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Annual Staff Recertificati on TACT TACT -2 -2 Therapeuti c Aggression Control Techniques

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Page 1: Annual Staff Recertification Rev July 2009 Annual Staff Recertification Rev July 2009 TACT-2 Therapeutic Aggression Control Techniques

Annual Staff Recertificati

on

Rev July 2009

Annual Staff Recertificati

on

Rev July 2009

TACTTACT-2-2Therapeuti

c Aggression Control

Techniques

Therapeutic

Aggression Control

Techniques

Page 2: Annual Staff Recertification Rev July 2009 Annual Staff Recertification Rev July 2009 TACT-2 Therapeutic Aggression Control Techniques

1. Edward and his family immigrated from Eastern Europe, where they lived in a refugee camp for several years. He is usually friendly but quiet, speaks broken English, and is often picked on by others. Today, he gets into a shoving match with one of the school bullies. When staff try to physically separate the two, Edward begins struggling wildly. He breaks free and runs off, bouncing off lockers and doors, eventually hiding in the boys’ room.

What would you do?What would you do?

a. How would you assess this situation?Immediately dangerous or not? Deliberate or Emotional?

b. What would you do to intervene, based on TACT-2?

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Page 3: Annual Staff Recertification Rev July 2009 Annual Staff Recertification Rev July 2009 TACT-2 Therapeutic Aggression Control Techniques

2. Antoine is a smaller, younger smart-mouthed resident of a group home for youthful offenders. He often antagonizes William, though only when staff are around to protect him. Today, he begins teasing: “So William, my brother says he’s gone out with your little sister, Janel. Isn’t that her name? Janel? And HE says she is FINE!” William is getting more and more upset as Antoine continues his story.

What would you do?What would you do?

a. How would you assess this situation?Immediately dangerous or not? Deliberate or Emotional?

b. What would you do to intervene, based on TACT-2?

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Page 4: Annual Staff Recertification Rev July 2009 Annual Staff Recertification Rev July 2009 TACT-2 Therapeutic Aggression Control Techniques

3. Ten minutes later, William is furious. “I know I’m supposed to be going home for good in 3 weeks, but I tell you what, I’m about to bust him in the @#$%in’ mouth anyway! He only talks trash like that cuz you’re there to protect him -- see what happens later when there’s no staff around! And I’m not the ONLY one who wants to teach him a lesson! Just watch!”

What would you do?What would you do?

a. How would you assess this situation?Immediately dangerous or not? Deliberate or Emotional?

b. What would you do to intervene, based on TACT-2?

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Page 5: Annual Staff Recertification Rev July 2009 Annual Staff Recertification Rev July 2009 TACT-2 Therapeutic Aggression Control Techniques

Immediately Dangerous?

Not Immediately Dangerous?

TACT-2 MODELTACT-2 MODEL

Deliberate

Emotional

Crisis Response1. Redirect 2. Remove 3. Restrict 4.

Restrain

Page 6: Annual Staff Recertification Rev July 2009 Annual Staff Recertification Rev July 2009 TACT-2 Therapeutic Aggression Control Techniques

PeersPeers

OutsiOutside de IssueIssuess

ExpressExpressionion

BehaviBehavioror

DeliberateDeliberate EmotionalEmotional

DeliberateDeliberate EmotionalEmotional

ApprovalNone

Calm

Usual

DisapproDisapprovalvalSignificSignificantant

IntenIntensese

UnusuaUnusuall

Page 7: Annual Staff Recertification Rev July 2009 Annual Staff Recertification Rev July 2009 TACT-2 Therapeutic Aggression Control Techniques

Immediately Dangerous?

CORRECTION1. Reminder

2. Warning

3. Confrontation

Not Immediately Dangerous?

COUNSELING1. Give space

2. Listen actively

3. Problem Solving

TACT-2 MODELTACT-2 MODEL

Deliberate

Emotional

Crisis Response1. Redirect 2. Remove 3. Restrict 4.

Restrain

Page 8: Annual Staff Recertification Rev July 2009 Annual Staff Recertification Rev July 2009 TACT-2 Therapeutic Aggression Control Techniques

UnderstandingUnderstanding

DeliberaDeliberate te

ProblemsProblems

TACT-2

TACT-2

Therap

eutic

Aggres

sion

Contro

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Techni

ques

Therap

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Page 9: Annual Staff Recertification Rev July 2009 Annual Staff Recertification Rev July 2009 TACT-2 Therapeutic Aggression Control Techniques

What is What is Deliberate Deliberate

Misbehavior?Misbehavior?“Purposeful

attempt to meet one’s own needs at the expense of

others.”

