A Little About Me and the Helen Ross McNabb Center

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Kerry Freeman
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Handle with Care Non Violent Crisis Intervention Model A Little About Me and the Helen Ross McNabb Center Jill Barnes, LAPSW, PHR (social worker supervisor who loved to trainwent to human resources)

1 Handle with Care Non Violent Crisis Intervention Model A Little About Me and the Helen Ross McNabb Center Jill Barnes, LAPSW, PHR (social worker supervisor who loved to trainwent to human resources) Helen Ross McNabb Center located in east TN has around 100 locations and 1000 staff members 45% child services, 55% adult services Crisis Stabilization Unit and Residential Treatment for Adolescentsour highest levels of care Other services: prevention, care coordination, outpatient cooccurring work, detox, IOPs, housing, medication management, juvenile justice, foster care, adult and child mobile crisis units, social services, supported living 1

2 The Handle With Care Philosophy Sample There is no dignity in allowing a child or adult to harm themselves of someone else A client will know the difference between something done to them or FOR them Focus on the Staff Person Emphasizes the staffs triggers and emotional thermostats Emphasizes when and how the staff member reacts to a crisis The skillful application of the therapeutic hold is a critical extension of the therapeutic relationship Focuses on the therapeutic relationship and the reactions and behaviors of the staff member the solid object The staff member is trained to stay calm, empathetic, and confident 2

3 The Solid Object Handle with Care teaches staff members what is means to be a solid object and the organization expects staff members to be a solid object for our clients Teaches that clients will test us to see if we are really solid A client will cling to a solid object for stability What Staff Learn About Client Crisis Clients are triggered by fear and/or anger Clients can have clear signs when they are escalating Clients can be an inward/delayed processor of tension Client can be an outward/immediate processor of tension Staff can and should intervene with support, limit setting, or the primary restraint technique DEPENDING on where the client is it is a TIMING MODEL 3

4 Tension/Tension Reduction Cycle Precipitous Discharge when tension exceeds tolerance threshold Assault Increasing Tension Overtly Threatening Bx Indirectly Threatening Bx Speech Motor Activity Autonomic Response Rapid Reduction of Tension PRT Limit Setting Support Time Overtly Threatening Behavior Before the client can hurt themselves or others, a staff member needs to intervene physically The restraint is called PRT the Primary Restraint Technique Can be accomplished with one or more staff members Is easy and memorable The hold is a skeletal lock and can be done on persons bigger and stronger than you (but it is not effective on everyone) 4

5 Debriefing Life Space Interview Supports the therapeutic relationship Allows the client to see the connection between feelings, thoughts and behavior Puts responsibility on the client Contracting for alternative behaviors Top 11 Reasons Why I Love Handle With Care Model 1. Company easy to work with/support by 2. Approx $5000 once per year to train 12 T4Ts 3. You can make your own certificates and documentation of training 4. Model is staff centered not centered on changing the client 5. You can use part or all 6. Little to no complaints by our staff members 7. Can be trained in one day ( verbal before lunch and physical after lunch) 5

6 Top 11 Reasons Why I Love Handle With Care Model 8. There is a 1 person therapeutic hold ( restraint ) 9. The solid object model is powerful and easy to train 10. The Life Space Interview is perfect for debriefing with staff and clients 11. I can have a certified trainer at my most crisis prone programs 12. Its fun The Difficult Parts of Handle with Care Every staff must be certified once per year so we run it weekly The trainer cannot train other agencies The physical won t work on everyone body type, staff physicial limitations 6

7 Questions? Handlewithcare.com 7

PATIENT AGGRESSION & VIOLENCE BEST PRACTICES NCQC PSO Safe Table July 2015

PATIENT AGGRESSION & VIOLENCE BEST PRACTICES NCQC PSO Safe Table July 2015 Minimize the impact of patient aggression and violence by focusing on various phases of the care process. RECOGNITION Understand