Expectations

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Expectations

• Prioritize safety within the workshop
• Participate Fully
• Keep an open mind and be inquisitive
• Punctuality
• Focus on fundamentals instead of speed
• Successful completion of the written and skills
  assessments
• Help your fellow participants and facilitator(s)
  learn
• Have fun!

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The Mindset Training Curriculum

• The purpose of this training program is to
  facilitate insight, raise awareness, enhance
  skills, and ultimately certify professionals in a
  system of preventing and managing aggressive
  behavior

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Keys to Success

• A comprehensive and clear policy and procedure
• Restraint/Seclusion must be the intervention of
  last resort
• Staff must be trained in de-escalation techniques
• Adequate and well prepared staff
• Consumer (student) involvement
• A system of data collection and analysis

• Strategies for organizational change
• Performance measurement systems
• Emphasis on staff and consumer (student) strength
• Cultural Competence
• Effective consumer (student) and staff debriefing
• An environment that prioritizes the consumer
  (student) dignity

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Prevention and pro-active

• The greatest disservice a risk or safety
  management program can have for any organization
  is to devolve into a system that primarily
  focuses on the physical management of aggressive
  behavior. The goal of the MindSet training
  curriculum is to set in motion a process of
  increased awareness, skill development, and
  appropriate parameters for individuals and
  organizations to eliminate the need for physical
  restraint or seclusion

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Questions

• What do you see as your personal, professional,
  and legal responsibilities to be in regards to
  safety management?
• What relevance does this information have for our
  training?
• What do you foresee as the keys to success in
  your classroom, school or system?

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The Mindset

• Punitive measures are not appropriate when
  dealing with aggressive behavior
• Emphasize everyones strengths to maximize a safe
  environment
• A crisis situation is a learning opportunity
• Consistency is essential
• Empowerment fosters learning and trust

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Guiding Principles (4)Promote Choice and Trust

• A person in crisis can and will choose
  alternatives to aggressive behavior if given the
  opportunity
• Fear and a sense of powerlessness often fuel
  aggression
• Trust and opportunities for choice can counteract
  fear and the sense of powerlessness

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Avoid Power Struggles

• Human emotions can tip the scale in a crisis
  situation
• Present yourself as an ally and assess your body
  language
• Get in your CAR (calm, aware, respectful) before,
  during, and after crisis situations

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Seek Pro-Action vs. Re-Action

• Timing is essential in effectively managing a
  crisis situation
• Use good judgment in not under reacting or over
  reacting
• Both staff/teachers and consumer/students should
  develop specific pro-action strategies relative
  to creating a safe environment.

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Set-up Everyone For Success

• To achieve a culture of prevention, everyone
  involved must establish and implement customized
  strategies for creating safe environments.
• Consistency and teamwork are essential
  ingredients of a safe environment
• Consumers/students must be empowered to become
  their own risk managers

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Questions

• What Specific strategies do you currently
  utilize, or have seen others utilize, that
  support any or all of these guiding principles?
• What specific strategies do you currently
  utilize, or have seen others utilize, that do not
  support these guiding principles?
• How can you apply these principles emotionally,
  verbally, and physically?

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Creating A Culture of Prevention
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Questions

• What barriers do you have little or no control
  over as a staff member?
• What barriers do you consider emotional,
  physical, or both?
• What barriers exist for both staff members and
  the individuals served?

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Awareness Checklist

• Environment-Physical Safety, Emotional Safety
• Individual Crisis Plans-Physical, verbal, and
  non-verbal antecedents, self-directed time out
• Group Crisis Plans-Self directed work, remove the
  group
• Cultural-Race, gender, socio-economic, language
  and social norms

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Ten Steps for Defeating Bias and Overcoming
Resistance

• Non-emotional instead of emotional requests
  (control your bias)
• Descriptive requests
• Do not use a question format
• Keep a safe distance
• Make eye contact
• Two requests only
• Check tone of voice
• Time to comply
• More start requests than stop requests
• Reinforce compliance

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Guidelines For Effective Crisis Communication

• Get in your CAR! (calm, aware, respectful)
• Create a one-on-one (minimize distractions)
• Timing is everything (be pro-active)
• Avoid advice or quick fixes
• Make empathetic statements when possible
• Promote Choice and Trust!

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The Four-Step Counseling Model

• Step 1 Say what you see and/or hear
• Be concrete, non-judgmental
• Focus on body language
• Purpose-To let the student know they have your
  attention in a non-judgmental way

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Four- step counseling model

• Step 2 Establish the feeling
• Seems to me like youre______
• Keep the communication focused
• Feelings drive the behavior
• Purpose-To connect a feeling to the behavior in
  an effort to establish a base or understanding
  for further communication.

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Four-step counseling model

• Step 3 Connect the feeling to the source
• Who, what, when, where, how
• Avoid why questions
• Ask open-ended questions
• Purpose- To connect the feeling to the source or
  sources of distress.

