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TCI > TCI > Flashcards

TCI Flashcards

1
Q

What is the Therapeutic Milieu?

A

The combination of people, emotions, attitudes, and objects that create a sense of safety, respect, belonging, care, and accountability.

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2
Q

What are the spaces within the therapeutic milieu?

A

Social space
Physical space
Ideological space
Cultural space
Emotional Space

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3
Q

What is the definition of setting conditions?

A

Anything that makes challenging behaviors or traumatic stress responses more or less likely to occur.

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4
Q

What are the 4 foundations for intentional use of self?

A

Self awareness
Self regulation
Relationship skills and attunement
Self-care

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5
Q

What are the three components of the Triune Brain?

A

Thinking brain (The neocortex, in charge of higher functioning such as reasoning)
Emotional brain (The limbic system, drive motivation, contains the amygdala)
Survival brain (Reptilian brain, responsible for automatic functions such as breathing)

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6
Q

What are the goals for crisis intervention?

A

Support and Teach

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7
Q

What are the stages and behaviors of the stress model of crisis?

A

Baseline
Triggering event (agitation)
Escalation (aggression)
Outburst (violence)
Recovery

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8
Q

What are the 3 outcomes of the recovery phase?

A

Higher change (met expectations, better outcomes!)
No change
Lower change (worse outcomes)

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9
Q

What are the 4 questions to ask during crisis (in order)?

A

What am I feeling?
What does the child feel, need, want, or expect?
How is the environment affecting the situation?
How do I best respond?

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10
Q

What are 3 examples of pain based behaviors?

A

*Withdrawal
*Defiance
*Trauma reenactment
Impulsive outbursts
Overreaction to situations
Inflexibility
Self-injury
Running away through anger or fear
Inability to regulate emotions

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11
Q

What are 5 of the 8 behavior support techniques?

A

Managing the Environment
Prompting
Caring Gesture
Hurdle Help
Redirection and Distraction
Proximity
Directive Statements
Time Away

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12
Q

What are the 3 goals of Emotional First Aid?

A

Provide immediate support to reduce emotional intensity (co-regulation)
Identify and resolve the underlying concerns causing distress
Keep the child in the activity

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13
Q

What are the three strategies of Emotional First Aid (in order)?

A

Co-regulate emotions (be a calm presence)
Maintain the relationship and lines of communication
Plan and anticipate (be a coach)

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14
Q

What is the definition of anger?

A

-Anger is an emotional and physical state
-that undermines objectivity
-and reduces cognitive abilities.

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15
Q

What are the 4 ways to avoid or end a power struggle?

A

Listening and validating feelings
Managing the environment
Give choices and time to decide what to do next
Drop or change the expectation

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16
Q

What are the 4 elements of a potentially violent situation?

A

The spark
The target
The weapon
The level of stress/motivation

17
Q

What is the easiest thing to address/remove during a potentially violent situation?

A

The target

18
Q

What is the best way to decrease the level of stress during a potentially violent situation?

A

Use co-regulation strategies

19
Q

What are 3 non-verbal crisis co-regulation strategies?

A

Give space and time
Use silence
Take a deep breath and slowly exhale
If it is safe to do so, move out of the child’s line of sight
Assume a neutral stance and concerned facial expression

20
Q

What are 3 of the 5 goals of the LSI?

A

*Help the child learn to regulate emotions
*Provide a sense of emotional safety
*Re-enter the child back into the routine
Help clarify the events for the child and staff
Repair and restore the relationship between staff and the child

21
Q

What are the steps of the LSI in order? (add detail!)

A

Identify a place and time to talk
Explore the child’s point of view
Summarize feelings and content
Connect trigger to feelings and behavior
Alternative responses to feelings discussed
Plan developed/practice
Enter the child back into the routine

22
Q

What are two ways to build the cultural space?

A

*Accept and celebrate cultural differences
*Develop culturally competent staff
Support family connections and involvement
Allow for culturally diverse staff-child interactions

23
Q

What is an example of an understanding/empathic or reflective statement?

A

I see that you are angry and frustrated
It makes sense that you might be scared or sad

Reflective: You seem upset
Empathic: You’re having a hard time aren’t you?

24
Q

What are the 3 options for handling physical violence without using restraint?

A

-Eliminate one of the elements of the violent situation (e.g., target, weapon)
-Use releases and maintain a safe distance with a protective stance
-Leave the situation and get assistance

25
Q

What 3 conditions have to be present to use a physical restraint?
(i.e., physical restraint should only be used when…)

A

-Agency policies and state regulations allow it
-The child’s ICSP prescribes it
-Our Professional Dynamic Risk Assessment indicates it

26
Q

What two ethical considerations should be considered when employing restraint?

A

Duty of Care
Duty of Candor

27
Q

What are 5 contra-indicators or situations in which restraint should be avoided or discontinued?

A

-The adult cannot control the child safely
-The adult is not in control (e.g., too angry)
-In a public space
-Child has a weapon
-*Sexual stimulation is the motivation
-Child is threatening and is capable of harming staff
-Child’s medical condition prohibits it
-Child has emotional problems risking traumatization
-Child is on medication(s) that affect their system

28
Q

What is the definition of Asphyxia?

A

The deprivation of oxygen to living cells

29
Q

What are 3 predisposing risk factors for asphyxia?

A

-Obesity
-Hot humid environments
-*Influence of alcohol or drugs
-Underlying natural disease (e.g., enlarged heart, asthma, sickle cell trait)
-Certain contraindicating medications
-Effects of severe trauma history
-Prolonged violent physical agitation

30
Q

What are 2 improper restraint techniques that increase the risk of asphyxia?

A

-Pressure on the neck or chest
-Incorrect positioning of arms
-Obstructing the mouth or nose
-Abnormal positioning of the body

Also remember: Never restrain on a soft surface!

31
Q

What are two things to monitor and observe/assess during restraint?

A

-Skin color
-Respiration
-Level of consciousness
-Level of agitation
-Range of motion in the extremities

32
Q

What are 2 of the 4 principles of the Letting Go process?

A

-It is directed by the team leader
-It states what is expected of the young person
-It is supportive of the young person
-It sets the tone for the recovery process

33
Q

How are developmental relationships characterized?

A

-Attachment
-Reciprocity
-Progressive complexity
-Balance of power

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