2012 CARF Behavioral Health Standards Manual: Section 2.F. Nonviolent Practices/Nonviolent Crisis Intervention® Training Program


Full CARF Alignment Printable Version

 

2012 CARF Behavioral Health Standards Manual: Section 2.F. Nonviolent Practices Nonviolent Crisis Intervention® Training Program
Even with supports, there are times when individuals may show signs of fear, anger, or pain, which may lead to aggression or agitation. Staff members are trained to recognize and respond to these signs through de-escalation, changes to the physical environment, implementation of meaningful and engaging activities, redirection, active listening, etc. On the rare occasions when these interventions are not successful and there is imminent danger of serious harm, seclusion or restraint may be used to ensure safety. Seclusion and restraint are never considered treatment interventions; they are always considered actions of last resort. The use of seclusion and restraint must always be followed by a full review, as part of the process to eliminate the use of these in the future.

The goal is to eliminate the use of seclusion and restraint in behavioral health, as the use of seclusion and restraint creates potential physical and psychological dangers to the persons subject to the interventions, to the staff members who administer them, or those who witness the practice. Each organization still utilizing seclusion or restraint should have the elimination thereof as an eventual goal.		 CPI shares CARF's goal of eliminating seclusion and restraint. The Nonviolent Crisis Intervention® training program equips staff with the tools necessary to create restraint-free environments.

The curriculum provides a wide array of strategies for preventing and de-escalating crisis situations. Strategies for offering support or redirection through changes to the environment, listening, limit setting, conducting engaging activities, and recognizing the impact of staff attitudes and behaviors are taught throughout. The program teaches that physical restraints should be used only as a last resort when there is an imminent danger of serious harm to the individual or others. Additionally, all physical interventions should be discontinued at the earliest possible moment when the person served is no longer an imminent danger to self or others. The curriculum offers a debriefing model to assess each crisis moment to ensure that future incidents of acting-out behavior are prevented.

CPI supports the goal of a seclusion-free and restraint-free environment. This occurs when organizations train staff as an ongoing process that includes staff and client debriefing that ensures the Care, Welfare, Safety, and SecuritySM of everyone involved in a crisis.

 

 

 The Nonviolent Crisis Intervention® Training Program and the 2009 CARF Child and Youth Services Standards Manual: Section 2.G Nonviolent Practices.

“The goal is to eliminate the use of seclusion and restraint in child and youth services, as the use of seclusion or restraint creates potential physical and psychological dangers to the persons subject to the interventions, to the staff members who administer them, or to those who witness the practice. Each organization still utilizing seclusion or restraint should have the elimination thereof as an eventual goal.”

—2009 CARF Child and Youth Services Standards

 

CARF Alignment Printable Version

 

2009 CARF Child and Youth Services Standards Manual: Section 2.G Nonviolent Practices The Nonviolent Crisis Intervention® Training Program
There are times when individuals may show signs of fear, anger, or pain, which may lead to aggression or agitation. Staff members are trained to recognize and respond to these signs through de-escalation, changes to the physical environment, implementation of meaningful and engaging activities, redirection, active listening, etc. On the rare occasions when these interventions are not successful and there is imminent danger of serious harm, seclusion or restraint may be used to ensure safety. Seclusion and restraint are never considered treatment interventions; they are always considered actions of last resort.

The Nonviolent Crisis Intervention® training program focuses on preventive techniques to avoid the use of restraint and seclusion by equipping staff with strategies to intervene through verbal and nonverbal means to create a respectful environment promoting Care, Welfare, Safety, and SecuritySM.

In the Nonviolent Crisis Intervention® training program, physical restraint is recommended only when all less-restrictive methods of intervening have been exhausted and when the individual presents a danger to self or others.

Definition of restraint: Restraint is the use of physical or mechanical means to temporarily limit a person’s freedom of movement.

On the rare occasions when these interventions are not successful and there is imminent danger of serious harm, seclusion or restraint may be used to ensure safety. Seclusion and restraint are never considered treatment interventions; they are always considered actions of last resort.

 The Nonviolent Crisis Intervention® training program provides instruction in the use of disengagement skills and physical restraint techniques. The restraint techniques are viewed as emergency procedures to be used as a last resort, only when an individual is an imminent danger to self or others.

Standard 2.G.1: The organization has a policy that identifies:

1. How it will respond to aggressive or assaultive behaviors.
 

2. Whether and under what circumstances:
 

    a. Seclusion is used within the programs it provides.

    b. Restraints are used within the programs it provides.

 CPI recommends that all facilities develop policies and procedures addressing behavior management, restraint, and seclusion. Facilities should ensure policies and procedures are in compliance with applicable state and federal laws, as well as appropriate regulatory bodies such as CARF. CPI can help organizations develop new policies and procedures or improve existing policies and procedures.