The Six Stages of a Crisis: The importance of stage 6 Post Incident Learning (PIL)

Colin Campbell. Asst. Advisory Officer, BST, SEELBJoe Duffy, Senior Ed. Psychologist, SEELB/QUB

22/11/13

Regional VP (Special) Conference: Nov 2013

Time

Anxiety / Trigger

Defensive / Escalation

Crisis

RecoveryDepression

Need for diversion, support and reassurance

Need for diversion, reassurance, clear limits, boundaries and choices

Possible need for Restrictive Physical Intervention appropriate for the service user

Need for coordinated letting go. Support, reassurance

Need for observation, support and monitoring - recovery and repair

Risk Restraint ReductionRisk Restraint Reduction

Follow UpNeed for positive listening and learning

Six Stages of a CrisisAdapted from Kapler and Wheelan 1980

CORE

Stage six of a crisis

The objective of Stage 6 of the Stages of a Crisis is for the child to understand that the reason why staff sometimes need tohold them is because they care aboutthem.This will involve staff listening to the child, linking their feelings to their behaviours and giving them the opportunity to learn from what they have done

Positive Listening and Learning.

Post Incident Support.

CORE

Staff – Child/Client

Relationship Improved

Staff – Child/Client

Relationship Unchanged

Staff – Child/Client

Relationship Damaged

Outcomes of a Crisis

CORE

Why Three Ls?

• Listen– What happened?

• Link– How did that make you feel?

• Learn– The next time you feel that way what could you do?

• Listen– To the child’s view first

• Link– Feelings to behaviours

• Learn– Find better ways for next time

Why Three Ls?

CORE

Conflict Spiral

Feelings

Experiences

Reactions

Behaviours

CONFLICT

Listen

Link

Learn

PIL - TELL

imeCannot rush it – only when they are ready

nvironmentComfortable and private

istenHear the individual’s view first

earnFind better ways for next time

PIL - HELP

earTo their side of the story first

xplainWhy staff took the action they did

inkTo show how feelings drive behaviour

lanTogether to find better ways

Pupils with communication difficulties

Ref: Cotton (2012)

Three Ls

LISTEN LINK LEARN

Communication Recognising Learning style feelings style

Any info regarding situation e.g. triggers:

What we did to rebuild our relationship

Pupil: ______________________Staff: ______________________Date: ______________________

Comic strip

Me

This happened…

I felt…

If I feel like this again I will…

Pupil: ______________

Staff: ______________

Date: ______________

When I was feeling sad or angry

I showed this by ____________________This was because ____________________

If I feel like this again I will_________________________ (strategy to de-escalate)

To help others know and to help make me happy Pupil: ______________________

Staff: ______________________

Date: ______________________

Behaviour

Feelings

ExperiencesEExperiences

What does the research say? [1]

The impact of training staff in special schools in safe handling: In one study involving 4 schools, all schools saw a

reduction in physical interventions post training. One school however witnessed more significant reduction Why?

- pupils were given the opportunity for listening & learning following incidents;

- the school had a dedicated staff member with overall responsibility for behaviour management;

- the entire staff was trained.

Source: www.team-teach.co.uk/casestudies/SEBDA_Article.pdf 

What does the research say? [2]

Perkins & Leadbetter (2002) in an evaluative study of aggression training management in a special school found that, following training, the lack of supporting action by the school was identified as key inhibiting factor. They recommended:- the development of systems for auditing behaviour & assessing its underlying function [see next slide];- ensuring that IEPs contain a behavioural management component- clear management support & leadership;- supporting staff through formal review of practice ( e.g. debriefing)

Assessing the function of behaviour

In relation to pupils with SLD functional assessment has been identified as a factor which is able to improve the efficacy of numerous treatments (Hasting & Noone, 2005)

After a crisis staff need support during the recovery period.

A member of staff usually requires:- support, space, reassurance & guidance.

As with the child, as soon as possible after the incident.

Support meeting with staff(s) involved & line manager.

Module Eight:

The Process for Staff Support?

Objectives of the Process for Staff

Discuss what happened in a non-blaming, supportive, caring manner.

Use crisis situation to clarify underlying causes, issues and feelings.

Examine what techniques were used to de-escalate and/or physically manage the situation.

Develop a strategy for the next time the child/client begins to lose control.

All items discussed concerning professional practice issues should be documented

ReferencesCotton, D. (2012). What communication strategies can be used to support the mental health of children with classical autism? Kidderminster: BILD

Perkins, J. & Leadbetter, D. (2002) An evaluation ofaggression management training in a special educationalsetting. Emotional & Behavioural Difficulties, 7, (1), 19-34

Hastings, R.P. & Noone, S.J. (2005) Self-injurious behaviour& functional analysis: ethics & evidence. Education &Training in Developmental Disabilities, 40, (4), 335 -342