This section deals with extreme stress and coping techniques, including anger management, relaxation, and crisis intervention. Page down for resources and links. (see Note below*)
CRISIS PREVENTION (originally on a poster by the CPI - http://www.crisisprevention.com/)
The following are tips for crisis prevention and are recommended as the least restrictive procedures for behaviour management.
a. BE EMPATHIC: Try not to be judgmental of the resident's feelings. They are real - even if not based on reality and must be attended to.
b. CLARIFY MESSAGES: Listen to what is really being said. Read the non-verbal body language. Ask reflective questions, and use both silence and restatements.
c. RESPECT PERSONAL SPACE: Stand at least one and one-half to three feet from the acting-out person. Encroaching on personal space tends to arouse and escalate an individual.
d. BE AWARE OF BODY POSITION: Standing eye to eye, toe to toe with the resident sends a challenge message. Standing one leg length away and at an angle off to the side is less likely to escalate the individual.
e. PERMIT VERBAL VENTING WHEN POSSIBLE: Allow the individual to release as much energy as possible by venting verbally. If this cannot be allowed, state directives and reasonable limits during lulls in the venting process.
f. SET AND ENFORCE REASONABLE LIMITS: If the individual becomes belligerent, defensive, or disruptive, state limits and directives clearly and concisely.
g. AVOID OVER-REACTING: Remain calm, rational and professional. How you, the staff person, respond will directly affect the individual.
h. IGNORE CHALLENGE QUESTIONS: When the resident challenges your position, training, policy, etc..., redirect the individual’s attention to the issue at hand. Answering these questions often fuels a power struggle.
i. KEEP YOUR NON-VERBAL CUES NON-THREATENING: Be aware of your body language, movement and tone of voice. The more an individual loses control the less he listens to your actual words. More attention is paid to your non-verbal cues.
j. USE RESTRICTIVE PROCEDURES AS A LAST RESORT: Use the least restrictive method of intervention possible.
*Note: These contents are assembled from several web sites, some of whom are now defunct. Although I have the documents in my records, I've provided the current links to available items. Copies of material from defunct sites, as well as my works, are provided below. Copyright belongs to the authors and/or publishers of the material according to the information contained in the documents. An internet search of the titles or of content from the material should be made for referencing purposes. The owner of this web site only claims authorship where indicated within the material.
Anger management issues The 9/11 attack on the Pentagon and its aftermath...the anthrax attacks, the sniper attacks, continued terror alerts, and the war on terror may make some of us more vulnerable to stress reactions including anger, fear, headaches, or sleeping problems. Many people are still experiencing anger about 9/11, even more than two years after the terrorist attacks. The information below will help you learn how to manage your anger.
Anxiety, stress management and coping skills (various resources)
APA Help Center for crisis and trauma resources
BEST PRACTICE GUIDELINES FOR WORKING WITH PEOPLE WITH DISABILITIES 2014 — Best practices and procedures for Customer Service
Best Practices in Self-Directed Services and Supports: Key Elements Across the Intellectual and Developmental Disabilities, Behavioral Health, and Elderly and Physical Disability Fields 2009 — The Council for Quality and Leadership (CQL) enlisted the Human Service Research Institute (HSRI) to compile a set of standards useful for examining the quality of self-directed services and supports across a range of populations.
Checklist of Potential Reactions and Coping Strategies 2004 It is common to experience a variety of emotional, physical, or behavioral reactions to highly stressful or traumatic situations, such as terrorism, war, and continued terrorist alerts. The information below shows common reactions, ways to help you and others cope now and in the future, and when to seek professional help.
Communicating with people with intellectual disabilities: a guide for general psychiatrists 2014 — In this article we consider the additional impairments that occur in people with intellectual disabilities who use psychiatric services and describe practical steps that can be taken by clinicians and service providers to overcome these impairments, to make reasonable adjustments and to ensure that patients obtain maximum benefit from services. Full text at http://apt.rcpsych.org/content/aptrcpsych/20/1/27.full.pdf
Courageous Action in the Face of Fear 2004 When we recognize the "Fear Factors" that make something more fearful, we can make better, more informed choices about the actions we take in response to our fear.
Crisis: Prevention and Response in the Community 2002 — Crisis: Prevention and Response in the Community takes a close look at crisis services for people with developmental disabilities and how they impact the surrounding community.
Crisis Intervention: A Review (2000) — ABSTRACT: Critical incidents are sudden, unexpected, often life-threatening time-limited events that may overwhelm an individual’s capacity to respond adaptively... review ... of Critical Incident Stress Management.
Effective coping techniques (various resources)
Evidence-Based Practices for Students With Severe Disabilities 2014 — Use of this tool to evaluate course syllabi can help teacher preparation leaders ensure that they emphasize proactive, preventative approaches instead of exclusive reliance on behavior reduction strategies.
Five Principles of Crisis Intervention: Reducing the Risk of Premature Crisis Intervention 2000 — Crisis intervention, as it has evolved over the last five decades, has clearly demonstrated its effectiveness as a tool to reduce human distress. Nevertheless, as with any effort to alter human behavior, there are risks associated with crisis intervention. One such risk is that of premature intervention. Premature intervention may not only waste valuable intervention resources, but may serve to interfere with the natural recovery mechanisms of some victims.
Five Training Best Practices in Supporting Individuals with Autism and Intellectual Disabilities 2015 — a few strategies believed to be best practices in training staff in the disabilities field.
How to hear me: a resource kit for working with people with intellectual disability — How to Hear Me: a resource book and accompanying DVD that together form an important tool for building the capacity of victim support agencies, counsellors and therapists to work effectively with people with an intellectual disability who have become victims of crime. This resource is available for download, and the pages within this section provide the same content in a web-based format.
Perceptions of Stress and Coping Strategies Among Adults With Mild Mental Retardation: Insight Into Psychological Distress 2005 — Decreasing opportunities for stress and increasing accurate perceptions of control and subsequently active coping may reduce psychological distress among people with mild mental retardation. Sigan L. Hartley, William E. MacLean Jr.Frank Floyd (2005) Perceptions of Stress and Coping Strategies Among Adults With Mild Mental Retardation: Insight Into Psychological Distress. American Journal on Mental Retardation: July 2005, Vol. 110, No. 4, pp. 285-297.
Personal Vulnerability to Victimization of People with Mental Retardation (2002) — Identifying potential victim characteristics and training before victimization occurs may reduce incidence of victimization and guide development of protective procedures.
Policy and Best Practice Information from the Challenging Behaviour Foundation
supporting a person in crisis/ supporting the people who care David Pitonyak (2009) — A common mistake we make in trying to help people in crisis is that we forget their behavior may be their only way to communicate to us that something is fundamentally wrong with the life they are living. For more resources see http://www.dimagine.com
Treating Individuals With Intellectual Disabilities and Challenging Behaviors With Adapted Dialectical Behavior Therapy (2013) — These findings suggest that modified DBT holds promise for effectively treating individuals with intellectual and developmental disabilities.
Various Relaxation Audios and Techniques — Self-Help Resources available at the Counseling Service of Luther College, Decorah, Iowa
What Is Child Abuse and Neglect? Recognizing the Signs and Symptoms 2013 — The first step in helping abused or neglected children is learning to recognize the signs of child abuse and neglect. The presence of a single sign does not mean that child maltreatment is occurring in a family, but a closer look at the situation may be warranted when these signs appear repeatedly or in combination.