All employees in programs certified by the Alabama Department of Mental Health (ADMH) must be trained in the safe use of restraint. As of March 1, 2012, the updated ADMH rules [PDF] require that restraint be used only when the client’s behavior presents a clear, present, and immediate risk to the physical safety of the client or others, and only when it is the least restrictive intervention available. High-risk positions such as those that do not give adequate attention to protecting the client’s head; those that place pressure or weight on the lungs, chest, sternum, diaphragm, back, abdomen, throat, or neck; and those that otherwise restrict breathing are prohibited.

Rules AL ADC 580-9-44-.07 Seclusion and Restraint and AL ADC 580-9-44-.08 Child and Adolescent Seclusion and Restraint guide the use of restraint and seclusion for employees and clients in Alabama's mental health system. The rules define seclusion and restraint as "safety procedures of last resort." They stipulate that employees be trained in identifying the underlying causes of the behaviors exhibited by the clients they serve, and in recognizing that staff behavior affects client behavior, and vice versa.

Training must include prevention and de-escalation techniques, and must provide alternatives to the use of restraint. Additionally, training should include information on evaluating risk of harm to determine whether physical restraint is warranted; monitoring for signs of distress; and documentation. Each trainee must demonstrate proficiency in administering physical restraint.

CPI Can Help!
Organizations across the US use the Nonviolent Crisis Intervention® training program because it's been shown to be effective in both the prevention of and the safe use of physical restraint. CPI training focuses on prevention and de-escalation techniques and other alternatives to restraint and seclusion, as well as how to use safer, less-restrictive physical interventions only as a last resort. Training gives staff tools to organize their thinking about risk behavior and help them determine the most appropriate, least restrictive intervention to use in each unique situation.

Tailoring Training to Your Needs
CPI training is flexible and can be tailored to the unique needs of your organization. With our train-the-trainer option, select staff can be certified to teach the program to other staff on a continuing basis. We also offer specialized materials to help connect the Nonviolent Crisis Intervention® training program skills and strategies with your PBIS plan to increase positive behavior.

How to Get Training
We can bring the Nonviolent Crisis Intervention® training program on site to your organization, or you can attend training in one of more than 150 public locations throughout the US.
Advanced Course
If you’re already a Nonviolent Crisis Intervention® Certified Instructor, you can share strategies with your staff from our advanced course, Trauma-Informed Care: Implications for CPI's Crisis Development ModelSM. This course dives deep into the influence of trauma on behavior and offers additional strategies to help you better support individuals who have experienced traumatic events. Locate an upcoming public program or have us bring the training to you.