Archives: Lessons

Types of Consent in Guardianship

Illustration of Jeffery, the new hire.

One of the major responsibilities guardianship staff fulfill is giving consent. There are many things to consider before giving medical consent. To begin, let’s review the different types of consent.

Phase VI: Post-Event / Action: Post-Crisis Activities

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This lesson examines what needs to be done after the crisis is over. It is essential that we use every crisis situation as an opportunity to learn how to better assist the individual and reduce the amount of crisis they experience. 

This is the most difficult part of crisis intervention, but it is vital to preventing future crises.  Much energy is used during previous stages, so people may not want to carry out these activities.

  • Plan a debrief.
    • Sort what is working and not working.
    • Use Positive Identity Development to analyze the next steps.

Phase V: Recovery / Action: Restoration & Re-Integration

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This lesson focuses on how to help the individual return to a pre-crisis level of functioning. It is important that staff take every precaution to ensure that the individual’s dignity and respect are maintained throughout a crisis episode and that their reputation is harmed as little as possible as a result.

  • Support the person in crisis.
  • Identify others affected by the situation.
  • Plan to resume regular activities.

Phase IV: Vent & De-escalate / Action: Stabilization

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This section addresses staff response as the crisis begins to de-escalate. Emphasis is placed on emotionally responsible caregiving.

  • Identify what venting is and how we can use venting to help a client.
  • Evaluate what type of support a person needs during a crisis.
  • Determine how mindfulness impacts physical and mental health.

Phase III: Acceleration to Peak/ Action: Intervention

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In this lesson, we will explore staff behavior influences a crisis situation. We’ll discuss specific ways staff can help alleviate the underlying problem leading to the crisis. This section also explores ways in which many persons with disabilities experience loss and the role that plays in crisis development.  

  • This lesson is NOT
    • Crisis Prevention Institute
    • The Mandt System
    • Safe Crisis Management
    • Using restraints

Phase II: Trigger/Agitation/ Action: Pre-Crisis/Early Intervention

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In this lesson, we review the basic needs and keys to understanding the behavior of ourselves and others. Specifically, we will address factors to explore when determining triggers.

Do you have triggers?

  • Do your friends and family know those triggers?
  • Do staff you work with or supervise know their triggers?
  • Why is having people around you knowing your triggers a good thing?

Keep your answers to these questions close, as we will review at the end of the lesson.

Phase I: Calm / Action: Prevention

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This lesson will review ways to enhance a person’s life through person-centered planning, focusing on gifts and dreams, to reduce stress and negative emotions. We will discuss including person-centered planning principles in the crisis prevention planning process.  We will also explore ways to maintain calm.

  • Prevent crises.
  • Help the individual manage an episode with as little disruption as possible.
  • Develop natural supports and decrease reliance on formal systems.
  • The key to prevention is the building of supportive and emotionally responsible interactions between support  providers and those receiving supports.

Six Action Phases of Crisis Prevention and Intervention 

These phases are a systematic process of listening and responding to empower the person and help them return to their pre-crisis psychological state. The six-steps emphasize two distinct components of helping someone with a problem — listening and taking action.

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1. Calm

Action: Prevention

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2. Trigger and Agitation

Action: Pre-Crisis / Early Intervention

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3. Acceleration to Peak

Action: Intervention

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4. Vent and De-escalate

Action: Stabilization

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5. Recovery

Action: Restoration & Reintegration

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6. Post-Event

Action: Post-crisis activities

Understanding the Role of Trauma in Behavior

Kristen is seeing a new client today. When they are seated, Kristen begins with her typical questions. Which of the following is the more sensitive question, to begin with?

“What’s wrong with you?”

Not really. Using the word “wrong” puts Phillip on the defensive. His past with substance abuse is not something he is proud of.

“What happened to you?”

This is the better opener. Phillip can more easily describe his past trauma with abuse and using drugs to cope.

