Developing Positive Relationships and Crisis Prevention

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• Developing Positive Relationships and Crisis
  Prevention

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Developing Positive Relationships

• Starting from the Inside

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Introduction

• Positive Relationships- A connection or bonding
  of one or more people that is anchored in trust,
  understanding, kindness, and respect.
• Why the need for Positive Relationships
• 1. To feel safe and comfortable with others.
• 2. To develop a sense of belonging.
• 3. To lay the framework that allows
  individuals to become more confident,
  interdependent, and engaged in their world.

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Laying the Foundation

• Safety- Many of us and those we serve are
  burdened with memories of distrust and fear. To
  feel safe we must experience unconditional love,
  acceptance, and the physical and emotional space
  that were comfortable with.
• Security- The feeling that Im safe, I wont be
  hurt, and everything is going to be okay.
• Love- The warmth of feeling cared for. Its trust
  and faith that you unconditionally honor, accept,
  and understand me.
• Attachment- I belong. Im accepted. Stay with me
  even when Im being difficult.

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The Ingredients I Will Be.

• Genuine Be real. Dont fake iteveryone catches
  on. Your credibility and your chances of
  developing a positive relationships starts with
  your being genuine and real in your actions.
• Consistent We need to be predictable and
  reliable in our interactions with others. We
  cant be loving, caring, supportive one day and
  be distant and aloof the next.
• Supportive The old saying, Be here now!
  applies. Be in the moment when interacting with
  someone. Show caring by using your eyes, face,
  body, voice and touch.

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We must use our

• Eyes- The eyes are often referred to as the
  window to the soul. To build relationships, we
  must embrace others with our eyes.
• Your gaze into others eyes should be soft, slow,
  loving and warm.
• Picture your eyes as hands and arms reaching out
  to people.
• Many people see a look as fists. Look gently and
  softly at the person, moving your gaze into the
  persons eyes with out piercing them.

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We must use our

• 2. Face- Our facial expression tells more about
  how we feel about someone than our words.
• Our faces should be calm, relaxed, and gentle.
• Smile
• Even if you dont feel like it sometimes.smile
  till your heart catches up!

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We must use our

• 3. Body- Remember body kinesics and proxemics.
• Where and how you stand in relation to a person
  is critical in how they perceive your presence.
• Avoid squaring up and/or standing over someone
  while talking with them.
• When communicating with children come down to
  their eye level.
• When standing and engaging someone, stand with an
  open stance with relaxed body posture and open
  hands facing towards the person.

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We must use our

• 4. Voice- Even if the people we are talking to
  dont understand what we are saying, theyll feel
  what we are saying by our tone, volume, warmth
  and rhythm.
• Use gentle, calming words.
• If your talking causes escalation, go the other
  direction with your voice.
• People need to feel warmth, tenderness, and
  unconditional love from your voice.

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We must use our

• 5. Touch/ hugs- Use as a sign of friendship and
  caring.
• Touch should be done softly, slowly, predictably,
  and you should be ready to back off at any moment
  if discomfort is being shown.
• Knowledgeable touching is key. Know the
  individuals life-story, experiences, and comfort
  levels.
• Touch should be used for the hands, forearms,
  shoulders, side and back of the head and upper
  back.
• If touch/hugs are not appropriate to the
  situation then use your voice, body, face and
  eyes to communicate safety, security and love.

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Putting it all together

• Understanding
• Awareness
• Road Blocks

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Role of the Direct Service provider

• Assist and support the individual to make
  informed choices, follow through on
  responsibilities and take risks
• Promote the individual participating in the
  design of support services
• Provide opportunities for self-advocacy by
  increasing awareness of self-advocacy techniques,
  encouraging the individual to speak on his/her
  own behalf

From the National Alliance for Direct Support
Professionals Direct Support Professional
Credentialing Guidebook
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More on Roles

• Promote community connections, friendships and
  other valued relationships
• Assist the individual to meet his/her physical
  needs by teaching skills, providing supports and
  building on strengths and capabilities
• Ensure the health and safety of the individual

From the National Alliance for Direct Support
Professionals Direct Support Professional
Credentialing Guidebook
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Understanding Walk in my shoes

• Know your audience. Learn about the person youre
  developing a relationship with.
• Put yourself in their life experiences and begin
  to understand where they are coming from.
• Focus and start with what's inside, then work
  your way out.
• Accept everyone where they are. Build on that
  starting place.

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Awareness Be in the moment

• Give your time and attention.
• Notice the tears, smiles, anxiousness, and
  comfort and respond accordingly.

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Road Blocks What's keeping you from Developing
Positive Relationships?

• We bring our own stuff into relationships.
  Sometimes our stuff gets in the way of Developing
  Positive Relationships.
• Keep yourself healthy. Go on an ego diet. Eat,
  drink, think, sleep, and do positive things. Get
  supports for those areas in life that need TLC.
• Love or learn to love yourself. Be kind and
  gentle to yourself and youll be able to give the
  same in return.

