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UNDERSTANDING DISTRESSED BEHAVIOURS
The Kaplan/Wheeler Model of the Assault Cycle
Brain function and Aggression/Stress
Recognising the cues for Primal/Social behaviours
The SCARF Model of influences on human behaviour
7-Phase model of incident management and recording
CONFLICT RESOLUTION for PMVA
Treating every person with Dignity and Showing them Respect
Having the correct attitudes needed for conflict resolution
Initiating contact with patients service users, visitors and other staff in a non-escalatory way
Discovering and Dealing with people’s communicated needs through listening and empathy
Managing resistance through appropriate persuasion and influencing skills
Deflecting and Redirecting verbal aggression through focus on key goals
Working with the audience and bystanders to positively influence conflict
Knowing when to disengage from conflict
PMVA PHYSICAL SKILLS
Proxemics, Prompting and Escorting
Fundamentals of Self-Protection
Survival from Common Assaults
Principles for Prompting and Escorting
Less-Intrusive Holding and Restraint Principles
More Restrictive Physical Restraint Interventions
Disengagement Methods
Advanced Control Tactics (for Higher-Risk environments)
Learning Outcomes
Proactive, Reactive and Retroactive Strategies
Learning Outcomes:
On completion of this PMVA training, your staff team* will be able to:
-Apply the legal principles of Reasonable Force to high-risk scenarios
-Apply the principles regarding Duty of Care to scenarios of high-risk
-Identify situations which may give rise to the risk of sudden death during restraint or of serious injury during an incident
-Understand that physical restrictive interventions are reactive strategies which are used in conjunction with proactive, preventative strategies
-Use tactics which encourage movement by prompting
-Use tactics which enable them to safely escort a compliant but unpredictable person from one place to another
-Employ control tactics for rapidly unfolding situations where they need to keep themselves and a vulnerable but physically-able subject subject safe from harm
-Employ control tactics in higher-risk situations where there is a risk that they might lose control and thereby allow harm to come to themselves, a colleague or the vulnerable (but physically capable) subject they are looking after record an incident clearly in a way that allows another person to understand their actions in the circumstances which faced them
-Communicate with their subject and with each other in a way which promotes the most positive outcomes in difficult and rapidly-unfolding circumstances
INCIDENT DECISION-MAKING for PMVA:
Core Person-Centred Values for Dealing with Distressed, Resistant, Dangerous Behaviour Legal, medical and professional implications of incidents involving PMVA Risk assessment (both formal and informal) during episodes of PMVA Legal and medical implications Good practice following PMVA incident management
- Making a profound impact on the quality of healthcare services provided.
- Fostering a culture of safety and trust within the healthcare community.
Restrictive Interventions
Where possible (in planned interventions) a thorough risk assessment must address:
any physical health problems and physiological contraindications to the use of restrictive interventions, in particular manual and mechanical restraint
any psychological risks associated with the intervention, such as a history of abuse
any known biomechanical risks, such as musculoskeletal risks
any sensory sensitivities, such as a high or low threshold for touch.
A restrictive intervention should also have a restrictive intervention reduction programme as part of a long-term behaviour support plan.
THREE-TIER MODEL
Proactive, Reactive and Retro-Active Strategies to Manage Potentially Harmful Behaviour
Our approach to providing advice, training and consultancy in the prevention and management of violence and aggression (PMVA training) follows a three tier model as follows:
PMVA Primary Prevention:
understanding the causes and triggers for challenging, risky or violent behaviour and attempting to change aspects of the environment in order to reduce the risk of their occurrence.PMVA Secondary Prevention:
selective interventions, mainly involving effective communication strategies which seek to prevent such situations, if they do occur, from escalating.PMVA Tertiary Management:
interventions, usually including some physical component, for mitigating and reducing risk if situations escalate to the point of violence or the possibility that serious harm or injury could occur.Dynamis offers courses which cover all three phases of the model and which emphasise both Tier 1 and Tier 2 interventions wherever possible, in line with the wider movement towards Restraint Reduction Programmes.
PMVA Physical Interventions are Reactive Strategies.
Physical Interventions are what we do to reactively manage potentially harmful behaviour – when it happens – to keep people safe and get things back to a baseline level of communication and coping as soon as possible when a person becomes distressed. These reactive strategies are only ever used as a last resort and are used together with proactive interventions.