Understanding the Role of the Brain in Behavior

The brain plays a crucial role in crisis prevention. In a crisis, your brain will want to make decisions, not always the best ones. There is science behind how people react to stressful situations, and we can use it to our advantage. Stress management may reduce health problems linked to stress, which include cognitive problems and a higher risk for Alzheimer’s disease and dementia. It can also help you predict when you are likely to be stressed. Reaching out can help you become more resilient and better manage stress, potentially protecting your brain health.

References

This is Your Brain on Emergencies | Blogs | CDC. https://blogs.cdc.gov/publichealthmatters/2016/11/this-is-your-brain-on-emergencies/

Protect your brain from stress – Harvard Health. https://www.health.harvard.edu/mind-and-mood/protect-your-brain-from-stress

Calming Your Brain During Conflict – Harvard Business Review. https://hbr.org/2015/12/calming-your-brain-during-conflict

Mental Health Promotion and Prevention | Youth.gov. https://youth.gov/youth-topics/youth-mental-health/mental-health-promotion-prevention

Moving From a Service Life to a Community Life 

Community Mental Health Centers- Crisis Services

Map outline of Kentucky

Key expectations of CMHC crisis services:

  • Establish a central point of contact for crisis coordination
  • Establish a crisis triage system
  • Ensure available on-call I/DD staff trained in risk assessment and mitigation
  • Ensure available mobile stabilization crisis services
  • Ensure a debriefing meeting occurs for every individual who accesses an I/DD crisis service
  • Crisis Contact Data Sheet filled out and submitted to DDID for all crisis calls for individuals with I/DD accessing crisis services – these are reviewed by the CMHC liaison, who approves or rejects the sheet based on contents of the document

KY Community Mental Health Centers (CMHC)

This map highlights the various regions and the CMHC that serves those areas.  If you are not sure which region is assigned to provide services to individuals you provide supports to, then this map will provide that information to you.

Each Region has an assigned Crisis Coordinator and after hours Crisis Number that can be utilized when an individual’s crisis needs are greater than can be addressed by an agency and/or family. Make sure every participant has an updated copy of the CMHC Listing with DD Director Names and Regional Adult I/DD Crisis Coordinators w/Crisis Line numbers. You can find the brochure on the DDID website at this link:

CMHC Crisis Services Contacts

Select “Crisis Program Brochure” from this page

Effective Communication with Families

Watch this short video on partnering with parents. Video must be watched entirely to progress through the course. You do not need to watch any recommended videos at the end.

Effective communication with families is an important part of the family-teacher relationship.  Effective communication is a way to build understanding and trust with families.  Once you better understand and trust each other, working together to support the child’s development will be much easier.

At the foundation of effective communication is respect for families.  Respect should be included for every family’s:

  • religious and cultural background, values, beliefs, and languages.
  • parenting arrangements – for example, blended families, co-parenting, single-parent family, and LGBTIQ+ families.
  • parents’ and children’s gender and preferred pronouns.
  • choices – for example, where families live, whether their houses are tidy or what their children are wearing.
  • circumstances – for example, parents with disabilities, teen parents, families experiencing challenges.

Respectful communication with families might mean (raisingchildren.net, 2021):

  • using preferred pronouns with parents and children.
  • using plain language and avoiding professional jargon.
  • using interpreters, if you speak a different language than the family.
  • making sure that your printed resources show images of diverse families.

Want some more information? 

Check out this video about Finley’s Parent Teacher Conference.

Click Here

References:

Raisingchildren.net (2021 July, 26). Effective Communication with parents and Carers: For Professionals. https://raisingchildren.net.au/for-professionals/working-with-parents/communicating-with-parents/communication-with-parents

Face to Face Visits Documentation

Illustration of a woman with blonde hair in a bun wearing a read jack and black glasses

Per regulation 922 KAR 5:170 and standard operating procedure (SOP) GField-18, Face to Face visits are a requirement for each individual under guardianship. 

Face-to-Face visit is defined as an in-person, on-site meeting with an individual in their residence, workplace, day program, and/or other community location.

FaceTime/video visits do not meet the SOP requirements for face-to-face visits, but can be utilized in addition to the required visits.

In this lesson, we’ll review why face-to-face visits are important, how to prepare for them, and how to effectively document them.