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EVIDENCE BASED PROTECTIVE INTERVENTIONS
 
   

EBPI PREVENTION – BLENDED ONLINE

 
UNIT ONE
Understanding Human Behavior
UNIT TWO
Forming Therapeutic Rapport
UNIT THREE
Constructing Solutions
UNIT FOUR
Crisis Behavior Assessment
UNIT FIVE
De‑escalating, Escalating Behavior

UNIT ONE – UNDERSTANDING HUMAN BEHAVIOR

Key Point

1) Emotional and learned factors such as smiling, scowling, displaying anger or yelling can influence how staff behaves and can trigger negative or positive dynamics of the interactions between them and the individual’s being served in a program

ROLE PLAY UNIT ONE

PLAY VIDEO

Emotional Factors

If you come in with a scowl on your face then and barking directions it can and will trigger negative and unwanted behaviors from the people you serve.

When you walk through the door with a smile on your face and using effective communications and active listening techniques the people you serve will respond accordingly.

Fear is powerful in provoking difficult or aggressive behaviors. Anger can arise at a time of threat, as part of bereavement, or if needs are not being met.

Key Point

2) Psychological factors such as delusions, paranoia, personality disorders or cognitive impairment can influence the behavior of the individuals served. Emotional factors such as fear and anger can influence aggressive behaviors in the individuals served.

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Individuals suffering from delusions, especially paranoia, can feel they are being threatened and this can lead to defensive and challenging responses on their part.

People with personality disorders may have difficulty foreseeing the consequences on others of their actions and may become acutely distressed.

Key Point

3) Environmental factors such as excessive noise, hot or cold weather, or time of day can cause negative behaviors. Social exposure to negative behaviors such as aggression can influence aggressive behaviors in individuals.

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Factors relating to an individual's surroundings (e.g. excessive noise) can be provocative particularly if they are prolonged or persistent and may also interfere with the individual's rest and sleep.

People with cognitive impairment often find care surroundings overwhelming and over–stimulating and may not keep up with the speed or volume of information or activity they are exposed to.

Individuals that are exposed to yelling may yell to get their point across.

Individuals that are exposed to physical punishment may tend to become physically aggressive when confronted with another person that is non–compliant to behave in a way they want.

PLAY VIDEO

Key Point

4) Personality traits, learned behavior and belief systems can influence and trigger certain behaviors in human beings.

The various factors that cause behavior are the same for all human beings

  • Behavior influenced by events
  • Belief systems or thoughts
  • Emotions or what we are feeling
  • What and how we learn
  • Present or current condition of our health
  • Environmental and organizational factors

What Influences Behavior

  • Hereditary factors (Nature)
  • Social Environmental factors (Nurture)

PLAY VIDEO

Debate – Nature vs. Nurture

  • A person's development is predisposed in his DNA
  • Influenced by this life experiences and his social environment
  • Both Nature and Nurture play important roles in human development
  • Not known yet whether we are developed majorly because of Nature or due to Nurture

Evidenced Based Models

The Genetics Approach: the personality traits of a human being are largely determined by inherited biological factors and that there is a significant inherited component to personality.

The Behavioral Approach: behaviors are shaped by what people learn in childhood but can be modified and new behavior patterns can be acquired at any age.

Cognitive Behavioral Approach: individual's belief system (thoughts about themselves and how they view the world and others around them), expectancies, and assumptions exert a strong influence on the well–being of the person, as well as on the persons directly observable behavior.

The Genetics Approach

PLAY VIDEO

In this approach it is argued that both heredity and environment influence personality.

However it is our genes that form a large portion of our personality, which gives us our basic physical statute, temperament and level of intelligence. These raw genetic factors are shaped as we develop by learning and experience.

Although we are all unique there are still some universal common traits however individual traits or personal disposition best describe our nature more accurately.

The Behavioral Approach

PLAY VIDEO

Behavior modification programs are used to shape behavior and include functional analysis which is:

  • Documenting the frequency of an identified behavior;
  • Documenting the situation or event and;
  • Reinforcement associated with the behavior
  • Documenting a Baseline Behavior

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Antecedent (A) It is important that documentation include the situation or event.

Behavior (B) that had previously occurred that triggered the behavior.

Consequence (C) document both appropriate behaviors which we reinforce positively as well as inappropriate behaviors that may receive a consequence (natural or programmed).

Cognitive Behavioral Approach

PLAY VIDEO

An individual's belief system is contrived from what they learn from others as well as what they learn through their experiences growing up.

When working with the individual served staff must understand that the individuals' behavior is influenced by their learned belief system (automatic thoughts) which triggers a healthy or unhealthy emotional response to that thought.

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The basic premise is that people often have thoughts or feelings that perpetuate problematic or destructive beliefs and these faulty beliefs can affect functioning and relationships at home, work, school and in the community at large.

Fundamentally, if one can change their thoughts, then they can change their feelings about a situation so therefore they can change their response to that situation or event which can inevitably change their life.

