Crisis Intervention Plan

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Crisis Intervention Plan

• Enable the individual to

• Prevent a crisis
• Self-manage a crisis
• Alleviate a crisis
• End the crisis

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Child/Family Perspective

• Key Elements

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Key Elements
Crisis Intervention Plan

• User-friendly
• Clear direction
• Individualized
• Preventive
• Real-life situations

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Crisis Intervention Plan
Key Elements

• User-friendly

• Clear Direction

• Individualized

• Preventive

• Real-life Situations

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Operational Definition
Crisis Intervention Plan
A collaborative plan that grows with the childs
needs.
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Crisis Intervention Plan
Operational Definition

• Collaborative

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Crisis Intervention Plan
Operational Definition

• Growth

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Crisis Intervention Plan
Operational Definition

• Childs Needs

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Crisis Intervention Plan
Planning Process

• Strength-Based Perspective
• vs.
• Problem-Based Perspective

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Crisis Intervention Plan
Planning Process

• Preparation prior to IDT meeting
• Use of planning tools
• Risk Assessment/reassessment
• Resources

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Crisis Intervention Plan
Planning Process

• POSITIVE STRATEGIES
• 4-STEP PROCESS

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Crisis Intervention Plan
Planning Process

• Understand why the individual engages in their
  behavior

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Crisis Intervention Plan
Planning Process

• Prevent the behavior through social or
  environmental changes

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Crisis Intervention Plan
Planning Process

• 3. Replace the behavior with alternative skills
  that serve the same function for the individual.

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Crisis Intervention Plan
Planning Process

• Identification, development and utilization of
  strengths and natural supports

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Crisis Intervention Plan
Contributing Components

• Setting Events
• Antecedents
• Problem Behavior
• Consequences
• Function

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Crisis Intervention Plan
Contributing Components

• Setting Events

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Crisis Intervention Plan
Contributing Components

• Antecedents

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Crisis Intervention Plan
Contributing Components

• Problem Behavior

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Crisis Intervention Plan
Contributing Components

• Consequences

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Crisis Intervention Plan
Contributing Components

• Function

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Crisis Intervention Plan
Stages and Strategies

• Preventive Stage

• Escalation Stage

• Crisis Stage

• Calming Stage

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Crisis Intervention Plan
Stages and Strategies
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Crisis Intervention Plan
Examples

• When I am feeling well, I am (describes himself)
• When I begin to feel depressed, I feel (like Im
  in a rut, tired, irritable, dont want to talk
  about sports)
• When I am feeling depressed, I want people not to
  ask me so many questions, like how do you feel?
  Just be available for me to talk with if I want
  to.
• I like to talk with my coach ( ) most often
  when I am depressed. I will ask permission to
  stay after school to talk to coach.
• If I begin get angry or disrespectful, place your
  hand over your heart, to remind me to be tender
  and lower my voice.

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Crisis Intervention Plan
Examples

• Sally gets into serious trouble when she runs
  away from home. She steals and shoplifts, uses
  drugs and stays with older men.
•  
• If Sally runs away from home
• The police will be notified immediately.
• Her aunt (the person she listens to best) will
  work with the police to find her and talk to her.
• When Sally returns, she will be put on 24-hour
  watch. Someone (family/relatives) will escort
  her to and from school, and be with her all day.
  She will be at home or with a parent after
  school.
• The family will meet with the case worker and
  Sallys therapist to help her learn what to do
  when she gets the urge to run.
• If these steps do not work, the team will look
  for a more secure living arrangement.
•  

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Crisis Intervention Plan
Examples

• Stage 1 Anxiety
• CLIENT BEHAVIOR
• Often displayed as increase or change in
  behavior, or undirected expenditure of energy.
• The clients specific behavioral cues during
  stage 1 include

• Stage 1 Anxiety
• APPROPRIATE STAFF RESPONSE
• Early Intervention is key to safely managing
  behaviors.
• The intervention plan for the client during
  Stage 1 is (include verbal tone, proximity, and
  specific intervention strategies)

• XXX will refuse to follow directives. He will
  chew on his clothing. He will verbally threaten
  staff and peers around him.

• Staff should give XXX space and allow him time to
  comply with the directives.
• Specific things to avoid for this client include
• Staff should avoid making demands, getting loud,
  and touching XXX.

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Crisis Intervention Plan
Examples

• Stage 2 Defensive Hostility
• CLIENT BEHAVIOR
• Often displayed as verbal barrage or challenge,
  insult, threats. Individual may need to vent or
  expend energy.
• The clients typical behavior and patterns during
  this stage include 

• Stage 2 De-escalation
• APPROPRIATE STAFF RESPONSE
• The intervention plan for the client during Stage
  2 is (include verbal tone, proximity, location,
  and specific intervention strategies)

• Staff need to give XXX time and space to come up
  with his own appropriate solution.
• Specific things to avoid for this client include
• Staff should avoid confronting.

• XXX will challenge authority, refuse to listen
  and refuse to accept possible solutions to the
  situation.

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Crisis Intervention Plan
Examples

• Stage 3 Physical Aggression
• CLIENT BEHAVIOR
• Assault to persons or property. This results in
  energy expenditure and loss of control.
• The clients typical behaviors and patterns
  during this stage include

• Stage 3 Therapeutic physical restraint.
•  APPROPRIATE STAFF RESPONSE
• Restraints restricted. 
• If Restraints are restricted, then the plan to
  manage the clients physical aggression is as
  follows

• Therapeutic restraint means we hold the
  individual until he has regained rational
  control. Restraints should not inflict pain upon
  the individual and should never be used to
  punish. Intentional infliction of pain is abuse.

•  
• Restraints limited.
• If Restraints are limited, then restraints are
  limited to the following procedures

• XXXX will attempt to throw punches at others.
  He will become physically threatening and
  aggressive.

• TCI Therapeutic Restraint

•  
• Specific information regarding the safe and
  effective management of the client during this
  stage includes 

• Follow the TCI-specific procedures

•  
• Specific things to avoid for this client include

• Staff should avoid continuing constant
  redirecting XXXX. He needs enough time to
  process the directives and make a decision. Once
  in the time out room, staff should not process
  with XXXX until he has completed ten minutes of
  nonverbal time. This allows XXXX to calm down and
  prepare to process with staff.

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Crisis Intervention Plan
Examples

• Stage 4 Tension Reduction
•  CLIENT BEHAVIOR
• Client displays the regaining of rational
  control, emotional reaction to event (guilt,
  residual anger, etc.)
• XXXX will process with staff and be able to
  regain control of his emotions and behaviors.

• Stage 4 Re-establish Rapport
•  APPROPRIATE STAFF RESPONSE
• Staff response during Stage 4 (include
  proximity, verbal tone).
• Staff need to find an appropriate place that is
  isolated in order to clear the distractions XXXX
  is easily distracted and is unable to process
  clearly with staff. Processing with XXXX is very
  important so he will be able to make the
  connection of his thoughts, behaviors, and
  consequences.
• Process event using Life Space Interview

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Childrens Mental Health Waiver

• Remember!

Listen to the experts!!
Children and Families!!!