Proactive interventions are a range of changes we can make in the person’s environment, in the ways that we communicate, in staff attitudes and in risky situations to reduce the need for the behaviour through which the person is communicating. When considering using Reactive Strategies as a last resort, consideration should be given to using the Least Restrictive Options wherever possible and only for the amount of time they are needed for.
- Making a profound impact on the quality of healthcare services provided.
- Fostering a culture of safety and trust within the healthcare community.
skills
What skills are developed in PMVA training?
PMVA Skills Development:
Duty of Care:
Understanding where the duty begins and ends and who carries responsibility for restraint during an intervention.Breakaway / Restraint Use of Force Rules:
Understanding Reasonable Force for Control and Restraint InterventionsRisk Awareness:
What are the risks of physical restraint intervention and how to reduce or avoid themGovernment Guidance:
What is expected by the national authorities who advise on best practice for restraint interventions and restrictive practices (e.g. Department of Health, NICE Guidance, Relevant Codes of Practice)Teamwork:
Working in cooperation with team-mates in high-risk restraint and non-restraint situationsPhysical Tactics:
-Reliable and Robust methods for last-resort physical intervention resolution of high-risk conflict situations
-Managing Proximity and Body Language Effectively (Proxemics)
-Low-Level Breakaway Skills from Common Assaults (grabbing)
-Functional Breakaway Skills from More Serious Assaults (impacts)
-Safe Prompting and Guiding Skills for use with unpredictable service users
-Control Tactics for early-stage engagement with a resistant or violent person
-Holding and Escorting Skills for use with disoriented persons
-Restraint Skills for more serious incidents requiring robust stabilisation (only where necessary)
-The use of restraint devices such as the Soft Restraint System (only where necessary)
- Making a profound impact on the quality of healthcare services provided.
- Fostering a culture of safety and trust within the healthcare community.
De-Escalation
Tried and trusted pathways for expertly managing patients and visitors who are abusive, refusing or resistant to the reasonable requests of staff. This is Conflict Resolution at its most critical.
De-escalation stands as the cornerstone of defusing volatile situations within healthcare settings, ensuring the safety of both patients and staff. It encompasses tried and trusted pathways that enable healthcare professionals to adeptly handle individuals who exhibit abusive behavior, refusal to comply, or resistance towards reasonable requests. This critical aspect of conflict resolution not only prioritizes the well-being of all parties involved but also serves as a fundamental pillar in maintaining a harmonious and secure environment within healthcare facilities.
Effective de-escalation techniques involve a combination of active listening, empathy, and strategic communication, fostering a sense of understanding and respect even in the midst of challenging circumstances. By prioritizing de-escalation strategies, healthcare providers can mitigate the potential risks of physical altercations, emotional distress, or further escalation of conflicts, thereby upholding the standards of patient-centered care and promoting a culture of mutual respect and safety.
Recognizing the significance of de-escalation in healthcare settings underscores the importance of preserving the dignity and integrity of every individual, while also safeguarding the well-being of the healthcare workforce. Proactive implementation of de-escalation practices not only minimizes the negative impact of confrontational situations but also cultivates an environment conducive to effective healing and optimal patient outcomes
- Making a profound impact on the quality of healthcare services provided.
- Fostering a culture of safety and trust within the healthcare community.
Breakaway
Breakaway Training
We train your team to quickly identify and safely breakaway from violence.
• Recognize
an escalating violence risk
• Use
de-escalation strategies to keep safe
• Use Body
Signals and identify Escape Routes
• Breakaway
from violence if needed
OVERVIEW
What is breakaway training?
Introduction to Breakaway
In any profession that involves physical contact with
others, there is a risk of violence or aggression. Whether you work in
healthcare, education, or security, it is important to have the skills and
knowledge to protect yourself and others from harm. This is where breakaway
training comes in. Breakaway training is a form of personal safety training
that teaches individuals how to disengage from physical confrontations and
prevent harm to themselves and others.
What is Breakaway Training?
Breakaway training is a set of techniques and strategies
designed to help individuals safely and effectively disengage from physical
confrontations. The training covers a range of skills, including non-violent
communication, de-escalation techniques, and physical interventions. The goal
of breakaway training is to provide individuals with the skills and knowledge
they need to prevent harm to themselves and others while minimizing the risk
of injury.
