2. Nonviolent Crisis Intervention® Training Program Luzerne Intermediate Unit #18

4. Unit I The CPI Crisis Development Model SM

5. Remember The CPI Crisis Development Model SM Crisis Development/ Behavior Levels 1. Anxiety 2. Defensive 3. Acting Out Person 4. Tension Reduction Staff Attitude/ Approaches 1. Supportive 2. Directive 3. Nonviolent Physical Crisis Intervention 4. Therapeutic Rapport Integrated Experience

6. The CPI Crisis Development Model SM Anxiety: –A noticeable increase or change in behavior –e.g., pacing, finger drumming, wringing of hands, rocking, etc… Supportive –An empathetic, nonjudgmental approach attempting to alleviate anxiety

7. The CPI Crisis Development Model SM Defensive: –The beginning stage of loss of rationality –Noncompliance, verbal venting, accuse or blame others Directive –Manage a potentially dangerous situation by setting limits

8. The CPI Crisis Development Model SM Acting Out Person: –The total loss of control which often results in a physical acting out episode Nonviolent Physical Crisis Intervention –Safe, nonharmful controls and techniques used to safely manage an Acting Out Person –Last Resort

9. The CPI Crisis Development Model SM Tension Reduction: –a decrease in physical and emotional energy which occurs after a person has acted out –Regaining control Therapeutic Rapport –Reestablish communication –Learning opportunity –Give closure –Build relationships

10. Unit II Nonverbal Behavior

11. Proxemics

12. Proxemics (Personal Space) Personal Space Varies 1 ½ to 3 feet Factors: –Gender –Size –Personal relationship –Age –Context of situation

13. Proxemics (Personal Space) It is respectful to observe individuals personal space Announce when and why you need to invade an individual’s personal space Personal space can extend to family, friends and belongings Invasion of one’s personal Space can increase anxiety

14. Kinesics

15. Kinesics Messages we communicate with our body posture and motion Our body language should be nonthreatening Includes: –Stances –Facial expressions –Gestures

16. CPI Supportive Stance SM About a leg length away On an angle Hands visible

17. Reasons for using the CPI Supportive Stance SM 1. Safety 2. Respectful 3. Nonthreatening

18. Unit III Paraverbal Communication

19. Paraverbal Exercise “______________, I am glad you came to school today, why don’t you get to your locker.”

20. Paraverbal Communication The vocal part of speech excluding the actual words one uses How you say what you say

21. Paraverbal Communication 3 Key Components Tone –Supportive, understanding and comforting Volume –Appropriate to situation and person Cadence –Even rate and rhythm

22. Unit IV Verbal Intervention

23. The CPI Verbal Escalation Continuum SM Part of the Defensive stage of the CPI Crisis Development Model SM The goal of staff is to deescalate the individual

24. The CPI Verbal Escalation Continuum SM DEFENSIVE-DIRECTIVE 1. Questioning 2. Refusal 3. Release 4. Intimidation 5. Tension Reduction CARE WELFARE SAFETY SECURITY

25. The CPI Verbal Escalation Continuum SM Questioning a. Information-seeking: a rational question seeking a rational response b. Interventions a.Give Information- be a resource b.Stick to the topic (redirect), ignore the challenge (not the person), avoid the struggle

26. The CPI Verbal Escalation Continuum SM Questioning b. Challenge: questioning authority, being evasive, attempts to draw staff into power struggle b. Challenge: questioning authority, being evasive, attempts to draw staff into power struggle * Intervention Stick to the topic (redirect), ignore the challenge (not the person), avoid the struggle

27. The CPI Verbal Escalation Continuum SM Refusal –Noncompliance, no-mode, drop and flop Intervention –The process of setting limits Choices/optionsIncentives/consequences Space and time (planned ignoring-extinction)

28. The CPI Verbal Escalation Continuum SM Release –Verbal venting, tantrums, screaming, yelling Intervention –Let child vent –Isolate the situation –Team approach –Enforce limits

29. The CPI Verbal Escalation Continuum SM Intimidation –Individual is making threats –Verbally or nonverbally Intervention –Take all threats seriously –(document and inform or exit room) –Take a team approach

30. The CPI Verbal Escalation Continuum SM Tension Reduction Decrease in Emotional and Physical energy Intervention –Establish Therapeutic Rapport Reestablish communication

31. Keys to Setting Limits Clear and Concise –Simple and easy to understand –Use their communicationReasonable –Fair, incentives, buy-inEnforceable –Remember space and time –Follow through

