For over 23 years, PCM physical interventions have never produced any fatalities. All of the information contained in this FAQ is evidence of the lengths that we go to in order to ensure that our procedures are as safe as possible. There is always the possibility of an injury during any physical intervention in any system. This is the nature of intervening with individuals who are aggressive or self-injurious at very high levels. We find, however, that when all of our safeguards are observed and policies and procedures followed, the likelihood of major injury is extremely small.

PCM can be used with children, adolescents, and adults. It doesn’t matter if the individuals have good, poor, or no verbal skills at all. Unlike other crisis management systems, PCM gives effective strategies for intervening with persons over a wide range of intellectual functioning.

Many facilities feel the need to use mechanical restraint in certain situations, or even a time-out room. PCM does not teach any methods of mechanical restraint, nor does it cover how to place individuals in mechanical restraint. We feel that these matters are best left to individual facilities and their state and local policies on the matter.

In the PCM system, we transport individuals by having them walk with assistance so that they may be able to eventually begin walking on their own. When people are carried like objects they can become de-humanized and are no longer part of the transportation process. Our philosophy is that a person who will not move off the ground is no longer a threat to others. In PCM, Practitioners are taught to step back slightly and monitor the individual. In most instances, the individual will calm themselves. If they get up to become aggressive we begin to transport them again, and if they become self-injurious on the ground we place them on a mat. Many systems employ a “carry” procedure, but we and our customers have found such procedures unnecessary.

Yes, PCM does have a prone immobilization procedure in addition to forms of vertical (standing) immobilization procedures. These procedures are only used as a “last resort” when the other less restrictive PCM procedures have been proven to be insufficient to contain the current level of aggression. For organizations that are prohibited from using prone holds, we also teach a supine (face-up) hold.

This is a good question and an important one. Prone (face down) restraints are not inherently dangerous, but individuals have most certainly died during prone procedures. Being held in a prone position (when done properly) is no more dangerous than lying on your stomach on your bed. True, for some individuals with particular types of heart conditions or other medical contraindications, ANY KIND OF STRUGGLING AGAINST RESISTANCE might be dangerous for that person. If a facility has concerns about a particular individual, that person should have a thorough medical evaluation to determine the appropriateness of any kind of physical intervention be it a prone procedure or any other kind of procedure.

There are some ways of holding people in a prone position that are dangerous and PCM avoids all of these potentially dangerous factors. Here are a few:

Unfortunately, what often happens is that when a standing procedure cannot stabilize the person in crisis, people will invariably end up on the floor. At this point, even a well-intentioned staff member may “improvise” their own hold to try to protect the individual, which can be very dangerous indeed. In fact, lawsuits have been filed (and won) for this very reason (Elliot Vs. Richmond Area ARC).

There is also some evidence that individuals with large, hyper-extended abdomens (a beer belly) may be at risk of positional asphyxia during a prone procedure as the pressure of the abdomen against the diaphragm may reduce the person’s ability to fully move their diaphragm. To date, there have never been any fatalities during any PCM prone procedure, and this is spanning a period of more than 20 years.

If you have an internet connection, please click here for our position paper on the importance of prone immobilization and why it can be performed safely.

Yes, in fact most crises can be resolved using our transportation procedures or vertical immobilization procedures and supine immobilization. Many of our organizations find it completely unnecessary to train staff above the level of Practitioner 1 (they are not authorized to use the prone procedure).

This is another way to ensure the safety of the individual, as well as protect their dignity, and to ensure the effectiveness of the procedure in stabilizing crisis behaviors. Although Practitioners are taught to gently lower an individual to the mat, should they trip or fall, no one gets injured (staff or clients) because the mat can absorb a tremendous amount of energy. The mat also protects the individual’s dignity by showing them that we care about them enough that we would not put them on a hard, dirty floor. We place them on a clean, comfortable mat. Finally, the effectiveness is ensured by allowing us to safely hold the individual against the mat without fear that we are causing them pain or discomfort.

