Nonviolent Crisis Intervention® Training Program (Refresher) Luzerne Intermediate Unit #18 Unit I The CPI Crisis Development Model The CPI Crisis Development Model 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 The CPI Crisis Development Model • 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 The CPI Crisis Development Model • Defensive: – The beginning stage of loss of rationality – Noncompliance, verbal venting, accuse or blame others • Directive – Manage a potentially dangerous situation by setting limits The CPI Crisis Development Model • 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 The CPI Crisis Development Model • 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 CPI Supportive Stance • About a leg length away • On an angle • Hands visible Reasons for using the CPI Supportive Stance 1. Safety 2. Respectful 3. Non-threatening Unit II Verbal Intervention The CPI Verbal Escalation Continuum • Part of the Defensive stage of the CPI Crisis Development Model • The goal of staff is to deescalate the individual The CPI Verbal Escalation Continuum 3. Release 4. Intimidation 5. Tension Reduction 2. Refusal 1. Questioning The CPI Verbal Escalation Continuum • Questioning a. Information-seeking: a rational question seeking a rational response b. Challenge: questioning authority, being evasive, attempts to draw staff into power struggle The CPI Verbal Escalation Continuum • Interventions a. Give Information- be a resource b. Stick to the topic (redirect), ignore the challenge (not the person), avoid the struggle The CPI Verbal Escalation Continuum • Refusal – Noncompliance, no-mode, drop and flop The CPI Verbal Escalation Continuum • Intervention – The process of setting limits • Choices/options • Incentives/consequences • Space and time (planned ignoring-extinction) The CPI Verbal Escalation Continuum • Release – Verbal venting, tantrums, screaming, yelling The CPI Verbal Escalation Continuum • Intervention – Let child vent – Isolate the situation – Team approach – Enforce limits The CPI Verbal Escalation Continuum • Intimidation – Individual is making threats – Verbally or nonverbally The CPI Verbal Escalation Continuum • Intervention – Take all threats seriously – (document and inform or exit room) – Take a team approach The CPI Verbal Escalation Continuum • Tension Reduction Decrease in Emotional and Physical energy The CPI Verbal Escalation Continuum • Intervention – Establish Therapeutic Rapport • Reestablish communication Keys to Setting Limits • Clear and Concise – Simple and easy to understand – Use their communication • Reasonable – Fair, incentives, buy-in • Enforceable – Remember space and time – Follow through Verbal Intervention Tips and Techniques • 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 Remember The CPI Crisis Development Model 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 Unit III CPI’s Personal Safety Techniques Definitions • STRIKE – A weapon coming in contact with a target • Grab – The attempt to control or destroy part of one’s body Principles of Personal Safety • Strike 1. Block or deflect the weapon 2. Move the target 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 Principles of Personal Safety • Response to the Strike – Natural and instinctive • Response to the Grab – Not natural and instinctive Unit IV Nonviolent Physical Crisis Intervention and Team Intervention Nonviolent Physical Crisis Intervention • • • • • Use a team approach Use as a last resort Used for protection, not punishment Intent is to calm a person down Non-harmful in design RISKS OF RESTRAINTS • What one needs to breathe – Open Airway – Gas Exchange – Movement of Ribcage and Diaphragm 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) Control Dynamics 2. Reduce lower body strength by controlling the back line a. Lower shoulders below hips 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) POST-TEST EVALUATION The End