5 Criterion for Medically Evaluating your Crisis Management System

School and treatment facilities are struggling with an increase in behavioral issues.?From off tasks behaviors like daydreaming to dangerous behaviors like aggression and self-injury, the demands placed on the professionals as a result of behaviors can feel overwhelming.?As a result, morale is down and attrition is up; moreover, the populations being served are not having their educational or treatment needs met.?Staff in these organizations crave an environment where individuals are invested in their education and treatment. One where they also feel invested and productive.?Moreover, both the individuals and the staff serving them want to feel safe.

Unfortunately, there are a number of crisis management systems making outrageous claims of increases in safety in the organizations they serve. This is despite the fact that they may have only been in business for a few years and the procedures have not undergone robust testing under multiple conditions. Sure, the procedures might seem fine during training; and sure, the practitioners might "feel" safer as a result; however, many of these procedures that have not undergone rigorous evaluation can actually lead to dangerous and even life-threatening situations. Many are coming out of different industries like law enforcement and martial arts. They are likely well-meaning and not simply trying to make a quick buck like larger organizations being run by private equity firms. But as you’ve heard us say, it’s not about intent. In the end, it’s about how the procedures being applied physically and psychologically impact those individuals being served.?Whatever the case might be, they do not possess the clinical or educational knowledge ultimately required to provide the precision of intervention based on the needs of each individual.

At?PCMA, our procedures have been tested and validated through millions of trials that have occurred across the world for more than 4 decades over hundreds of thousands of different conditions. For example, different types of facilities, different types of professionals, different types of disorders, different magnitudes of behaviors, etc. In addition, we have had our procedures medically evaluated by a Medical Doctor. In this video, I will cover 5 areas that you need to consider for having your crisis management system evaluated in. Ok, here we go.

1.???First up, how suitable are the techniques for various populations including young people and adults.?This means that each set of procedures should be evaluated to determine if they are physiologically sound with respect to the size, age and functioning level of an individual. In other words, are the procedures physically safe.

2.??The next thing to consider is if there is any psychological impact of the crisis management techniques. In other words, is distress minimized by ensuring there is no awkward or painful positioning as part of the procedure.?And do the procedures consistently require least restrictive techniques based on the behavior of the individual??At PCM, we employ a system of shaping and fading which requires responding within 3 seconds to the behavior of the individual to guarantee the least restrictive procedure is being used at all times.

3.??But crisis management isn’t just about the individuals we are trying to keep safe.?You must also consider if there are any potential risks of harm to staff members who are required to apply the techniques.?Things to consider here are not just the procedures, but also the number of people required to carry them out safely.?Oh, and then there must also be a component that includes post training observation and evaluation before being certified to use the procedures.?This is very important for safety.

4.??Now, beyond any obvious potential impact to the physical and psychological well-being, you must consider if there is any potential risk of harm to health or any safety implications at all for the individuals being served.?Staff need to be trained to observe for signs and symptoms that require immediate response and the appropriate remedial actions to take.?The safety of the physical environment should also be taken into consideration.?For example, does any prone or supine procedure require safety equipment like a foam mat, or are individuals being restrained on the hard ground??Restraining individuals on a hard surface has a number of negative effects including injury to the individual, staff, and damage clinical and educational relationships.?But let’s unpack number 4 a little further by considering by different things.??

• a)???The first thing to consider is extremely important as it has led to death.?This has to do with positional asphyxia.?In short, are there any risks that the physical techniques may have relative to the process of breathing??This could occur by placing the individual in an awkward and unnatural position, or from the practitioner placing their body on the individual in a way that affects their breathing processes.?PCM’s procedures require practitioners always keep individuals in their natural body positions.
• b)???Next you must look for evidence that techniques taught do not intentionally or even unintentionally inflict pain and are not developed with pain compliance as a means of control or as a component of the techniques taught.?Moving the hand an inch one way or the other can be the difference in the individual experiencing pain or not.?This is why procedures should be precise in nature, not general and based solely on principles. And the procedures should be tested across multiple conditions to ensure they are robust.?In PCM, there is no contact with joints, pressure points or other sensitive areas of the body.
• c)???Similar to intentionally avoiding pain, the next thing to consider is if there is evidence that the techniques taught avoid vulnerable parts of the body like the neck, chest, and sexual areas.
• d)???The fourth part of number 4 is considering the impact on joints and limbs.?So the procedures must be evaluated to determine if there is evidence that the crisis management system avoids hyperextension and hyper flexion of limbs and joints.
• e)???The final thing to consider as a part of number 4 has to do with potential.?In short, is care given to avoid positions that could lead to potential movements by staff or service users that could lead to uncomfortable or unnatural positions.?While a procedure looked at in isolation might appear safe, how great is the potential for error??And what are the ramifications of this error.???

6.??The 5th and final area to consider when medically evaluating your crisis management system has to do with training. In short, is the training evidence based? And is it being delivered as such??Training should include instruction, observation and?rigorous physical practice?with corrective feedback; moreover, it should include documentation of the repetitions as well as a measurement of competency.?

We hope the criteria we’ve laid out can help you to better evaluate your current system or potential systems for addressing the cycle of crisis.?To find out more about how you can bring the?Safest, Most Effective and Humane Crisis Management Solution?in the world to your school or facility, contact Drew Carter by email?@ [email protected].

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