Crisis Intervention Plan

1. Crisis Intervention Plan Enable the individual to: • Prevent a crisis • Self-manage a crisis • Alleviate a crisis • End the crisis

2. Child/Family Perspective Key Elements

3. Crisis Intervention Plan Key Elements • User-friendly • Clear direction • Individualized • Preventive • Real-life situations

4. Key Elements Crisis Intervention Plan • Clear Direction • Individualized User-friendly • Preventive • Real-life Situations

5. Crisis Intervention Plan Operational Definition A collaborative plan that grows with the child’s needs.

6. Crisis Intervention Plan Operational Definition Collaborative

7. Crisis Intervention Plan Operational Definition Growth

8. Crisis Intervention Plan Operational Definition Child’s Needs

9. Crisis Intervention Plan Planning Process Strength-Based Perspective vs. Problem-Based Perspective

10. Crisis Intervention Plan Planning Process • Preparation prior to IDT meeting • Use of planning tools • Risk Assessment/reassessment • Resources

11. Crisis Intervention Plan Planning Process POSITIVE STRATEGIES 4-STEP PROCESS

12. Crisis Intervention Plan Planning Process • Understand why the individual engages in their behavior

13. Crisis Intervention Plan Planning Process • Prevent the behavior through social or environmental changes

14. Crisis Intervention Plan Planning Process 3. Replace the behavior with alternative skills that serve the same function for the individual.

15. Crisis Intervention Plan Planning Process • Identification, development and utilization of strengths and natural supports

16. Crisis Intervention Plan Contributing Components • Setting Events • Antecedents • Problem Behavior • Consequences • Function

17. Crisis Intervention Plan Contributing Components • Setting Events

18. Crisis Intervention Plan Contributing Components • Antecedents

19. Crisis Intervention Plan Contributing Components • Problem Behavior

20. Crisis Intervention Plan Contributing Components • Consequences

21. Crisis Intervention Plan Contributing Components • Function

22. Crisis Intervention Plan Stages and Strategies • Preventive Stage • Escalation Stage • Crisis Stage • Calming Stage

23. Crisis Intervention Plan Stages and Strategies

24. Crisis Intervention Plan Examples • When I am feeling well, I am (describes himself) • When I begin to feel depressed, I feel (like I’m in a rut, tired, irritable, don’t want to talk about sports…) • When I am feeling depressed, I want people not to ask me so many questions, like how do you feel? Just be available for me to talk with if I want to. • I like to talk with my coach ( ) most often when I am depressed. I will ask permission to stay after school to talk to coach. • If I begin get angry or disrespectful, place your hand over your heart, to remind me to be tender and lower my voice.

25. Crisis Intervention Plan Examples • Sally gets into serious trouble when she runs away from home. She steals and shoplifts, uses drugs and stays with older men. If Sally runs away from home: • The police will be notified immediately. • Her aunt (the person she listens to best) will work with the police to find her and talk to her. • When Sally returns, she will be put on 24-hour watch. Someone (family/relatives) will escort her to and from school, and be with her all day. She will be at home or with a parent after school. • The family will meet with the case worker and Sally’s therapist to help her learn what to do when she gets the urge to run. • If these steps do not work, the team will look for a more secure living arrangement.

26. Stage 1: Anxiety CLIENT BEHAVIOR Often displayed as increase or change in behavior, or undirected expenditure of energy. The client’s specific behavioral cues during stage 1 include: Stage 1: Anxiety APPROPRIATE STAFF RESPONSE Early Intervention is key to safely managing behaviors. The intervention plan for the client during Stage 1 is (include verbal tone, proximity, and specific intervention strategies): Crisis Intervention Plan Examples • XXX will refuse to follow directives. He will chew on his clothing. He will verbally threaten staff and peers around him. • Staff should give XXX space and allow him time to comply with the directives. • Specific things to avoid for this client include: • Staff should avoid making demands, getting loud, and touching XXX.

27. Stage 2: Defensive Hostility CLIENT BEHAVIOR Often displayed as verbal barrage or challenge, insult, threats. Individual may need to vent or expend energy. The client’s typical behavior and patterns during this stage include:  Stage 2: De-escalation APPROPRIATE STAFF RESPONSE The intervention plan for the client during Stage 2 is (include verbal tone, proximity, location, and specific intervention strategies): Crisis Intervention Plan Examples • Staff need to give XXX time and space to come up with his own appropriate solution. • Specific things to avoid for this client include: • Staff should avoid confronting. • XXX will challenge authority, refuse to listen and refuse to accept possible solutions to the situation.

28. Stage 3: Physical Aggression CLIENT BEHAVIOR Assault to persons or property. This results in energy expenditure and loss of control. The client’s typical behaviors and patterns during this stage include: Stage 3: Therapeutic physical restraint. APPROPRIATE STAFF RESPONSE Restraints restricted.  If Restraints are restricted, then the plan to manage the client’s physical aggression is as follows: Crisis Intervention Plan Examples • Therapeutic restraint means we “hold” the individual until he has regained rational control. Restraints should not inflict pain upon the individual and should never be used to punish. Intentional infliction of pain is abuse. • Restraints limited. • If Restraints are limited, then restraints are limited to the following procedures: • XXXX will attempt to throw punches at others. He will become physically threatening and aggressive. • TCI Therapeutic Restraint • Specific information regarding the safe and effective management of the client during this stage includes:  • Follow the TCI-specific procedures • Specific things to avoid for this client include: • Staff should avoid continuing constant redirecting XXXX. He needs enough time to process the directives and make a decision. Once in the time out room, staff should not process with XXXX until he has completed ten minutes of nonverbal time. This allows XXXX to calm down and prepare to process with staff.

29. Stage 4: Tension Reduction CLIENT BEHAVIOR Client displays the regaining of rational control, emotional reaction to event (guilt, residual anger, etc.) XXXX will process with staff and be able to regain control of his emotions and behaviors. Stage 4: Re-establish Rapport APPROPRIATE STAFF RESPONSE Staff response during Stage 4: (include proximity, verbal tone). Staff need to find an appropriate place that is isolated in order to clear the distractions XXXX is easily distracted and is unable to process clearly with staff. Processing with XXXX is very important so he will be able to make the connection of his thoughts, behaviors, and consequences. Process event using Life Space Interview Crisis Intervention Plan Examples

30. Children’s Mental Health Waiver Remember! Listen to the experts!! Children and Families!!!