If you were to count the decisions you make every day, what do you think the tally would be?
Before we even walk out the front door, we make decisions involving routine—everyday tasks like whether to press the snooze button, what to eat for breakfast, and what to wear.
Then we begin the commute to work and the decisions become more frequent and potentially risky.
We decide whether or not to wear a seatbelt, how fast we drive, when to switch lanes, and the ultimate question of stop or go when the light turns from green to yellow.
Once the workday starts, we begin making countless decisions revolving around tasks, goals, interactions, and the almost inevitable crisis.
Early in the day, we’ve already accepted several risks. The house could have burned down while we were cooking breakfast, a car accident could have occurred on the highway, or we could have been issued the dreaded traffic violation on the way to work.
But accepting and managing risks relating to crisis intervention is a whole different ballgame.
The reason we accept and sometimes even ignore risk in our everyday lives is that we perceive either the likelihood of a bad consequence occurring or the severity of outcome (or both) to be low.
This is what the Decision-Making Matrix encapsulates.
The Decision-Making Matrix, a tool in the Nonviolent Crisis Intervention®
training program, teaches us to objectively assess risk behaviors and make decisions that will reduce the likelihood of more severe outcomes occurring.
Let’s say a crisis just came your way.
While you’ve already accepted some potentially severe risks earlier in the day, the difference now is that when you’re working with vulnerable people in times of crisis, you are tasked with the enormous responsibility of maintaining the Care, Welfare, Safety, and Security
℠ of yourself, your coworkers, bystanders, and the person in crisis.
So we owe it to the individuals in our care to make our decisions based on actual risk rather than fear, concern, or emotions that may be unproductive.
It’s important to remember that sometimes we become extremely concerned over behaviors that present a lower level of risk. We also must remain objective so we can avoid showing too little concern for behaviors that may actually present a higher level of risk.
The more decisions you consciously make, the more intentional and in control of your own behaviors you will be.
Too often, well-intentioned staff members negatively impact a crisis because they’re not engaging in an intentional
process of decision making. Instead of maintaining focus on what outcome we would like to achieve, we can easily fall into the trap of getting lost in the moment.
But when staff are well trained, they have a wide range of interventions at their disposal to manage the wide range of behaviors they are sure to encounter.
And if we choose our actions wisely, hopefully we can decelerate the situation before it escalates past the Defensive or Anxiety level of the Crisis Development Model
℠. (If you're not familiar with it, the Crisis Development Model
℠ is another tool in CPI training that describes recognizable behavior levels that a person might go through during a crisis, and corresponding staff attitudes and approaches to de-escalate challenging behaviors.)
Use the matrix to choose your response early—to PREVENT things from getting out of control.
When thinking about decision making, it’s important to think about the process in terms of a much larger picture, rather than as solely the decision of whether or not to use the last-resort tool of physical intervention. If we only begin the decision-making process at the third level of a crisis, we are likely to have missed several opportunities to decelerate the behaviors of the individual in crisis.
The Decision-Making Matrix can help you prevent crisis situations from escalating or occurring at all.
In order to achieve maximum effectiveness in our decision making, we must first overcome a culprit that has been often known to hijack the decision-making process:
Many of our day-to-day decisions are based on habit, which usually serves to simplify our lives.
But when we’re intervening in a crisis, making habitual decisions can have unproductive consequences that we may not foresee. In other words, unintentional actions can have unintended consequences.
We might use habitual nonverbal behaviors such as gestures, posture, facial expressions, or use of touch. Or we might fall into the habit of using the same tone and cadence to repeat the same phrases to the same individuals day after day.
Part of understanding the process of decision making is understanding the need to align the intent and the impact of our actions. One of the best ways to reduce the likelihood of your own behaviors escalating a situation is to be aware and intentional in terms of your nonverbal communication, paraverbal communication, and the decisions you make about the actual words you say.
You can also use the Decision-Making Matrix to plan for specific risk behaviors of individuals, plus emergencies and other crisis situations.
We’ve all probably come across that individual who engages in the whole gamut of behaviors and who goes into crisis frequently.
If we were to plot all of this person’s behaviors on the Decision-Making Matrix, we would likely see that some of the person’s behaviors are very likely to occur, but actually present a low severity of outcome (Lower Risk).
While such behaviors may be unproductive and disruptive, we might realize that there are other behaviors that occur with similar frequency and that present a more severe set of outcomes (Higher Risk).
In this scenario, we might choose to focus on strategies to reduce the severity of the higher risk behavior and/or the frequency with which it occurs.
To manage this, you could:
- Plan to use a team approach
- Role-play specific strategies for using verbal intervention with the person
- Teach the person coping mechanisms
- Identify resources to reduce the risk to the person in crisis, and to staff and bystanders
- Develop emergency plans
You might also choose to pay less attention to the behaviors that do not pose as severe of an outcome (at least until staff learn how to more effectively manage and PREVENT crisis situations).
