Question 1

Integrated Experience

Accepted Answer

Behavior influences Behavior

Question 2

Crisis Development Model

Accepted Answer

Crisis Development/Behavior Levels-CLIENT-1 anxiety 2 Defensive 3 Risk Behavior 4 Tension Reduction. Staff Attitudes/Approaches-STAFF- 1 Supportive 2 Directive 3 Physical Intervention 4 Therapeutic Rapport

Question 3

Anxiety

Accepted Answer

a change in behavior. Example: silence, pacing, fidgetting...

Question 4

Supportive

Accepted Answer

an emphatic nonjudgmental approach. Example: give space, give time, give CHOICE....

Question 5

Defensive

Accepted Answer

begining to lose rationally. Example: Yell, withdrawl, point......

Question 6

Directive

Accepted Answer

Decelerating an escalating behavior. Example: Stay in control of self and give a simple direction

Question 7

Risk Behavior

Accepted Answer

Behaviors that may present a risk to self or others. Example: Hitting, biting, self injury......

Question 8

Physical Intervention

Accepted Answer

Disengagement and/or holding skills to manage risk behavior. Example: Lower-medium and higher level disengagement and/or holding skills.

Question 9

Tension Reduction

Accepted Answer

Decrease in physical and emotional energy. Example: Crying, apology, sleeping, back to normal.

Question 10

Therapeutic Rapport

Accepted Answer

Re-establish communication. Example: Listen, Teach, Model

Question 11

Proxemics

Accepted Answer

Personal Space Approx. 1.5 to 3 feet in range, which is considered an extension of self.

Question 12

Kinesics

Accepted Answer

Body Launguage Example: Posture, gesture, stance, and movement

Question 13

Haptics

Accepted Answer

Communication through touch.  Example: handshake, high five, pat on the back, hold hand

Question 14

The Supportive Stance

Accepted Answer

Keep one leg distance from person and at an angle.  REASONS FOR USE: Communicate respect, nonthreatening, maintain safety

Question 15

Position

Accepted Answer

where we are in relation to others

Question 16

Posture

Accepted Answer

How we hold and move our body

Question 17

Proximity

Accepted Answer

Distance between individuals

Question 18

Physical Interventions: Key Principles

Accepted Answer

Position,Posture,Proximity

Question 19

Para-verbal Communication

Accepted Answer

The vocal part of speech, excluding words COMPONENTS: Tone,Volume,Cadence

Question 20

Keys to Limit setting

Accepted Answer

Simple and clear, Reasonable, Enforceable

Question 21

Verbal Escalation Continuum (kite)

Accepted Answer

3. Release   /  /   3. Intimidation /  2. Refusal   /   /  4. Tension / 1. Questioning  Reduction --------------------------------------------------------------------------------- Client Staff  Intervention  1. Questioning Information seeking- give answer 2. Refusal Set limits 3. Release Allow venting, remove audience 4. Intimidation Take threats serious, seek asistance 5. Tension Reduction Therapeutic Rapport

Question 22

Approaches for Limit Setting

Accepted Answer

Interrupt and redirect When and then if and then

Question 23

Empathic Listening

Accepted Answer

Non judgmental, undivided attention, listen carefully, allow silence for reflection, restate and paraphrase

Question 24

Precipitating Factors

Accepted Answer

Factors that influence behavior  Example of Internal: impaired cognitive ability, impaired communication skills, fear, lack of esteem, trauma Example of External:Attitudes and behaviors of others, noise, space, temperature, stimulus response

Question 25

Rational Detachment

Accepted Answer

The ability to manage your own behavior and attitude and not take the behavior of others personally Stay Calm Maintain Professionalism Find Positive outlets

Question 26

Integrated Experience Key Points

Accepted Answer

Consider how our behavior impacts those in our care Treat those in our care respectfully Make objective decisions

Question 27

Unproductive outcomes of staff fear and anxiety

Accepted Answer

freeze, overreact, Respond Inappropriately

Question 28

Productive outcomes of staff fear and anxiety

Accepted Answer

Increased speed, strength and sensory acuity, Decreased reaction time(respond quicker)

Question 29

Decision Making: Key Legal and Professional Considerations

Accepted Answer

Accreditation and regulation, professional codes of practice, benchmarks for good practice, criminal/civil law.

