'Problems with our Current Crisis Management System'

What makes a crisis management system succeed?

• Clearly defined implementation criteria: 
  The solution is to present staff with clear criteria for the use of restraint and clear instructions on which behaviors warrant physical crisis intervention procedures and which warrant non-physical de-escalation strategies. So if a client or student is screaming and cursing loudly, staff would identify the behavior as “pre-crisis” and know they should be using non-physical de-escalation strategies. A student who hits multiple times in a row would be identified as being “in crisis” and staff would prevent further injury by starting transportation procedures.
• Designed to be used with diverse populations:
  PCM strategies for prevention and de-escalation were designed to be used with a variety of individuals with different skill sets. There are strategies that will work well with persons with good verbal skills, poor verbal skills or none at all. Even for those with excellent verbal skills, a crisis for them might mean that all their communication completely shuts down. In this case staff must turn to strategies that can work with any skill level. Even the PCM physical procedures are designed to give ALL individuals continuous physical feedback about their behavior. This physical feedback requires no language skills at all. So whether the individual has a chronic language deficit or has just temporarily stopped using language because of a crisis, PCM has the right procedures and strategies to manage ALL individuals safely.
• Evidence-based:
  PCM prevention and de-escalation strategies and procedures are based on the same basic principles of learning that have been used by behavior analysts for more than half a century to effectively treat and educate individuals with special needs. Many of the strategies used by behavior analysts all over the world are used in the PCM system. Strategies like stimulus fading for removing prompts, shaping of new behavior through differential reinforcement of target behaviors, and the programmed and spontaneous use of praise and other forms of reinforcement for on-task and pro-social behaviors.
• Preserves educational/clinical relationships:
  The PCMA has respect for the way the body should naturally be positioned and because of this, all of our procedures are painless and comfortable, which translates to shorter crises. Because of this it is very easy to preserve the clinical/teaching relationship as the individual is not being harmed even while they are trying to harm others. The individual controls when the procedure ends by choosing to relax. The very moment the individual relaxes, the staff must begin to release, therefore the client/student is the one who decides when the procedure ends, not staff. This “shared-governance” over the individual’s behavior makes them a key decision maker in their own physical intervention rather than the victim of vengeful non-clinical act.
• Fluency-based training methodology:
  The PCM system uses the time-tested 'Train-to-Fluency' methodology for teaching all physical intervention skills. Participants then learn sets of 'nested' procedures, each one designed such that it contains portions of other closely related but separate procedures. These nesting procedures are then taught in forward and reverse order of intrusiveness and practiced dozens of times. Initial mastery and generalization of skills over time is ensured by teaching physical skills using distributed practice (over several days) rather than massed practice (all skills taught on a single day). Remember, teaching to fluency may initially take more time, but ultimately it saves time and money because people are taught properly the first time instead of taking shortcuts that will require more training down the line.