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© 2012
2012CPI eRefresher Series –
Instructor Options
Advanced Renewals: Enhancing Verbal Skills: Applications of Life Space Crisis InterventionSM
and Supporting Individuals With Dementia and Related Cognitive Challenges
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2© 2012
Webinar Co-Presenters
Today’s Presenter
Alison MuellerGlobal Professional Instructor
Today’s Presenter
Dr. Randy BoardmanCPI’s Executive Director ofResearch and Development
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3© 2012
The Training Process
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4© 2012
Formal Refresher Requirements
Review and apply concepts of
Nonviolent Crisis Intervention®
training used by your staff.
Hours: From three to 12 hours.
Frequency: Every six to 12 months.
Purpose: Build on Nonviolent Crisis Intervention®
training content.
Minimum Content: Pre-test; course models such as the CPI Crisis Development Model℠, the CPI VerbalEscalation Continuum℠, CPI’s Personal Safety Techniques℠, Nonviolent Physical Crisis Intervention℠, and the CPI COPING Model℠; problem-solving based on staff needs; post-test; evaluation.
Training Materials: Use approved materials and a post-test.
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5© 2012
Poll Question 1
What do you think Life Space Crisis Intervention is about?
Talking with individuals in crisis.
Physically managing a crisis.
Verbal strategies for short- and long-term change.
Mediating between an individual, his or her stress, and behavior.
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6© 2012
Webinar Objectives
• Gain an understanding of Life Space Crisis Intervention.
• Identify how the Conflict Cycle is another representation of crisis development.
• Recognize ways you can develop staff’s verbal skills.
• Develop an understanding of how Enhancing Verbal Skills can expand the concepts introduced in Nonviolent Crisis Intervention® training.
• Identify whether Enhancing Verbal Skills is the appropriate refresher for your staff.
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7© 2012
Enhancing Verbal Skills: Applications of Life Space Crisis Intervention℠
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8© 2012
Training Program Overview
Nonviolent Crisis Intervention®
Training ProgramLife Space Crisis Intervention
4 DaysTrain the trainerCertified InstructorsCrisis Development Model SM
Nonverbal skills Verbal skills Physical interventionCPI COPING Model SM
Crisis as an opportunity
5 DaysSubcontract formatSenior Trainer of LSCILSCI Conflict CycleNonverbal skillsVerbal skillsNo physicalsSix Stages of LSCICrisis as an opportunity
CPI’sEnhancing
Verbal Skills
3 Days
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9© 2012
The CPI Crisis Development Model SM
Crisis Development/Behavior Levels Staff Attitudes/Approaches
1. Anxiety
2. Defensive
3. Acting-Out Person
4. Tension Reduction
1. Supportive
2. Directive
3. Nonviolent Physical Crisis InterventionSM
4. Therapeutic Rapport
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10© 2012
Possible Outcomes of a Crisis
The situation, behavior, relationship
. . . Stays the same
. . . Becomes worse
. . . Improves
CRISIS
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11© 2012
The Conflict Cycle
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12© 2012
Unbroken, the Conflict Cycle Spirals Into Crisis
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13© 2012
Enhancing Verbal Skills: Applications of Life Space Crisis Intervention℠
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14© 2012
Verbal Messages
Restate to convey a positive, supportive message.
• “You need to go to group.”
• “You forgot to take your meds again this morning. Take your medicine now.”
• “How many times have I told you, no yelling and screaming during lunch?”
• “No touching others or their belongings.”
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15© 2012
The Six Stages of LSCI
TIMELINE 2
DRAIN OFF 1
CENTRAL ISSUE 3
INSIGHT 4
NEW SKILLS 5
TRANSFER OF TRAINING 6
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16© 2012
Three Red Flag Reclaiming Interventions
• Carry In problem from another setting, such as home to school.
• Tap In to an unresolved emotional conflict.
• Carry Over problem from within current setting, such as lunch break.
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17© 2012
Poll Question 2
Why would you use this refresher option?
We have a hands-off policy and don’t use physicals.
Staff need additional de-escalation and debriefing skills.
Staff can’t get individuals to do what they want.
To do a better job turning Postvention into prevention.
http://www.crisisprevention.com/CPI/media/Media/Specialties/nci/advanced courses/evs/EVS-Sims-07-LSC-CRD-001.pdf
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18© 2012
Supporting Individuals With Dementia and Related Cognitive Challenges
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19© 2012
Supporting Individuals With Dementia and Related Cognitive Challenges
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20© 2012
Webinar Objectives
• Gain an understanding of CPI resources for persons with dementia.
• Review key concepts covered within Supporting Individuals With Dementia and Related Cognitive Challenges.
• Develop an understanding of how Supporting Individuals With Dementia and Related Cognitive Challenges can expand the concepts introduced in Nonviolent Crisis Intervention® training.
• Identify whether Supporting Individuals With Dementia and Related Cognitive Challenges is the appropriate refresher for your staff.
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21© 2012
Poll Question 3 - Review
Which are examples of person-centered care?
Everyone must eat at exactly the same time.
All residents go to activities at an assigned time.
Change our menu for likes and dislikes.
Staff do everything for the resident.
Allow those in care to do ADLs; staff only assist.
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22© 2012
A New Perspective
Old Perspective
People with dementia…
• “Can’t walk, need a wheelchair.”
• “Are sad, angry, and stubborn.”