32. Verbal Intervention Tips and Techniques

33. DO –Remain Calm –Isolate the situation –Enforce limits –Listen –Be aware of nonverbals –Be consistent –Ignore challenge questions –Be nonthreatening DON’T –Overreact –Provide an audience –Change them –Ignore –Communicate emotion –Make false promises –Get in a power struggle –Be threatening

34. Empathetic Listening

35. An active process to discern what a person is truly saying

36. Empathetic Listening 1. Be nonjudgmental 2. Give undivided attention 3. Listen carefully to what the person is really saying (feelings, not just facts) 4. Use restatement to clarify message 5. Allow silence for reflection S I LEN T

37. Unit V Precipitating Factors, Rational Detachment, Integrated Experience

38. Precipitating Factors Internal or external causes of an acting out behavior of which staff has little or no control

39. Precipitating Factors

40. Rational Detachment Ability to stay in control of one’s own behavior and not take acting out personally A professional and calm approach

41. Rational Detachment

42. Integrated Experience The concept that the behaviors and attitudes of staff impact on those in their care and vice-versa

43. Remember The CPI Crisis Development Model SM Crisis Development/ Behavior Levels 1. Anxiety 2. Defensive 3. Acting Out Person 4. Tension Reduction Staff Attitude/ Approaches 1. Supportive 2. Directive 3. Nonviolent Physical Crisis Intervention 4. Therapeutic Rapport Integrated Experience

44. Unit VI Staff Fear and Anxiety

45. Fear Is a natural human emotion Produces physiological and psychological responses

46. Reactions to Fear and Anxiety Unproductive –Freezing –Overreacting PhysiologicallyPsychologically –Respond Inappropriately Saying things Doing things Productive –Increase of speed and strength –Increase in sensory acuity –Decrease in Reaction time

47. How do we manage fear? Acknowledge and understand Learn personal safety skills Use a team approach Learn controls to safely manage and Acting Out Person

48. Unit VII CPI’s Personal Safety Techniques SM

49. STRIKEGRAB PunchBite KickPinch Spit Hair Pull Throw Objects Choke SIBSIB

50. Definitions STRIKE –A weapon coming in contact with a target Grab –The attempt to control or destroy part of one’s body

51. Principles of Personal Safety Strike 1. Block or deflect the weapon 2. Move the target

52. Principles of Personal Safety Grab 1. Gain a physiological advantage a.Weak point b.Leverage c.Momentum 2. Gain a psychological advantage a.Remain calm b.Have a plan c.Use element of surprise or distraction

53. Principles of Personal Safety Response to the Strike –Natural and instinctive Response to the Grab –Not natural and instinctive

54. Unit VIII Nonviolent Physical Crisis Intervention and Team Intervention

55. Nonviolent Physical Crisis Intervention (pg 15) Use a team approach Use as a last resort Used for protection, not punishment Intent is to calm a person down Nonharmful in design

56. RISKS OF RESTRAINTS (pgs 12s 13s 14s) What one needs to breathe –Open Airway –Gas Exchange –Movement of Ribcage and Diaphragm

57. Control Dynamics 1. Reduce upper body strength by controlling arms as weapons a.Turn palms up b.Raise arms above shoulders c.Anchor arm to your body (hip area)

58. Control Dynamics 2. Reduce lower body strength by controlling the back line a.Lower shoulders below hips

59. Control Dynamics 3. Reduce mobility by close body contact a.Move hips close to individual’s body b.Move the individual’s center of gravity forward, bring him onto his toes (ball of foot)

60. Team Intervention (pg 20) WHO?HOW?WHEN?

61. Team vs. Solo Intervention 1. Safety 2. Litigation 3. Professionalism

62. Team Leader 1. The first person on the scene 2. Competence and confidence in handling crisis situations 3. Good rapport with the Acting Out Person

63. Team Leader Duties 1. Assess situation 2. Plan intervention 3. Direct or cue team members 4. Communicate with the Acting Out Person

64. Auxiliary Team Member Duties CheckAddressRecognize Engage in

65. Unit IX Situational Role-Plays

66. Unit X Postvention

67. The CPI COPING Model SM ontrolrientatternsnvestigateegotiateive

68. For Individuals Emotional and physical control Orient yourself to the feelings and views of the individual Look for patterns of past behaviors of individual and triggers Investigate alternatives to behaviors Negotiate a contract Give back control

69. For Staff All staff are in control Orient the team to the facts of the crisis Look for patterns of staff behavior Investigate ways to strengthen staff Negotiate and agree to changes that will take place in future interventions Give support and encouragement

70. POST-TEST EVALUATION The End