Shared Flashcard Set

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TCI 2011
TCI 2011 Edition 6
83
Education
Professional
07/04/2011

Additional Education Flashcards

 


 

Cards

Term

CRISIS PREVENTION

 

What does TCI stands for?

Definition

 

 

Therapeutic Crisis Intervention

Term

CRISIS PREVENTION

 

What does effective TCI implementation include?

Definition

Effective TCI implementation includes 

  • leadership and programme support
  • clinical participation
  • supervision and post crisis response 
  • training and competency standards
  • documentation and incident monitoring and feedback
Term

CRISIS PREVENTION

 

 

Describe conditions or settings that can affect behaviour

Definition

Anything that makes challenging behaviour more or less likely to occur

for example:

 

Organisational culture (e.g. control orientated, poorcommunication)

environment (e.g. hot, crowded)

Programme related (e.g. routine, staffing, activities)

Personal(e.g. illness, medication, trauma)

Relationship Based (e.g. excessive controls, "us versus them", culture)

Term

CRISIS PREVENTION

 

What constitutes a positive organisational culture?

Definition

a positive organisational culture:-

  • Supports developmentally appropriate practice
  • Provide opportunities children to participate successfully in activities
  • Involves children, families, and staff members in decision-making
  • Encourages relationship building activities
  • Creates a learning organisation
Term

CRISIS PREVENTION

 

Describe a calming physical environment?

Definition

a calming physical environment:-

 

  • Makes good use of space of a personal public use
  • Is clean, orderly, inviting
  • Soft lighting and regional calming noise levels
  • Is furnished and decorated a properly in the age group living there

 

Term

CRISIS PREVENTION

 

What should Programmes, activities, and routines do?

Definition

Programmes, activities, and routines should:-

 

  • Balance structure and flexibility to meet individual needs.
  • Provide for thoughtful transitions.
  • A consistent and satisfying.
  • Have goals, structure, and be designed to help children develop skills.
  • Be adequately resourced
Term

CRISIS PREVENTION

 

With what should you treat each child as an individual with?

Definition

Treat each child as an individual with:-

 

  • Individual baseline behaviour.
  • Different strengths and abilities.
  • Specific effects of trauma.
  • Underdeveloped co-regulation and self-regulation skills.
  • Possible physical discomfort (e.g., illness, medication)
  • A need for individual crisis management plan (ICMP)

 

 

Term

CRISIS PREVENTION

 

How would you encourage positive relationships?

Definition

Encourage positive relationships by:-

 

  • Meeting children's basic needs and building attachments.
  • Building culturally competent staff members.
  • Helping staff develop emotional competence and self-awareness.
  • Teaching children relationship skills.
    Providing teambuilding experiences the staff members and Young people.
Term

CRISIS PREVENTION

 

What does emotional competence mean?

Definition

Emotional competence means:-

  • Being aware of personal goals, values, beliefs.
  • Understanding cultural differences and each other's worldview.
  • Demonstrating self-regulation skills.
  • Knowing personal triggers.
Term

CRISIS AS OPPORTUNITY

 

When does a crisis occur?

Definition

 

 

A crisis occurs when a young persons inability to cope results in a change in behaviour

Term

CRISIS AS OPPORTUNITY

 

What are the goals of crisis intervention?

 

batchwood

 

Definition

 

 

SUPPORT: environmentally and emotionally to reduce stress and risk

 

TEACH: children better ways to cope with stress

Term

CRISIS AS OPPORTUNITY

 

 

Describe the stress model of crisis

Definition

Pre-crisis date = baseline.
Triggering event.
Escalation phase.
Outburst crisis.
Recovery phase

 

 

 [image]

 

Term

CRISIS AS OPPORTUNITY

 

 

What are the three levels of recovery of the recovery phase?

Definition
  1. Lower (Abuser) - we end up yelling or threatening
  2. No Change (Fire Fighter)
  3. Higher ((Educateur) = We want to be/get here

 

[image]

Term

CRISIS AS OPPORTUNITY

 

 

Describe the skills building pyramid: self-awareness

Definition

Six levels.
LSI.
Crisis co-regulation.
Emotional first aid.
Behaviour support techniques.
Active listening crisis communication.
Self-awareness (the four questions)

[image]

Term

CRISIS AS OPPORTUNITY

 

 

What are the four questions we ask ourselves in a crisis situation?

Definition
  1. What am I feeling now?
  2. What is this young person feel, need, or want?
  3. How is the environment affecting the young person?
  4. How do I best respond?
Term

CRISIS AS OPPORTUNITY

 

 

How do I best respond?

