FYI . . .
SCS offers Personalized In-Home & Site-Based Interventions: Play Intervention and Assessment Floor Time Specialists •  Discrete Trial Training • Consultation on Children's Behavior • Intervention for Serious Behavior Problems • Pivotal Response Training • Developmental Assessment • Educational Advocacy • Therapuetic Companion • Social Skills Classes in Development • SCERTS • Play Groups • Hanen Language • RDI
 
 
Crisis Intervention/Stages and Appropriate Adult Actions PDF Print E-mail
It should be noted first that the most effective way to reduce oppositional and rage attacks is to reduce the number of power struggles that occur.  

View Power Struggles and Oppositional Behavior as a Failure of Problem-Solving:  It is important here to view power struggles as a failure of one or both parties to engage in more productive means of problems-solving.  Problem-solving may be thwarted by either party's faulty perceptions or reasoning process, but as you learned from training in problem-solving, the whole process of problem-solving is to clarify situations and teach logical emotional reasoning.

View Resistant and Explosive Behaviors as Defenses Against Anxiety: It is also important to view oppositional behavior in terms of the Student's valid need to regulate anxiety.  It is not the need that is the problem - it is the means in which the Student goes about it that is the problem.


Therefore, the main point of crisis intervention is to reduce a Student's anxiety to the point where he or she can engage in higher forms of thinking - namely, constructive problem solving.  The more physiologically escalated the Student is, the more the adrenaline is flowing, the more his or her heart rate, breathing, and muscle tension are escalated - the less ability they have to use their higher mental functions.  These escalated physiological functions are designed by evolution to prepare one for fighting or escaping, not systematic logical problem-solving and productive behavior.

Stages of the Crisis
: All crisis behavior occurs in recognizable stages, and there are discretely different adult responses which are appropriate at each stage. The correct response at a particular stage will have a de-escalating effect on the behavior, while a mismatch of response to behavior will likely result in an escalation of the crisis. The following is a list of the stages, and the appropriate adult responses for each stage:

Prior to the Crisis: The key to effective management of crisis behavior is to intervene as early as possible, because as the Student becomes more escalated, there is a physiological change which occurs, commonly called the "fight-flight" response, in which blood flows to the muscles and organs - and away from the brain.  It is only at the earlier stages, that the Student is amenable to any form of verbal intervention.

In this stage, the objective is to educate the Student about his own behavior, and to prepare him beforehand, to accept the kinds of cues and directions which will help him avoid an embarrassing and debilitating reaction.

Anxiety Stage: This stage is marked by some noticeable change in his behavior,   what we are calling "telegraphic signals," or "storm signs," because they warn of an impending crisis.  These signs have already been identified by the family - louder, more pressured speech, increased motor activity, etc.  These signs should cue adults to exercise the following supportive actions:

Clarify: First, help him state what his problem is - he has a great deal of trouble expressing what is wrong.  Use context clues to help you do this: "I can see you want to finish the game - you don't want to stop right now."

Empathize: "You don't like it when you have to stop something you like.   I understand.  But the work must be done. Let's figure out what we can do..."    This is called "attunement."  The partners try to understand the other's point of view without judgment.  This promotes a problem solving attitude (as opposed to a war), and we now know this actually promotes psychological growth in Students.

Reassure: "We can figure this out. I'm not here to punish you - just to help."  We can discuss the most psychologically accurate statements to make for individuals at a moment such as this, but the point is to take away any threat, so he does not escalate into the next stage:  Defensiveness.

Cue: "Let's both take a deep breath, and let it out real slowly."   

•Focus on the Problem
, not the Person:  This describes language which minimizes reference to anyone in particular.  For instance, a seemingly innocuous request such as, "Please clean your area" in reality is, "I would like you to please clean your area for me.  This normally not a problem, except in the cases of people who are very sensitive, or already involved in a power struggle with the requester. 

To "depersonalize" the statement, one might say, "The area needs to be clean."  Instead of the request being for one person to make, and another person to either to comply or not comply, the statement very objectively points out the problem to be solved - not who's responsible.  In most cases, what one will find is that the Student volunteers the solution to the problem.  In the above case, "But homework must be done... "Probably implies a lot less pressure than "You need to do your work [for me]."   It is recommended that this type of statement be used for just about any issue which can lead to a power struggle.

Defensive Stage: This stage is marked by argument and [mild to moderate] refusal.     Intentional ignoring of adult requests is also a form.

At this stage, it is important to use fewer words, and to avoid making threats.  As the physiological changes begin to occur, words place too much demand on already weakened verbal reasoning powers, and threats push a Student more towards a fight-flight response.  The worse thing to do is to get in his face and try to use power to control the situation.

The thing to do is to try to ratchet down to the previous stage - by discontinuing the impending power struggle, and pausing.  "I can see you're upset.  I'll wait until you calm down.  Let's try the deep breath again. "  If he continues to argue, just repeat, "I 'm not arguing.  I'll just wait until you're ready to talk. When I see you take a breath, I'll know you're ready." 

Threatening Stage: This stage is marked by overt threats and defiant refusals.  A blow up is imminent at any moment.   It is even more critical to simplify the words at this point, and try not to overreact.

Don't respond to threats
: Statements such as, "You can't talk to me like that...," or "Now you're really in trouble...," will merely make acting out more likely - now the Student has nothing to lose. You can always go over misbehavior after the crisis.

Prepare: Don't talk to him if you can get away with it.  Talk instead to the other adult or other person who may assist you in managing physical behavior.  At this point, what the Student needs to see is strength on the part of the adult.  Not brute strength.  What he needs to know is that the adult is in full command of his or her own behavior.  The most frightening thing to a child is to see an adult begin to lose their own composure.

Strength is shown by remaining calm, even when the Student is yelling.  It is also showing him that if necessary, you will contain him.  Get help.  Move away from windows and glass.   Remove objects that may be used as projectiles.  Give him ample physical space.  Move slowly and don't get in his face.

Acting Out Stage: The emphasis here is safety.  Use as little hands-on as possible.  Try to redirect him towards safe places.  Give him ample time, as well as space if possible.

Post Crisis Stage: Once he has discharged whatever emotional energy built up in the prior stages, you will see a precipitous drop in every aspect of his internal and external behavior.  He will appear spent, his heart-rate and blood pressure will drop dramatically. Crying and contrition are normal responses at this stage.  It is now, that he will be most amenable to going over his behavior, and one can talk about negative consequences if necessary.   It is better however, to avoid a focus on punishment, and instead focus on productive restitution and problem solving for the next time.

 
(p.) 310.521.0112 (f.) 310.831.7291 (e.) info@sponderworks.com

 
Saturday, 18 May 2013
 
Think About...
A characteristic of the normal child is he doesn't act that way very often. ~Author Unknown
Most Read
 
Copyright 2004 Sponderwrks Childrens Services. All rights reserved.
Designed and maintained by QuasiCo.