BST
Physical Interventions
Safety Grab Bag
Stress Model of Crisis
Conflict Cycle
Nonverbals
LSI's
TCI Wild Cards
100
Give an example of a redirection/distraction
Coloring, helping, cognitive questions, taking walks, etc
100
Name this move!
Protective Stance
100
Youth is threatening another youth with a knife; restrain or don't restrain?
NO - they have a weapon
100
Name 3 potential triggers in a hospital setting
Examples: parent leaving, having to be admitted, having phone taken, not going outside, etc.
100
Share one of your go-to positive self-talk thoughts when faced with a crisis
Examples: "They are in crisis, I just happen to be in the way," "I've got this," or "This is just temporary."
100
True or false: it is often helpful to utilize physical touch and close proximity when a patient is angry/agitated
FALSE
100
What is the LSI acronym we use to remember the steps?
I-ESCAPE
100
Anything that makes challenging behavior more or less likely to occur is called a...?
Setting Condition
200
Name this Behavior Support Technique!
Caring Gesture
200
Physical restraints are NOT used to... (name 2)
Demonstrate authority, enforce compliance, inflict pain or harm, punish or discipline
200
What are 3 warning signs of Asphyxia?
Examples: Going limp, saying they can't breathe, vomiting, making grunting noises, turning dusky purple, respiration is labored.
200
List the 5 stages of the Stress Model of Crisis
Basline, Triggering Event, Escalation Phase, Outburts/crisis, and Recovery
200
Label this
Stressful event, youth feelings, youth behavior, adult's response
200
What might this patient be thinking/feeling?
Examples: Distrust, lack of interest, worker pushing too hard, not happy to be here, no longer interested in this activity or conversation, etc
200
"You feel disappointed when plans are cancelled" is an example of what?
Reflective Response
200
The "three R's" of Emotional First Aid stand for what?
Reduce stress; resolve the immediate crisis; remain in the program/activity
300
Name this Behavior Support Technique
Proximity
300
What are things we want to monitor during a restraint?
Examples: Skin color, respiration, and positioning
300
Name 3 things to remember/consider with positioning when in this restraint:
Examples: stay off wrists; stay off knees; do not bend child forward; face out on the legs; wrap legs; maintain shoulder contact with your partner on the way down the wall; heads out of the way
300
What are the 3 Recovery Phase Outcomes?
Higher (Educateur), No Change (Firefighter), and Lower (abuser)
300
A patient is standing on the bed. You are concerned he will get hurt. You ask the patient to get down; he refuses. Name one option to avoid the conflict cycle.
Options include: redirect to something more positive; change the expectation; manage the environment and make the ground around the bed safe, etc.
300
What are 3 non-verbal techniques to utilize when working with an agitated individual?
Silence, head nods, facial expression, eye contact, and personal space
300
List the steps of an LSI
Isolate, Explore, Summarize, Connect Feelings to Behaviors, Alternative Behaviors, Plan/Practice, Enter back into the program
300
Running away, self-harm, and defiance are all examples of what type of behavior?
Pain Based Behavior
400
"Adam! Stop fighting now!" is an example of which Behavior Support Technique?
Directive Statement
400
Physical restraint should only be used when what criteria are present?
Agency policies and state regulations approve it; ICMP approves it, professional dynamic risk assessment indicates it.
400
What are the 4 elements of a potentially violent situation?
Trigger, target, weapon, level of stress or motivation
400
Proactive or Reactive?
Reactive Aggression
400
Give an example of something that could be used as a redirection to a more positive activity
Examples: having child help with something, coloring, writing thoughts down, etc
400
What are 3 non-verbal considerations when working with an agitated patient?
Height, gender, eye contact, personal space, body language, culture
400
Which LSI step is demonstrated here?
Connect
400
What are the two goals of crisis intervention?
Support environmentally and emotionally to reduce stress and risk; Teach new coping skills
500
Name the technique!
Prompting
500
Name this maneuver!
NCH-approved Backwards Carry
500
List 4 ways to handle physical violence that DON'T include a restraint
Eliminate one of the elements, make a directive statement, use releases and keep distance, leave situation and get help
500
Label the off-ramps...
Agitation, Aggression, and Violence
500
"If you're in it to win it, you've ____ ______!"
If you're in it to win it, you've already lost!
500
Fill in the blank. Then, explain the point of this graphic
Words; graphic shows that our facial expression and our tone are so important in terms of what we are communicating; words are not primary. It's also important for our body language and expressions to match the words we are saying.
500
As a careworker, you should be spending the most time inside of this step when conducting an LSI.
Explore
500
Make a "connect" statement
Example: "Every time you feel threatened, you punch what's in front of you."
600
Adam and Dan are playing UNO on the unit. Both are very energetic about the game and have difficulty remaining appropriately calm. Dan begins to tease Adam for picking the wrong cards. Adam begins to escalate and appears overwhelmed. Which Behavior Support Technique would you use, and what would we need to know about Adam for this to be an option?
Time Away; we need to know he can self-regulate
600
Name 3 ways to reduce injury/death in a restraint
Examples: never place weight on chest or back, never put pressure on neck, never bend a child forward, never use on kids under 5, never restrain on a soft surface, etc.
600
List all 6 predisposing risk factors to a restraint
Obesity, under influence of alcohol/drugs, prolonged agitation, underlying natural disease, hot humid, taking certain meds
600
True or False (and explain your answer): A patient throws a chair at the TV in his room. This is an example of a violent outburst.
False; TCI would consider this aggression (not violence), as it is property destruction and NOT harm toward self or others.
600
Share a good validating statement that could be used when a child is upset about having to stay at the hospital
Example: "I'm sorry, I know today isn't going the way you had hoped. You're right, this is a stressful situation...but we will get through it together."
600
What are the 4 questions we ask ourselves when faced with a crisis situation?
What am I feeling? What does the patient feel/need/want? How is the environment affecting the patient? How do I best respond?
600
List the 5 goals of an LSI
Return to baseline, clarify events, repair relationship, teach new coping skills, re-enter back into the program
600
The BHP has TV's installed in each patient room, providing kids with the ability to control channels, movies, etc. on their own. This is an example of an environmental setting condition. How might this choice make challenging behavior more or less likely to occur?
Example answer: Patients may feel that they have control and personal choice during their leisure time; tv/movies can offer a distraction/redirection; can promote a calming physical environment