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Fostering Emotionally Safe Environments for Caregiving

By  Dr. Randolph Boardman

Fostering Emotionally Safe Environments for Caregiving

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The Crisis Prevention Institute's Nonviolent Crisis Intervention® training program advances the Care, Welfare, Safety, and SecuritySM of all stakeholders in caregiving settings such as schools, residential, or other youth services. This article will discuss the emotional safety of challenging youth and staff who serve them. Selected authors that have focused on relationship-based interventions and staff skills will be reviewed. Youth who have a history absent of well-grounded relationships with adults may require staff to be even better at developing such. The article will briefly discuss how the use of restraints also surfaces dangers of emotional, social, and psychological risks. Finally, I will introduce a concept I like to call "Youth-ship" and ask readers to inventory their own skill sets.

 

Ginott (1976) was an advocate for advancing healthy, proactive interactions and relationships with youth when he wrote, "I have come to the frightening conclusion that I am the decisive element in my classroom. It's my personal approach that creates the climate; it's my daily mood that makes the weather. As a teacher, I possess tremendous power to make a child's life miserable or joyous. I can be a tool of torture, or an instrument of inspiration. I can humiliate or humor. In all situations it is my response that decides whether a crisis will be escalated or de-escalated, or a child humanized or de-humanized" (p. 13).

 

Neil Postman (1982) counsels us that, "Children are the living messages we send to a time we will not see" (p. xi). The reader is encouraged to evaluate what messages your interactions and relationships are foreshadowing with the youth at your school or facility that you will be forwarding on to the next generations.

 

Brendtro, Ness, and Mitchell (2001) discuss four prevailing principles for promoting a climate and culture of respect with youth depicted in The Circle of CourageTM.
 

  • Belonging—building of relationships and bonds of trust, so the youth feels, "I am loved."
  • Mastery—advancing a quest for learning to cope, so the youth feels, "I can succeed."
  • Independence—fostering responsibility so the youth can say, "I am in charge of my life."
  • Generosity—nurturing a concern for others so the youth can feel, "I have a purpose in my life" (p. 96).


Long, Wood, and Fecser (2001) talk extensively to the emotional intensity of youth in crisis. Youth can be flooded with intense emotion and unable to respond with rational thinking or talking. Within the Life Space Crisis Intervention training, three adult skills are advanced to provide Emotional First Aid to reduce this emotional intensity for the youth in crisis. These staff skills are inclusive of three broad categories: positive nonverbal body language, an appropriate verbal style, and relationship-building skills.

 

Establishing Connectivity
In my 2002 article, I speak to the need for establishing "connectivity" between staff and the youth they serve, and advocate seeking out what may be important to the youth in their life space, on their turf, on their terms. Engaged, conversational connected time with individual youth is paramount to building and maintaining reclaiming relationships with the youth in our care. In my 2004 article, I also speak to the need for adults to practice "Behavior Management by Walking Around." Turn off your computer, leave your safe office area, walk around, talk, and listen to those you serve at your facility.

 

The Crisis Prevention Institute's Nonviolent Crisis Intervention® training program promotes the development of supportive, relational staff skills inclusive of nonverbal messages sent by posture, gestures, and facial expressions; respectful of personal space and belongings; and the paraverbal messages relating to voice qualities of volume, tone, and cadence.

 

Birdwhistell (1970) points out that the human face is capable of exhibiting kinesic messages to mean different things and be interpreted in different ways. Similarly, Ekman, Freisen, and Ancoli (1980) has 40 documented research studies regarding human facial expressions, and correlating movements to what a person is feeling inside. He refers to these fleeting, involuntary changes as microexpressions, and has identified seven universal emotions which cross a person's face in milliseconds. These microexpressions expose feelings a person does not verbalize and are perceived by others, sometimes even subconsciously.