TACT-2

TACT-2

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Page 10: Annual Staff Recertification Rev July 2009 Annual Staff Recertification Rev July 2009 TACT-2 Therapeutic Aggression Control Techniques

Glasser’s Social Glasser’s Social NeedsNeeds

Love Love BelongiBelongi

ngng

Power Power ImportanImportan

cece

Freedom Freedom ChoiceChoice

Fun Fun PleasuPleasu

rere

Page 11: Annual Staff Recertification Rev July 2009 Annual Staff Recertification Rev July 2009 TACT-2 Therapeutic Aggression Control Techniques

Negative Needs Fulfilling Behaviors

BelongingClass clown, neediness, giving into peer pressure

Importance

Defying authority,

breaking rules, intimidating

othersFun

Teasing others, vandalism,

thrill seeking activities

FreedomRefusal to

work, running away, using drugs or alcohol

Page 12: Annual Staff Recertification Rev July 2009 Annual Staff Recertification Rev July 2009 TACT-2 Therapeutic Aggression Control Techniques

Positive Needs-Fulfilling Behaviors

Belonging

Mentor relationships

Social activities Sports teams

Importance

Group leadership Community

service Helping younger kids

FunGames & puzzles

Music & dancing

Community trips

FreedomAllowing choice in clothing, chores, etc. Journaling, art, poetry,

etc.

Page 13: Annual Staff Recertification Rev July 2009 Annual Staff Recertification Rev July 2009 TACT-2 Therapeutic Aggression Control Techniques

Which Needs Are Met?Which Needs Are Met?Which need(s) are met by each of the following misbehaviors? And what

alternative prosocial options we could offer to meet the same need in a more socially appropriate way?

1. Spray painting gang logos on school wall.

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Page 14: Annual Staff Recertification Rev July 2009 Annual Staff Recertification Rev July 2009 TACT-2 Therapeutic Aggression Control Techniques

Which Needs Are Met?Which Needs Are Met?Which need(s) are met by each of the following misbehaviors? And what

alternative prosocial options we could offer to meet the same need in a more socially appropriate way?

2. Playing two boyfriends off against each other.

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Page 15: Annual Staff Recertification Rev July 2009 Annual Staff Recertification Rev July 2009 TACT-2 Therapeutic Aggression Control Techniques

Deliberate Deliberate example:example:Later that same day, you overhear Antoine antagonizing William again

while the larger boy is flipping through a magazine. “So Trey, did I hear that YOU dated William’s sister too? Is she as hot as my brother says she is? Or is she a dog? Cuz I’ve seen the family picture William keeps in his room, and there’s definitely a bit of cocker spaniel in her, if you ask me!”

William lunges out of his seat, chasing Antoine around the room. Antoine is giggling foolishly as he ducks behind a staff member, crying “Restrain him! Restrain him!” The other youth are literally rolling on the floor laughing.

Which cues of deliberate behavior are seen here? Which social needs are met by Antoine’s behavior?

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Page 16: Annual Staff Recertification Rev July 2009 Annual Staff Recertification Rev July 2009 TACT-2 Therapeutic Aggression Control Techniques

UnderstandingUnderstanding

EmotionaEmotional Crisisl Crisis

TACT-2

TACT-2

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Page 17: Annual Staff Recertification Rev July 2009 Annual Staff Recertification Rev July 2009 TACT-2 Therapeutic Aggression Control Techniques

What is What is Emotional Crisis?Emotional Crisis?

“Impulsive reaction to overwhelming

stress or misperceptions.”

TACT-2

TACT-2

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Page 18: Annual Staff Recertification Rev July 2009 Annual Staff Recertification Rev July 2009 TACT-2 Therapeutic Aggression Control Techniques

Irrational Irrational BeliefsBeliefs

Low Self-EsteemLow Self-Esteem

Irrational Irrational BeliefsBeliefs

Low Self-EsteemLow Self-EsteemStressful Problem

Thoughts Feelings

Impulsive Behavio

r

Conflict CycleQuickTime™ and a

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Based on a model created by Nicholas Long, Ph.D.

Negative Consequenc

es

Page 19: Annual Staff Recertification Rev July 2009 Annual Staff Recertification Rev July 2009 TACT-2 Therapeutic Aggression Control Techniques

Understanding StressorsUnderstanding StressorsSome stress is external (getting pushed around) and some is internal (worrying about being

popular). Youth become overwhelmed by their emotions and act impulsively, bringing consequences on themselves.

