Term
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Definition
Situational
and
Maturational |
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Term
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Definition
| Stress produced from progression through developmental stages |
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Term
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Definition
1. There is a sudden change in the young persons' behavior
2. The young person has run out of or never learned effective, rational, constructive ways of coping with internal or interpersonal problems |
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Term
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Definition
| External stressful events - things that just happen |
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Term
| What are the 2 Goals of Crisis Intervention? |
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Definition
Short term: To provide immediate emotional and environmental support in a way that reduces the stress and risk
Long Term: To teach better, more constructive, and effective ways to deal with stress or painful feelings |
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Term
| Stress Model of Crisis (Curve) |
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Definition
Pre-Crisis = Baseline
Triggering Phase
Escalation Phase
Outburst Phase
Recovery Phase |
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Term
| Pre-Crisis Stage is where on the curve? |
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Definition
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Term
| Triggering Phase is where and what? |
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Definition
| First one after baseline (Pre-Crisis) on left = Agitation = Something is beginning to happen or something has set them off |
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Term
| Escalating Phase is where and what on the curve? |
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Definition
| Second up from baseline on left = Aggression = Opportunity to teach better coping skills |
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Term
| Outburst Phase is where and what on the curve? |
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Definition
| Top of curve = Violence = Sometimes the restraint is the safest thing for the child and/or others |
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Term
| Recovery Phase is where and what on the curve? |
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Definition
| Bottom right = almost returned to baseline |
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Term
| What are the 3 levels of the Recovery Phase? |
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Definition
1. Lower (Abuser) - we end up yelling or threatening
2. No Change (Fire Fighter)
3. Higher ((Educateur) = We want to be/get here |
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Term
What are the Four Questions we ask ourselves in a crisis situation?