CBT Example

For example: Imagine it's your birthday. You're expecting a phone call from a close friend, but it never comes. You called them on their birthday, so why didn't they call you? Do they not care enough to remember your birthday? You feel hurt.

Where did this feeling of hurt come from? It wasn't the lack of a phone call that caused the hurt. It was the thoughts about the lack of a phone call that hurt.

What if, instead of taking the missing phone call personally, you had thought: "My friend is so forgetful! I bet they don't know anyone's birthday." "Maybe something came up unexpectedly, and they're busy." "We did talk earlier in the week, so I guess it isn't a big deal."

Core Beliefs and Perceptions

PLAY VIDEO

The thoughts we have in any given situation are influenced by our core beliefs or how we perceive situations or other people. These are beliefs that we hold at the center of who we are that describe the basic nature of the world. Some examples of common core beliefs are: "People are generally good." "I am unlovable." "Everything turns out OK in the end." The world is a dangerous place."

Core beliefs are developed from a person's unique personal experiences. However, these beliefs aren't always accurate. For example, someone who was mistreated by a parent as a child might develop the belief that they are unlovable, when the problem was actually their parent.

Situation: Michelle and Audrey both call a friend who does not answer the phone.

Michelle – Core Belief: I believe that I'm unlovable, so how does this situation make sense with my belief? Thought: "My friend didn't answer the phone because she doesn't like me."

Audrey – Core Belief: I believe that I'm valuable, so how does this situation make sense with my belief? Thought: "My friend didn't answer the phone because she's busy or just not in the mood to talk. She'll probably call back, and if not, I'll call her again tomorrow."

Changing Thought Patterns

  1. Catch the thoughts – become more aware of thoughts.
  2. Check the thoughts – question the accuracy of your assumptions and interpretations.
  3. Challenge the thoughts – actively challenge thoughts that are unhealthy for you.

Example: Thought Record Situation – Everyone's busy, so I'm spending an evening alone with no plans. Thoughts – No one wants to hang out with me. I'm just wasting my life, sitting here alone. Emotions – Depressed Behaviors – Stayed home all night and did nothing. Just sat around having bad thoughts. Alternate Thought – I'm alone tonight, but everyone is alone from time to time. I can do whatever I want! Situation – A difficult assignment is due at school. Thoughts – This is so much work. I'm horrible at this stuff. I don't think I can do it. Emotions – Anxious Behavior – Avoided the assignment until the last minute. Had to rush my work. Alternate Thought – This is a difficult assignment, and it'll take a lot of work. But I know I can do it if I break it into small pieces. Use "Thought Record" Activity – Discuss how beliefs and automatic thoughts affect emotions and behaviors and how to teach consumers to challenge those thoughts

Key Point

5) Health issues, stress, losses, fears and lack of control over what goes on in life can lead to feelings of sadness, anger and hostility Anger, Fear, and Other Emotions Affect Escalating Behavior.

Stress, losses, fears and lack of control over what goes on in life can lead to feelings of anger and hostility.

When controlled, anger helps us. Anger drives us to make changes to situations that are bad.

The problem isn't having anger, it's having too much anger, and expressing it in an ineffective way.

Anger Management

PLAY VIDEO

Anger management begins with practicing self–awareness--learning to take a step back and see your anger before it takes over your mind.

Once you've learned to catch your anger early, you'll learn techniques to control it.

If you catch your anger before it explodes, you will be able to control it.

    When you feel yourself getting angry:
  • think about what is making you angry
  • pushing your buttons or triggering that anger
  • do you notice changes in your voice and body language?

  • How do you respond when the person you serve is getting angry?
  • Think about what is making them angry
  • Pay attention to what may be pushing their buttons or triggering the anger
  • Think about their normal reactions when they get angry
  • Make sure that you are not the issue or concern that is triggering their anger
  • Remove yourself from the situation while making sure it is safe to do so
  • If not then use a low tone of voice
  • make sure you are standing at least one and a half feet away from the person and;
  • offer choices other than hostility and aggression to the person

  • HEALTH FACTORS THAT INFLUENCE BEHAVIOR
  • Chronic pain
  • Illnesses related to poor health care and hygiene
  • Side effects of medications
  • Intoxication
  • Withdrawal
  • Energy level – no sleep; tired
  • Illness – Colds, flu, headaches, indigestion and other illnesses can cause reactions like grouchiness, crying or short temper. These reactions may be important indicators that the person is ill.
  • Poor eyesight
  • Poor hearing
  • Difficulties grasping things
  • Difficulties walking
  • Hunger – Hungry people are often difficult to deal with. A good meal can affect more than our mood, it can also influence our willingness to take risks.