1. What internal or external stresses might youth experience from home that affect their behavior in school or in a residential setting? QuickTime™ and a

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2. What internal or external stresses might youth experience from within the school or program that might affect their behavior?

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Page 20: Annual Staff Recertification Rev July 2009 Annual Staff Recertification Rev July 2009 TACT-2 Therapeutic Aggression Control Techniques

Emotional Emotional example:example:

Twenty minutes after the incident in the hallway, Edward is sitting in the school counselor’s office, trying to explain what happened. His eyes are red and puffy, and he has a faraway look on his normally friendly face.

Which cues of emotional crisis are seen here? What stresses might Edward be experiencing?

“It was a rough night at home. My father lost his job at the warehouse this week, and he’s worried that we’ll all be deported if he doesn’t find work soon. My little sister woke up screaming again, and kept us all up for hours. And then this @#$ pushes me into the lockers for no reason at all. And everyone else is laughing too. I just had enough! I don’t know....”

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Page 21: Annual Staff Recertification Rev July 2009 Annual Staff Recertification Rev July 2009 TACT-2 Therapeutic Aggression Control Techniques

Skills for Skills for HandlingHandling

EmotionaEmotional Crisisl Crisis

TACT-2

TACT-2

Therap

eutic

Aggres

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Contro

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Page 22: Annual Staff Recertification Rev July 2009 Annual Staff Recertification Rev July 2009 TACT-2 Therapeutic Aggression Control Techniques

Counseling response

Use when problem behavior is the

result of OVERWHELMING EMOTIONAL STRESS

Counseling response

Use when problem behavior is the

result of OVERWHELMING EMOTIONAL STRESS

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Page 23: Annual Staff Recertification Rev July 2009 Annual Staff Recertification Rev July 2009 TACT-2 Therapeutic Aggression Control Techniques

Maximum Stress

Escalation Model

1. Warning

2. Escalati

on

3. Crisis

4. Resoluti

on

Page 24: Annual Staff Recertification Rev July 2009 Annual Staff Recertification Rev July 2009 TACT-2 Therapeutic Aggression Control Techniques

Maximum Stress

Tasks During Crisis

1. Warning

2. Escalati

on

3. Crisis

4. Resoluti

onPREVENT

DE-ESCALATE Promote

LEARNING

SAFETY

Page 25: Annual Staff Recertification Rev July 2009 Annual Staff Recertification Rev July 2009 TACT-2 Therapeutic Aggression Control Techniques

Escalation Model

3. Crisis 3. Crisis PhasePhase

Problem Solving

Active Listening

Give Space

4. Resolution Phase

1. Warning Phase

2. Escalation Phase

Tension

Page 26: Annual Staff Recertification Rev July 2009 Annual Staff Recertification Rev July 2009 TACT-2 Therapeutic Aggression Control Techniques

Giving Giving SpaceSpaceGiving Giving SpaceSpace

1. PHYSICALLY SAFE, but

2. TOO UPSET to talk rationally.

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youth is:

Use a calm tone and non-threatening body language. Acknowledge feelings, offer time to calm down, set limits, and monitor the youth.

Page 27: Annual Staff Recertification Rev July 2009 Annual Staff Recertification Rev July 2009 TACT-2 Therapeutic Aggression Control Techniques

Giving Space Giving Space example:example:Staff hold William back as Antoine steps out of the room, barking and

yipping several times on the way out. William looks about ready to explode, so you decide to give him a moment to calm down before trying to work through the problem with him.

What could you say to William to give him space?

“William, it looks like you’re pretty UPSET RIGHT NOW. Why don’t you TAKE A COUPLE OF MINUTES TO YOURSELF IN THE KITCHEN and when you’re ready, we’ll talk.”

“William, it looks like you’re pretty ______________. Why don’t you ____________ _________________________________________ and when you’re ready, we’ll talk.”

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Page 28: Annual Staff Recertification Rev July 2009 Annual Staff Recertification Rev July 2009 TACT-2 Therapeutic Aggression Control Techniques

Active Active ListeningListeningActive Active

ListeningListening1. CALM ENOUGH to

talk, but

2. TOO UPSET to problem solve.

Use active listening when a youth is:

First, be attentive and encourage the youth to vent. Do not take sides, or engage in premature problem solving.

Instead, reflect or paraphrase the youth’s feelings and reasons. Ask non-threatening, open-ended questions to get

more information.

