Therapeutic Crisis Intervention
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| Two goals of crisis intervention | Support and Teach
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| Support in Crisis | environmentally and emotionally reduce stress and risk
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| Teach in Crisis | coach children on better ways to cope with stress
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| Stress Model of Crisis | Baseline (agitation), Triggering Event (Aggression), Escalation , Outburst/Crisis (violence),Recovery (higher, no change, lower)
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| Recovery stage | the last stage in the stress model of crisis. Higher (educateur), no change (firefighter), lower (abuser)
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| Conflict cycle | stressful situation, young person's feelings, young person's behavior's, adult response
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| Ways to avoid conflict cycle | Positive self-talk, Listen/validate feelings, Manage environment, Give choice/time to decide, Redirect to positive activity, Appeal to self-interest,Drop/change expectation
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| Four questions we ask ourselves in a crisis situation | 1) What am I feeling now? 2) What does the child feel, need, or want? 3) How is the environment affecting the young person? 4) How do I best respond?
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| Setting condition | anything that makes a challenging behavior more or less likely to occur (room too hot, medical issue, change in routine, trama)
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| Pain Based Behavior | -impulsive outburst, -aggression, -running away, -self injury, -definace, -inability to regulate emotions, -trauma re-enactment
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| Behavioral Support Techniques | -manage environment, -prompting, -caring gesture, -hurdle help, -redirection, -proximity, -directive statement, -time away
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| Goals of Emotional First Aid | -provide immediate help and support, resolve immediate crisis, and keep child in program (Return to Baseline)
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| Strategies of Emotional First Aid | drain off emotions (validate feelings, open ended questions), clarify events (reflective statements, summarize), maintain the relationship/ lines of communication, remind students of expectations/mediate if necessary
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| Help me Help Myself | co-regulation
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| Co-regulation | provide support/reduce stress and risk
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| Help me Help Myself Non-Verbal Stragegies | -take a deep breath, -use protective stance, -step back, -give time, -sit down, -body language/facial expression
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| Help me Help Myself Verbal Stragegies | -very little talk, -understanding responses (Ï can see...", "When you...", Ï know we...","I am sorry..."), -tone of voice
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| LSI | Life Space Interview
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| Steps to LSI | -Isolate the converstaion, -Explore childs point of view, -Summarize feelings and situation, -Connect feelings to behavior, -Alternative behaviors discussed, -Plan developed and practiced, -Enter child back into program
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| Goals of LSI | -Return young person back to baseline, -Clarify events, -Repair and restore relationship, -Teach new coping skills, -Re-integrate child back to program
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| 4 elements of a potentially violent situation | 1) Trigger 2) Target 3) Weapon 4) Level of Stress/motivation (T-T-W-L)
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| Risk factors to be aware of before a restraint | obesity, influence of drugs and alcohol, prolonged violent physical agitation, disease, hot humid environment, medication
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| When to avoid a restraint | we are not in control (too angry), sexual stimulation is motivation, in a public place, child has a weapon, child has a medical condition, child has emotional problems, child is on medication
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| Physical Warning Signs during a restraint that a child is in Danger | position of child, skin color, repiration, level of consciousness, level of agitation, range of motion or swelling of body parts
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| During a restraint you should NEVER.... | never ignore warning conditions of asphyxia (suffocation) or fail to take action if there is a need to emergency medical treatment
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| Reactive Aggression | expressive, loss of control and emotional flooding, and emotions are dominant
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| Proactive Aggression | planned aggression, goal oriented, and cognitions (thoughts) are dominant
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| Ways to deal with Reactive Aggression | safety, understanding and support, remove or reduce stimulus, anger management
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| Ways to deal with Proactive Aggression | teach appropriate thinking, values, and social skills and reward socially appropriate behavior , not anti-social behavior
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| ICMP (individual crisis management plan) | functional analysis of high risk behavior, strategy of intervening, tailored to child, periodic review and update
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Created by:
Catherine_R