strike/grab)” “Being able to identify a strike or a grab can lead to how one will react”

104. Principles of Personal Safety A. Strike 1. Block (or deflect) the weapon. 2. Move the target These are natural, instinctive responses to a strike

105. Principles of Personal Safety B. Grab 1. Gain a physiological advantage by using the following: a. The weak point of the grab b. Leverage c. Momentum 2. Gain a psychological advantage by remaining in control of your behavior. Do this by: a. Stay calm b. Have a plan (knowing what to do when) c. Using an element of surprise or distraction

106. In contrast to a strike, these may not be natural, instinctive responses. Our instinctive response to a grab usually is to pull away which is not as effective and may increase injuries.

108. Video: “Reading, Writing, and Weapons ”

109. End Of Day 1

110. Video: “The Disruptive Adolescent ”

111. DUE CARE FOR PARTICIPANTS * We will treat each other as peers. * We are all responsible for each other’s safety. * You are responsible to gauge for yourself any past/current injuries and your comfort level. If you have any concerns, please see us. * Horseplay will not be tolerated. * In all exercises, you will act only on my command/direction. * You must report all injuries to me immediately. * Cooperate, don’t compete. (No points for style). * Take off all jewelry.

112. Break

113. TEAM CONTROL DYNAMICS R educe Upper Body Strength by controlling arms as weapons A. Turning Palms Up B. Raising Arms above the shoulders C. Anchoring Arm on Hip R educe Lower Body Strength by controlling the back incline A. Lowering shoulders below hips R educe Mobility by Close Body Contact

114. Video: “Team Intervention ”

116. TEAM LEADER DUTIES 1. Assess the situation a. What level of intensity/How dangerous is b. How many c. Who is involved d. Bystanders e. Any weapons f. Is outside help necessary 2. Plan the intervention a. One that is willing to make a decision -What to do -Who to contact 3. Direct or cue the other team members 4. Communicate with the acting out individual

118. “You may not get it right the first time but keep practicing until you feel comfortable”

119. Lunch

120. Postvention During a crisis a tremendous amount of energy is built up, then expended by the acting out person. This high level of energy can not last forever and finally dissipates, and the individual begins to calm down.. This final behavior level is called Tension Reduction. Postvention is reestablishing a relationship with the person that has acted out. Another name for this is establishing Therapeutic Rapport This is the final step of providing an individual with care, welfare, safety and security.

121. The second part of postvention involves the Tension Reduction that is experienced by staff members- who have also expended a great deal of energy during the crisis. Debriefing allows staff members to discuss both the facts and their feelings. Postvention leads to a focus on prevention It gives the staff an opportunity to focus on What happened? How did the staff respond? How could the intervention have been better handled? How can we prevent this situation?

122. The CPI COPING MODEL Control Orient Patterns Investigate Negotiate Give

123. Control Make sure that staff and the person who acted out are back under emotional and physical control

124. Orient Orient yourself to the basic facts. What happened? Be nonjudgmental; listen to the perspective of the acting out person

125. Patterns Look for patterns of past behavior

126. Investigate Investigate alternatives to the inappropriate behavior and resources that could be helpful in making behavioral changes

127. Negotiate Negotiate a contract with the acting out individual. Make sure that the person understands what she can do instead of displaying inappropriate behavior.

128. Give Return control to the person that is acting out. Give her back the responsibility to control her own behavior, along with your support and encouragement

129. COPING, FOR STAFF CONTROL Be sure that the staff members are back in control before discussing the incident

130. Orient Establish the basic facts of the incident team members may have arrived at different points in the intervention and may have observed and hear events differently

131. Patterns Review the staff response to the crisis situations. Are there patterns in the way the team responds?

132. Investigate Look for ways to strengthen individual and team responses to crisis situations

133. Negotiate Agree to changes which will improve future interventions

134. Give Provide one another with support and encouragement. Express trust and confidence in fellow team members

135. Break

136. Role Play