Managing the Crisis

Question 1

What are the two types of aggression and their components?

Answer 1

Reactive aggression:

• affective / expressive
• loss of control + emotional flooding
• emotion dominant

Proactive aggression (rarer):

• instrumental / operant
• goal oriented
• cognition dominant

Question 2

Draw the model for proactive aggression:

Answer 2

*see notes

Question 3

What are immediate response priorities to reactive aggression?

Answer 3

Safety
Understanding + Support
Remove / Reduce Stimulus

Question 4

What are immediate response priorities to proactive aggression?

Answer 4

Safety
Containment + Negotiation
Engagement + Reasoning

Question 5

What are ongoing response priorities to reactive aggression?

Answer 5

Teach coping skills
Teach self-regulation skills
Anger management

Question 6

What are ongoing response priorities to proactive aggression?

Answer 6

Teach appropriate thinking + values + social skills

Reward socially appropriate behaviour (not anti-social behaviour)

Question 7

An individual crisis management plan (ICMP) is:

Answer 7

Functionally analyzing high-risk behaviour
A strategy for intervention, tailored to the client
Periodically reviewed + updated

Question 8

What are non-verbal behaviours (component to nonverbal communication)?

Answer 8

Eye contact
Body language
Personal space
Height differences
Gender differences
Cultural differences

Question 9

What are the elements to a potentially violent situation?

Answer 9

Potential trigger to violence
A target
A weapon (can be a young person’s body)
Level of stress (reactive) or motivation (proactive)

Question 10

How do we remove the potential trigger to violence in a situation?

Answer 10

Never touch angry / potentially violent person
Avoid aggressive moves + provocative statements
Avoid conflict cycle + counter aggression
Remove others who may trigger violence
BODY LANGUAGE IS CRITICAL

Question 11

How do we remove the target of violence?

Answer 11

Ask the target to leave
If you, remind the young person of your relationship / leaving the situation (asking neutral staff to sub in)
TARGETS MAY SHIFT DURING EPISODES

Question 12

How do we remove the weapon of violence?

Answer 12

Discreetly remove objects
Maneuver youth away from weapons
Maintain a safe distance away

Question 13

How do we decrease levels of stress / motivation in a potentially violent situation?

Answer 13

Use your relationship
Actively listen to identify feelings
Remove the audience
Use co-regulation strategies for reactive aggression
Offer alternate, non-aggressive methods to achieve goals for proactive aggression

Question 14

What is the goal of crisis co-regulation

Answer 14

To provide support in a way that reduces stress + risk

Question 15

What should we think in crisis co-regulation?

Answer 15

SELF AWARENESS:

• ask self four questions
• use positive self-talk

Question 16

What should we do in crisis co-regulation?

Answer 16

NON VERBAL STRATEGIES:

• take a deep breath
• use protective stance
• step back
• give the situation time
• sit down if appropriate
• remember the importance of body language + facial expression

Question 17

What should we say in crisis co-regulation?

Answer 17

VERBAL STRATEGIES:
- say very little
- offer understanding responses
  ~ validate feelings ("I can see")
  ~ encourage positive behaviour ("when you")
  ~ emphasize desirable outcomes ("I know we")
  ~ offer an apology ("I am sorry")
- remember importance to tone of voice

Question 18

When is crisis co-regulation over and what should we do when it is?

Answer 18

I) When the young person is no-longer potentially violent + complies with requests
II) LSI

Question 19

What is an LSI?

Answer 19

Life Space Interview: A therapeutic, verbal strategy for intervening with a young person

Question 20

What are the goals of an LSI?

Answer 20

1. Return a young person to normal functioning
2. Clarify events
3. Repair + restore the relationship
4. Teach new coping skills
5. Reintegrate the young person back into the program

Question 21

What are the steps to an LSI?

Answer 21

I - isolate the conversation

E - explore young person's point of view
S - summarize the feelings + content
C - connect feelings to behaviour
A - alternative behaviours discussed
P - plan developed + proactive new behaviour
E - enter young person back into routine