PMDB

1
PMDB
Limit Setting
2
LEVELS OF STRESS
3
Therapeutic Verbal Interventions

• Using silence
• Accepting
• Giving recognition
• Offering self
• Giving broad openings
• Asking open ended questions

4
Therapeutic Verbal Interventions

• Placing event in time or sequence
• Making observations
• Encouraging descriptions of perceptions
• Encouraging comparison
• Restating

5
Therapeutic Verbal Interventions

• Reflecting
• Focusing
• Exploring
• Giving information
• Seeking clarification
• Presenting reality
• Voicing doubt
• Seeking consensual validation

6
Therapeutic Verbal Interventions

• Verbalizing the implied
• Encouraging evaluation
• Attempting to translate into feelings
• Suggesting collaboration
• Summarizing
• Encouraging formulation of a plan of action

7
SEVERE LEVEL OF STRESS

• Perceptual Field Limited
• Focused on One Thing
• Tunnel Vision
• Processing of Information Severely Limited

TOUCH
TASTE
VISION
SELF
SOUND
SMELL
8
SIGNS OF ESCALATION

• Threats to Others
• Increasingly Loud / Boisterous Behavior
• Begins to Lose Control
• Harmful or Dangerous Behavior
• Violation of Policy or Procedures

9
LIMIT SETTING

• Clear / Calm
• Non-Threatening
• Encouraging
• Enforceable
• Person may need time to process the information
• Directions may need to be repeated

10
LIMIT SETTING

• Firm Yet Supportive
• Simple and Direct
• Describe Desired Behavior
• Appropriate to Situation
• Progressive in Nature

11
By Enforcing Consequences, Staff Provide a
Structure for Future Learning
12
AVOID POWER STRUGGLES
13
Limit Setting Summary

• Use when more control is needed
• Should be appropriate to circumstances
• Be clear, direct and supportive
• Show respect for others
• Give options if possible
• State consequences if necessary
• Seek to maintain personal dignity and therapeutic
  relationships

14
PANIC LEVEL OF STRESS

• Perceptual Field Very Narrow
• Unable to Process Information
• Unable to Problem Solve
• Dangerous to Self or Others

15
INTERVENTIONS FOR ACTING OUT PERSON

• Personal Safety Skills
• Therapeutic Containment

16
LEVELS OF STRESS
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TENSION REDUCTION

• Returning to Normal
• Perceptual Field is Keen
• Taking in Information
• Returning to Normal
• Takes Time

Touch