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Page 29: Annual Staff Recertification Rev July 2009 Annual Staff Recertification Rev July 2009 TACT-2 Therapeutic Aggression Control Techniques

Active Listening Active Listening example:example:

After calming down a little, William begins talking in a miserable voice: “All I wanna do is get home to my family. I don’t wanna cause any more problems or get into any fights. Why can’t you guys just do your jobs and shut him up so that I can go home on time?”

What could you say to reflect William’s statement?

SURFACE REFLECTION: “It sounds like you’re upset because staff haven’t done enough to stop Antoine from

messing with you.”

DEEPER REFLECTION: “I can see how badly you want to get home… and right now you’re worried that you might lose your temper and mess that up somehow.”

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Page 30: Annual Staff Recertification Rev July 2009 Annual Staff Recertification Rev July 2009 TACT-2 Therapeutic Aggression Control Techniques

Problem Problem SolvingSolvingProblem Problem SolvingSolving

1. CALM ENOUGH to talk, and

2. READY to problem solve.

Use Therapeutic Problem Solving when a youth is:

Begin with the “therapeutic” steps by using active listening skills to explore the youth’s side of what happened.

LISTEN, EMPATHIZE and SUMMARIZE their point of view.

Then move into “problem solving” steps by helping the youth see other options and resolve the situation. SUGGEST new perspectives, explore OPTIONS, then create a NEW PLAN.

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Page 31: Annual Staff Recertification Rev July 2009 Annual Staff Recertification Rev July 2009 TACT-2 Therapeutic Aggression Control Techniques

Skills for Skills for ManagingManaging

DeliberaDeliberate te

ProblemsProblems

TACT-2

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Page 32: Annual Staff Recertification Rev July 2009 Annual Staff Recertification Rev July 2009 TACT-2 Therapeutic Aggression Control Techniques

Corrective response

Use when aggressive

behavior is the result of INTENTIONAL DELIBERATE CHOICES

Corrective response

Use when aggressive

behavior is the result of INTENTIONAL DELIBERATE CHOICES

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Page 33: Annual Staff Recertification Rev July 2009 Annual Staff Recertification Rev July 2009 TACT-2 Therapeutic Aggression Control Techniques

RemindersRemindersRemindersRemindersUse “Friendly Reminders” to

verbally or non-verbally recall a

rule or expectation

without putting youth on the spot.

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Page 34: Annual Staff Recertification Rev July 2009 Annual Staff Recertification Rev July 2009 TACT-2 Therapeutic Aggression Control Techniques

Friendly Friendly ReminderReminder

Later that same day, you see Antoine sitting in the TV room when William enters. Antoine begins to whimper and whine like a dog, drawing giggles from his peers.

What are some VERBAL or NON-VERBAL reminders you could use to redirect Antoine’s behavior?

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Page 35: Annual Staff Recertification Rev July 2009 Annual Staff Recertification Rev July 2009 TACT-2 Therapeutic Aggression Control Techniques

WarningsWarningsWarningsWarningsUse “Fair

Warnings” to privately

caution about consequences

which will occur if youth does

not comply with rules.

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Page 36: Annual Staff Recertification Rev July 2009 Annual Staff Recertification Rev July 2009 TACT-2 Therapeutic Aggression Control Techniques

Three Types of Consequences

Three Types of Consequences

a. NATURAL CONSEQUENCES

b. LOGICAL CONSEQUENCES

c. PUNITIVE CONSEQUENCES

Student drops lunch on floor and walks away from mess:

√ Natural Consequences of this behavior?

√ Logical Consequences of this behavior?

√ Punitive Consequences of this behavior?

Page 37: Annual Staff Recertification Rev July 2009 Annual Staff Recertification Rev July 2009 TACT-2 Therapeutic Aggression Control Techniques

Fair WarningFair WarningFive minutes later, a dog food commercial comes on the TV. In an innocent voice, Antoine asks, “Excuse me William. Just curious: What IS your sister’s favorite food anyway?”

LIST ONE NATURAL AND ONE LOGICAL CONSEQUENCE.

NATURAL CONSEQUENCE:Upset William. Might get into a fight.

LOGICAL CONSEQUENCE:Might have to leave the room. TV might get turned off.

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Page 38: Annual Staff Recertification Rev July 2009 Annual Staff Recertification Rev July 2009 TACT-2 Therapeutic Aggression Control Techniques

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ConfrontatConfrontationion

ConfrontatConfrontationion

Use “Firm Confrontations” to directly address a serious problem behavior in a

calm, professional manner.

