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[Case Study] Changes in Attitudes, Changes in Outcomes

[Case Study] Changes in Attitudes, Changes in Outcomes
The Crew at Pine Hills Youth Correctional Facility include: (Front row, left to right): Fred Willard, and Lisa Malloy; (Back row, left to right): Casey Strub, Erv Bohlman, and Simon Niece. Not pictured: Mark Lingg.

Sometimes you have to take a new look at what you already have in order to find something you might not have considered before.
 
Pine Hills Youth Correctional Facility in Miles City, MT is a 96- bed, secure-care program for 10- to 17-year-old males judged delinquent by Youth Court. The facility has a staff of 126 employees and averaged a daily population of 64 youths in fiscal year 2012.
 
Pine Hills offers a year-round educational program accredited by the state Board of Public Education, one-on-one and group counseling, treatment programs for sexual offenders and chemical dependency, spiritual activities, daily recreation, life skills programs, and work restitution programs.
 
An American Correctional Association (ACA) accredited juvenile correctional facility for more than a decade, in May 2010 the ACA Commission on Accreditation for Corrections Standards Compliance conducted a reaccreditation audit at Pine Hills, scoring the facility a perfect 100% compliance rating.
 
However, during this same fiscal year, the facility accumulated 48 staff workers’ compensation injury claims and a three-year average workers’ compensation claim rate of 73 per year. Virtually all of these injuries resulted directly from staff physical intervention to control aggressive and acting-out youth.
 
Clearly this was not a perfect situation and needed to be addressed. 
 
Pine Hills became a member of Performance-Based Standards for Youth Correctional Facilities, which provides a system for juvenile agencies to identify and monitor critical areas of performance and to demonstrate effectiveness using the highest national standards and performance outcome measures set by the Council of Juvenile Correctional Administrators.
 

Use of Force

The facility focused on key critical outcome measures, one of which was the frequency of using force to control aggressive, acting-out youth. A key discovery was that while Pine Hills had for many years trained staff in Nonviolent Crisis Intervention® training, they were not fully implementing the philosophy of Care, Welfare, Safety, and SecuritySM to staff members and those in their care.
 
At Pine Hills, Nonviolent Crisis Intervention® Certified Instructors focused most of their training time on CPI’s Personal Safety TechniquesSM and Nonviolent Physical Crisis InterventionSM techniques, as the physical techniques fit well within the expectations of the facility’s Use of Force policy.
 
With such a heavy focus on the physical elements of the program, little focus was given to verbal intervention skills, and as one might expect, frequency of use of force was high.
 
“For years we subscribed to Nonviolent Crisis Intervention® training, but we didn’t fully use everything the training gave us,” said Jeffrey Holland, Quality Assurance Manager for the facility. “Our primary focus was the physical elements of the program.”
 
Sensing a need to impose their authority, staff would often forego any attempts at verbal intervention, rapidly responding with physical intervention, even for minor incidents of noncompliance. Not only was the use of force rate high, so were workers’ compensation claims, many of which were the result of the use of force.
 

Need for Change

Seeing the data on use of force and on the resulting injuries, Holland knew something had to change. Holland said he knew staff needed to take another look at the verbal intervention strategies in the Nonviolent Crisis Intervention® program, but he also knew that the techniques alone might not get the results they needed. A cultural shift was necessary to get staff to prioritize Care, Welfare, Safety, and SecuritySM over a fast resolution to disruptive behavior.
 
“Our biggest challenge was to figure out how to get the training from the classroom to the dayroom,” said Holland. He said he knew it would be a tough sell to convince corrections officers that a less aggressive approach could prove to be a safer approach.
 
With the support of the Youth Services Director, Pine Hills trained six new Nonviolent Crisis Intervention® Certified Instructors from a cross section of facility staff: line staff, frontline supervisors, and managers. In the months following, all direct care facility staff and supervisors received initial Nonviolent Crisis Intervention® training. For most staff, this was a repeat presentation, but the emphasis was increased on forming professional relationships with the youth they serve, focusing on and properly utilizing Nonviolent Crisis Intervention® de-escalation techniques.
 
Staff received key topic reviews of Nonviolent Crisis Intervention® concepts during monthly all-staff meetings. Instructors visited housing units weekly during shift change to discuss successes/ failures and to answer staff questions regarding applications of Nonviolent Crisis Intervention® principles and techniques. Finally, the Instructor group also conducted after-action reviews following any event that resulted in a use of force, and provided coaching to staff as warranted.
 
Roughly six months later, this process was augmented by training two additional staff to instruct the Enhancing Verbal Skills: Applications of Life Space Crisis InterventionSM program, which was likewise trained to all staff and kept alive through monthly topical review during all-staff meetings and individual coaching.
 

Emphasis on Nonviolence

“While Nonviolent Crisis Intervention® was not a new concept at the facility, the increased emphasis on fully utilizing the intervention and techniques was new,” said Holland. “There was considerable concern from staff that this ‘new way’ was not safe for staff or youth. But through the cynicism and resistance we continued with our efforts, demonstrating to staff that the concept of Care, Welfare, Safety, and SecuritySM was important to us.”

By learning to view escalating behaviors through the CPI Crisis Development ModelSM, staff were better able to see alternative strategies.
jeff-holland.jpg
Jeff Holland, with wife Teza, receiving the 2012 Governor’s Award for Excellence in Performance.
 
“Gradually it became important to all and no longer was there merely the black and white, compliant and noncompliant view of youth behavior,” said Holland. “There were recognizable behavioral shades of grey. Staff now had the ability to distinguish these behavioral shades and intervene accordingly, with tangible benefit to youth and staff.”
 

Culture Change and Results

After the first full year of the new training implementation strategy, Holland says the change in culture at the facility is apparent. That change in culture is also reflected in the facility’s established outcome measures:
 
  • The facility recorded an 80% decrease in staff injuries compared to the average of the three preceding years.
  • Workers’ compensation liability from staff injury claims decreased 90.5% compared to the three-year average of preceding years.
  • Frequency of all youth Major Rule Violations (any type) decreased 48% from the preceding year.
  • Frequency of use of force (surpassing team control) used to control youth behavior decreased 87% compared to the preceding year.
  • Injury to youth resulting from any use of force (now a much rarer event) decreased 85% compared to the preceding year.
 
By changing attitudes, and by focusing training on additional verbal intervention techniques, staff at Pine Hills Youth Corrections Facility were able to promote significant changes in culture, reflected nicely on major safety outcomes.
 
Holland said that he was so proud of the impact on the facility’s culture and tangible results he has seen from training, that he nominated his entire Nonviolent Crisis Intervention® training team (“The Crew,” as he calls them) for the Montana Governor’s Award for Excellence in Performance. The team was selected and is slated to receive this award in a ceremony to be held later this fall in the state capital of Helena.


Originally published in the Journal of Safe Management of Disruptive and Assaultive Behavior, Fall 2013. © 2013 CPI. Certified Instructors, log in to read more JSM articles.

 
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