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Function is the ✔✔reason or motivation for a target behavior 3 zones of personal space ✔✔intimate, personal, social; oval shape since we tolerate proximity from the side more than in front or behind 4 types of power struggles ✔✔defending authority or credibility, personal button pushing, reminders of past history or irrelevant issues, empty threats and ultimatums 5 levels of CPI Verbal Escalation Continuum 1 - information seeking ✔✔questioning, information seeking; provide a rational response, avoid power struggle 5 levels of CPI Verbal Escalation Continuum 2 ✔✔refusal, noncompliance, slight loss of rationality; set limits 5 levels of CPI Verbal Escalation Continuum 2 - challenging question ✔✔questioning authority, attempting to draw staff into a power struggle; provide rational response and avoid power
CPI Nonviolent Crisis Intervention®
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5 roles of nonverbal communication - Repetition ✔✔it repeats and strengthens the message you're making verbally 5 - step approach to setting limits ✔✔1. identify the unwanted behavior 2. explain why it is unwanted 3. give reasonable choices and consequences 4. allow time 5. be prepared to enforce the consequences 7 types of nonverbal communication ✔✔facial expression, body movement and posture, gestures, eye contact, touch, space, voice A B C S ✔✔antecedent, behavior, consequence, setting event Acting out person - grap (response) ✔✔gain a physiological advantage Acting out person - strike (response) ✔✔block or deflect the weapon, move the target Acting-out person: nonviolent physical crisis intervention ✔✔ antecedent ✔✔conditions that occur before behavior, which trigger the behavior Anxiety, anxious (Crisis Development/Behavior Levels) ✔✔Change in behavoir; pacing, jimmy leg, repetitive body movement, sweating, perseveration
Auxiliary team member duties ✔✔check, address, recognize, engage in behavior ✔✔observable actions that immedicately follow the antecedent Behavior level and interventions - Acting-out Person/Nonviolent Physical Crisis Intervention ✔✔CPI Classroom Models of CPI Personal Safety Techniques and Nonviolent Physical Crisis Intervention as a last resort Behavior level and interventions - anxiety/supportive ✔✔proxemics, kinesics, CPI Supportive Stance, paraverbal communicataion Behavior level and interventions - defensive/directive ✔✔CPI Verbal Escalation Continuum and Setting Limits Behavior level and interventions - Tension Reduction/Therapeutic Rapport ✔✔The CPI COPING Model Biomechanical Benefit ✔✔Hold & stabilize, pull/push, lever Build on the CPI foundation - demonstrate ✔✔demonstrate ability and confidence in applying course content and skills to real-life work experiences
Complete the CPI Verbal Escalation continuum: ✔✔Defensive in the middle of the kite and then around the edges goes: 1. Questioning 2. Refusal, 3. Release, 4. Intimidation and 5. Tension Reduction Components of the initial training - focus ✔✔focus on alternatives when a person loses control and become violent Components of the initial training - intervention skills ✔✔use nonverbal, paraverbal, verbal, and physical intervention skills Components of the initial training - organize ✔✔Organize thoughts about responding to agitated, disruptive, assaultive individuals Components of the initial training - techniques ✔✔use techniques to control your anxieties during interventions, maintain a professional attitude Components of the initial training - work ✔✔work as a team to resolve disruptive and dangerous situations effectively, safely, and respectfully Components of the Postvention process - control ✔✔be sure everyone is calm and rational Components of the Postvention process - give ✔✔provide support and encouragement
Components of the Postvention process - investigate ✔✔look for alternatives Components of the Postvention process - negotiate ✔✔reach agreement on changes Components of the Postvention process - orient ✔✔establish basic facts Components of the Postvention process - patterns ✔✔look for trends consequence ✔✔what happens after the behavior occurs ~natural consequence ~staff or peer responses COPING ✔✔Control emotions & physical state, Orient to facts, Patterns or triggers, Investigate, Negotiate, Give control back Coping model - Control ✔✔Ensure that emotional and physical control is regained Coping model - Give ✔✔Give control back; provide support and encouragement Coping model - Investigate ✔✔investigate alternatives to the behavior Coping model - Negotiate ✔✔negotiate future approaches, expectations, and behavior
CPI Crisis Development Model ✔✔series of recognizable behavior levels of crisis and staff attitudes/approaches for intervention CPI Crisis Development Model staff attitude/approach - Anxiety ✔✔Anxiety: Supportive CPI Crisis Development Model: Anxiety ✔✔Supportive CPI front choke release ✔✔Raise arms straight up for leverage and distraction, lean away from the person to weaken the grab, CPI kick block ✔✔remove the target, deflect the weapon, shield yourself from a strike CPI one-hand hair pull release ✔✔secure person's hand to your head, move toward the person, reducing the strength of the grab CPI one-hand wrist grab release ✔✔use leverage and momentumto pull away from the weak area of the wrist grab between the thumb and fingers CPI refersher purpose: demonstrate ✔✔demonstrate capabilities in applying course content and skills to work experiences since last training
CPI refersher purpose: is to know how to ✔✔problem solve and strengthen intervention skills CPI refersher purpose: receive ✔✔receive additional supporting information CPI refersher purpose: review ✔✔review concepts, skills, and application principles to reinforce understanding CPI Supportive Stance- 3 reasons why you should use it: ✔✔1. communicate respect by honoring personal space, 2. nonthreatening/nonchallenging and 3. Contributes to staff's personal safety/offers an escape route CPI two-hand hair pull ✔✔secure both hands to your head, move toward the person reducing the strength of the grab CPI two-hand wrist grab release ✔✔use free hand to pull grabbed hand away from the grab Crisis Development Model - define ✔✔pairs crisis development/behavior levels with staff attitudes/approaches; recognizes behavior levels experienced during a crisis moment and the corresponding staff response to de-escalate challenging behaviors Crisis Development Model - Therapeutic Rapport ✔✔Re-establish communication; listen carefully, debrief