Question 30

Decision Making: Key Themes

Accepted Answer

Duty of care, best interest, Reasonable and proportionate(level and Risk), Last resort and least restrictive, the risk of doing something and the risk of doing nothing, Human rights.

Question 31

Decision Making Matrix

Accepted Answer

3X3 set of boxes showing outcome and likelihood to gauge high to low risk

Question 32

Decision Making Matrix Key terms

Accepted Answer

Likelihood and Outcome

Question 33

Risk

Accepted Answer

the chance of a bad consequence

Question 34

likelihood

Accepted Answer

the chance that an event or behavior may occur

Question 35

outcome

Accepted Answer

severity of harm if event /behavior occurs

Question 36

Reasons to choose Team Intervention

Accepted Answer

Safety, Professionalism, litigation

Question 37

Team leader

Accepted Answer

first on the scene, confident/competent,best rapport

Question 38

Team Leader duties

Accepted Answer

planning, decision making, communication, safety, postvention approaches

Question 39

Physical Intervention: Key Principles

Accepted Answer

Position, Posture, Proximity

Question 40

Biomechanical Benefit(Movement)

Accepted Answer

Understanding how the body moves in order to create a release while minimizing injury or harm. Hold and Stablize Push/Pull  Lever

Question 41

Strikes

Accepted Answer

a weapon(body part or object) making contact with a target.

Question 42

Grab/Hold

Accepted Answer

Maintaining physical contact without consent.

Question 43

The RESPONSE Continuum

Accepted Answer

A range of verbal and nonverbal strategies to manage behavior. R-Relax and Downplay E-Explain or Ask S-State or Tell P-Prompt, Gesture, or Sign O-Option to use Physical Interventions  (AFTER CRISIS) N-Nurture Recovery S-Support E-Engage and Learn

Question 44

Biomechanical Benefit

Accepted Answer

Outside and Inside Limit the range of motion ----------------------------------------------------------- Consider the individual,behavior and risk

Question 45

Physical Interventions Holding Skills

Accepted Answer

MUST BE Last Resort,reasonable,least restrictive, proportionate to the level of risk behavior.

Question 46

Standing Team Control--Control Dynamics

Accepted Answer

Manage the arms, Manage the incline, Manage mobility

Question 47

Physical Skills Review

Accepted Answer

Safe: what makes these skills safe Effective: what makes it an effective strategy Acceptable: is this an acceptable response to risk behavior Transferable: is this skill transferable

Question 48

Postvention: THE COPING MODEL

Accepted Answer

Individual/Client | Staff -------------------------------------------- ---|--------------------------------- C-control emotional &physical | emo. & physical  control regained control regained  O-orient yourself to the basic yourself to the basic   facts facts  P-patterns look for triggers in staff responses to   for the behavior to behaviors  I-investigate alternatives to the ways to improve  behavior staff responses  N-negotiate future approaches, changes that will   expectations and improve future  behavior interventions  G-give Give back,provide give Support and   support and encouragement  encouragement

Question 49

Postvention

Accepted Answer

provides and opportunity to work toward change and growth for individuals who have engaged in risk behavior as well as for staff members. Without a Postvention process crises are likely to occur over and over again.

Question 50

What is the value of learning the 4 levels and corresponding staff attitudes of the Crisis Development Model.

Accepted Answer

Help us intervene early and appropriately Helps avoid overreacting or underreacting Helps us avoid crisis.

Question 51

Postvention is used for

Accepted Answer

STAFF AND CLIENTS!!!!

Question 52

Potential risks associated with the use of physical interventions.

Accepted Answer

Psychosocial injury(posttraumatic stress disorder), soft-tissue injury, articular or bone injury, respiratory restriction, cardiovascular compromise.

Question 53

What are the 2 types of aggressive behavior

Accepted Answer

Physical and Verbal

Question 54

BEST PRACTICE INDICATORS

Accepted Answer

No element of pain, intent is to calm individual, intent is to keep the individual off the floor, team interventions are used when necessary, attempt to minimize avoidable restraint, physical interventions should only be used as a last resort, never use as punishment, should have an individual risk assessment, must be within authorization, only trained staff, monitor the individuals safety at all times, use within the opt-out sequence, staff should be trained in emergency first aid, minimum amount of time.

Question 55

The Opt-Out Sequence

Accepted Answer

Can we let go? Why are we holding the person? What can be done to reduce the risks? What are the risks?

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