CPI Crisis Model
This is the first behavior level of the CPI Crisis Development Model
What is "Anxiety":
A change in typical behavior.
Examples: Nervous movements, pacing, fidgeting, sighing, or shutting down.
Body language such as gestures, facial expressions, eye contact, personal space, posture, and the use of touch.
What is "non-verbal communication"?
A tapping their foot, beginning to pace, looking around the room a lot, loudly sighing, or grunting are signs of this.
What is "anxiety"?
What are the staff interventions when a client is in the defensive behavior level "Intimidation"?
Intimidation:
Making threats of harm towards staff, themselves, or the people around them.
What is, take the threat seriously and seek assistance?
What are the Core Values or Philosophy of CPI?
What is CARE, WELFARE, SAFETY, SECURITY?
The behavior that presents as a "demonstrable danger" on the CPI Crisis Development Model.
The staff approach would be "safety intervention"
Non-restrictive and restrictive strategies to maximize safety and minimize harm.
What is Risk Behavior?
Behavior that presents an imminent or immediate risk of harm to self or others.
Examples: Striking, throwing objects, pulling/pushing others, harming oneself.
A Person Served tapping their foot, beginning to pace, looking around the room a lot, loudly sighing, or grunting are signs of.
What is the fancy word for the vocal part of speech (not the words)?
"Not what we say, but how we say it"
What is "Paraverbal Communication"?
Use caring, supportive tones.
Keep the volume appropriate to the situation.
Deliver your message at a speed the person can process.
Strategies that can be used in a crisis moment include:
Breathe
Use Grounding
Think, then say
Observe
Ask for help
What is "Rational Detachment Strategies"?
Page 22
DOUBLE JEOPARDY!
The two types of questions clients will ask during the defensive behavior, "Questioning"
What is "information-seeking" and "challenging"?
1. Information-seeking
Asking a question to get clarity or more information.
2. Challenging
Asking a question that staff perceive as challenging your authority (attempting to draw you into a power struggle)
Behavior influences behavior. Your attitudes and behaviors influence the attitudes and behaviors of the person in distress and vice versa.
What is "Intergrated Experience?"
Double Jeopardy
What is the staff attitude/approach when a client has reached the Tension Reduction level?
Tension reduction:
Decrease in physical and emotional energy. It communicates the client is starting to regain some sense of calm and control.
What is Therapeutic Rapport?
Re-establish communication and repair relationships.
How:
1. Address the needs of the person
2. Support the person
3. Understand the incident and agree upon approaches for the future.
DOUBLE JEOPARDY
The three components of Paraverbal Communication
What is Tone, Volume and Cadence?
True or False
Post Crisis includes:
1. Supporting in the Present
2. Understanding the Past
3. Planning for the Future.
True
The staff intervention for a client in the defensive behavior level, "Release"
Release:
An emotional outburst
What is:
Let them vent acknowledge their feelings.
The two variables used in the "Decision-Making Matrix" to make a judgment about the level of risk.
What is:
1. Severity
2. Likely hood
The staff attitude/approach when a client is showing signs of anxiety.
What is "Supportive"?
How:
Be empathetic
Remain neutral
Offer help or check in
Acknowledge the anxiety "I notice you tapping your foot..."
What are the three "P's" of the Supportive Stance?
Supportive Stance:
1. Communicates respect
2. Present non-threatening
3. Maintain safety.
What is "Position, Posture, Proximity"?
Position
Avoid standing directly across from the person, face to face. Pivot to the side so you are at an angle.
Posture
Remains non-threatening, balanced, and relaxed.
Proximity
Think about how close you need to be to provide help in any given situation. Respect personal space.
What is a Precipitating Factor? and give two examples.
Internal and/or external causes of a behavior.
The defensive behavior level where a client is being seen as unwilling to cooperate or follow reasonable instructions or request.
What is "Refusal"?
We should:
Provide safe and respectful choices and explain the possible outcomes (limit setting).
Give the person time to process.
TRIPLE JEOPARDY
A time to reflect/discuss an incident, make any necessary changes and plans for the future. It strengthens relationships, provides closure, and is a time to teach and learn from one another. It is for both the CPI team and the person in the situation. It includes therapeutic rapport.
What is Post crisis?
The staff attitude/approach when a client is showing signs of defensive behavior and losing rationality.
What is Directive?
Providing clear direction or introduction
Use short, simple phrases that the person can follow.
Give them simple and reasonable choices that help them consider positive behaviors and outcomes.
Keep in mind, we need to still be supportive as we layer on a directive response.
Listening with Empathy: Which two do NOT belong?
A. Remain non-judgmental
B. Use closed ended questions
C. Give your undivided attention
D. Do all the talking and interrupt often.
What is B and D?
Factors that can increase the likelihood of the “emotional brain” taking control
What is:
"Trauma" can change a person’s brain.
"Frequent stress" can also affect the brain’s ability to dampen the stress response.
"Cognitive development" is another factor. Managing emotions is a slowly developing skill.
The three "limit setting patterns" in the directive staff approach, "Directive"
What is: "Interrupt and Redirect"
This pattern interrupts the client's emotional flow to get their attention and redirects them to an alternative positive behavior. Example: "Interrupt" You sound upset. "Redirect" Why don't you take a breath and tell me what happened?
"Desired Behavior, Desired Outcome"
This pattern helps the person identify the behavior that will help them reach the desired outcome. Example: When you lower your voice, then I'll be able to address your concerns?
"Fail safe choice"
This pattern provides an individual with two acceptable options for fulfilling a request. Example: Would you like to talk about this now or later in private?
The approach that includes the following:
Recognize that a person knows themselves best
Consider the person's life experiences
Understand that every person is unique
Value the person's rights and dignity
What is a trauma informed approach? Page 5