Lions and Tigers and Bears Oh my This

Lions and Tigers and Bears! Oh, my! This Photo by Unknown Author is licensed under CC BY-SA Nonviolent Crisis Intervention Crisis Prevention Institute, Inc. , 2005 Presented by Thomas Curpenski November 16, 2018

Crisis Development Behaviors Anxiety ◦ A noticeable change/increase in behavior Staff Attitude/Approach ◦ Supportive ◦ Empathic, non-judgmental approach

Crisis Development Behaviors Defensive ◦ Beginning to lose rational thinking Staff Attitude/Approach ◦ Directive ◦ Staff begin to take control “set limits”

Crisis Development Behaviors Acting Out Person ◦ Physical danger to self and others Staff Attitude/Approach ◦ Seek assistance

Crisis Development Behaviors Tension Reduction ◦ Decrease in both emotional and physical energy Therapeutic Rapport ◦ Re-establish communications, builds trust

Reasons for Recognizing Crisis Development Behavior Levels We want to: Intervene early Prevent over or under reacting Help avert a crisis

Paraverbal Communication How we say what we say ◦ Tone – avoid inflections ◦ Volume – too soft or too loud ◦ Cadence – rate/rhythm of speech Total Voice Control (TVC)

Verbal Intervention Questioning A. Information seeking (When am I going to be seen? ) (Did doctor prescribe this? ) ◦ Intervention – answer question B. Challenging (Why don’t you make me? ) ◦ Intervention – stay calm, ignore challenge, restate/clarify, “set limits”

Verbal Tips and Techniques Do ◦ ◦ ◦ ◦ Introduce self Offer “What can I do” Let them talk/listen Ask questions & paraphrase Let them know here to help Compassion Consistency Don’t ◦ ◦ ◦ Yell at patient Deny what they think Make false promises (lose trust) Say “calm down” Be argumentive or confrontational Intimidate

Empathic Listening Defined as the active process to discern person is really saying what the other ◦ Remain non-judgmental ◦ Use silence as a tool for reflection ◦ Listen carefully ◦ Give undivided attention ◦ Use restatement for clarification

Precipitating Factors, Rational Detachment, Integrated Experience Precipitating Factors ◦ Internal or external causes of acting out behavior, over which staff have little or no control Rational Detachment ◦ The ability to stay in control of your own behavior & not taking acting out behavior personally Integrated Experience ◦ Behavior affects behavior both ways

Staff Fear and Anxiety Knowledge + Skills = Higher Level of Confidence and Competence Unproductive ◦ Freeze ◦ Over-react ◦ Inappropriate response ◦ Verbally ◦ Physically Productive ◦ Increase in speed & strength ◦ Increase in sensory activity ◦ Decrease reaction time