And once these plans are created and implemented by staff members, you can assess the effectiveness of your strategies and make adjustments as needed.
Just as it can help with individual behavior plans, the Decision-Making Matrix can also help you identify situations that present extremely severe outcomes—even if such events are unlikely to occur.
Think about how often we do fire drills compared to how often a fire actually occurs.
It’s important to plan for the scenarios we may be faced with (or have been faced with) where the outcomes can pose a severe threat to safety.
In this way, you can use the Decision-Making Matrix to help you develop emergency plans, procedures for removing an audience, procedures for fostering a safe environment for Release, methods of setting limits to make Refusal a less likely occurrence, and just about anything else you can think of.
Now things are easier
Now that we’ve transformed our habitual behaviors to intentional decisions and we have our plans in place, we’ve made our jobs significantly easier.
I said easier.
I didn’t say it was going to be easy.
So when a crisis begins, we have to keep in mind . . .
- Our training
- Our values
- Organizational policies
- State laws
- The environment in which the crisis is occurring
- Our team competencies
. . . not to mention who the person in crisis is, what the person’s known patterns of behavior are, and what kind of (if any) relationship we have with the individual.
Did I mention that some crisis situations can become incredibly intense, chaotic, and hazardous to the safety of everyone involved?
And in this example, whether we’ve planned for the behaviors or not, their likelihood is as high as can be because they’re occurring in the present.
This means that our goals at this point should be to:
- Limit the severity of potentially unsafe outcomes.
- Make decisions that will reduce the likelihood of more extreme and potentially risky behaviors arising.
One of the most critical decisions we have to make is whether or not to use physical intervention.
I would venture to guess that any competent staff member who has ever found themselves in the position of using physical intervention will tell you that it is nothing we should ever want to have to use. It is, in fact, just more reason to master the art of de-escalation to avoid being in that predicament.
But unfortunately, in this example, the crisis has risen to the degree that your heart is racing, your adrenaline is flowing, and your mind is moving a mile a minute. Questions and potential risks begin flashing through your mind quicker than you can process them:
- Should I get closer or back up?
- Where is my nearest staff member?
- Is this man going to throw that chair?
- What is that in her hand?
- What other people are at risk?
- What environmental risks are here?
- What Precipitating Factors are impacting behavior and/or risk?
- Do I need to use physical intervention to protect those involved? And if I do, can it be used safely and effectively within the parameters of our policies?
The problem is that we’re often tasked with answering these questions as fast as we can ask them.
But the Decision-Making Matrix can assist you in simplifying this process.
The Decision-Making Matrix teaches us to make decisions that will reduce the likelihood of more severe outcomes occurring.
If we keep our decisions rooted in these two factors—likelihood and severity of outcome—we can increase our chances of safely managing the behavior of the person in crisis and minimizing physical, emotional, and psychological risks
Using the matrix for debriefing
OK. So we’ve made it through the crisis.
As much as we want to just sneak out to our car and call it a day, we understand the value of a strong debriefing session, and we have an obligation to restore our relationship with the person in crisis to the best of our ability. After all, good prevention can start with good Postvention
Lucky for us, CPI has a great tool for this in the COPING Model
℠. Once everyone is calm and under Control, we can use the Decision-Making Matrix as we Orient ourselves to the facts of what happened during the crisis and how staff decisions impacted the individual’s behavior.
We can also address the other half of the Integrated Experience and discuss how the behavior of the person in crisis impacted staff decisions.
This discussion is likely to uncover both productive and unproductive Patterns of staff behavior. This is the time to talk about:
- What’s working?
- What’s not working?
- Are we missing opportunities to intervene earlier?
- Are we using interventions too often or too infrequently?
In other words, what are we doing to increase or decrease the likelihood of more severe outcomes occurring?
As you answer these questions, you’ve entered into the Investigate, Negotiate, and Give steps of the CPI COPING Model
℠. And through this Postvention, the process of prevention has begun.
Making decisions can be complex, but it doesn’t have to be.
When it comes to our personal lives, our professional experiences, and intervening in crisis situations, we are always looking for ways to simplify the process of decision making in order to produce desired outcomes.
The Decision-Making Matrix can help you achieve this goal—but only if you use it.
Our decisions can often make the difference between behavior escalation and Tension Reduction. Between safety and injury. Between building relationships and building walls.
So the next time you find yourself intervening in a crisis, make sure your actions are decided based on the factors of likelihood and severity of outcome
, rather than fear or unproductive habits.
Be sure to make intentional decisions about how you stand, the gestures and expressions you make, where you position yourself, and what you say and how you say it. Be aware of how your decisions and behaviors are impacting the behavior of the person in crisis.
If you do these things, the potential for successful crisis management—and crisis prevention
—can increase dramatically, and you can better serve the individuals in your care.
If you’re a Certified Instructor and you’re ready to experience the training enhancements, register for a program near you or give us a call at 888.426.2184.