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2/9/2011
1
© 2010
CPI’s eRefresher Series for
Nonviolent Crisis Intervention® Certified Instructors
Unit IV: Verbal Intervention
2 © 2010
eRefresher Series
Welcome to CPI’s eRefresher Series for Nonviolent Crisis Intervention® Certified Instructors
Moderator:
Susan Keith Program Developer and
Professional Staff Instructor
3 © 2010
eRefresher Series
Pre-Test (aired October 6, 2010) Unit I: The CPI Crisis Development Model SM
(aired November 10, 2010)
Unit II: Nonverbal Behavior
(aired December 15, 2010)
Unit III: Paraverbal Communication
(aired January 12, 2011)
Unit IV: Verbal Intervention
Unit V: Precipitating Factors, Rational Detachment, Integrated Experience (March 9, 2011)
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4 © 2010
eRefresher Series
Unit VI: Staff Fear and Anxiety
Unit VII: CPI’s Personal Safety Techniques SM
Unit VIII: Nonviolent Physical Crisis InterventionSM
Unit IX: Situational Role-Plays
Unit X: Postvention, Post-Test, and Evaluation
Improving Training Transfer
5 © 2010
Outline for Sessions
Primary Objective
Meeting the Primary Objective
Instructional Objectives
Facilitation Dynamics
Content Presentation
6 © 2010
Outline for Sessions
Unit Discussion
Transitions
Ideas for Your Refreshers
Reinforcing Adult Learning
Questions
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7 © 2010
Materials You Will Need
8 © 2010
Verbal Communication
Today’s Presenter:
Jeff Schill
Associate Director
of Staffing
9 © 2010
Primary Objective
To organize thinking around verbal acting-out behavior.
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10 © 2010
Poll Question 1
What is the benefit of learning the Verbal Escalation ContinuumSM?
Allows staff to define behavior that they witness
Shows difference between verbal and physical behavior
Allows staff to always intervene effectively
Matches interventions with behaviors
11 © 2010
Meeting the Primary Objective
Objective: To organize thinking around verbal acting-out behavior.
How do we do this?
Allow participants to experience verbally acting- out behavior in a safe environment.
Present staff with an organized model that will assist them in a crisis situation.
Allow participants the ability to practice intervention strategies.
12 © 2010
Instructional Objectives
By end of Unit IV, participants will:
• Identify different levels of defensive behavior in the Verbal Escalation ContinuumSM.
• React to the verbally acting-out person with an appropriate verbal response to defuse the potential crisis situation.
• Illustrate how inappropriate staff reactions may cause an escalation in behavior.
• Provide the best possible Care, Welfare, Safety, and SecuritySM for individuals in our facilities.
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13 © 2010
Facilitation Dynamics
Verbal Escalation ContinuumSM Exercises
• Demonstrate – Participate – Explain.
• Setting up the exercise.
• Clear directives.
• Debriefing – don’t give away your lecture.
14 © 2010
Facilitation Dynamics
Verbal Escalation ContinuumSM Exercises
• Review content with each exercise.
• How might you stop the exercise?
• Make it realistic.
• Can exercise be adapted for nonverbal clients?
• Focus on what we CAN control.
15 © 2010
Facilitation Dynamics
Verbal Escalation ContinuumSM Lecture
• Connect the Verbal Escalation ContinuumSM to the Defensive level of the Crisis Development Model SM.
• Integrated Experience.
• Customize your examples.
• Think about your visuals – keep the model front and center.
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16 © 2010
Unit Presentation
17 © 2010
Unit Discussion
Questioning
• Tailor your examples to fit your needs.
– Information seeking
– Challenging
– Gray areas
– Nonverbal
18 © 2010
Unit Discussion
Questioning Interventions
• Focus on the individual, not the question.
• Redirect back on track.
Practice
• Break into groups and have them decipher challenging from information-seeking questions.
• Come up with ways to redirect questions.
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19 © 2010
Unit Discussions
Refusal
• Tailor your examples to fit your needs.
– Many different ways to refuse.
• How might someone who is nonverbal refuse?
• Might a person have a valid reason to refuse?
• Are we listening to their concerns?
20 © 2010
Unit Discussion
Refusal Interventions
• Setting Limits
– What happens when we set ineffective limits?