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Four-step counseling model

• Step 4 Plan of Action
• What else can you do?
• What have you tried?
• What are you willing to do?
• What are the pros and cons?
• Purpose-to assist the person in crisis towards
  establishing a plan of action in getting their
  needs met in acceptable and safe ways What do
  you want?

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• What current communication strategies do you
  effectively utilize in preventing aggressive
  behavior?
• What will be challenging about applying the new
  techniques you have learned?
• How can you apply the guiding principles to these
  communication strategies?

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Avoiding Contact

• Stance
• Movement
• Protection

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• What challenges do you face in trying to avoid
  physical contact?
• What actions can other staff members take to
  increase safety?
• How can you apply the guiding principles when
  avoiding contact?
• How does your communication change once
  aggression becomes physical

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Physical Contact

• Aggression from the front (grasp, choke, bite)
• Aggression from behind (arm twist, choke, hair
  pull)
• Assisted choke release

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• What are ways you have experienced forceful
  contact in the past?
• What is challenging about applying the techniques
  you have just learned?
• How can you apply the guiding principles to the
  techniques you have just learned?

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Safe Practice Guidelines(During Training)

• Ask questions following any facilitator
  demonstrations.
• Start the practice slowly and focus on the
  fundamentals.
• Utilize medium force and speed.
• Help your partner learn and be patient with
  yourself.
• Remove potentially harmful objects.
• Inform the facilitator of any pre-existing
  conditions
• Participate fully

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Safety Continuum(Staff /Teacher Response)

• Ignore/Ten-step Process/Behavior Management
• Crisis Communication/directed time-out
• Avoid Contact/Set up for success
• Communicate/Release/Positioning
• Neutralize/Release/Embrace
• Embrace/Leveraged Embrace/Communication
• Embrace/Object Removal
• Horizontal Containment

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• In addition to the safe practice guidelines
  established, additional guidelines must be
  followed when using vertical containment
  techniques.
• 1)This technique should only be applied as a last
  resort and as a response to immediate or imminent
  danger
• 2)Always communicate and ask for what you want
  (de-escalation)
• 3)Use the least amount of force necessary
• 4)Avoid using containment techniques as a
  response to oppositional/defiant behavior

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• When are you justified in applying physical
  restraint techniques?
• What circumstances do not justify physical
  restraint?
• How can the principles shape our attitudes and
  behaviors regarding physical restraint?

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Vertical Containment

• Embrace
• Leveraged Embrace
• Influential Escort
• Size differentials and adjustments

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• Describe restraint experiences you have been
  involved with.
• What is challenging about applying the techniques
  you have just learned?
• How can you apply the guiding principles to the
  techniques you have just learned?

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Additional Guidelines(Horizontal Containment)

• 1)Communicate with your partner in addition to
  the aggressor
• 2)SHOULDERS PERPENDICULAR to the GROUND
• 3)No direct pressure
• 4)Monitor breathing and circulation. Release
  immediately if problems detected.
• 5)No single staff takedowns
• 6)Use only minor adjustments once containment is
  fully applied
• 7)Release when appropriate. (15 minute checklist)

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Horizontal Containment

• Single Staff
• Dual Staff
• Size differentials and adjustments

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• What responsibilities can additional staff
  members take on during a physical restraint?
• What action should you take if you observe or
  sense physical duress in a student being
  restrained on the ground?
• How can you apply the guiding principles to the
  horizontal containment procedures?

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Ending the Containment

• LiFo (Last in, first out)
• Be patient and clearly define what you want

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Size Differentials

• Shoulders perpendicular
• Staff/Teacher positioning

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Additional Guidelines(Object Containment)

• 1)Communication and body language are your most
  powerful tools
• 2)Never ask for the object to be handed to you
• 3)Use a buffer when necessary
• 4)Check your proximity
• 5)Clear the audience!

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Object Containment and Release

• Thumb rotation release

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• Why would you focus on communication with a
  student threatening to use an object?
• What is challenging about the thumb rotation
  technique?
• How can you apply the four guiding principles to
  situations involving an object being used
  aggressively?

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Additional Guidelines(Seclusion Time Out)

• 1)Never seclude an individual for punitive
  reasons or for staff convenience
• 2)A secluded individual must be constantly
  monitored.
• 3)An individual should never be carried or
  dragged to a seclusion area (Horizontal
  containment should be used for active aggression)
• 4)The requirements to end time-out and seclusion
  must be clearly defined.
• 5)Separate documentation and notification
  requirements must be met.

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Seclusion and Time out

• Student and staff directed time-out (opportunity
  room)
• Door locks and observation

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• What are the dangers of secluding a consumer or
  student during a crisis?
• What are the physical and psychological
  differences between time-out and seclusion?
• How can you apply the guiding principles to
  seclusion and time-out?

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Making it Stick

• Policy and Procedure
• Debriefing between Staff/Teacher and
  Consumer/Student
• Timing and Emotional Impact
• Exploring future solutions
• Staff/Staff debriefing
• What went well
• What could be done differently
• Incident Report (Template)
• Safety Director and Committee
• Staff/Teacher and Student/Consumer recognition