Defensive level ✔✔beginning stage of loss of rationality; belligerence, challenges authority (2nd level) Defensive: Directive ✔✔ Defensive-Crisis Development/Behavior Levels ✔✔Beginning to lose rationality; increase voice volume, threatening, isolation, challenging, etc. Define aggression ✔✔behavior that is characterized by vigorous, intense, or hostile actions where force is used to injure or abuse another person Define last resort ✔✔risk of life or serious injury Describe how the interventions and skills in the program can support the PBIS framework ✔✔ Directive staff attitude/approach ✔✔staff takes control of escalating situation; recommended approach to the defensive level Directive-Crisis Development Model ✔✔decelerating an escalating behavior; staff takes control by providing clear instruction requesting compliance using a calm tone, keeping space, removing the trigger, offer choices, focus on "can' do, not saying no, not being parental, ; recommended approach to the defensive level 2
Empathic Listening ✔✔active process of nonjudgemental, undivided attention, listen carefully, allow silence, Restate & Paraphrase Examples of antecedents or setting events that may trigger challenging behavior ✔✔the word no, overstimulation, changes Examples of antecedents or setting events that may trigger challenging behavior ✔✔the word no, overstimulation, changes examples of limit setting ✔✔Interrupt and redirect pattern, when and then pattern examples of limit setting ✔✔interrupt and redirect pattern, when and then pattern, if and then pattern Examples of limit setting ✔✔interrupt and redirect pattern, when and then pattern, if and then pattern, Freeze ✔✔inability to react to a situation Function is the ✔✔reason or motivation for a target behavior
Increased speed and strength ✔✔physiological response - increase in motor reaction, increase of oxygenated blood to the muscles in preparation of movement Information-seeking Question intervention - Verbal Escalation Continuum ✔✔a rational question seeking a rational response; give a rational response Integrated experience ✔✔behavior influences behavior: the concept that behaviors and attitudes of staff impact behaviors and attitudes of individuals and vice versa Integrated experience ✔✔the concept that behaviors and attitudes of staff impact behaviors and attitudes of individuals and vice versa integrated experience to verbal escalation ✔✔consider how your behavior impacts those in your care, be respectful, make objective decisions Integrated Experience: Anxiety ✔✔Supportive Integrated Experience: Defensive ✔✔Directive Integrated Experience: Risk Behavior ✔✔Physical intervention Integrated Experience: Tension Reduction ✔✔Therapeutic rapport
Integrating experience - precipitating factors ✔✔hungry, disappointment, lack of power/options, environment, proximity to others, illness, tired, med change, discomfort, bored, overstim, staff, holiday/anniversary, pain integrating experience - rataional detachment ✔✔perspective - their day is always more difficult than yours, training and resources, rational detachment Interrupt and redirect pattern ✔✔help the person stop and consider an alternative positive behavior; you are shouting at me, please speak to me intimidation ✔✔The individual is verbally and/or non-verbally threatening staff Intimidation intervention-Verbal Escalation Continuum ✔✔allow venting, remove the audience; state nonthreatening directives; offer understanding and a reasonable approach, enforce limits that were set Intimidation-Verbal Escalation Continuum ✔✔The individual is verbally and/or non-verbally threatening staff Key features of PBIS - conceptually ✔✔conceptually sound and empirically validated practices
Likelihood ✔✔the chance that an event or behavior may occur Limit seting - what is it? ✔✔verbal intervention technique in which choices and consequences are offered; limits should be clear, simple, reasonable, and enforceable Limit Setting - Verbal Intervention ✔✔What are you trying to accomplish; simple/clear calm and even tone; be reasonable using minimal requests; keep it enforceable limit setting needs to be ✔✔clear and simple, reasonable, enforceable and entail consequences not punishment Maximizing Productive Responses- Staff fear and anxiety ✔✔Learn to keep yourself safe, to keep the individual in crisis safe, use a team approach, understand your fears and what drives your decisions Name two ways that an individual can act out ✔✔Verbal acting out and physical acting out nonverbal behavior ✔✔behavior that may emphasize parts of a verbal message Nonviolent Crisis Interventiom Values and Philosophy: Care ✔✔demonstrating respect, dignity, and empathy; providing support in a nonjudgmental and person-centered way
Nonviolent Crisis Interventiom Values and Philosophy: Safety ✔✔protecting rights, safeguarding vulnerable people, or managing risk to minimize injury or harm Nonviolent Crisis Interventiom Values and Philosophy: Security ✔✔maintaining safe, effective, harmonious, and therapeutic relationships that rely on collaboration Nonviolent Crisis Interventiom Values and Philosophy: Welfare ✔✔providing emotional and physical support; acting in the person's best interests in order to promote independence, choice, and well-being Nonviolent Crisis Intervention produces outcomes in 3 categories ✔✔Decreasing new cases of problem behavior, use specialized supports for at-risk individuals, decrease the intensity, duration, or frequency of complex long-standing behaviors that put individuals at risk for emotional and social failure Nonviolent Crisis Intervention Program ✔✔safe, nonharmful behavior management system to aid staff in maintaining CARE, WELFARE, SAFETY, AND SECURITY for individuals during violent moments Overreact ✔✔Phychologically - perceiving a situation as worse than it is; physiologically - motor skills do not function normally
