TCI Flashcards
Spaces within the therapeutic Millieu?
Social
Physical
Ideological
Cultural
Emotional
What are the four questions we ask ourselves in a crisis situation?
WHAT,WHAT,HOW,HOW
• What am I feeling now?
• What does this young person feel,need, expect or want?
• How is the environment affecting the situation?
• How do I best respond?
Crisis Co-Regulation
• What to think
• What to do
• What to say
Elements of a potential violent situation
• The Spark
• The Target
• The Weapon
• Level of stress or motivation
What are the Four foundations of intentional use of self
• Self awareness
• Self regulation
• Self care
• Relationship skills and attunement
Active listening techniques:
- Non-Verbal
- Encouraging & Eliciting
- Responses
NON VERBAL
• Silence
• Facial expressions
• Eye contact
• Tone of voice
ENCOURAGING & ELICITING
• Minimal encouragements
• Door openers
• Closed questions
• Open questions
RESPONSES
• Reflective response
• Empathic response
• Summarisation
Stress Model of Crisis
• Baseline
• Triggering event
• Escalation
• Outburst
• Recovery
Strategies to avoid or end the Power Struggle
• Listen & validate feelings
• Managing the environment
• Give choices & the time to decide what to do next
• Dropping or changing the expectation
Behaviour Support Techniques
Managing the environment
Caring gesture
Redirection and distraction
Directive statement
Prompting
Hurdle Help
Proximity
Time Away
Strategies of emotional first aid
• Co-regulate emotions
• Maintain the relationship and lines of communication
• Plan and anticipate
The Triune Brain
• The Thinking Brain
• The Emotional Brain
• The Survival Brain
Recovery Phase Outcomes
• Higher
• No Change
• Lower
Developmental Relationships are characterised by:
• Attachment
• Reciprocity
• Progressive complexity
• Balance of Power
Goals of crisis intervention
SUPPORT - provide immediate emotional and environmental support to reduce stress and rush and increase the YP’s sense of safety
TEACH - help YP learn and practice ways to regulate their emotions and behaviours
Help Me Help Myself: Crisis Co-regulation
What to think:
• Ask yourself the 4 questions
• Use positive talk
What to do:
• Take a deep breath and slowly exhale
• Give the YP space and time
• Use silence
• If safe, step away from the YP’s sight
What to say:
• Very little
• Speak calmly, assertively, respectfully
• Understanding response
• Remember the importance of tone of voice
Setting Condition
A seeing condition is: anything that makes challenging behaviours more or less likely to occur
Objectives of Emotional First Aid
Provide immediate support to reduce emotional intensity. Identify and resolve the underlying concerns causing distress. Keep the young person in the activity
Life Space Interview Steps -
IESCAPE
• Identify a time and place to talk
• Explore the YP’s point of view
• Summarise feelings and content
• Connect trigger to feeling to behaviour
• Alternate responses to feelings discussed
• Plan/develop and practice
• Enter YP back into routine
Pain based behaviours
• Running away
• Defiance
• Self injury
• Withdrawal
• Inability to regulate emotions
• Overreaction to situations
Impulsive outbursts
• Inflexibility
Help Me Help Myself
•Take a deep breath and exhale slowly
•Give the child space and time
•Use silence
•If safe,step out of child’s sight
•Assume a neutral stance and concerned facial expression
Empathic Response examples:
•I’m sorry to hear that
•I understand how that could be frustrating
•Thanks for reaching out
Reflective Response examples:
•I get a sense that you are angry
•It feels as though your upset and saddened by this
•It sounds like you are very mad about this
Where physical force is used in an emergency, staff are required to ensure that the force is:
• Reasonable and necessary to prevent the child from harming themselves or others
• The least restrictive option, in that it is the minimum level of force which is reasonable and necessary to protect the child or YP against danger
• Applied for shortest amount of time possible and is removed as soon as the risk has reduced
• Only used where the risk of not using forced outweighs the risk for using force
What are the situations in which restraint would be avoided
• The staff cannot remain calm
• The child is threatening the stuff with bodily injury
• when the child has a weapon
• when the childs medical condition can be aggravated
• if the child is on medications
• when the restraint may result in serious trauma for the child