 

Brennan, Bradley, Ama, and Cawood (2003), from Portland State University's Research and Training Center on Family Support and Children's Health, offer a series of suggestions to promote positive emotions and pro-social behavior with young children who present challenging behavior:
 

  • Build relationships with each child based on trust and respect.
  • Work from a basis of knowledge about the child, be familiar with family or home history, and key events in their life.
  • Create a consistent, predictable environment, consistency in rules, expectations and consequences, while maintaining flexibility.
  • Prepare and assist the youth through periods of transition of activities or life events.
  • Allow for "safe" quiet spaces when overwhelmed, and teach self-soothing behaviors.
  • Offer developmentally appropriate curriculum and activities.
  • Promote the use of multiple sensory channels.


Emotional Holding
Winnicott (1965) and Steckley (2007) speak to the concept of "emotional holding" when working with youth. The concept is more of a metaphor, rather than a reference to encouraging the use of physical restraints. This notion is suggested as central to nurturing an effective caregiving relationship. Much as a new mother introduces an infant to the comfort and nurturing of physical touch and holding, caregivers may need to deflect, absorb, and reflect back feelings to contain the anxiety, stress, and intense emotions of youth. Within the context of normal development, parents gradually move a child from dependence to a greater range of independence. Troubled and troubling youth may have had an interruption in this natural developmental progression. We as caregivers may have to recreate such. Environments that promote such "emotional holding," create safe boundaries, offer protective space, enable the youth to experience a sense of value and security, and are associated with providing a secure base. In such emotionally safe environments, three types of staff behavior are prevalent: emotional containment, empathic acknowledgement, and enabling perspectives.

 

happyclass150.jpgPhysical Restraint
In some youth settings, when a child's behavior poses an immediate risk of physical harm to themselves or others around them, physical restraint is used as a last resort. The Crisis Prevention Institute (CPI) (2005) has a well-chronicled history of advocating for the reduction in the use of restraints and for educating care providers about the physical risks and dangers of restraint-related positional asphyxia, as associated with the use of restraints and physical interventions as a last resort. The use of restraints also surfaces dangers of emotional, social, and psychological risks. Restraints can interfere with the relationship between the staff and the person being restrained and can foster a sense that the person has no control over their lives.

 

Mohr, W., Petti, T., and Mohr, B. (2003) discuss the potential emotional impact of physical restraints, such as provocation of memories and thoughts of a previous trauma such as sexual abuse, anger, rage, and mistrust. Morgan, R. (2004) provides quotes from youth who have been restrained, "It makes you feel like you're nothing" and "I still bear a grudge against the way I was restrained" (p. 16). Some children and young people also reported negative feelings when seeing someone else being restrained. Restraints can emotionally affect staff, the person being restrained, as well as the children seeing the restraint happen. One group of youth interviewed reported that there were many ways staff could take the heat out of a situation that was heading for dangerous anger and restraint. Morgan continues to advise staff to always try to give a child or young person space and help them to calm down before things build up to a crisis.

 

Leadership Skills
In our professional careers, we have all attended numerous conferences and seminars, and read many professional publications intended to develop our "Leadership" skills. Book stores are filled with many such publications, purported formulas, essential habits, and the like, depicting the pathway to hone these skills and provide effective leadership in organizations. "Youth-ship" is a term I use to describe similar skills recommended for care providers who intervene with difficult youth. This listing is based on common strands developed in the above representative publications and perspectives. Assess your "Youth-ship" skill sets through a self inventory. When working with youth at your facility, do you consciously and consistently demonstrate the following?
 

  • Evidence of active, empathic listening; attending and affirming skill sets that foster youth to talk, versus preaching or a language of blame.
  • Evidence of supportive nonverbal messaging, posture, gestures, and interactions, versus messages predicated on threats, compliance, and intimidation.
  • Evidence of the appropriate use of silence, versus interruptions to talk over the youth, or discourse infused with excessive "shoulds."
  • Evidence of a supportive voice, tone, and rate of speech, versus sarcastic intonation, and messages reliant on power and authority.
  • Evidence of relationship-building skill sets, versus diminishing or dismissing comments and interactions.
  • Evidence of asset or strength-based expectations and perspectives of the youth, versus deficit-based approaches.
  • Evidence of statements, actions, beliefs, and attitudes that value, versus devalue the youth.
  • Evidence of youth-centered statements, actions, beliefs, and attitudes, versus self-serving or staff-centered approaches.
  • Evidence of genuine warmth, caring, respect, and sensitivity toward youth in their charge, versus a callous sense of obligation to "the job."