– Practiced.
– Best when developed ahead of time and not on the spot.
– Focus on what we can control – our own behavior.
21 © 2010
Unit Discussion
Simple and Clear
• Emphasize that the client is losing rationality.
• Ask ourselves “what is it” we are trying to say.
• Use a variation of if/then statements.
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22 © 2010
Unit Discussion
Reasonable
• Reasonable to staff or to the client?
• What does it mean for something to be reasonable?
• Use of choices.
23 © 2010
Unit Discussion
Enforceable
• What can and can’t we enforce as staff?
• What happens if we set a limit that we cannot enforce?
• Follow up of consequences afterward.
24 © 2010
Unit Discussion
Practice Setting Limits
• Group activity
• Worksheet
• Role-play
• Drills
• Situational Applications
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25 © 2010
Unit Discussion
Release
• Tailor examples to be realistic.
• Can clients release nonverbally?
• Can release be a good thing?
• Remind staff we are at the Defensive level.
26 © 2010
Unit Discussion
Release Interventions
• Focus on what staff can control.
• Discuss the energy cycle.
• Look at different ways staff can isolate a situation.
• Foreshadow Rational Detachment.
27 © 2010
Unit Discussion
Intimidation
• What does this look like?
• How might someone intimidate nonverbally?
• Why is this still considered the Defensive level?
• Discuss why this may be a challenging level for staff.
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Unit Discussion
Intimidation Interventions
• Why is it important to bring in your team?
– Foreshadow fear and anxiety.
– May be time to switch staff.
– May switch over to physically acting-out individual.
29 © 2010
Unit Discussion
Tension Reduction
• What does this look like?
– Client could go backward on the continuum.
• How can we as staff help an individual get there?
• This doesn’t mean the crisis is over – an individual could go back into the Verbal Escalation ContinuumSM.
30 © 2010
Unit Discussion
Verbal Escalation ContinuumSM Discussion Points
• What can staff control?
• What can we do to the environment to better address verbally acting-out individuals?
• What are our polices and procedures?
• Behavior doesn’t always go in order.
– What is the benefit of learning these levels?
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31 © 2010
Poll Question 2
How can we use the Tips and Techniques section?
As a review of previous content
As a gauge of participant understanding
To brainstorm strategies that have arisen during the program
It’s not very useful . . . just skip it
To stimulate class discussion
32 © 2010
Unit Discussion
Verbal Intervention Tips and Techniques
• Use as part of the pre-test.
• Group activity.
• Class discussion.
• Transition to Empathic Listening.
33 © 2010
Unit Discussion
• Important for Instructor to “set up” this section.
• Possible “set up” activities.
- Role-play a scenario.
- Group activity.
- Example.
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34 © 2010
Unit Discussion
Empathic Listening
• What does it mean to be active?
• What does it mean to be part of a process?
• Be prepared with examples.
35 © 2010
Transitions
Transitions help link chunks of content.
Between Units:
“We just discussed a variety of strategies for staff to intervene
with a professional, caring attitude. But let’s now consider some issues that may influence staff attitudes.”
“There are many behaviors that we may see when a person is verbally acting-out. If we are listening carefully we may start to hear some precipitating factors. These are things that could be part of the cause of the behavior.”
36 © 2010
Ideas for Your Refreshers
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37 © 2010
Ideas for Your Refreshers
• Enhancing Verbal Skills: Applications of Life Space Crisis InterventionSM Refresher
• The Preventive Techniques II DVD
• The Principles of Effective Limit Setting DVD
• The Power of Listening DVD
38 © 2010
Adult Learning Strategies
• Open Questions
• Reflective Questions
• Leading Questions
39 © 2010
Questions?
Please feel free to submit a question.
We will answer a few in the remaining time.
If we do not cover your question on air,
we will contact you within a few days or just call
Instructor Services at 877.877.5390.
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40 © 2010
Thank You
The next webinar in this eRefresher Series will be:
Date: March 9, 2011
Time: 10:00 a.m. CT
Topic: Unit V – Precipitating Factors, Rational Detachment, and Integrated Experience
Today’s Presenter:
Jeff Schill
Associate Director
of Staffing