Page 39: Annual Staff Recertification Rev July 2009 Annual Staff Recertification Rev July 2009 TACT-2 Therapeutic Aggression Control Techniques

Firm Firm ConfrontationConfrontationAntoine ignores your warning. He drops to his hands and knees,

snuffling around the floor like a hound dog searching for a treat. “Kibbles and Bits! Kibbles and Bits! I want my BACON!” he growls, getting more excited as he approaches William. The larger boy’s face is beet red, and you can see he is about to explode. You take Antoine into the hall for a private confrontation.

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Write a FIRM CONFRONTATION.1. Misbehavior: “Antoine, you’re still teasing, even though I told you to stop.”2. Effects: “It’s demeaning, and just plain wrong.”3. Consequences: “I want you to leave the TV room right now and go to your room until we have time to talk more about this. I’ll be down at lunch to discuss this further with you.”

Page 40: Annual Staff Recertification Rev July 2009 Annual Staff Recertification Rev July 2009 TACT-2 Therapeutic Aggression Control Techniques

RecognizingRecognizing

Adult Adult Anger Anger TrapsTraps

TACT-2

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Page 41: Annual Staff Recertification Rev July 2009 Annual Staff Recertification Rev July 2009 TACT-2 Therapeutic Aggression Control Techniques

ADULT ANGER TRAP #1OUTSIDE

STRESSLeftover stress

from other home or work problems…

makes it easy to overreact angrily

to a minor situation.

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Page 42: Annual Staff Recertification Rev July 2009 Annual Staff Recertification Rev July 2009 TACT-2 Therapeutic Aggression Control Techniques

ADULT ANGER TRAP #2EMBARRASSME

NTWe feel helpless or inadequate trying to manage a challenging situation… then turn

embarrassment to anger.

Page 43: Annual Staff Recertification Rev July 2009 Annual Staff Recertification Rev July 2009 TACT-2 Therapeutic Aggression Control Techniques

ADULT ANGER TRAP #3

FEARWe feel a natural shock or fear in response to a threatening

situation… then turn anxiety

into anger.

Page 44: Annual Staff Recertification Rev July 2009 Annual Staff Recertification Rev July 2009 TACT-2 Therapeutic Aggression Control Techniques

ADULT ANGER TRAP #4VALUES VIOLATI

ONA core value is violated by a resident’s

behavior, sparking feelings of

righteous anger.

VALUES VIOLATIO

N

Page 45: Annual Staff Recertification Rev July 2009 Annual Staff Recertification Rev July 2009 TACT-2 Therapeutic Aggression Control Techniques

ADULT ANGER TRAP #5AUTHORITY

CHALLENGE

We engage in an angry power struggle to

establish dominance over a defiant

resident.

Page 46: Annual Staff Recertification Rev July 2009 Annual Staff Recertification Rev July 2009 TACT-2 Therapeutic Aggression Control Techniques

Anger Trap Anger Trap exampleexampleLater that week, Edward has another emotional incident, this one

triggered by a movie about the Jewish holocaust. Shortly after it began, Edward asked to leave the class to use the bathroom, but the teacher denied him a hall pass. Edward left anyway, shoving the teacher out of the way, and ended up doing in-school suspension. Later, the teacher says:

“Honestly, I didn’t know WHAT to do. It was scary: he was trembling all over, and I could see that he was freaking out. I’ve never had any training to deal with PTSD! And I didn’t want it to look like I couldn’t control my classroom, so I kept insisting that he stay in his seat and put his head down. It had already been a very long day, and I guess I wasn’t thinking clearly. I feel like such an idiot for putting that movie on in the first place. That poor boy....”

What Anger Traps did this staff fall into?

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Page 47: Annual Staff Recertification Rev July 2009 Annual Staff Recertification Rev July 2009 TACT-2 Therapeutic Aggression Control Techniques

25-item 25-item multiple multiple

choice test choice test

25-item 25-item multiple multiple

choice test choice test

Prepare Prepare forfor

TACT-2TACT-2

Page 48: Annual Staff Recertification Rev July 2009 Annual Staff Recertification Rev July 2009 TACT-2 Therapeutic Aggression Control Techniques

Immediately Dangerous?

CORRECTION1. Reminder

2. Warning

3. Confrontation

Not Immediately Dangerous?

COUNSELING1. Give space

2. Listen actively

3. Problem Solving

TACT-2 MODELReviewing TACT-2 MODEL

Deliberate

Emotional

Crisis Response1. Redirect 2. Remove 3. Restrict 4.

Restrain