ASK OURSELVES BEFORE WE GET INVOLVED IN A CRISIS SITUATION |
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Definition
1. What am I feeling now?
2. What does this young person feel, need, or want?
3. How is the environment affecting the young person?
4. How best do I respond? |
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Term
| What does Importance of Self-Awareness mean? |
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Definition
1. Role Model
2. Cultural and ethnic differences
3. Personal life experiences
4. Past experiences and present behavior |
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Term
| Describe the Feelings, Needs, and Behaviors Iceberg |
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Definition
Feelings and Needs are under the water and
Behaviors are above the water |
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Term
| What does Assessing Behavior Mean? |
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Definition
1. All behavior has meaning
2. Behavior reflects needs |
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Term
| What are the 2 Types of Aggressive Behaviors? |
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Definition
1. Reactive Aggression
2. Proactive Aggression |
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Term
| What is Reactive Aggression mean and what does it look like? |
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Definition
1. Affective or expressive aggression
2. Loss of control and emotional flooding
3. Emotions are dominant |
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Term
| What is Proactive Aggression and what does it look like? |
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Definition
1. Instrumental or operant aggression
2. Goal Oriented
3. Cognitions are dominant (Thinking is dominant)
4. Planning it out |
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Term
| What questions do you ask to identify a Yong Person's Needs? |
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Definition
1. Why did this happen today, and not yesterday?
2. Is this typical behavior for this young person?
3. Is the young person expressing a need?
4. Is this normal for a young person of this age?
5. Does this behavior reflect a family or cultural belief? |
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Term
| What is important about The Physical Environment? |
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Definition
1. Good use of space
2. Clean, orderly, inviting - Sally inspects for cleanliness
3. Lighting and noise levels
4. Furnishings and decorations - maintenance dept. will come and shampoo or replace couch cushions.
BE AWARE OF THE KIDS ARE and
CLEANLINESS/ORGANIZATION OR OFFICE USUALLY REFLECTS THE CLEANLINESS OF THE KIDS ROOMS, ETC. |
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Term
| What is important to know about the Programs, Activities, and Routines? |
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Definition
1. Meet the young people
2. Thoughtful transitions
3. Consistent routines
4. Adequate structure
5. Strong and well-resourced program
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Term
| What is important to know about the AGENCY POLICY AND PROCEDURE? |
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Definition
1. Clearly written
2. Communicated
3. Understood |
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Term
| What are the five main intervention approaches? |
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Definition
1. Listening (ear) = major part of de-esculation
2. Teaching (lightbulb)
3. Relating (conversation bubbles)
4. Directing (megaphone)
5. Structuring (clipboard with RULES) = Safe, secure environment - remind of expectations
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Term
| What does structuring look like? |
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Definition
1. Provide a safe and secure environment
2. Be predictable and consistent
3. Maintain routines based on the needs of the young people
4. Depend on the structure of the program
5. Remind young people of program expecations |
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Term
| What does listening look like? |
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Definition
1. Identify feelings
2. Focus on internal conflicts
3. Be non-judgemental, accepting, supportive
4. Use active listening techniques |
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Term
| What does directing look like? |
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Definition
1. Redirect behaviors
2. Use rewards and punishments
3. Make directive statements
4. Establish control and order |
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Term
| What does relating look like? |
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Definition
1. Role model effective behaviors
2. Use personal influence
3. Engage withdrawn, isolated young people
4. Give personal attention and encouragement |
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Term
| What does teaching look like? |
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Definition
1. Process events throughout the day
2. Make decisions together
3. Hold young people responsible for actions and choices
4. Create opportunities for learning |
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Term
|
Definition
Facial expression = 55%
+ Tone of voice = 38%
+ Words = 7% |
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Term
| What are nonverbal techniques? |
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Definition
1. Silence
2. Nods
3. Facial Expression
4. Eye Contact |
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Term
| What are ENCOURAGING and ELICITING techniques? |
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Definition
1. Minimal Encouragements: "Uh-huh", "Go on", "I see"
2. Door Openers: "I'd like to hear more", "Tell me about that"
3. Closed questions: "Do you like your teacher?"
4. Open questions: "How do you feel?", "What happened next?"
5. Validation: "Yea that would make it easier" |
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Term
| What are REFLECTING techniques? |
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Definition
Reflective Responses:
"You feel uncomfortable when your friends talk about school."
"You are angry about your visit being canceled. I'd be upset too."
SUMMARIZATION:
"Here is what I hear you saying, you felt good at first, but now..." |
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Term
| What is Active Listening? |
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Definition
1. Identifies and expresses emotions
2. Is respectful of a young person
3. Responds to feelings, rather than just behavior
4. Communicates that we care and understand
5. Helps young people "talk out rather than act out" |
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Term
| What is Active Listening NOT? |
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Definition
1. Throwing up roadblocks
2. Premature problem solving
3. Arguing or establishing facts
4. Permission giving
5. Necessarily time consuming
YOU WANT THEM TO TALK - SHUT MY MOUTH! |
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Term
| List the Behavior Management Techniques from Least Intrusive to Most Intrusive |
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Definition
| 1. Managing the environment 2. Prompting 3. Caring gestures (Hypodermic affection) 4. Hurdle help 5. Redirection 6. Proximity 7. Planned ignoring and positive attention 8. Directive Statements 9. Time away |
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Term
| Describe the Stress Model of Crisis opportunities between Triggering (agitation) and Escalation (Aggression). |
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Definition
| Your ENCOUNTER with the young person can either ENGAGE OR ENRAGE - If you engage, the youth can return to pre-crisis (baseline) phase; if you ENRAGE, the youth continues to Escalation (Aggression) phase. |
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Term
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Definition
| Star at the top represents The Stressful Incident - the cycle then continues down to the right to the Young Person's Feelings - then the cycle continues down and around to the bottom to the Young Person's Behavior - then the cycle continues up to the left to thee Adult's Response - what happens between the young person's feelings and their behaviors: the young person is responsible for their behavior; what happens between the behavior and the adult's response is where we either engage or enrage the youth |
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Term
| Why do you ask yourself "What am I feeling now?" |
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Definition
