© 2012

2012CPI eRefresher Series –

Instructor Options

Advanced Renewals: Enhancing Verbal Skills: Applications of Life Space Crisis InterventionSM

and Supporting Individuals With Dementia and Related Cognitive Challenges

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2© 2012

Webinar Co-Presenters

Today’s Presenter

Alison MuellerGlobal Professional Instructor

Today’s Presenter

Dr. Randy BoardmanCPI’s Executive Director ofResearch and Development

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3© 2012

The Training Process

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4© 2012

Formal Refresher Requirements

Review and apply concepts of

Nonviolent Crisis Intervention®

training used by your staff.

Hours: From three to 12 hours.

Frequency: Every six to 12 months.

Purpose: Build on Nonviolent Crisis Intervention®

training content.

Minimum Content: Pre-test; course models such as the CPI Crisis Development Model℠, the CPI VerbalEscalation Continuum℠, CPI’s Personal Safety Techniques℠, Nonviolent Physical Crisis Intervention℠, and the CPI COPING Model℠; problem-solving based on staff needs; post-test; evaluation.

Training Materials: Use approved materials and a post-test.

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5© 2012

Poll Question 1

What do you think Life Space Crisis Intervention is about?

Talking with individuals in crisis.

Physically managing a crisis.

Verbal strategies for short- and long-term change.

Mediating between an individual, his or her stress, and behavior.

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6© 2012

Webinar Objectives

• Gain an understanding of Life Space Crisis Intervention.

• Identify how the Conflict Cycle is another representation of crisis development.

• Recognize ways you can develop staff’s verbal skills.

• Develop an understanding of how Enhancing Verbal Skills can expand the concepts introduced in Nonviolent Crisis Intervention® training.

• Identify whether Enhancing Verbal Skills is the appropriate refresher for your staff.

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7© 2012

Enhancing Verbal Skills: Applications of Life Space Crisis Intervention℠

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8© 2012

Training Program Overview

Nonviolent Crisis Intervention®

Training ProgramLife Space Crisis Intervention

4 DaysTrain the trainerCertified InstructorsCrisis Development Model SM

Nonverbal skills Verbal skills Physical interventionCPI COPING Model SM

Crisis as an opportunity

5 DaysSubcontract formatSenior Trainer of LSCILSCI Conflict CycleNonverbal skillsVerbal skillsNo physicalsSix Stages of LSCICrisis as an opportunity

CPI’sEnhancing

Verbal Skills

3 Days

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9© 2012

The CPI Crisis Development Model SM

Crisis Development/Behavior Levels Staff Attitudes/Approaches

1. Anxiety

2. Defensive

3. Acting-Out Person

4. Tension Reduction

1. Supportive

2. Directive

3. Nonviolent Physical Crisis InterventionSM

4. Therapeutic Rapport

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10© 2012

Possible Outcomes of a Crisis

The situation, behavior, relationship

. . . Stays the same

. . . Becomes worse

. . . Improves

CRISIS

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11© 2012

The Conflict Cycle

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12© 2012

Unbroken, the Conflict Cycle Spirals Into Crisis

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13© 2012

Enhancing Verbal Skills: Applications of Life Space Crisis Intervention℠

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14© 2012

Verbal Messages

Restate to convey a positive, supportive message.

• “You need to go to group.”

• “You forgot to take your meds again this morning. Take your medicine now.”

• “How many times have I told you, no yelling and screaming during lunch?”

• “No touching others or their belongings.”

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15© 2012

The Six Stages of LSCI

TIMELINE 2

DRAIN OFF 1

CENTRAL ISSUE 3

INSIGHT 4

NEW SKILLS 5

TRANSFER OF TRAINING 6

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16© 2012

Three Red Flag Reclaiming Interventions

• Carry In problem from another setting, such as home to school.

• Tap In to an unresolved emotional conflict.

• Carry Over problem from within current setting, such as lunch break.

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17© 2012

Poll Question 2

Why would you use this refresher option?

We have a hands-off policy and don’t use physicals.

Staff need additional de-escalation and debriefing skills.

Staff can’t get individuals to do what they want.

To do a better job turning Postvention into prevention.

http://www.crisisprevention.com/CPI/media/Media/Specialties/nci/advanced courses/evs/EVS-Sims-07-LSC-CRD-001.pdf

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18© 2012

Supporting Individuals With Dementia and Related Cognitive Challenges

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19© 2012

Supporting Individuals With Dementia and Related Cognitive Challenges

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20© 2012

Webinar Objectives

• Gain an understanding of CPI resources for persons with dementia.

• Review key concepts covered within Supporting Individuals With Dementia and Related Cognitive Challenges.

• Develop an understanding of how Supporting Individuals With Dementia and Related Cognitive Challenges can expand the concepts introduced in Nonviolent Crisis Intervention® training.

• Identify whether Supporting Individuals With Dementia and Related Cognitive Challenges is the appropriate refresher for your staff.

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21© 2012

Poll Question 3 - Review

Which are examples of person-centered care?

Everyone must eat at exactly the same time.

All residents go to activities at an assigned time.

Change our menu for likes and dislikes.

Staff do everything for the resident.

Allow those in care to do ADLs; staff only assist.

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22© 2012

A New Perspective

Old Perspective

People with dementia…

• “Can’t walk, need a wheelchair.”

• “Are sad, angry, and stubborn.”