Definition

Provide environmental support by managing the environment to neutralise potential triggers.


Provide emotional support by engaging young person.


Exercise self-control over on feelings.

Term

Knowing Ourselves

 

"What am I feeling now?"

Definition

Anger can undermine objectivity.


Anger is an emotional and physical state.

Cognitive abilities are reduced.

Term

Knowing Ourselves

 

 

What are the effects of anger?

Definition

"When we after angriest, we are at our stupidest."

 


As anger increases, cognitive functioning decreases

[image]

Term

 

Knowing Ourselves

 

 

Describe the Feelings, Needs, and Behaviors Iceberg

Definition

Feelings and Needs are under the water

 

and


Behaviors are above the water

 

[image]

Term

Knowing Ourselves

 

 

What does Assessing Behavior Mean?

Definition
  1. All behaviour has meaning.
  2. Behaviour reflects needs.
  3. Trauma affects our children behave.
Term

Knowing Ourselves

 

 

Pain-based behaviour includes?

Definition
Impulsive outbursts.
Aggression.
Running away.
Self injury.
Defiance.
In ability to regulate emotions.
Trauma re-enactment.
Term

Knowing Ourselves

 

 

Identifying a young person's needs

Definition
What is this individuals child baseline behaviour? Is this typical behaviour?
Is this normal or young person in this age?
Does this behaviour reflect the child or family's worldview?
Is this a pain based behaviour related to past trauma?
What feeling in the child expressing?
Term

MANAGING THE ENVIRONMENT

 

What would you examine the physical setting for?

Definition
Possible weapons.
Stimulating lights or noise levels.
Crowding.
Chaotic, messy, disorganised messages.
Term

MANAGING THE ENVIRONMENT

 

What questions should be asked about activities and routines?

Definition

Are they causing frustration, boredom or anger?
Are they in adequately resource so that children cannot fully participate?
Are they conducted in areas without enough space or equipment?
Do they build on children's strength or point out their weaknesses?
Do they allow individuals (adult or child) to agitate others?

Term

MANAGING THE ENVIRONMENT

 

Agency policy and procedures should be?

Definition

Clearly written

Communicated

 

Understood

 

Applied

Term

COMMUNICATION 

 

 

Nonverbal techniques include?

Definition

Silence.

 

Nods.

 

Facial expression.

Eye contact.

Term

CRISIS COMMUNICATION AND ACTIVE LISTENING

 

What does MEANING in emotional communication equal?

Definition

Facial expression = 55%
+ Tone of voice = 38%
+ Words = 7%

 

[image]

Term

CRISIS COMMUNICATION AND ACTIVE LISTENING

 

 

What are Encouraging and eliciting techniques?

Definition
  • Tone of voice.
  • Minimal encouragements: "uh-huh", "go on", "I see."
  • Door openers. "I'd like to hear more," "tell me about that".
  • Close questions: "do you like your teacher ?".
  • Open questions: "how did you respond?" "What happened next?"
Term

CRISIS COMMUNICATION AND ACTIVE LISTENING

 

Understanding responses

Definition

Reflective responses:


"you feel uncomfortable when your friends talk about school."
"You're angry about your visit being counselled. I be upset, too."

 

Summarisation:

"here's what I hear you saying, you felt good at first, but now..."

Term

CRISIS COMMUNICATION AND ACTIVE LISTENING

 

What is active listening?

Definition

Acting listening:-

  1. Identifies and validates feelings.
  2. Reduces defensiveness.
  3. Promotes change.
  4. Communicate that we care and understand.
  5. It is an effective co-regulation strategy.
  6. Help young people. "Talk out rather lacked out"
Term

CRISIS COMMUNICATION AND ACTIVE LISTENING

 

Active listening is not

Definition
  1. Throwing up roadblocks.
  2. Arguing or blaming.
  3. Giving permission.
  4. Giving advice or solving the problem to the child.
  5. Necessarily time-consuming.
Term

BEHAVIOUR SUPPORT TECHNIQUES

 

What behaviour support techniques?

Definition

Behaviour support techniques are:-

 

  1. Managing environment.
  2. Prompting.
  3. Caring gesture.
  4. Hurdle help.
  5. Redirection and distractions.
  6. Proximity
  7. Directive statements.
  8. Time away
Term

EMOTIONAL FIRST AID

 

Adults can help children by?