1. Anger can undermine objectivity
2. Anger is an emotional and physical state
3. Cognitive abilities are reduced |
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Term
| What does "Effects of Anger mean and look like? |
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Definition
| "When we are our angriest, we are our stupidest." Visualize a baseline going through the center of the paper and an arrow is pointing up to ANGER, and an arrow is pointing down to Cognitive Functioning. The anger curve goes up at the same time the cognitive functioning curve goes way below baseline |
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Term
| What do you do when young people do not comply? |
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Definition
1. Actively listen and problem solve
2. remove the others from the area
3. Give the young person choices and time to decide
4. Let the program consequences stand
5. Redirect the young person to another more attractive activity
6. Appeal to the young person's self-interest
7. Use your relationship with the young person |
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Term
| What are non-verbal behaviors? |
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Definition
1. Eye contact
2. Body language
3. Personal Space
4. Height Differences
5. Gender Differences
6. Cultural Differences |
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Term
| What does I-ASSIST stand for? |
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Definition
| I = isolate the young person A = Actively listen S = Speak calmly, assertively respectfully S = Statements of understanding precede requests I = Invite the young person to consider positive outcomes and behaviors S = Space reduces pressure T = Time helps young people respond to requests |
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Term
| What are the 4 Elements of a Potentially Violent/Crisis Situation? |
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Definition
1. A potential trigger to violence
2. A target
3. A weapon
4. Level of stress |
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Term
| What does the Stress model of a Crisis Cycle look like with I ASSIST added to it? |
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Definition
| A dotted line between Escalation Phase (Aggression) can lead back down to Pre-Crisis State (Baseline Behavior) if we are able to DISENGAGE or the Escalation Phase (aggression) can continue to Outburst Phase (Violence) if we use I ASSIST and are able to ENGAGE the young person |
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Term
| To De-Escalate the crisis, remove the potential trigger to the violence by: |
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Definition
1. Never touching an angry and potentially violent person
2. Avoiding any aggressive moves and proactive statements
3. Avoiding the crisis cycle and counter aggression
4. Removing others who might trigger the violence
BODY LANGUAGE IS CRITICAL |
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Term
| To de-escalate the crisis, Remove the target by: |
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Definition
1. Asking the targeted person to leave
2. If it's you, remind the young person of your relationship or
3. Leave the situation and ask a "neutral" staff to manage the incident
THE TARGET MAY SHIFT DURING THE EPISODE |
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Term
| To de-escalate the crisis, Avoid the weapon by: |
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Definition
1. Discretely removing objects
2. Maneuvering away from weapons
3. Staying a safe distance away |
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Term
| To de-escalate the crisis, decrease the level of stress by: |
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Definition
1. Using your relationship
2. Actively listening to identify feelings
3. Using non-confrontational limit-setting (I ASSIST) |
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Term
| What is the Objective of I ASSIST? |
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Definition
| To make the situation safe by reducing the level of arousal in order to promote compliance |
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Term
| Part of I ASSIST is SCAR which means |
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Definition
| the first S = Speak calmly, Assertively, and Respectfully (SCAR) |
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Term
| List the Tips of I ASS... OF I ASSIST |
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Definition
| I = DO Isolate = AVOID Audience effects S = DO Actively Listen = AVOID Assumptions and negative expectations S = DO Speak calmly, assertively, and respectfully = AVOID Aggressive and disrespectful language and tone of voice S = DO Make statements of understanding before instructions or requests = AVOID Thoughtless, coercive commands that ignore the young person's feelings |
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Term
|
Definition
| I = Isolate the conversation E = Explore the young person's point of view (ask open ended questions) Listening - don't be judgemental S = Summarize the feeling and content(some of the content) C =Connect the behavior to feelings (Donna took the broom, you got angry, I came out, and separated you, is that what happened?) A = Alternative behaviors discusssed P = Plan developed/Practice new behavior E = Enter young person back into the routine GET THEM TO SEQUENCE THE EVENTS |
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Term
| What is involved in the LSI |
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Definition
| (Life Space Interview) I = Isolate the conversation Target Behavior Indentified E = Explore the young person's point of view S = Summarize the feelings and content C = Connect the young person's feelings and behaviors A = Alternative behaviors discussed P = Plan developed/Practice the plan E = Enter young person back into the program |
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Term
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Definition
| Life Space Interview = a therapeutic, verbal strategy for intervening with a young person "the clinical exploitation of life events" by Fritz Redl |
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Term
| What are the goals of the LSI? |
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Definition
| 1. Return the young person to normal functioning (for them) 2. Clarify the events 3. Repair and restore the relationship 4. Teach new coping skills 5. Reintegrate the young person back into the program (GET THEM BACK INTO THE ROUTINE) |
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Term
|
Definition
Connect behavior to feelings = "In the past, I have seen this happen, etc."
When you get your feelings hurt, you get mad and punch someone." |
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Term
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Definition
| Alternative behaviors discussed = "Is there something else you could do?" What things do you like to do?" Brainstorming - new coping skill - you accept all of their ideas |
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Term
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Definition
| Plan developed/Practice new behavior = Don't tell the youth, "Would you like to practice? Just say "Let's practice" also "I'm going to put this in your notes so that the other staff know that...." Ask again, "Now, what are you going to do?" GET THEM BACK INTO THE MILIEU AGAIN (THE ROUTINE) AS SOON AS POSSIBLE |
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Term
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Definition
"I'd like to talk to you" or "Lets go ....and sit down...."
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Term
| The verbiage for E in I ESCAPE: |
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Definition
| E = "What was happening?" "And then what happened?" "So you felt...." I was worried when...." |
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Term
| The verbiage for the first S in I ESCAPE: |
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Definition
| "Let's make sure I got this straight." |
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Term
| The verbiage for the C in I ESCAPE |
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Definition
| "So, when you feel..... you....?" |
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Term
| The verbiage for the A in I ESCAPE: |
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Definition
| "Let's think of some different ways you could...." |
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Term
| The verbiage for the P in I ESCAPE: |
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Definition
"You've got some good options."