This article provides a discussion based on the premise of advancing the emotional safety of challenging youth and the staff who serve them. Selected authors that focus on relationship-based staff skills are highlighted. Youth who have a history absent of well-grounded relationships with adults, may have understandable deficiencies at developing such. The reader is reminded to remain cognizant of not only the physical but also emotional, social, and psychological dangers associated with the use of physical restraints, if such are allowed as an intervention at their setting. Lastly, I introduce the concept of "Youth-ship" and ask the reader to assess their own skill sets accordingly. Embracing youth-centered relationships and interactions can place youth care workers in a posture to improve the emotional safety for all stakeholders, and positively change the culture of care at their facilities.
 


The Author
Randolph M. Boardman, Ed.D. is the Executive Director of Research and Development with the Crisis Prevention Institute (CPI). Dr. Boardman is also a Senior Trainer of Life Space Crisis Intervention and a primary contributing author to the CPI advanced training program, Enhancing Verbal Skills: Applications of Life Space Crisis InterventionSM. He can be contacted at 877.877.5390 or by email at rboardman@crisisprevention.com.
 


References

Birdwhistell, R. (1970). Kinesics and context: Essays on body motion communication. Philadelphia, PA: University of Pennsylvania Press.

 

Boardman, R. (2002). Just some thoughts about connections, nouns, and verbs. Reclaiming Children and Youth, 11(1), 35–36.

 

Boardman, R. (2004). Behavior management by walking around. Reclaiming Children and Youth, 13(1), 48–50.

 

Brendtro, L., Ness, A., & Mitchell, M. (2001). No disposable kids. Longmont, Co: Sopris West.

 

Brennan, E. M., Bradley, J. R., Ama, S. M., & Cawood, N. (2003). Setting the pace: Model inclusive child care centers serving families of children with emotional or behavioral challenges. Portland, OR: Portland State University, Research and Training Center on Family Support and Children's Mental Health.

 

Crisis Prevention Institute, Inc. (2005). Instructor manual for the Nonviolent Crisis Intervention® training program. Brookfield, WI: Author.

 

Crisis Prevention Institute, Inc. (2005). Risk of restraints: Understanding restraint-related positional asphyxia. Brookfield, WI: Author.

 

Ekman, P., Friesen, W. V., & Ancoli, S. (1980). Facial signs of emotional experience. Journal of Personality and Social Psychology, 39, 1125–1134.

 

Ginott, H. G. (1976). Teacher and child. New York: Avon.

 

Long, N., Wood, M., & Fecser, F. (2001). Life Space Crisis Intervention: Talking with Students in Conflict (2nd ed.). Austin, TX: Pro-Ed.

 

Mohr, W., Petti, T., & Mohr, B. (2003, June). Review paper: Adverse effects associated with physical restraint. Canadian Journal of Psychiatry, 48, 330–337.

 

Morgan, R. (2004). Children's views on restraint: The views of children and young people in residential homes and residential special schools [Electronic version]. Newcastle upon Tyne: Commission for Social Care Inspection. Retrieved November 28, 2006, from http://www.rights4me.org/content/beheardreports/101/restraint_report.pdf

 

Postman, N. (1982). The disappearance of childhood. New York: Delacourt Press.

 

Steckley, L. (2007, October) Containment and physical restraint. Paper presented at the 5th European Congress on Violence in Clinical Psychiatry, Amsterdam, The Netherlands.

 

Steckley, L., & Kendrick, A. (2007). Physical restraint in residential child care: A literature review. In A. Kendrick (Ed.), Residential child care: Prospects and challenges. London: Jessica Kingsley.

 

Winnicott, D.W. (1965). The maturation process and the facilitating environment. London: Hogarth.

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