ORR
What does ORR stand for?
Observe, Record, Report
Name 2 actions that help to build trust with a client.
-Following through on what you say
-Listening without interrupting
-Being calm and respectful
If you notice sudden, severe changes in mood or behavior, should you report it?
Yes; immediately.
-Changes in tone or pace of speech
-Agitated body language
-Increased volume or abrupt movements
-Sudden withdrawal or refusal to speak
-Hypervigilance or appearing on edge
Client says, "I just don't see the point in anything anymore."
Report it - this could be a sign of depression or suicidal ideation. This does not appear to be urgent, but still record it and report it to your CS.
Who should you report worrisome observations to?
Care Supervisor (report to Service Support if outside regular hours).
Name 2 actions that break trust with a client
-Showing up late
-Missing visits without notice
-Promising things you can't deliver on
-Ignoring a client's feelings
-Appearing distracted or rushed
Who do you usually report mental health concerns to?
Care Supervisor
What is de-escalation?
De-escalation means using communication and behavior techniques to reduce conflict, calm a situation, and prevent harm.
Client is laughing to themselves and talking to someone who isn't there.
Report it - Possible signs of hallucinations or worsening mental health condition.
True or False: You should always include opinions in your observations.
False! Observations should always be objective and based on facts.
Name 2 things that may happen if trust is broken.
-Client may pull away and refuse care
-They may hide info from you
-Care tasks may become harder or unsafe
-Stress rises for everyone involved
Who should you call if your client is showing signs of overdose?
Call 911 first! Once help arrives, contact the MCToD to explain what happened.
Name the steps to de-escalate an agitated client with mental health issues.
Speak calmly, give them space, and listen without judgment.
Client seems more irritated than usual and tells you they had a bad day.
Don't report it - unless their agitation grows or persists across multiple visits, this does not need to be reported.
List 2 possible behavioral changes that should be reported.
-Sudden mood changes
-Increased isolation or refusal to engage
-Verbal aggression or threats
-Talking to oneself or responding to unseen stimuli
-Changes in sleep, appetite, hygiene, or appearance
Why is trust especially fragile with our clients?
Many clients have PTSD, mental health challenges, or substance use issues and they may feel judged or rejected easily.
When should you get extra support when rebuilding trust with a client?
If the client refuses care or becomes aggressive.
List out the 5 key steps to de-escalation.
-Stay calm
-Maintain a safe distance
-Actively listen
-Respond with respect and empathy
-Take action or seek help
Client begins hoarding trash and food containers.
Report it - hoarding may indicate mental health decline or cognitive issues and can lead to safety/health hazards.
Give an example of paraphrasing.
Stating in your own words and from your understanding what you think someone has said or expressed.
Example: "What I hear you saying is..." or "It sounds like you're feeling..."
Name 2 situations where you should leave and get help instead of attempting de-escalation.
-You feel unsafe
-Verbal threats
-Escalating aggression
-Client refuses to stop substances
-Client is threatening with a weapon or violent behavior
-Unpredictable or disoriented client due to intoxication
True or False: It is okay to stay with a client even if they are mildly intoxicated.
True! As long as you are able to maintain professional boundaries and complete care, it is okay to stay.
Client tells you they had a weird dream last night.
Don't report it - unless they start confusing dreams with reality or if the dreams become distressing and repetitive.