"Let's make a plan."
"Let's now practice/rehearse" |
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Term
| The verbiage for the last E in I ESCAPE: |
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Definition
"Here's what's happening now..."
"Do you think you are ready to go back?" |
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Term
| List the tips of IST of I ASSIST |
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Definition
| I = DO Invite the young person to consider positive outcomes and behaviors = AVOID Threats or suggestions: Don't you dare throw that chair! If you keep this up, you know what will happen! S = DO Give space - It facilitates consideration of requests and avoids focusing on adult = AVOID Crowding and pressuring the young person T = DO Give time for the young person to process and respond to the request = AVOID Demands for immediate compliance (unless safety is the issue) |
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Term
| Options to handle physical violence are (5) |
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Definition
| 1. Eliminate one of the elements of the violent situation. 2. Make a directive statement that clearly communicates that the violence must stop 3. Use releases and maintain a safe distance with a protective stance 4. Leave the situation and get assistance 5. Employ physical restraint techniques (if indicated on the ICMP) |
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Term
| What are the ongoing Response Priorities? |
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Definition
| Reactive: 1. Teaching coping skills for difficult emotions 2. Anger management Proactive: 1. Teaching appropriate thinking 2. Instituting effective behavioral controls |
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Term
| What is the Individualized Crisis Management Plan? |
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Definition
| 1. Functional analysis of crisis behavior 2. Strategy for intervening tailored for the young person 3. Periodic review and update |
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Term
| What is the goal of physical intervention? |
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Definition
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Term
| What is the definition of Physical Restraint |
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Definition
| Physical Restraint: The use of staff members to hold a young person in order to contain acute physical behavior Acute Physical behavior: Behavior likely to result in physical injury; the young person, other clients, staff members, or others are at imminent risk of physical harm 2. The young person, other clients, staff members, or others are at imminent risk of physical harm |
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Term
| What is the Physical restraint Criteria? |
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Definition
| Physical restraint should only be used when: (all criteria must be met) 1. Agency policies and state regulations approve restraint 2. The young person's ICMP indicates it 3. Our professional judgement indicates it |
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Term
| Physical restraint is not used to? |
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Definition
| 1. Demonstrate authority 2. Enforce compliance 3. Inflict harm or pain 4. Punish or discipline |
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Term
| What are the basic principles of physical intervention? |
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Definition
| A maximum amount of caring and a minimum amount of force with the goal of de-escalating the situation by reducing stimulation |
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Term
| What is the letting go process in a physical restraint? |
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Definition
| 1. Is a gradual test of a young person's self-control 2. States what is expected of the young person 3. Is directed by the team leader 4. Is supportive of the young person |
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Term
| What are the Poential Pitfalls of an LSI? |
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Definition
| Young person refuses to talk: 1. Convey calm support and sanction silence 2. Ask a focused question 3. Reschedule LSI Young person gets off subject: 1. Allow exploration and relate it to the incident 2. Focus on the incident at hand Premature plan 1. Don't interrupt young person's thought process 2. Don't develop plan for young person 2. |
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Term
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Definition
| 1. How did the worker isolate the young person from the problem? 2. Did the worker explore the young person's version of what happened, including: A. the young person's concern about the situation B. The young person's feelings about what happened C. Did the worker share his/her view of what happened to clear up any misunderstandings or misconceptions? 3. Did the worker summarize what the young person did, how the young person felt, and sequence the events? 4. What feelings and behaviors did the worker connect for the young person? |
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Term
| Do not use physical restraints when? |
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Definition
| 1. We cannot control the young person safely 2. We are not in control 3. Sexual stimulation is the motivation 4. We are in a public place 5. Young person has a weapon 6. Young person's medical condition prohibits it 7. Young person has emotional problems (trauma) 8. Young person is on medication(s) that effect his/her system |
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Term
| What are the definitions of Asphyxia? |
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Definition
| Asphyxia: the deprivation of oxygen to living cells. Positional Asphyxia: Fatal respiratory arrest in which the ability to breath is compromised by the positioning of the body in relationship to its immediate surroundings. |
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Term
| What are the Predisposing Risk factors of Asphyxia? |
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Definition
| 1. Obesity 2. Individual under the influence of alcohol or drugs 3. Prolonged violent physical agitation 4. Underlying natural disease, i.e., enlarged heart, asthma, high blood pressure, diabetes 5. Hot, humid environment 6. Individual taking certain types of medication |
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Term
| What are the warning signs of Asphyxia? |
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Definition
