non-violent crisis intervention and how it has been
TRANSCRIPT
![Page 1: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/1.jpg)
Non-Violent Crisis Intervention and How It Has
Been Impacted by the Pandemic
Mary Gubbe Lee, MS, LSW, LCPC Training Consultant
![Page 2: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/2.jpg)
Pandemics are Irritating
• Lockdowns• Home School• No Travel• No Eat In Restaurants• Increased Prices• Social Distancing• PPE• Missing Family and Friends• Unemployment• Ruined Holidays• No hugs• No handshakes• And more!
![Page 3: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/3.jpg)
What?!? No Hugs?!?!• Instantly boost oxytocin levels which decrease stress
hormones and heal feelings of loneliness, anger and isolation.• Build trust and a sense of safety.• Lift one’s serotonin levels, elevating mood and creating
happiness.• Strengthen the immune system by stimulating the thymus
gland balancing the body’s production of white blood cells.• Boost self-esteem – they provide a tactile sensation that show
us we are loved and special increasing feelings of self-worth.• Relax muscles, release tension in the body and take away pain
because they increase circulation into the soft tissues.• Teach us how to give and receive.• Encourage empathy and understanding.
![Page 4: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/4.jpg)
Masks = No Smiles
![Page 5: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/5.jpg)
Smiles
• Reassure others
• Are polite.
• Communicate trustworthiness, belonging
and good intentions.
• Function as social connectors.
• A gentle smile is often perceived as a sign of compassion.
![Page 6: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/6.jpg)
Smiles
Brain releases tiny molecules called neuropeptides to help fight off stress.
Endorphins come into play and act as a mild pain reliever.
Serotonin is an antidepressant.
![Page 7: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/7.jpg)
Pandemics are Stressful
• The COVID-19 pandemic is stressful for all people.
• Fear and anxiety about a new disease and what could happen can be overwhelming and cause strong emotions in adults and children.
• Public health actions, such as social distancing and wearing masks, can make people feel isolated and lonely and can increase stress and anxiety, even though these actions are necessary to reduce the spread of COVID-19.
![Page 8: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/8.jpg)
Stress During a Pandemic Can Cause:
• Fear and worry about your own health and the health of your loved ones, your financial situation or job, or loss of support services you rely on.
• Changes in sleep or eating patterns.
• Worsening of chronic health problems.
• Worsening of mental health conditions.
• Increased use of tobacco, and/or alcohol and other substances
![Page 9: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/9.jpg)
![Page 10: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/10.jpg)
People with mental illness or substance use disorders are particularly vulnerable.
Mental illnesses such as depression, anxiety, bipolar disorder, or schizophrenia affect a person’s thinking, feelings, mood or behavior in a way that influences their
ability to relate to others and function each day. Additional stress, fear, anxiety, social
isolation and loneliness increase symptoms and put people at risk.
![Page 11: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/11.jpg)
The Pandemic Can Cause Neurological Changes in the Brain
![Page 12: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/12.jpg)
The Brain
![Page 13: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/13.jpg)
The Players of the Brain• Neurons - the cells of the brain
– 100 billion– Dendrites, Axons, Cell body with Nucleus
• Neurotransmitters - chemicals that communicate information throughout our brain and body– 50+
• Synapse – The space between the axon terminal and the receptor
dendrite where neurotransmitters flow…– 10,000 per neuron
![Page 14: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/14.jpg)
![Page 15: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/15.jpg)
![Page 17: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/17.jpg)
Neurotransmitters
Glycine
SerotoninGlutamate
NorepinephrineGTP
Substance P
Histamine
GABA
NEUROHORMONES
TRHDopamineATP
Acetylcholine
![Page 18: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/18.jpg)
Dopamine regulates
• Attention
• Motivation/Drive
• Pleasure
• Reward
• Mood
![Page 19: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/19.jpg)
Norepinephrine regulates
• Alertness• Concentration• Energy• Anxiety• Mood
![Page 20: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/20.jpg)
Serotonin regulates
• Obsessions• Compulsions• Anxiety• Memory• Mood
![Page 21: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/21.jpg)
Behavior is related to…
• Characteristics of brain regions
• The functions of neurons, including their connectivity into pathways or circuits
• The neurochemistry that exists between neurons that allows them to interact
• External stimuli
![Page 22: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/22.jpg)
Key Parts of the Brain
• Pre-frontal Cortex– Voluntary control of skeletal muscle
– Personality
– Higher intellectual processes (prefrontal cortex takes up the majority of the frontal lobe –executive suite)
• Concentration, planning, decision making
– “On second thought… ”
– Matures last (ages 25-26 for full maturity)
– Modulated by Dopamine…
![Page 23: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/23.jpg)
Pandemics
• Cause physical isolation and distancing
• Isolation causes decreases in dopamine
• People tend to become more subordinate and lose feelings of control and empowerment
• People lose ability to plan
![Page 24: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/24.jpg)
Rhesus Monkeys• Have an important historywith humans and
have aided a great deal to medical and scientific research.
