TCI Foundation
What are the 5 spaces that make up the therapeutic milieu?
Social
Physical
Ideological
Cultural
Emotional
What are the three parts of the triune brain?
Survival
Emotional
Thinking
What is a pain based behavior?
Behaviors that are the result of emotional and psychological pain
What are the two goals of crisis intervention?
1. support immediate safety
2. teach new regulatory strategies
What are setting conditions?
Anything that makes challenging behavior or traumatic stress response more or less likely to occur
What part of the brain includes the amygdala (threat detector)?
Emotional brain/limbic system
True or false, trauma affects children's ability to regulate their emotions and behavior? Give an example.
True
Trauma could cause youth to overreact to situations
What are the three possible recovery outcomes, post-crisis.
1. higher (learn and support)
2. no change (support but no learning)
3. lower (unsupported and no learning)
Give an example of a setting condition that would increase challenging behavior AND an example of a setting condition that would decrease challenging behavior
1. increase challenging behavior could be something like loud noises in environment, overstimulating lights, yelling at youth etc.
2. decrease challenging behavior could be something like dimming the lights, removing an audience, giving child time and space
Trauma creates hypervigilance which means which part of the brain is overreactive?
Survival
Trauma can affect youth in care in different ways.
Some youth will have greater difficulty with authority resulting in what pain based behavior?
Some youth will desire predictable routines and struggle when there are surprises or changes resulting in what pain based behavior?
1. defiance
2. inflexibility
What are the four questions staff should ask themselves before intervening in crisis?
1. what am I feeling now
2. What does the child, need, want, expect?
3. How is the environment affecting the situation?
4. How do I best respond?
Name three of the six domains essential to effective implementation of TCI
1. Child and Family Inclusion
2. Clinical participation
3. Supervision/post-crisis response
4. Training/competency standards
5. Documentation, incident monitoring, feedback
6. Leadership/program support
You can use active listening skills to encourage the child to be in which part of their brain?
Thinking brain
What do we call the pattern of thinking where the brain immediately goes into panic mode? Why is it different for youth with typical development?
Trauma-driven perception. Youth with typical development will be able to use their thinking brain to make a decision rather than act on impulse.
Name 6 of the 8 behavior support techniques AND give examples for 2 of them.
1. Proximity
2. managing the environment
3. caring gesture
4. hurdle help
5. prompting
6. directive statement
7. redirection and distraction
8. Time away
What are the skills necessary for intentional use of self? (4)
1. self-awareness
2. self-regulation
3. self-care
4. relationship skills and attunement
Developmental relationships are characterized by 4 skills...can you name at least three?
1. Progressive complexity
2. Balance of power
3. Reciprocity
4. Attachment
Name 8 pain-based behaviors
1. defiance
2. impulsive outburst
3. Inability to regulate emotions
4. Trauma re-enactment
5. Self-injury
6. Overreaction to situations
7. Withdrawal
8. Inflexibility
9. running away through fear or anger
Which is the empathic response and which is the reflective response?
"you seem angry" "you are having a hard time right now"
you seem angry is reflective (connect to feeling)
you are having a hard time right now is empathic (connect to experience)