Defining Target Behaviors
Staff Response - How do you respond?
Safety - How do we make the environment safer?
Severity levels
Documentation
100
What type of behavior is described below?
Your member uses a broom to hit their staff.
Physical aggression
100
What type of voice should staff use when redirecting a member during escalation?
Use a neutral tone -
"Using a neutral tone supports the decrease in continued escalation by reducing feelings of being challenged or overwhelmed"
100
Your member begins displaying precursor behaviors What should staff do to reduce the risk if the member becomes physical escalated?
-Maintain a safe distance
"Safety is a priority when working with your member- you are a support not the director of this situation, keep a safe distance and begin by offering coping skills to support".
100
What behavior and severity level is this?
Your client has speech therapy that comes to the home. The client walks away from the table and goes into the other room during their session.
Elopement - Level 2
100
When do you submit an incident report? How long do you have to submit it?
Any time there is a behavior of Level 3 severity or above. 24 hours to submit.
200
What type of behavior is described below?
Your member leaves the approved area without permission or notifying a caregiver.
Elopement
200
What should staff do as an immediate response when a member begins to show signs of frustration?"
Hint: "in an emergency you should _____ ______"
-Stay Calm
"Staying calm helps reduce the chance of escalation and models how a member should respond safely when frustrated".
200
The member is showing visible signs of frustration in their room pacing back and forth, looking at items. What should staff do if objects nearby can be thrown or used unsafely?
-Remove unsafe items
"Staff should remove unsafe items to prevent further safety risks for staff and helps to give the member a safe space to calm down".
200
What behavior & severity level is this?
Your client kicks the TV and it no longer will turn on.
Property Destruction - Level 3
200
Give an example of when to submit a disturbance report. How long do you have to submit it?
Any time there is a relevant issue that is not directly related to the member's behaviors, but poses a barrier to service delivery. (e.g.: group home is out of ratio). 24 hours to submit.
300
What behavior is described below?
Your member picks up a rock off the ground and begins scratching their arms with it causing irritation.
Self-Injury
300
What should staff do if a member is becoming more upset after being given multiple directions?
Hint: pausing and reflecting
-Reduce/reducing demands
" Reducing demands lowers the need for a member to follow through or comply when overwhelmed, it gives the provider a better opportunity to regain control."
300
What should staff do if a situation with a member if the member is becoming unsafe or difficult to manage alone?
-Call for support
"When a dangerous situation occurs, immediately find staff/guardian for support. LBHS does not use physical management procedures; & you are not meant to handle behaviors on your own, as this can become a potential safety risk for you."
300
What behavior and severity level is this?
Your member gets into an altercation with their roommate. Your member hits their roommate over the head with a blunt object. Your member is taken by the police, and the roommate is admitted to the hospital.
Physical Aggression - Level 5
300
How would you document your client punching a hole in the wall, in a way that aligns with psychosocial rehabilitation? (who, what, when, where, why, intervention) - Give an example of what you would put in your note.
Bx coach supported member by prompting use of coping strategies when precursors were observed. Member refused and began to pace. Bx coach offered space to the member to promote regulation. Member continued to escalate and punched a hole in the hallway wall. Bx coach encouraged member to take space in order to regulate.
400
What types of behaviors are described below?
Your member is threatening you. You provide your member with some space in their room. You hear crashing in the room. Once your member has calmed down, you notice that multiple items in the room are broken and no longer functional.
Verbal aggression
Property Destruction
400
What strategy gives a member some control while still guiding them to another appropriate option or alternative?
-Offer choices
"Offering choices can support to reduce refusal for a member by helping them to feel more in control while still following expectations".
400
Your member is in crisis and the situation is unmanageable. You are in the community with your member and their group home staff. Staff are attempting to utilize physical management, and they ask you to call 9-1-1. What do you do?
-Step away and support staff by calling 9-1-1.
"You can be a support to the team by helping to dial 9-1-1 if the group home or guardian requests this. Following your completed call, make sure to follow up with your case supervisor or clinical supervisor and begin documenting the occurrence in an incident report."
400
What behavior and severity level is this?
Your member tells you that they are feeling suicidal. You attempt to regulate and redirect them, however are unsuccessful. Your member calls 9-1-1 and states that they want to kill themselves. EMS arrives, and your member has regulated a bit, stating that they no longer feel suicidal. EMS leaves.
Verbal aggression - Level 4
400
Working on interpersonal relationships baseline goal. Make this sound more clinical:
"when i arrived member was in his room just waking up. Once he was fully awake, member had wet him self staff tried to reinforce him to shower but he refused so instead he just changed his clothes and staff changed his sheets. Once member got done changing he went in the dining room area and waited for his breakfast to be done."
500
How would you track this behavior on your coaching note?
Your member begins stealing food from a store that they frequent. Your member does not have a history of stealing. Your member steals the food and eats it without paying for it. When asked about it, your member shares that they did not have money and wanted the snack.
Note this as "Other behavior" + Write about it in the descriptive part of the note or in "notes to supervisor" section.
500
What should staff do if there is a serious injury, aggression towards staff or a significant safety concern?
- Outreach to the case supervisor/clinical supervisor for support and further documentation.
"Contacting Case Supervisor is essential to helping make sure documentation is completed and collaboration as a team for the occurrence of high intensity behavior".
500
What should you do if the member's behavior reaches a high-risk level (Aggression,Verbal Aggression, AWOL, Self-injury, Property Destruction)?
-Follow the member's crisis plan/Safety and support plan
"When a member engages in high-risk behavior, Coaches should support them by having their nearest staff or guardian follow the crisis/safety and support plan. This is a written, agreed-upon procedure that helps outline ways to provide support during escalation and the appropriate level of response."
500
State all of the behaviors and their severity levels:
Your member states that they are feeling suicidal. The member walks out of the front door of the home, and remains on the property, without letting anyone know. You try to redirect your member, but they use profane language toward you while stating they would like to be left alone. Once staff comes to check on the member, they punch their staff in the face causing a black eye.
Verbal aggression - Level 3
Verbal aggression - Level 1
Elopement - Level 2
Physical aggression - Level 3
500
Working on functional communication baseline goal, make this sound more clinical:
"when it was time to go to circle k i tried to guide member into get in the car, he took his time and just sat there for a little bit after I asked him again he looked at me and got in the car when we got to circle k and member got what he needed to get it was time for him to get back in the van but he took his time again and didn't respond until I asked him a few more times"
