Therapeutic Crisis Intervention Cornell| 54 questions and answers

Effective TCI Implementation Includes 5 things leadership clinical participation supervision and post crisis response training documentation Setting conditions definition anything that makes challenging behavior more or less likely to occur Setting Conditions Organizational Culture Environment Program Related Personal Relationship-Based Programs and Activities Should... Balance flexibility Thoughtful transitions Consistent Goals/structure Resourced Individualized crisis management plan ICMP Emotional Competence Goals Values Beliefs Cultural and Ethnic differences Self Regulation Personal triggers A crisis occurs when... a young person's inability to cope results in a change in behavior Goals of intervention Support: environmentally and emotionally to reduce stress and risk Teach: children better ways to cope Recover Phase Higher No Change Lower (injured) Four questions we ask ourselves in crisis situation What am I feeling now What does this young person feel, need, or want How is the environment affecting the young person How do I best respond When assessing behavior know... all behavior has meaning behavior reflects needs trauma affects how children behave Pain Based Behavior impulsive outbursts aggression running away self-injury defiance inability to regulate emotions trauma re-enactment Agency policy and procedure should be... clearly written communicated understood applied Nonverbal TECHNIQUES silence nods facial expression eye contact Encouraging techniques minimal encouragements door openers open questions closed questions Active listening can... validate feelings reduce defensiveness promote change communicates co-regulation talk out rather than act out Active listening is not... roadblock argue permit solve time consuming Behavior support techniques manage environment prompt care gesture hurdle help redirect/distract proximity directive statements time away Adults can help emotional first aid by... child's perspective connect feelings and behavior responsible for actions Goals of emotional first aid help and support (co-regulation) resolve immediate crisis keep child in program strategies for emotional first aid drain off emotions clarify events maintain relationship remind expectations child should understand that worker during emotional first aid... believes child has ability to successfully participate will have time later to talk again, if needed Conflict cycle stressful event young persons feelings young persons behavior adults response How to avoid the conflict cycle positive self talk listening and validating managing environment giving choices and time to decide redirecting appealing to young person's self interest dropping or changing expectation reactive aggression expressive loss of control emotions dominant proactive instrumental goal oriented cognitions dominant immediate response for reactive safe understand remove immediate response for proactive safe contain/negotiate engage reasoning ongoing response for reactive coping skills self regulation anger management ongoing response for proactive appropriate values reward socially appropriate behavior ICMP functional analysis of high risk behavior specific intervention strategy periodic review/updates Nonverbal BEHAVIORS eye contact body language personal space height difference gender difference cultural difference elements of a potentially violent situation trigger target weapon level of stress remove potential violence trigger by... never touch violent person avoid aggressive moves avoid conflict cycle remove others body language critical remove target by ask target to leave remind young person of relationship avoid weapon by... discretely remove objects maneuver away safe distance decrease stress level or motivation by use relationship actively listen remove audience co-regulation offer alternative objective of co-regulation provide support in a way that reduces stress and risk what to think self awareness ask four questions use positive self talk nonverbal STRATEGIES deep breath protective stance step back give situation time sit down importance of body language and facial expression what to say verbal strategies crisis very little understanding responses remember tone