• “Refuse care.”

New Perspective (Best ability to function)

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23© 2012

A New Perspective

Old Perspective

People with dementia…

• “Can’t walk, need a wheelchair.”

• “Are sad, angry, and stubborn.”

• “Refuse care.”

New Perspective (Best ability to function)

Would you have your loved one live in

your facility? Why or why not?

People with dementia…

• “Can walk with assistance.”

• “Express how they feel.”

• “Want to be independent.”

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24© 2012

Memory Activity

Short-Term, Long-Term, Working, Procedural

• “I was born on a farm in Michigan.”

• “I think we have bingo tonight.”

• “I may be getting old, but I can still drive!”

• “How does this new phone work?”

• “What did we have for lunch today?”

• “Where is the elevator in this place?”

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25© 2012

Memory, Attention, and Sequencing

List all of the steps needed to pay monthly bills.

Start ____________________________________________

Step ____________________________________________

Step ____________________________________________

Step ____________________________________________

Step ____________________________________________

Step ____________________________________________

Step ____________________________________________

Finish ____________________________________________

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26© 2012

Cognitive Hierarchy

“Last in, first out” (Reisberg et al., 2003)

Executive

Function• Reasoning

• Problem solving

• Judgment

• Organization

Memory Processing• Working memory system

• Long-term memory system

• Quantity and quality of information

• Visual field and concentration

Attention

(Katz, 2005)

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27© 2012

Developmental Stages Activity

Common Abilities or Expectations (e.g., dress)

• 0 to 12 months

• 4 to 12 years

• 20+ years

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28© 2012

Best Ability to Function

Can Do

• Realistic abilities.

• BATF.

• What they still can do.

Will Do

• Relevant activities.

• Influenced by interests and values.

• Culture.

May Do

• Possible abilities.

• Externally influenced.

• Impact of care givers, family, and environment.

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29© 2012

An Integrated Model of Care

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30© 2012

Potential Communication Breakdowns

Message

SenderStaff, Relative,Other Clients

ReceiverPerson With

Cognitive Challenges

Expressive

Communication

Verbal

Paraverbal

Nonverbal

Receptive

Communication

Receptive

Communication

Nonverbal

Paraverbal

Verbal

Expressive

Communication

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31© 2012

Adapting Communication

Communication Do’s

• Use nouns; avoid pronouns: “Bob, put on your shirt.”

• Eliminate noises/visual distractions (radio, TV).

• Short sentences: “Bill, wash your face.”

• Use closed-ended questions: “Chris, apple or orange juice?”

• Wait for response; 10–20 seconds to process.

• Visual and tactile cues; prompts with words.

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32© 2012

Post-Test Addendum

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33© 2012

Quality of Life

Care, Welfare, Safety, and Security SM

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34© 2012

Poll Question 4 - Review

Which are true about this refresher option?

Instructors can use course activities in trainings.

Course videos are on the Leader’s Guide disk.

For this refresher, at least six hours works best.

Instructor still needs to use a Nonviolent Crisis Intervention® workbook.

Course focus is on remaining abilities.

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35© 2012

2012 eRefresher Schedule

January 18: Motivating Refreshers: The Choice Is Yours —

2012 Instructor Options series overview

February 15: Key Point Refresher and Personal Prevention PlanSM

March 14: Advanced Renewals

• Autism Spectrum Disorders: Applications of Nonviolent Crisis

Intervention® Training

• Trauma-Informed Care: Implications for CPI’s Crisis

Development ModelSM

April 18: Special Topics Session—Informal Refreshers: Reviews; Practice;

Policy Discussions; Rehearsals and Drills; Situational Applications

May 16: DVD-Based Options such as Preventive Techniques II and

Effective Limit Setting

June 22: Applied Physical TrainingSM and Master Level Refreshers

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36© 2012

2012 eRefresher Schedule

August 15: Adapting Nonviolent Crisis Intervention® Training for Young

Children and Keys to Organizational Buy-In and Support for Training

September 19: Advanced Renewals

• Enhancing Verbal Skills: Applications of Life Space Crisis

InterventionSM

• Supporting Individuals With Dementia and Related Cognitive

Challenges

October 17: Nonviolent Crisis Intervention® Workbook and Hybrid Training

Rescheduled from July to November 14: Integrating Positive Behavioral

Interventions and Supports (PBIS) and Bullying Behaviors: Applying CPI’s

Crisis Development ModelSM

Specific dates for each may vary due to training schedules of CPI staff.

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37© 2012

Questions? - Thank You!

The next webinar in this eRefresher Series will be:

Date: October 17, 2012

Time: 10:00 a.m. CT

Topics: Nonviolent Crisis

Intervention® Workbook and

Hybrid Training

Call toll-free @ 877.877.5390

Alison MuellerGlobal Professional Instructor

Dr. Randy BoardmanCPI’s Executive Director ofResearch and Development

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38© 2012

On-Demand Post-Test

1. What is LSCI and how can it help you assist an individual in a moment of crisis?

2. How can Enhancing Verbal Skills expand concepts learning in Nonviolent Crisis Intervention® training?

3. How can the verbal message exercise help staff enhance their verbal skills?

4. Describe at least three examples of how you can promote an abilities-based approach to care.

5. List examples of how you can move away from atask-centered focus to a person-centered care approach.

6. Give at least three examples of how you can adjust your communication skills for your care receivers.

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