A good question, and a practical one. We have found that facilities have no problem keeping mats nearby in key areas of their facility where problems may happen often. The mats are easily transportable (you can even run with one), they fold in half, and they have handles. In PCM, you can either transport the person to the mat, or you can stabilize the person in a standing position and wait for someone to bring you a mat. Although there are occasional “emergencies” in which no one expected the behavior at all, in clinical practice, most staff members know which individuals show a high probability of showing crisis behaviors and often can even predict when they will happen!

PCM was not designed to be used “in a vacuum,” that is, the information taught in the PCM course was designed to integrate smoothly with existing treatment programs and was not designed to be a “stand alone” behavior management system.

Do you have a schedule or a daily list of activities? Do you teach people new adaptive skills? If your answer is yes to some or all of these, then PCM can be used with your existing teaching and routines. Remember, PCM is not simply physical holding when people are in crisis; this is a last resort. The PCM curriculum emphasizes that crises should be prevented in a pro-active manner. True, you can safely contain people in crisis and protect them from themselves and protect others, but “putting out fires” will not move your clients in a forward direction.

Please contact the PCMA sales team to receive contact information from a current PCM user that works with a similar population to yours.

Yes, simply click here and someone from PCMA will contact you to set up either a web-presentation or an on-site presentation!

All of the requirements of the PCM system have evolved over the past 23 years based upon a commitment to provide the finest crisis management system available. All of our policies and procedures are in place to protect the integrity of the system, the safety of the individuals who need crisis management, and the reputation of the facility using our system. These policies and procedures have also been developed to decrease the likelihood of successful litigation against a facility. Crisis management is serious business and there are inherent risks any time that one person puts a hand on another person. Our goal is decrease these risks as much as possible. No one can stop the threat of litigation or unwanted publicity, but at least a facility can show that they have taken all the steps possible to ensure that the people they serve are treated safely and humanely, and that their staff was properly trained. PCMA staff have provided expert testimony on a number of law suits and we are extremely sensitive to the kinds of things that cause injury, litigation, and large settlements. This is why we have so many conventions in our system, and our customers are ultimately very happy that we do!

We certify both Practitioners and Instructors. Most facilities prefer to have a group of their own Instructors “on-site.” PCM Practitioners may implement the PCM procedures (according to their certification level), but they may not teach them to anyone else. PCM Instructors, on the other hand, teach the course to other staff members who may then become PCM Practitioners.

Absolutely! There are currently 6 different levels of Practitioner certification in the PCM system:

Basic Practitioner is certified to use all of the PCM non-physical strategies. This certification is for those individuals not requiring physical intervention.

Practitioner is certified to use all of the PCM non-physical strategies, and the physical procedures of personal safety and transportation.

Practitioner 1 is certified to use all of the PCM non-physical strategies, and the physical procedures of personal safety, transportation and vertical immobilizations (holding persons in an upright position).

Practitioner 2 (P) is certified to use all of the PCM non-physical strategies, and the physical procedures of personal safety, transportation, vertical immobilizations, and prone (face down) horizontal immobilization procedures (on a foam mat).

Practitioner 2 (S) is certified to use all of the PCM non-physical strategies, the physical procedures of personal safety, transportation, vertical and supine (face up) immobilization procedures (on a foam mat).

Practitioner 2 (PS) is certified to use all of the PCM non-physical strategies, the physical procedures of personal safety, transportation, vertical, supine (face up) and prone (face down) immobilization procedures (on a foam mat).

Different staff have different physical abilities and different clients display different levels of aggression. In many instances, some clients may only require transportation procedures when they are in crisis.

The benefits of having “on-site” Instructors are numerous. First, it is more cost-effective for facilities to train their own Practitioners rather than have a representative of PCMA travel to their facility to conduct the course. Secondly, there is an added benefit of having an “expert” at the facility to answer some of the more difficult crisis management questions that may arise, and to help ensure that all PCM procedures are being used appropriately and effectively. Finally, the on-site Instructors can help Practitioners “brush-up” on their skills in between the yearly re-certifications.

No, PCM Instructors can only be certified or recertified by a PCMA Instructor Specialist. This is done, in part, to ensure the quality of every PCM Instructor.

The Practicum is a way of allowing the new Instructor to gain experience while teaching and minimizing errors while teaching for the first time. During the Practicum, we help you learn to teach the PCM system to reinforce the concepts learned in the Instructor training, especially the physical procedures.

