How We Keep Experienced Hospital Workers Engaged in Training

“Well, it’s a nice class, but Nonviolent Crisis Intervention^® training does not work in the real world of psychiatric hospitals,” grumble the staff as they file into the classroom, scowling.

For the past fifteen years, since our facility began using CPI’s program, we have found ourselves battling this frequently heard indictment of the training. Teaching the initial class to new employees is no big deal, but it can be a hard sell at refresher time when we’re addressing people with years of experience, who in some cases have developed jaded views.

Rather than trying to confront the resistance, we Certified Instructors have found ways to work around it and ultimately garner more engagement from our participants. 

Here’s how we’ve modified our approach.

1. We enter the classroom as leaders among learners.

Before a session starts, the Instructor must set aside his or her ego, taking a stance similar to the popularized concept of servant leadership. This self-preparation is a vital step toward removing psychological obstacles. We signal this attitude through our introductions; for example, “We’re excited to have so many seasoned staff in the class today because we always learn so much from you.”

2. We meet the issue head-on early in the session.

Some literature discourages what could be considered negative admissions from the Instructor.
In our case, because disarming resistance is critical to success, we often begin by asking, “Have you heard anyone say that NCI doesn’t work, or have you said it yourself?”

Participants are not shy about raising their hands! We may follow up by asking someone to share why they have reached this conclusion. On closer inspection, we often find that there is not much substance to the perception.

We acknowledge the limitations of the environment and of the available options. We talk about the delicate balance that exists between Care/Welfare and Safety/Security. We verbalize the sobering perspective of adult protection laws that regulate facilities in our state.

3. We acknowledge our participants’ valuable experience and solicit their participation.

Because we generally know our audience well, we are able to sincerely congratulate them on their years of experience and success in handling difficult situations. Often, we request that they share a personal story about managing an agitated individual. By acknowledging our dependence on their good judgment, we enhance the meaningfulness of the class content for all participants.

4. We use group activities to engage staff as “peer teachers.”

The Key Point Refresher class lends itself well to dividing up the material among groups. Here are a couple examples of how this has worked in our trainings:

In 2015, we assigned each group a behavior level of the Crisis Development Model℠. Next, we asked them to review the key concepts of that level, and to develop and present a role-play demonstrating the behavior level and corresponding staff approach. Afterwards, the entire class had the opportunity to critique the role-play. To ensure that all key elements were covered during this exercise, we referred to the Participant Workbook and the post-test.

During the physicals, we take the following steps:  

• We ask participants to share personal experiences or situations they have witnessed, and invite the group to help troubleshoot. 
• We solicit stories of incidents in which staff achieved de-escalation through verbal interventions alone, therefore avoiding the use of physical intervention altogether. 
• We also encourage the sharing of stories where physical interventions seemed necessary. This gives participants an opportunity to work through issues related to the third level of the Crisis Development Model℠.
• We carefully monitor the training demonstrations for safety’s sake while still trying to maintain realism. This helps staff members feel more confident that the principles can work in real life.

Results

Using this positive approach has resulted in many smiles, handshakes, and even some thank-yous at the end of our sessions. 

The principles of Nonviolent Crisis Intervention^® training, which have proven effective in many treatment settings, can also be applied in the classroom when Instructors identify participant reactions of anxiety and defensiveness. You can significantly enhance the critical buy-in process using these same familiar concepts—and their responses, such as supportiveness, Empathic Listening, etc.

What works for you in your trainings?

Lisa Quintero Prewitt obtained a master’s degree in social work from the University of Alabama in 1975. Her clinical experience includes some child welfare but is mostly in mental health. For the past 15 years, she has managed the staff development department at Bryce Hospital, a state inpatient psychiatric facility. She became a CPI Certified Instructor in 2004 and has thus far logged close to 700 training hours. Besides her passion for the promotion of mental health recovery, Ms. Prewitt loves spending time with her six grandchildren, and enjoys reading and the outdoors.