Definition
  • Seeing the incident from the child's perspective.
  • Helping children see the connection between feelings and behaviour.
  • Encouraging children to be responsible for their actions.
Term

CRISIS COMMUNICATION AND ACTIVE LISTENING

 

What are the goals of emotional first aid?

Definition
  1. To provide immediate help and support to reduce emotional intensity (co-regulation).
  2. To resolve the immediate crisis.
  3. To keep the child in the programme / activity
Term

CRISIS COMMUNICATION AND ACTIVE LISTENING

 

What are the strategies are emotional first aid?

Definition
  • Drain off emotions.
  • Clarify events.
  • Maintain a relationship and lines of communication.
  • Remind a child of expectations immediate situation if necessary.
Term

CRISIS COMMUNICATION AND ACTIVE LISTENING

 

What should the worker ensure that the child understands?

Definition
  • That the child believes they have the ability to successfully participate in activity.
  • But there will be time to talk again later if needed.
Term

THE CONFLICT CYCLE

 

What are the four elements of the conflict cycle?

Definition
  1. Stressful situation/incident.
  2. Young Persons feelings.
  3. Young person's behaviour.
  4. Adults response

[image]

Term

CONFLICT CYCLE

 

How can we avoid a conflict cycle?

Definition

We can avoid a conflict cycle by:-

  • Using positive self talk.
  • Listening and validating feelings.
  • Managing the environment (e.g. removing others).
  • Giving choices and the time to decide.
  • Redirecting young person to another positive activity.
  • Appealing to young persons self-interest.
  • Dropping or changing the expectation

 

Term

MANAGING AGGRESIVE BEHAVIOUR

 

What are the 2 Types of Aggressive Behaviors?

Definition
1. Reactive Aggression
2. Proactive Aggression
Term

MANAGING AGGRESIVE BEHAVIOUR

 

What is Reactive Aggression mean and what does it look like?

Definition

 

 

  1. Affective or expressive aggression
  2. Loss of control and emotional flooding
  3. Emotions are dominant
Term

MANAGING AGGRESIVE BEHAVIOUR

 

What is Proactive Aggression and what does it look like?

Definition

 

 

1. Instrumental or operant aggression
2. Goal Oriented
3. Cognitions are dominant (Thinking is dominant)

Term

MANAGING AGGRESIVE BEHAVIOUR

 

What are the features of reactive aggression?

Definition

Facial features           wide-eyed red-faced (pale if afraid).
Actions                                             disorganised, impulsive

Tone of voice                                               angry, loud, shrill

Emotions                                                        highly aroused

Term

MANAGING AGGRESIVE BEHAVIOUR

 

What are the features of proactive aggression?

Definition

Facial features               impassive staring smiling or smirking Actions                                                      deliberate, methodical

Tone of voice                                               firm, calm, menacing

Emotions                                                     apparently controlled

Term

MANAGING AGGRESIVE BEHAVIOUR

 

what are the immediate response priorities reactive and proactive aggression?

Definition

 

REACTIVE                         PROACTIVE

 

safety                         safety

 

understanding and support                       containment and negotiation

 

remove or reduce stimulus                      engagement and reasoning

Term

MANAGING AGGRESIVE BEHAVIOUR

 

what are the ongoing response priorities reactive and proactive aggression?

Definition

REACTIVE                         PROACTIVE

Teach coping skills                    Teach appropriate

                                                                    thinking, values, and social

                            skills

 

teach self regulation skills                        reward sociallyappropriate

                                                                 behaviour, not antisocial

                                       behaviour

 

                   anger management                                                              

Term

MANAGING AGGRESIVE BEHAVIOUR

 

What is an individual crisis management plan?

Definition

 

 

Functional analysis of high risk behaviour.

Strategy intervening tailored to the young person.

Periodic review and update

Term

MANAGING AGGRESIVE BEHAVIOUR

 

 

What are non-verbal behaviors?
Definition
1. Eye contact
2. Body language
3. Personal Space
4. Height Differences
5. Gender Differences
6. Cultural Differences
Term

ELEMENTS OF A POTENTIALLY VIOLENT SITUATION

 

What are the elements of a potentially violent situation?

Definition

 

  • A potential triggered violence.
  • A target.
  • A weapon.
  • Level of stress or motivation
Term

ELEMENTS OF A POTENTIALLY VIOLENT SITUATION

 

How do you remove the potential triggered violence?

Definition
  • Never touching and angry and potentially violent person.
  • Avoiding any aggressive moves and provocative statements.
  • Avoiding the conflict cycle and counter aggression.
  • Removing others who might trigger the violence.