The Practicum consists of having an approved Practicum-Instructor support you while you teach your first class, ensuring that your first class runs as smoothly as possible. Practicum-Instructors are either provided by PCMA directly, or existing Instructors may be authorized by PCMA to provide practicum-instruction. Each Instructor is only required to complete one Practicum.

Practitioners and Practitioners 1 should be reasonably physically fit. They do not need to be “athletes”, but they should be able to walk briskly for brief periods and should have no problems with their arms or back.
Practitioners 2 (P), Practitioners 2 (S) and Practitioners 2 (PS) should meet the above requirements, and they should have no problems with their knees and/or legs that would prevent them from easily getting to a kneeling position OR getting up from a kneeling position unassisted.
Instructors should be even more physically fit than Practitioners because they may have to demonstrate the procedures dozens of times during a single course. Again, they do not have be an “athlete” but they do have to be in good physical condition. In addition, Instructors should be good communicators and, ideally, already have experience in teaching.

The course length varies depending upon the certification:
Instructor course: minimum 28 hours (4 days)
Basic Practitioner course: minimum 6 hours
Practitioner course:  minimum 14 hours
Practitioner 1 course: minimum 18 hours
Practitioner 2 (P) course: minimum 22 hours (3 days)
Practitioner 2 (S) course: minimum 22 hours (3 days)
Practitioner 2 (PS) course: minimum 22 hours (3 days)

Recertification for Basic Practitioners is a minimum of 2 hours.
Recertification is a minimum of 7 hours for all other levels of Practitioners.

Recertification of Instructors is a minimum of 8 hours.

Only the Instructor course conducted by PCMA must be done in consecutive days. Although we recommend for Instructors to complete the Practitioner course in 3 to 4 days consecutively, it can be split up into several days. 

One Instructor may train up to 10 Practitioners, and up to 15 Practitioners may be trained using 2 instructors. This is done to control the quality of the training and the amount of individual instruction that participants may receive.

Certifications for all levels of Practitioners and for Instructors are good for one year from the time of certification. However, there is a 90 day grace period for Practitioners and a 180 day grace period for Instructors.

Re-certification is the process by which PCMA ensures that Practitioners and Instructors maintain their skills, as well as providing them with new information about crisis intervention. Re-certification must be completed annually.

Participants must score an 80% or better on a written exam, pass all critical items, complete their performance checklists, pass the practical exam, complete and sign their application and meet the minimum number of hours for the course they attend.

If a person goes beyond their grace period without re-certification (practitioner or instructor) then they must go through the original certification process again.

One of the many strengths of the PCM system is that PCMA determines whether or not practitioners should be certified to practice, much in the same way that no hospital can certify a physician, it must be a state or federal board. By determining whether or not individuals pass, and by issuing the certification, PCMA helps maintain rigorous certification standards that would no doubt be altered if each individual facility were responsible for determining eligibility for certification. Having an independent organization maintaining the certification helps to prevent the accountability and quality control problems that can arise from “in-house” forms of crisis management systems that have no external controls or balances.

Sometimes, students will fail to meet criteria on their examination. In that event, you will be contacted by PCMA and you may then make a request for a re-training package.

Once received by our office, it takes about 2-3 business days to process materials and enter them into our database. Once entered, however, results are immediately made available over the internet. This way, Instructors can check our website for results.

The retraining is given when a student fails to meet criteria on either the written or the practical examination. It involves the request for retraining materials, a minimum of 3 hours of instruction, and the re-administration of the written and/or practical exams. Retraining is an option if a student scores at least between 60% to 79% on the written examination.

 Practitioners and Instructors must be re-certified annually. Instructors must attend a PCM Instructor re-certification course that is a minimum of 8 hours and is typically taught in 2 days. Practitioners must attend a course that is a minimum of 7 hours. Both Participants and Instructors are tested again and complete a “refresher” performance checklist.

Yes!  The PCM Instructor certification allows you to train people outside of your own agency/school district.

Yes, both Practitioners and Instructors receive certificates from PCMA that verify their date of training, level of certification and certification expiration date.