CDPVTC Mission Statement

• To assist Kentuckians with disabilities to achieve suitable

employment and independence.

What Can Cause an Outburst

• Outside Issues Often we are unaware of a consumers home life.Abuse, mental or physical or can even be emotional. Also we have consumers that have been neglected for many years, making it difficult for them to conform to our rules and the over all setting of this large facility. Many of our consumers are used to small class rooms and just seeing the same few people most of the day.

• Our consumers may act out if there's a death in the family or the close friend. Just a change in someone's routine can cause issues to arise.

A change in medication, or just being away from home for the first time.All of these issues and so many more we face and understanding the consumers needs will help us in assisting those needs. As well as the behavior that the outburst can trigger.

First Responder

• Reasons why.Better understanding May have better rapportSomething may be lost in communicating it to othersEasier on the consumer ( to many staff may cause confusion)May intimidate consumer with many staff present

When you’re the first staff member to arrive, you should be the primary staff interacting with the consumer, unless it becomes to emotional for yourself.

Public Outburst

• If a consumer is in a public setting if you can’t get them away from the situation then it is often best to clear the area if possible.

• This will take away the audience and tends to lead them to cooperate with less stress on the consumer.

• This also will help the consumers private information from being exposed to other consumers.

Don’t Be This Guy

• It is important to be sincere when dealing with a consumer. They can pick up on being “fake”.

• This can make the issue escalate even further and cause the consumer to lose trust in staff.

• Consumers will be more likely to discuss further issues with you as opposed to other consumers.

Rapport• Building rapport can assist you when there is a

crisis later on.• Consumers are more likely to discuss issues with

staff they feel comfortable with.• Rapport can be established by remembering a

first name or taking an interest in their hobbies.• Congratulate them on any milestone no matter

how big or small. (i.e Birthdays, passing test, completing training)

• De-escalation Techniques

Verbal and Non-Verbal De-escalation Techniques

Non-verbal Intervention

• When a person begins acting out we can sometimes intervene without speaking a word.

• Making eye contact-allows the person to know we see what they are doing.

• We want to appear neutral, not nervous; we want to come across as natural and not fake.

• Proxemics- we want to be three to four feet from client, standing to the side of them.*

• We want our movements to not be jerky or fast.• No clinched fists or pointing. Hands should not

be in pockets and arms should not be crossed. • Moving closer to acting out individual or group

can sometimes be enough to bring the situation under control.

• Adapted from http:// crisis prevention.com

Para-Verbal Communication

Para-verbal communication simply means how we say things; it has 3 components: *Tone-inflection of voice

*Cadence-rate of speech

*Volume-lowering or raising of our voice. 93% of communication is non-verbal according to an UCLA study * Adapted from http://crisisprevention.com

Verbal Intervention

* In a verbal intervention we want to show the individual that we care. * We want to show empathy *Be calm, but confident *Don’t confuse the individual with lengthy or elaborate directions *Get individual into new environment especially if you are in an open area with an audience.

What not to do in a De-escalation Situation

T.A.C.O.S Do Not:

Threaten the individualArgue or contradict individual

Challenge the individualOrder or command

Shame or disrespect* Fink, S. (1986) Crisis Management for the inevitable

Behavior Curve

Four areas of acting out behavior * Prodromal * Crisis Breakout * Chronic * Resolution

Prodromal

Is beginning phase; person may be: *Fidgeting * * Pacing * Name calling We want to exhibit: * Self –control * Be supportive * Don’t be defensive * Adapted from de-escalation strategies for crisis situations, page 16

Crisis Breakout

* Individual goes from anxious to actual rule breaking. * We don’t want to: *turn our backs *we want to know where the door is and place ourselves between it and the individual *Remain calm * Give the individual choices * Adapted from De-escalation strategies for Crisis situations, Page 17

Chronic

* Height of acting out behavior when person is doing harm to themselves or others. * Explain limits; be firm but respectful *Empathize with the individual * Suggest alternatives

Resolution

* The individual has calmed and may appear tired * If individual is able we can explain consequences of the behavior *If individual is tired we may allow them time to be alone

Things to remember

• It is important to not take acting out individual personally; Their behavior is usually not about you, you just become the focus when you intervene

• “When you’re a hammer, everything looks like a nail…” By Bernard Baruch