| Asphyxia due to neck compression: Goes limp and ceases to breathe spontaneously Asphyxia due to respiratory interference: 1. States he/she can't breathe 2. Respiration is labored, rapid, or abnormal 3. may make grunting noises 4. Vomiting or turning a dusky purple color, especially of the face 5. Limp and ceases to breathe |
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Term
| What are the first 5 recommendations to reduce the risk of asphyxia? |
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Definition
| 1. Never place weight on a young person's chest or back 2. never put pressure on the young person's neck 3. Never place the head in a position that causes the neck to be compressed 4. Never allow a young person to stay in the prone position once he or she is no longer a safety risk - get the person up and in a seated position. 5. Never place a young person's arms behind his/her back when that person is in a prone position |
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Term
| What is required for documentation after a restraint? |
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Definition
| 1. Who, what, when, and where? 2. What were the antecedents? 3. What did staff do to de-escalate the situation? 4. If physical contact, who did what (be specific) 5. How long did the restraint last? 6. Staff/child injuries? Medical attention? 7. What plan was developed in the Life Space Interview? 8. Debriefing of staff? 9. Was follow-up needed? 10. Was the family notified? |
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Term
| What are the 5 phases of the Stress Model of Crisis? |
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Definition
| 1. Pre-Crisis State-basline 2. Triggering Phase (agitation) 3. Escalating Phase (aggression) 4. Outburst (violence) 5. Recovery Phase |
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Term
| What are the 2 goals of crisis intervention? |
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Definition
| 1. To provide immediate emotional and environmental support in a away that reduces the stress and risk 2. To teach better, more constructive and effective ways to deal with stress or painful feelings |
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Term
| What are the 3 Outcomes of the Recovery Phase? |
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Definition
| 1. Educateur 2. Firefighter 3. Abuser |
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Term
| When assessing a crisis situation, what are 4 questions we ask ourselves? |
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Definition
| 1. What am I feeling now? 2. What does this young person feel, need or want? 3. How is the environment effecting the young person? 4. How do I best respond? |
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Term
| What are 2 types of aggression? |
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Definition
| 1. Reactive aggression - emotions are dominant 2. Proactive aggression - Thinking is dominant |
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Term
| What are the 4 aspects of the Importance of Self Awareness? |
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Definition
| 1. Role model 2. Cultural and ethnic differences 3. Personal life experiences 4. Past experiences and present behavior |
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Term
| Agency policy and procedure need to be? |
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Definition
| 1. Clearly written 2. Communicated 3. Understood |
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|
Term
| What are the 5 Intervention approaches? |
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Definition
| 1. Listening 2. Teaching 3. Relating 4. Directing 5. Structuring |
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Term
| What are some non-verbal techniques? |
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Definition
| 1. Silence 2. Nods 3. Facial Expressions 4. Eye Contact |
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Term
| What is an example of a door opener? |
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Definition
| "I'd like to hear more." "Tell me about that." "Do you want to talk? |
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Term
| Meaning is spoken language = %______, %_____, %_______. |
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Definition
| 55% Facial Expression 38% Tone of Voice 7% Words |
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Term
| What is an example of a minimal encouragement? |
|
Definition
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|
Term
| What is an example of a closed question? |
|
Definition
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Term
| What is an example of an open question? |
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Definition
| "How do you feel?" What happened next?" |
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Term
| What is an example of a reflective response? |
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Definition
| "You feel uncomfortable when your friends talk about school." "You are angry about your visit being canceled. I'd be upset too" |
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Term
| What is an example of summarization? |
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Definition
| "Here is what I hear you saying." First this happened, then this happened." |
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Term
| What are the 9 Behavior Management Techniques? |
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Definition
| 1. Managing the environment 2. Prompting 3. Caring gestures 4. Hurdle help 5. Redirection 6. Proximity 7. Planned ignoring and positive attention 8. Directive statements 9. Time away |
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Term
| What are the last 5 recommendations to reduce the risk of asphyxia? |
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Definition
| 6. Never bend a child forward in a small child restraint 7. never place anything over or near the young person's face, mouth, or nose that can be inhaled or conform to the contours of the face 8. Never conduct a restraint on a soft surface such as a mattress 9. never ignore any of the warning signs of pending asphyxia 10. Never fail to take immediate action if there is any need for emergency medical treatment |
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Term
|
Definition
| 5. What alternative behaviors and choices did the worker help the young person develop? Were ideas coming from the young person validated? 6. What plan did the worker help the young person develop? Was it specific as to when and how? Did the worker have a role? Did the young person practice the new behavior? 7. How did the worker help the young person enter back into the program? |
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