• “Refuse care.”
New Perspective (Best ability to function)
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23© 2012
A New Perspective
Old Perspective
People with dementia…
• “Can’t walk, need a wheelchair.”
• “Are sad, angry, and stubborn.”
• “Refuse care.”
New Perspective (Best ability to function)
Would you have your loved one live in
your facility? Why or why not?
People with dementia…
• “Can walk with assistance.”
• “Express how they feel.”
• “Want to be independent.”
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24© 2012
Memory Activity
Short-Term, Long-Term, Working, Procedural
• “I was born on a farm in Michigan.”
• “I think we have bingo tonight.”
• “I may be getting old, but I can still drive!”
• “How does this new phone work?”
• “What did we have for lunch today?”
• “Where is the elevator in this place?”
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25© 2012
Memory, Attention, and Sequencing
List all of the steps needed to pay monthly bills.
Start ____________________________________________
Step ____________________________________________
Step ____________________________________________
Step ____________________________________________
Step ____________________________________________
Step ____________________________________________
Step ____________________________________________
Finish ____________________________________________
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26© 2012
Cognitive Hierarchy
“Last in, first out” (Reisberg et al., 2003)
Executive
Function• Reasoning
• Problem solving
• Judgment
• Organization
Memory Processing• Working memory system
• Long-term memory system
• Quantity and quality of information
• Visual field and concentration
Attention
(Katz, 2005)
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27© 2012
Developmental Stages Activity
Common Abilities or Expectations (e.g., dress)
• 0 to 12 months
• 4 to 12 years
• 20+ years
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28© 2012
Best Ability to Function
Can Do
• Realistic abilities.
• BATF.
• What they still can do.
Will Do
• Relevant activities.
• Influenced by interests and values.
• Culture.
May Do
• Possible abilities.
• Externally influenced.
• Impact of care givers, family, and environment.
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29© 2012
An Integrated Model of Care
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30© 2012
Potential Communication Breakdowns
Message
SenderStaff, Relative,Other Clients
ReceiverPerson With
Cognitive Challenges
Expressive
Communication
Verbal
Paraverbal
Nonverbal
Receptive
Communication
Receptive
Communication
Nonverbal
Paraverbal
Verbal
Expressive
Communication
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31© 2012
Adapting Communication
Communication Do’s
• Use nouns; avoid pronouns: “Bob, put on your shirt.”
• Eliminate noises/visual distractions (radio, TV).
• Short sentences: “Bill, wash your face.”
• Use closed-ended questions: “Chris, apple or orange juice?”
• Wait for response; 10–20 seconds to process.
• Visual and tactile cues; prompts with words.
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32© 2012
Post-Test Addendum
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33© 2012
Quality of Life
Care, Welfare, Safety, and Security SM
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34© 2012
Poll Question 4 - Review
Which are true about this refresher option?
Instructors can use course activities in trainings.
Course videos are on the Leader’s Guide disk.
For this refresher, at least six hours works best.
Instructor still needs to use a Nonviolent Crisis Intervention® workbook.
Course focus is on remaining abilities.
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35© 2012
2012 eRefresher Schedule
January 18: Motivating Refreshers: The Choice Is Yours —
2012 Instructor Options series overview
February 15: Key Point Refresher and Personal Prevention PlanSM
March 14: Advanced Renewals
• Autism Spectrum Disorders: Applications of Nonviolent Crisis
Intervention® Training
• Trauma-Informed Care: Implications for CPI’s Crisis
Development ModelSM
April 18: Special Topics Session—Informal Refreshers: Reviews; Practice;
Policy Discussions; Rehearsals and Drills; Situational Applications
May 16: DVD-Based Options such as Preventive Techniques II and
Effective Limit Setting
June 22: Applied Physical TrainingSM and Master Level Refreshers
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36© 2012
2012 eRefresher Schedule
August 15: Adapting Nonviolent Crisis Intervention® Training for Young
Children and Keys to Organizational Buy-In and Support for Training
September 19: Advanced Renewals
• Enhancing Verbal Skills: Applications of Life Space Crisis
InterventionSM
• Supporting Individuals With Dementia and Related Cognitive
Challenges
October 17: Nonviolent Crisis Intervention® Workbook and Hybrid Training
Rescheduled from July to November 14: Integrating Positive Behavioral
Interventions and Supports (PBIS) and Bullying Behaviors: Applying CPI’s
Crisis Development ModelSM
Specific dates for each may vary due to training schedules of CPI staff.
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37© 2012
Questions? - Thank You!
The next webinar in this eRefresher Series will be:
Date: October 17, 2012
Time: 10:00 a.m. CT
Topics: Nonviolent Crisis
Intervention® Workbook and
Hybrid Training
Call toll-free @ 877.877.5390
Alison MuellerGlobal Professional Instructor
Dr. Randy BoardmanCPI’s Executive Director ofResearch and Development
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38© 2012
On-Demand Post-Test
1. What is LSCI and how can it help you assist an individual in a moment of crisis?
2. How can Enhancing Verbal Skills expand concepts learning in Nonviolent Crisis Intervention® training?
3. How can the verbal message exercise help staff enhance their verbal skills?
4. Describe at least three examples of how you can promote an abilities-based approach to care.
5. List examples of how you can move away from atask-centered focus to a person-centered care approach.
6. Give at least three examples of how you can adjust your communication skills for your care receivers.
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