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Making it work

• Training
• Practice
• Patience
• Openness

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1. Training

• When working with individuals with disabilities,
  learn all you can about them. Use the library,
  computer, seminars, co-workers, etc. as
  resources.
• Learn beyond this power point presentation on how
  to develop and maintain positive relationships in
  your life.
• Resource websites www.dimagine.com
• www.gentleteaching.com
• www.positiveway.com

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2. Practice

• If loving, caring, and supporting doesnt come
  naturally to youpractice.
• Volunteer at a senior center, or Special Olympics
  event. Join the Big Brothers Big Sisters
  organization.
• If your heart is vested in developing positive
  relationships all these concepts will fall into
  place and itll become a part of who you are.

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3. Patience

• Take a deep breath.
• You may not succeed in developing a positive
  relationship the first, second, hundredth time.
  If your heart is genuine it will happen!!
• Give it time, dont personalize setbacks, and
  always see the potential. The greatness that sits
  on the horizon needs to be visualized and
  realized by you!

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4. Openness

• It is very difficult to see through a cloudy
  window or a closed door.
• To be successful in developing relationships, you
  have to open up yourself.
• You must be willing to take the risk of love,
  trust, care and support.
• You cant give, what you dont have!

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A Commitment

• If you are willing to unconditionally
• Love
• Support
• Care
• Understand
• what commitment can you make today?

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What to do if a crisis occurs.
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Purpose of Crisis intervention

• To maintain
• Care
• Welfare
• Safety
• Security

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Physiological impact of a crisis

• Increased Heart Rate .
• Dilation of bronchioles for easier breathing.
• Constriction of arterioles in skin, digestive
  system, and non-exercising muscles.
• Inhibition of digestive functions.
• Widening of pupils.

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• Crisis development/Behavior levels
• Anxiety a noticeable increase or change in
  behavior.
• Examples pacing, finger drumming, wringing of
  the hands, staring

• Staff attitudes/approaches
• Supportive an empathic, non-judgmental approach
  attempting to alleviate anxiety

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• Crisis Development/Behavior levels
• Defensive Beginning of the loss of rationality.
  Person may become belligerent and challenge
  authority.

• Staff attitudes/approaches
• Directive An approach in which a staff member
  takes control of a potentially escalating
  situation by setting limits.

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• Acting out person
• Total loss of control which often results in
  acting out episode.

• Nonviolent Physical Crisis Intervention
• Safe non-harmful control and restraint techniques
  used to control an individual until they can
  regain their behavior. Techniques should be
  utilized as a last resort, when an individual
  presents a danger to self or others

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• Tension Reduction
• Decrease in physical and emotional energy which
  occurs after a person has acted out,
  characterized by the regaining of rationality.

• Therapeutic rapport
• An attempt to re-establish communication with an
  individual who is experiencing Tension Reduction.

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Nonverbal behavior

• Personal Space
• Factors that influence personal space include
  gender, size, cultural differences, familiarity,
  and situation occurring.
• Body positioning Body posture and motion which
  include facial expression

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Paraverbal Communication

• Definition the vocal part of speech, excluding
  the actual words one uses.
• A. Tone
• B. Volume
• C. Cadence
• Suggested approaches
• Try to avoid inflections of impatience,
  condescension, inattention, etc.
• Keep the volume appropriate for the distance and
  situation.
• Deliver your message using even rate and rhythm

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Release
Intimidation
Refusal
 
Tension Reduction
Questioning
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Tips for verbal intervention

• Do
• Remain calm
• Isolate the situation
• Enforce limits
• Listen
• Be aware of non-verbals
• Be consistent

• Dont
• Over-react
• Get in a power struggle
• Make false promises
• Be threatening
• Use jargon

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Empathetic listening

• Be non-judgmental
• Give undivided attention
• Listen carefully to what is being said (not just
  the facts)
• Allow silence for reflection
• Use restatement to clarify messages

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Compartmentalization of feelings

• DefinitionSeparation of ones feelings from the
  crisis situation.
• A professional attitude must be maintained so
  that we can control the situation.
• Outlets are needed for negative energy absorbed
  during the crisis
• An open discussion about the events may be needed.

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A very human experience
Individuals do not operate in a vacuum. Staff and
individuals effect each other.

• Individuals behavior level
• Anxiety (-)
• Defensive (-)
• Act out person (-)
• Tension reduction (-)

• Staff attitude/approach
• A. Supportive
• B. Directive
• C. NVCPI-only to be used if properly trained
• D. Therapeutic rapport

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After the incident

• Make sure everyone is safe
• Identify concerns and brainstorm ways to address
  those concerns.
• Look for patterns among crisis situations.
• Provide support and praise to your team members.

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Finally

• Remember Everybody is safe and tomorrow is
  another day.