-  BODY LANGUAGE IS CRITICAL -

Term

ELEMENTS OF A POTENTIALLY VIOLENT SITUATION

 

Remove the target by

Definition

 

 

  • Asking the targeted person to leave.
  • It's you, reminding young person of your relationship only when the situation and asking a "neutral" staff to manage incident.

- THE TARGET MAY SHIFT DURING THE EPISODE -

Term

ELEMENTS OF A POTENTIALLY VIOLENT SITUATION

 

 

How would you avoid the weapon?

Definition

 

 

  • Discreetly removing objects.
  • Manoeuvering away from weapons.
  • Staying a safe distance away
Term

ELEMENTS OF A POTENTIALLY VIOLENT SITUATION

 

How would you decrease the level of stress or motivation?

Definition

 

 

  • Usual relationship.
  • Actively listen to identify feelings.
  • Remove the audience.
  • Using co-regulation strategies (reactive aggression).
  • Offering alternative, nonaggressive ways to achieve goals (pro active aggression)
Term

HELP ME HELP MYSELF : CRISIS CO-REGULATION

 

What is the objective of crisis co-regulation?

Definition
To provide support in a way that reduces stress and risk
Term

HELP ME HELP MYSELF : CRISIS CO-REGULATION

 

What should I think (self-awareness)

Definition

Ask yourself the four questions

 

 

1. What am I feeling now?
2. What does this young person feel, need, or want?
3. How is the environment affecting the young?

4. How do I best respond?

 

Use positive self talk
Term

HELP ME HELP MYSELF : CRISIS CO-REGULATION

 

What should you do? (non-verbal strategies)

Definition
  • Take a deep breath.
  • Use protective stance.
  • Step back.
  • Give the situation time.
  • Sit down if appropriate.

-remember the importance of body language and facial expression-

Term

HELP ME HELP MYSELF : CRISIS CO-REGULATION

 

What should you say? (Verbal strategies)

Definition
  • "I can see...." (validate feelings.)
  • "When you...." (encourage positive behaviours).
  • "I know we..." (emphasise desirable outcomes).
  • "I am sorry..." (offer an apology).

- remember the importance of tone of voice -

Term

HELP ME HELP MYSELF : CRISIS CO-REGULATION

 

What to do when it's over

Definition

 

 

  • It's over when the.............
  • Prepare to discuss the situation in an LSI
Term

THE LIFE SPACE INTERVIEW

 

The life space interview (LSI) is?

Definition

 

A therapeutic, verbal strategy to intervene with the young person.

 

 

"The clinical exploitation of life events"

 

- Fritz Redl

Term

THE LIFE SPACE INTERVIEW

 

What are the goals of the LSI?

Definition
  1. Return the young person to normal functioning.
  2. Clarify events.
  3. Repair and restore the relationship.
  4. Teach new coping skills.
  5. Reintegrate young person back into the programme.
Term

THE LIFE SPACE INTERVIEW

 

What are the steps to the LSI

Definition

 

 I  - Isolate the conversation.

E - Explore young person's point of view.
S - Summarise the feelings and content.
C - Connect feelings to behaviour.
A - Alternative behaviour is discussed.
P - Plan developed/practice new behaviour.
E - Enter young person back into the routine

Term

THE LIFE SPACE INTERVIEW

 

I verbiage in I ESCAPE

Definition

 

"I'd like to talk to you" or "Lets go ....and sit down...."

Term

THE LIFE SPACE INTERVIEW

 

The verbiage for E in I ESCAPE:

Definition

 

 

E = "What was happening?" "And then what happened?" "So you felt...." I was worried when...."

Term

THE LIFE SPACE INTERVIEW

 

The verbiage for S in I ESCAPE:

Definition

 

 

"Let's make sure I got this straight."

Term

THE LIFE SPACE INTERVIEW

 

The verbiage for the C in I ESCAPE

Definition

 

 

"So, when you feel..... you....?"

Term

THE LIFE SPACE INTERVIEW

 

The verbiage for the A in I ESCAPE:

Definition

 

 

"Let's think of some different ways you could...."

Term

THE LIFE SPACE INTERVIEW

 

The verbiage for the P in I ESCAPE:

Definition

 

 

"You've got some good options."
"Let's make a plan."
"Let's now practice/rehearse"

Term

THE LIFE SPACE INTERVIEW

 

The verbiage for the last E in I ESCAPE:

Definition

 

 

"Here's what's happening now..."
"Do you think you are ready to go back?"