HOW STRESS INFLUENCES BEHAVIOR

PLAY VIDEO

– Stress happens when day–to–day demands become overwhelming, unpredictable, or out of control – Stress symptoms may be affecting your health, even though you might not realize it. You may think illness is to blame for that nagging headache, your frequent insomnia or your decreased productivity at work. But stress may actually be the culprit

Common Effects of Stress
  • Body
  • Headache
  • Muscle tension or pain
  • Chest pain
  • Fatigue
  • Change in sex drive
  • Stomach upset
  • Sleep problems
Common Effects of Stress
  • Mood
  • Anxiety
  • Restlessness
  • Lack of motivation or focus
  • Feeling overwhelmed
  • Irritability or anger
  • Sadness or depression
Common Effects of Stress
  • Behavior
  • Overeating or under eating
  • Angry outbursts
  • Drug or alcohol abuse
  • Tobacco use
  • Social withdrawal
  • Exercising less often

Managing stress

MANAGING STRESS VIDEO CLIP
  • Regular physical activity
  • Relaxation techniques, such as deep breathing, meditation, yoga, tai chi or getting a massage
  • Keeping a sense of humor
  • Socializing with family and friends
  • Setting aside time for hobbies, such as reading a book or listening to music

Burnout

Burnout is not a simple result of long hours. The cynicism, depression, and lethargy of burnout can occur when you're not in control of how you carry out your job, when you're working toward goals that don't resonate with you, and when you lack social support.

Dealing with Burnout

  • Self– Care
  • Expressing and Soothing
  • Soaking up joy
  • Be mindful of warning signs
  • Spiritual Self–Care

Key Point

6) How you think about the behaviors and habits of others can influence how you think about and respond to them.

CULTURAL BACKGROUND

WATCH VIDEO

  • Cultural background constitutes the ethnic, religious, racial, gender, linguistic or other socioeconomic factors and values that shape an individual’s upbringing
  • A cultural background can be shaped at the family, societal or organizational level
  • Cultural background is an important way to define an individual's identity Cultural Perspectives
  • People of different cultural backgrounds often have to interact with each other
  • These interactions may lead to strong relationships that help build diverse communities capable of achieving substantial goals
  • Understand your own culture before you can appreciate any other
  • One can learn about culture by meeting people of other cultures, evaluating any biases towards other cultures, asking questions and reading

Stereotypes

WATCH VIDEO

A stereotype is any thought widely adopted about specific types of individuals or certain ways of behaving intended to represent the entire group of those individuals or behaviors as a whole. These thoughts or beliefs may or may not accurately reflect reality.

Prejudice

WATCH VIDEO

  • An affective feeling toward a person or group member based solely on their group membership
  • A preconceived notion, usually unfavorable, feelings toward people or a person because of their sex, gender, beliefs, values, social class, age, disability, religion, sexuality, race/ethnicity, language, nationality, beauty, occupation, education, criminality, sport team affiliation or other personal characteristics

Racism

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  • Is a discrimination and prejudice towards people based on their race or ethnicity
  • While the concepts of race and ethnicity are considered to be separate in contemporary social science, the two terms have a long history of equivalence in both popular usage and older social science literature
  • Racism can be present in social actions, practices, or political systems (e.g., apartheid) that support the expression of prejudice or aversion in discriminatory practices
Key Point

7) We can learn more about the people we serve by doing things with them, reading their record and talking to others that know the person like family, friends and staff that work with the individual.

WATCH VIDEO

  • People who interact with people who have disabilities have a great impact on the success of that person
  • We are all more alike than different
  • How you think about the behaviors and habits of others can influence how you think about and respond to them

  • How "WE" Think About and Respond to "THEM"
  • We like things; They fixate on objects
  • We try to make friends; They seek attention
  • We love people; They develop dependencies
  • We take a break; They go off task
  • We insist; They have tantrums
  • We stand up for ourselves; They are non–compliant
  • We change our minds; They have short attention spans

Person Centered Language

WATCH VIDEO

USE

  • Say "people who happen to have a disability"
  • Use simple be descriptors
  • Speak directly to a person and focus on her abilities rather than her disability
AVOID
  • Avoid labels for groups of people with disabilities
  • Avoid emotionally–charged descriptors
  • Avoid euphemisms to describe disabilities

Learning About People We Serve

    Get to know that particular person to be able to identify how anger, fear, and other emotions affect when their behaviors are escalating

  • Spend time with the person
  • Review the person's records
  • Talk to family, friends, and other staff members

Organizational Factors Influencing Staff Behavior

  • Physical Facilities
  • Organization Structure and Design
  • Leadership
  • Reward System

Organizational Factors Influencing Behavior of Individual Served

  • Laws, rules standards, policies and procedures regulate agencies – Possible conflict between what makes sense for the person with a disability and what makes sense for the agency
  • Documentation – spend more time filling out forms and writing notes than spending time with the people
  • Scheduling – Pressure to do staff schedules, activity schedules, scheduling visits to doctors and therapists and others put those things first.

Conflicts with the people who need staff are bound to arise.