Benefits of Breakaway Training
There are many benefits to breakaway training. For starters,
it provides individuals with the skills and confidence they need to handle
potentially violent situations. This can help reduce stress and anxiety, which
can lead to better decision-making and a safer workplace. Additionally,
breakaway training can help improve communication skills, which are essential
in any profession that involves working with others. By learning how to
effectively communicate and de-escalate situations, individuals can help
prevent confrontations from escalating and potentially becoming violent.
Another benefit of breakaway training is that it can help
reduce the risk of injury. By learning how to safely disengage from physical
confrontations, individuals can minimize the risk of harm to themselves and
others. This is particularly important in professions that involve working with
vulnerable populations, such as healthcare workers or teachers. By having the
skills and knowledge to safely handle potentially violent situations,
individuals can provide better care and support to those in need.
Essential
Breakaway training is an essential form of personal safety
training that provides individuals with the skills and knowledge they need to
prevent harm to themselves and others. By learning how to effectively
communicate, de-escalate situations, and safely disengage from physical
confrontations, individuals can minimize the risk of injury and provide better
care and support to those in need. If you work in a profession that involves
physical contact with others, consider investing in breakaway training to keep
yourself and others safe.
LEARNING OUTCOMES
Learning Outcomes for Breakaway Training
Staff will learn:
• Health and safety principles for managing violence in the workplace (Duty of Care)
•
Principles of resolving conflict using non-physical means were possible prior
to needing a breakaway.
•
Managing proximity using body-language ‘barrier signals’ for protection and
breakaway
• Escape
route selection and movement in confined spaces (rooms, toilets, corridors,
lifts, etc.)
• Legal
rules on the use of reasonable force in self-defense or breakaway situations
• The
risks inherent in breakaway and self-defense scenarios and how to reduce or
avoid them.
•
Practical ways – including a small number of physical skills that can be broadly applied – for staff to protect and safeguard themselves and disengage
from the most common assaults prevalent in care services.
Staff will be able to do physical skills as follows:
• Managing
Proximity while approaching unpredictable persons
• Managing
Proximity moving away from danger
• Understanding
‘Instinctive Protection’ when suddenly assaulted
• Connecting
‘Instinctive Protection’ to sudden assault stimulus
• Building
‘Frames’ which naturally protect the body
• Strengthening
the Frames
• Maintaining
balance during movement
• Protecting
our consciousness as a priority
• Survival
and Breakaway versus Hair Grab or Hair Pull
• Survival
and Breakaway versus Limb Grabs
• Survival
and Breakaway versus Biting, Pinching, Scratching
• Survival
and Breakaway versus being punched, hit or slapped in the head
• Survival
and Breakaway versus throat grabs
• Escape
tactics for disengaging (Breakaway) from the assailant
PHYSICAL SKILLS DEVELOPMENT:
Basic Self-Protection Tactics
☐ Understanding Instinctive
Protection
☐ Being Alert to the Threat of
Physical Assault or Distressed Behaviour
☐ Understand the natural ‘Frames
of the body' for defense and protection
☐ Strengthening Natural Frames
to withstand Pressure and Movement
☐ Maintaining Balance under
Pressure and Movement
☐ Mitigate and Reduce the damage
caused by any physical assault
Survival from Common Attacks
☐ Survival and Breakaway versus impacts to the
face or head
☐ Survival and Breakaway versus body grabs
☐ Survival and Breakaway versus clothing/limb
grabs
☐ Survival and Breakaway versus throat grab
☐ Survival and Breakaway versus hair grab
☐ Survival and Breakaway versus the rear
choke-hold
DIFFERENT NEEDS
Different teams will need more or less Breakaway training.
Healthcare Workers
Breakaway training is particularly important in healthcare
settings because of the unique environment in which healthcare workers operate.
Healthcare workers often work with patients who are under significant stress or
experiencing emotional distress, which can increase the risk of violent or
aggressive behavior. Additionally, healthcare workers often work in confined
spaces, such as hospital rooms or examination rooms, which can make it
difficult to disengage from physical confrontations.
Furthermore, healthcare workers are often required to
provide care to patients who are physically or mentally impaired, which can
increase the risk of injury to both the patient and the healthcare worker.
Breakaway training can help healthcare workers learn how to safely and
effectively disengage from physical confrontations, while also minimizing the
risk of injury to themselves and their patients.
- Making a profound impact on the quality of healthcare services provided
- Fostering a culture of safety and trust within the healthcare community.