Term

SAFETY INTERVENTIONS

 

Options to handle physical violence are? (5)

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)

Term

SAFETY INTERVENTIONS

 

What is the goal of physical intervention?

Definition

 

 

To ensure safety

Term

SAFETY INTERVENTIONS

 

What is the definition of Physical Restraint?

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

Term

SAFETY INTERVENTIONS

 

 

 physical restraint should only be used when?

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

Term

SAFETY INTERVENTIONS

 

Physical restraint is not used to?

Definition

 

 

1 at 480. Demonstrate authority

2. Enforce compliance

3. Inflict harm or pain

4. Punish or discipline

Term

SAFETY INTERVENTIONS

 

What are the basic principles of physical intervention?

Definition

 

 

A maximum amount of caring and a minimum amount of force with the goal of de-escalating the situation by reducing stimulation

Term

SAFETY INTERVENTIONS

 

What is the letting go process in a physical restraint?

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

Term

LIFE SPACE INTERVIEWS

 

What are the Poential Pitfalls of an LSI?

Definition

1. Person refuses to talk

  • convey calm support and sanction silence.
  • Ask a focused question
  • reschedule LSI

2. Young person gets off subject

  • allow exploration and relate it to incident.
  • Focus on issue at hand

3. Worker or young person wants to just "fix it"

  • don't interrupt a young person's thought process.
  • Don't develop a plan for young person.
Term

SAFETY CONCERNS

 

Do not use physical restraint when?

Definition
  1. We cannot control young person safely.
  2. We are not in control or are too angry.
  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 risking retraumatisation.
  8. Young person is on medication is perfect his or her system
Term

SAFETY CONCERNS

 

What are the definitions of asphyxia?

Definition

Asphyxia: the deprivation of oxygen to living cells

.
Positional asphyxia: fatal respiratory arrest, in which the ability to breathe is compromised by the position of the body in relationship to its immediate surroundings

Term

SAFETY CONCERNS

 

What are the predisposing risk factors of asphyxia?

Definition
  • Obesity.
  • Individuals under the influence of alcohol or drugs.
  • Prolonged violent physical agitation.
  • Underline natural disease (ie, enlarged heart, asthma, sickle cell trait, high blood pressure, diabetes).
  • Hot humid environments.
  • Individuals taking certain types of medication.
Term

SAFETY CONCERNS

 

What are the warning signs of asphyxia?

Definition

Due to neck compression:

 

Goes limp and ceases to breathe spontaneously

 

Due to respiratory interference:

 

States he or she can't breathe.
Restoration is laboured, rapid or abnormal.
May make grunting noises.
Vomiting or turning a dusky purple colour, especially of the face.
Goes limp and ceases to breathe

Term

SAFETY CONCERNS

 

What should you monitor during a restraint?

Definition
  • Position of child and staff (appropriate restraint being applied).
  • Skin colour.
  • Respiration (no breathing problems).
  • Level of consciousness (is responsive).
  • Level of agitation (overexertion).
  • Range of motion and/or swelling in extremities.
Term

SAFETY CONCERNS

 

What are the recommendations to reduce the risk of injury or death?

Definition
  • Never place weight a young person's chest or back.
  • Never put pressure on the young person's neck.
  • Never placed a head in a position because of a neck to be compressed.
  • Never allow young person to stay in the prone or supine position once he or she is no longer a safety risk-get person up and in a seated position.
  • Never place a young person's arms behind his or her back when that person is in a prone position.
  • Never bend, a child forward in the small child or seated restraint.
  • Never place anything over or near the young person's face, mouth, or knows that can be inhaled or conform to the contours of the face.
  • Never ignore any of the warning signs appending asphyxia. Never failed to take immediate action if there is a need for an emergency medical treatment.
  • Never restrain a child in the prone position on a mattress or surface that can conform to the contours of the face.
  • Never use these restraint techniques on children under five years of age.
Term

SAFETY CONCERNS

 

Following a restraint what documentation should be kept?

Definition
  • Who, what, when, where?
  • What were the antededents?
  • What did staff do to de-escalate situation?
  • If physical contact, who did what (be specific)?
  • How long did the restraint last?
  • Staff/child injuries? Medical attention?
  • What plan was developed in the Life Space Interview?
  • Debriefing of staff?
  • Was follow-up needed? What is the family notified?
Term

MANAGING AGGRESIVE BEHAVIOUR

 

All of the physical intervention techniques used in TCI are based on the priniples of ?

Definition

 

 

(a) a maximum amount of caring with minimum amount of force

 

(b) the goal of de-escalating the situation by reducing stimulation

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