TCI (Therapeutic Crisis Intervention) Exam 100% Correct

What is a setting condition? - ANSWER Anything that makes challenging behavior more or less likely to occur. True or False An example of a setting condition that makes challenging behavior more or less likely to happen is organizational culture. - ANSWER TRUE What does ICMP stand for? - ANSWER Individual Crisis Management Plan The goals of crisis intervention are to _______ and ________. - ANSWER Support & Teach Stress Model of Crisis - ANSWER 1. Baseline 2. Triggering Event 3. Escalation Phase 4. Outburst Crisis 5. Recovery What are the four questions that we ask ourselves before intervening in a potential crisis? - ANSWER 1. What am I feeling now? 2. What does this child feel, need, or want? 3. How is the environment affecting the child? 4. How do I best respond? Behavior Support Techniques (need to know 4) - ANSWER 1. Managing the environment 2. Prompting 3. Caring gesture 4. Hurdle help 5. Redirection and distractions 6. Proximity 7. Directive statements 8. Time away What are the three goals of emotional first aid? **Be able to write these out - ANSWER 1. Co-regulation (provide immediate help and support to reduce emotional intensity) 2. Resolve the immediate crisis 3. Re-enter the child back into the program Strategies for Emotional First Aid **Need to know terms and be able to write them out - ANSWER 1. Drain off emotions 2. Clarify events 3. Maintain the relationship and lines of communication 4. Remind the child of expectations and mediate the situation if necessary Conflict Cycle - ANSWER 1. Stressful situation/incident 2. Young person's feelings 3. Young person's behavior 4. Adult's response Avoid the conflict cycle by: **Know at least four of these and be able to write them out! - ANSWER 1. Listen and validate the child's feelings 2. Manage the environment 3. Give the young person choices and the time to decide what to do next. 4. Redirect the young person to another positive activity 5. Appeal to the young person's self interest 6. Drop or change the expectation 7. Use positive self-talk Reactive vs. Proactive Aggression - ANSWER Reactive Aggression -emotions are dominant -loss of control and emotional flooding -eg. impulsive, angry, loud, highly aroused emotions Proactive Aggression -cognitions are dominant -goal oriented -eg. impassive, staring, smiling/smirking, firm, calm What are the four elements of a potentially violent situation? - ANSWER 1. Trigger 2. Target 3. Level of Stress 4. Weapon True or False The goal in crisis intervention is to lower the stress and risk by providing emotional and environmental support? - ANSWER TRUE Nonverbal crisis co-regulation Help Me Help Myself strategies to help a potentially violent child. (NEED TO KNOW 4) - ANSWER 1. Deep breath 2. Protective stance 3. Step back 4. Give the situation time 5. Sit down (if appropriate) 6. Remember importance of body language and facial expression What are the five goals of the LSI? - ANSWER 1. return the young person to baseline (normal functioning) 2. clarify the events 3. repair and restore the relationship with the adult 4. teach new coping skills 5. reintegrate the young person back into the program What are the steps of the LSI? **Know these word for word - ANSWER I --- Isolate the conversation E ---Explore the young person's point of view S ---Summarize the feelings and content C ---Connect feelings to behavior A ---Alternative behaviors discussed P ---Plan developed/practice new behavior E ---Enter the young person back into the routine What does LSI stand for? - ANSWER Life Space Interview What are the options to manage physical violence that do not involve a physical restraint? - ANSWER 1. eliminate one of the elements of the violent situation 2. make a directive statement 3. use releases or prospective interventions 4. leave the situation and get assistance If a child is exhibiting acute physical behavior, what three conditions must be present to use physical restraint? ALL of these criteria must be met in order to use a physical restraint. - ANSWER 1. agency policies and state regulations allow it 2. the young person's ICMP prescribes it 3. the worker's professional judgement What are the situations in which restraint--while indicated--should be avoided? NEED TO KNOW 3 - ANSWER 1. we cannot control the young person safely through restraint techniques 2. we are not in control or are too angry 3. the young person is threatening us with bodily injury and appears capable of inflicting it 4. sexual stimulation is the motivation 5. young person begins to act out in public 6. young person has a weapon 7. young person's medical condition prohibits it 8. young person has emotional problems which risks re-traumatization 9. young person is on medication that affects his/her system Predisposing risk factors that will put the young person at risk for serious injury during a restraint NEED TO KNOW 3 - ANSWER 1. obesity 2. influence of alcohol or drugs 3. prolonged violent physical agitation 4. underlying natural disease (enlarged heart, diabetes,etc.) 5. hot humid environment 6. individual taking certain types of medication True or False In a prone restraint the child should be on a soft surface. - ANSWER FALSE Improper restraint methods that pose a risk of injury or death - ANSWER 1. pressure on the neck 2. pressure on the chest 3. incorrect positioning of the arms 4. obstructing the mouth or nose 5. abnormal positioning of the body What are physical warning signs during a restraint that indicate a child is in danger? - ANSWER 1. young person states he/she cannot breathe 2. respiration is labored, rapid, or abnormal 3. the young person makes grunting noises 4. the person begins vomiting or turns a dusky purple color (especially the face) 5. sudden decrease in a struggle 6. the young person goes limp and ceases to breathe True or False Exposure to trauma affects how a child is feeling. - ANSWER TRUE True or False After a restraint a child can go to sleep. - ANSWER FALSE Recommendations to reduce the risk NEED TO KNOW 3 - ANSWER 1. never place weight or put pressure 2. never put pressure on the young person's neck or place the head in a position that causes the neck to be compressed 3. never allow a young person to stay in the prone or supine position 4. never place a young person's arms behind his/her back 5. never bend a child forward or place pressure or weight on the child's back 6. never place anything over or near the young person's face, mouth, or nose 7. never ignore any of the warning signs of pending asphyxia or fail to take immediate action if there is a need for emergency medical treatment 8. never allow the young person to continue lying or sleeping on the floor after a restraint 9. do not apply restraint techniques to children under five years old 10. make sure the position of the young person's body is correctly positioned as taught in training Answers: - ANSWER #49: Self-awareness #50: Target HINT: - ANSWER On the true/false questions, any questions with quotes in them the answer is TRUE MAKE SURE TO LOOK AT THE RESTRAINT PACKET!