1. North Carolina Interventions NCI

2. Philosophy To prevent and avoid the use of physical interventions
If the physical interventions are needed, the interventions are to be used safely and only as a last resort.

3. History
Western Carolina Center (J. Iverson Riddle Center) recognized need to train staff in techniques for dealing with crises.
Murdoch Center Staff Development published the first illustrated guide - A Better Way-Protective Intervention Techniques.
Education & Training developed standardized , revised and published Basic Protective Intervention Techniques Manual
1984/1988 edition - Protective Intervention Course and implementation of Divisionwide policy for implementation and quality improvement.
Curriculum revised and standardized with further emphasis on prevention and alternatives as well as modification to some of the physical techniques to result in the NCI curriculum.

4. Why People Do What They Do? Part A Unit 1
NCI
Why People Do What They Do?
Part A
Unit 1

5. Outside factors that affect behavior:
Cultural Background
Health
Education
Work experience
Environment
Finances

6. Inside Factors Personality Traits How You Think
Individual’s Ability to Communicate
Question:
What you think is happening is more important than what is actually happening? True/False

7. Other factors that influence behavior
Health Issues
Stress
Anger
Lack of knowledge of the person - How can we learn more?

8. Building Positive Relationships Part A Unit 2
NCI
Building Positive Relationships
Part A
Unit 2

9. Therapeutic Relationships
Definition
Friendship versus therapeutic relationship
Strategies for a therapeutic relationship
Safe Environment
Whole Person - People First
Orderly Routines
Help people to learn what they want and to lead independent lives

10. Communication Ways you communicate Body Language
Why people communicate
Feedback Guidelines
Active Listening
Communication Roadblocks

11. Empathy Definition Strategies for showing empathy
Learn to pay attention to how the other person feels
Use positive verbal, body language, and active listening skills
Reflect the person’s feelings/needs
Encourage the person to continue

12. Decision Making & Problem Solving Part A Unit 3
NCI
Decision Making & Problem Solving
Part A
Unit 3

13. Losses Freedom of Movement/ Spontaneity Privacy Dignity
Limits on Personal Possessions
Access to Family/friends
Feelings based on losses and what the feelings may lead to

14. Ways to Empower People Encourage decision-making Teach Problem-solving
Offering hope
Offering choices
Avoiding unnecessary confrontation
Helping people make their own decisions
Teach Problem-solving
State the problem
List options
Evaluate options
Choose and do
Evaluate action

15. Assessing Risk for Escalating Behavior Part A Unit 4
NCI
Assessing Risk for Escalating Behavior
Part A
Unit 4

16. Staff Attitudes & Behavior
Ignoring people
Expecting absolute obedience
Telling rather than asking
Making decisions for the person instead of with the person.
Teasing or picking
Not following through
Making unreasonable and unenforceable consequences

17. Risk and Protective Factors
Risk Factors
Mental illnesses
Mental Retardation
Past history of violence
Health problems
Poor communication skills
Poor support system
Protective Factors
Sense of Responsibility
Problem solving abilities
Good Self esteem
Feeling of Control over one’s life
Planning for future events
Good social interpersonal skills
Able to look for support from others

18. Environmental Factors
Time
Weather
Space
Resources
Organizational Factors

19. Personal Factors Physical Emotional Hormone Imbalance Low Blood Sugar
PMS
Brain chemistry
Drug/Alcohol Abuse
Physical Ailments and Illness
Diet
Medication
Emotional
Hallucinations/Delusions
Post Traumatic Stress Disorder
Personality Disorders
Psychotic brain syndromes

20. Assessing Cues for Escalating Behavior

21. Early Crisis Intervention Part A Unit 5
NCI
Early Crisis Intervention
Part A
Unit 5

22. What you say: Voice tone/volume Giving reassurance Use “I” messages
Get the facts
Be clear and up front about the rules of the situation

23. How you say it: Use non-threatening body stance Give personal space
Monitor yourself

24. Things to Consider: Self check On the spot problem solving
Positive reinforcement
Scheduling
Arrangement of the environment
Redirection
Natural consequences

25. 10 Questions to Consider Prior to Physical Intervention
Can I handle this situation alone?
Is there potential for danger for others?
Is help readily available?
Can I keep from getting angry?
Is my appearance going to interfere with my ability to respond?
Can I get others to a safe exit, if necessary?

26. 10 Questions (cont.)
Does this person have a history of hitting, biting, running away, etc?
What is this person’s crisis plan?
What is my agency’s policy regarding this type of intervention?
Before I have to put my hands on, is there anything else that might be done to resolve this crisis appropriately without using physical intervention?

28. North Carolina Interventions
NCI