One of the great things about working for CPI is the passion that the folk here have for what we do. The belief that whatever the travails of the working day, our training is making a big impact on the lives of those we train and those they support. But, as in most walks of life, sometimes there’s too much to do and too little time to do it. Sometimes, it seems like a constant battle to meet persistent deadlines. Sometimes, well sometimes you just feel under-motivated.
I’ll admit to some or all of these emotions recently as a seemingly never-ending process of internal change battled with my ever-lengthening ‘to do’ list to produce a ‘what is it all about’ moment of existential angst. But then, just when I was needing a pick-me-up, recovering at home as I was from some minor surgery, I received an email from an on-site participant which reminded me just why I haul myself out of bed and onto the tram of a morning. Rather than selectively edit, I quote more or less in full:
Hi, I have just completed the [MAPA®] course in Hull with Global Professional Instructors Mike Sumner and Matt [Devaliant]. I am a newly qualified Learning Disability Nurse working in a medium-secure setting.
I found the course Instructors to be very professional and I was impressed at their flexibility in their approach to scenarios offered up by the group. They were respectful in their approach at all times and it was noted by my colleagues and me that their focus held the Care, Welfare, Safety, and Security℠ of the patients at the forefront of all discussions and interventions.
The Crisis Development Model℠, although 'bread and butter' in my profession, is extremely useful in grounding interventions and really helps to focus things on each patient's best interests and how to support them through a crisis before physical intervention is required. This is so important in terms of maintaining a therapeutic relationship with patients and, when considering the experiences of my patient group, verbal de-escalation is by far going to be the least traumatic for them.
The RESPONSE Continuum℠ is very helpful for structuring thoughts, and when used alongside the limit-setting resources from CPI, it has helped me to think more about communication before, during, and after any intervention—whether that be verbal or both verbal and physical.
The Instructors were patient and supportive throughout and offered support in adapting physical interventions to fit with individual need and commonly experienced scenarios whilst enforcing the principles of posture, proximity, position, and biomechanical benefit.
Having had the opportunity to experience the interventions from the perspective of a patient has been an important aspect of developing both verbal and physical skills, as it will help to increase my awareness of the patient experience and be more mindful of maintaining communication with the patient at all times. Experiencing physical intervention from the perspective of the patient I feel is extremely important in demonstrating just how essential the communication is in lowering anxieties.
The Instructors were excellent in promoting the verbal skills from day one right up to the end of the course when looking at high-risk physical interventions. It cannot be emphasised enough the value of verbal skills in preventing and managing crisis situations without the need for physical intervention. It is a skill that should be used far more and should be promoted much more than it is. This is one of the main reasons why I have found the MAPA® course to be so positive and I would highly recommend it.
That said, the physical intervention skills that have been taught throughout the course have been based on the basic principles of posture, proximity, position, and biomechanical movement, as well as the inside–outside principle. This is not only a simple and effective way of managing risky behaviours without causing injury to the patient, it is also flexible and allows for the management of newly experienced situations based upon these principles.
Another skill I will take away from the course and promote in practice is the post-crisis CPI COPING Model℠. I think this is a highly valuable skill and may help in the prevention and management of future crisis situations.
Overall I found the course to be a very positive experience and it had really underpinned my own values of working in a patient-centred and least-restrictive manner. I feel much more confident in taking control of risky situations having had this training, and I hope that having a more confident approach will help to make my patient group to feel better supported.
Many thanks and keep up the excellent work.
—Gemma Willingham-Storr, RNLD, Staff Nurse, a mental health trust in the Yorkshire and Humber region
I couldn’t have put it better myself. Thanks, Gemma—you really made my day.
Note: Management of Actual or Potential Aggression
) is a CPI training offering in Europe. The programme incorporates the units of Nonviolent Crisis Intervention®
training with alternative physical skills taught in Units VII and VIII. An additional model—the MAPA®
Decision-Making Matrix—provides a tool for assessing risk behaviours.
programme will premiere in the US this July at the 2013 Instructors’ ACT Conference. Nonviolent Crisis Intervention®
Certified Instructors can attend MAPA®
as an Advanced and Instructor Excellence Renewal Course
Learn more about MAPA®
and the other training programmes and events taking place at the 2013 Instructors’ ACT Conference
July 8–12 in Milwaukee, WI.