TCI - Therapeutic Crisis Intervention Test Review Rated A+

TCI - Therapeutic Crisis Intervention Test Review Rated A+ TCI purpose: - trauma informed care/de-escalate - having physical presence - this technique works for ages 5 and up (no one younger than 5) - all feelings are valid, how you respond is what is important developmental relationships are characterized by: - reciprocity (ex: throwing a ball back and forth) - progressive complexity (ex: the medal system) - balance of power a trauma informed organization: - attachment - supports and facilitates trauma-informed care through: - policies - procedures - practice a trauma informed organization ensures that staff: it impacts everyone within the system - understand - understand what trauma is/how - recognize - recognize behaviors and patterns that reflect trauma (past or present) - respond - respond in ways that avoid bringing up trauma the TCI system assists organizations to: - de-escalate potential crises - manage - acute physical behavior - prevent crisis from occurring - reduce - potential and actual injury to young people and staff - teach - young people adaptive coping skills - develop - a learning organization competencies 1.) be able to prevent and/or de-escalate a potential crisis situation with a child/young person 2.) be able to safely and therapeutically manage a crisis situation 3.) be able to process with children - help improve their capacity to regulate their emotions and use positive coping strategies therapeutic milieu ("the living") the combination of people, emotions, attitudes, and objects that create a sense of safety, respect, belonging, care and accountability spaces within therapeutic milieu (these are the things that we can control - the spaces) - ideological - connection/programming - physical - safe/clean environment - cultural - diversity - accept/celebrate cultural differences - social - attachments/relationships, develop skills - emotional - safety/acceptance, effects of trauma setting conditions less likely to occur anything that makes challenging behavior/traumatic stress responses more or foundations for intentional use of self (ready/willing/able - 'neutrality) - self awareness - knowing own attitudes, beliefs, values - self regulation - focus attention, awareness of physical/emotional state (regulate behaviors) - relationship skills/attunement - listen/engage, "tune-in" respond to child, be aware of own feelings (be present and aware) - self care - monitor personal, levels of stress, healthy lifestyle/reflexive supervision the triune brain - practiced process - co-regulation techniques (neocortex) 1.) the thinking brain - reasoning, higher functioning, thinking 2.) the emotional brain (limbic system) emotions and motivations 3.) the survival brain - (brain stem) heart rate, breathing, automatic pain-based behavior (fight, flight, or freeze) - behaviors that are the result of emotional and psychological pain - inability to regulate emotions, overreaction to situations, outbursts, withdrawl, running away through anger/fear/defiance (depends on emotions displayed feelings/needs/behaviors - child's behaviors (top of the iceberg - visible/surface level) - child's feelings and needs/memories/thoughts (under the surface iceberg) assessing behavior all behavior has meaning - behavior reflects emotions/needs - trauma affects children's ability to manage feelings and behaviors ("there's a bear in the room") stress model of crisis (diagram) - baseline reduces stress and anxiety - triggering even (agitated) - escalation (aggression) - outburst (violence) - recovery (band aid affect) recovery phase outcomes practice new skills - higher - no change - lower a crisis occurs when - create a healing environment trusting relationships, sense of safety, a child's fight, flight or freeze response is activated and they are unable to regulate their emotions/behaviors - consistent and caring - what staff needs to be for youth - move into pain based behaviors (fight, flight or freeze) goals of crisis intervention - support - provide immediate emotional and environmental support to reduce stress and risk and increase child's sense of safety - teach - help children learn/practice ways to regulate their emotions/behaviors questions we ask ourselves in a crisis situation 1.) what am I feeling now? these go in order 2.) what does this child feel/need/expect/want? (trauma informed word) 3.) how is the environment affecting the situation? 4.) how do I best respond? how do I best respond? - exercise/self control (over our own feelings) - manage environment (to neutralize potential triggers) - engage child/defuse pain-based behavior (provide emotional support) - assess impact of the response of the child/situation/environment (decrease stress levels)