• Rhesus antigens found in their blood enabled doctors to identify the different human blood groups.
• They are second only to chimps with comparable human DNA
• They also preceded humans into space starting in 1949.
![Page 25: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/25.jpg)
![Page 26: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/26.jpg)
Rhesus Monkey Experiment
• Isolated
– Low dopamine
– Stressed
– Subordinate
– Preferred cocaine
• Grouped
– High dopamine
– Non-Stressed
– Did not prefer cocaine
![Page 27: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/27.jpg)
What can pandemics cause in humans?
PTSDAnxiety Disorders
DepressionSubstance Use Disorder
![Page 28: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/28.jpg)
Biological Basis of PTSD
• Hormonal Differences
– Higher levels of stress hormones
• Cortisol, epinephrine, norepinephrine– Autonomic nervous system is more reactive
– Concept of Threat
• Summary of Key Brain Differences
– Smaller hippocampus (processing memories)
– Over-reactive amygdala (fear reaction)
– Under-reactive pre-frontal cortex (controls amygdala)
![Page 29: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/29.jpg)
Biological Basis of PTSD:
![Page 31: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/31.jpg)
Brain stem
PFC
Threat (fireworks on July 4th)
Amygdala
Well-modulated emergency response
Amygdala
Resick and Rasmusson, 2010
![Page 32: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/32.jpg)
PFC
Brain stem
Amygdala
PTSD Response
Trauma Triggers(fireworks on July 4th)
Resick and Rasmusson, 2010
![Page 33: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/33.jpg)
Cortisol - Needed for fight or flight decisions
Increases sugars (glucose) in the bloodstream and causes
– Weight gain
– Acne
– Heart attacks
– Strokes
![Page 34: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/34.jpg)
Adrenaline - hormone secreted by the adrenal glands
• Released on conditions of stress
• Increases rates of blood circulation
• Increases breathing
• Prepares for fight or flight
![Page 35: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/35.jpg)
Trauma rates are very high.
![Page 36: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/36.jpg)
Hurt people hurt people.
![Page 37: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/37.jpg)
Since the rates of trauma are so high, assume that the person has a trauma
background.
Always use trauma-informed approaches.
![Page 38: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/38.jpg)
Trauma-Informed Approach
• Safety
• Trustworthiness and Transparency
• Peer support
• Collaboration and mutuality
• Empowerment, voice and choice
• Race, Cultural, Historical, and Gender Issues
![Page 39: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/39.jpg)
Anxiety Disorders
• Generalized Anxiety Disorder
• Panic Disorder
• Phobias
![Page 40: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/40.jpg)
![Page 41: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/41.jpg)
Depression
![Page 42: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/42.jpg)
Depression SymptomsEmotional Symptoms
• Sadness
• Guilt
• Lack of interest
• Thoughts of suicide
Physical Symptoms
• Changes in appetite
• Changes in sleep
• Lack of energy
• Sexual dysfunction
![Page 43: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/43.jpg)
![Page 44: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/44.jpg)
Substance Use Disorder
• Illness of the brain.
• Chronic condition that requires life-long management.
• Compared to:– Type 2 Diabetes, Chronic hypertensive disease, Asthma,
Obesity
– All have a complex of physiological and behavioral health components
• No one treatment episode will resolve illness.
• Course of dependency is multiple episodes of treatment, recovery activities, relapse periods.
https://newsinhealth.nih.gov/2015/10/biology-addiction
![Page 45: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/45.jpg)
During 2020 alcohol sales rose nationally 262%
81% of SUD do not receive treatment.
![Page 46: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/46.jpg)
Overdose deaths in the US in 2020 reached 93,000
![Page 47: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/47.jpg)
166 overdose deaths in Winnebago County in 2020.
Up 28%
![Page 48: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/48.jpg)
Pandemics Cause
• More crises
• Less patience
• Less self control
• Need for more de-escalation
![Page 49: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/49.jpg)
Precipitating Factors of Crises
Internal and external causes of verbally and physically acting out behavior over
which staff have no control.
![Page 50: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/50.jpg)
Precipitating Factors
▪ Loss of personal power
▪ Lack of sleep
▪ Problems at home
▪ Not being at home
▪ Court issues
▪ Chemical abuse
▪ Hormones
▪ Pregnancy
▪ Anniversaries
▪ Displaced anger
▪ Psychological cause/triggers
▪ Physiological cause
▪ Trauma
![Page 51: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/51.jpg)
Understanding Precipitating
Factors Can Help Staff
▪ Prevent acting out behavior by being proactive
▪ Depersonalize crisis situations by recognizing that we are seldom the cause of the acting out behavior
▪ Avoid becoming a precipitating factor ourselves
![Page 52: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/52.jpg)
Signs of Conflict Escalation
• A person clenching his or her fists or tightening and untightening their jaw.
• A sudden change in body language or tone used during a conversation.
• The person starts pacing or fidgeting.• A change in type of eye contact.• The “Rooster Stance” – chest protruding out
more and arms more away from the body.• Disruptive behaviors – Such as yelling, bullying,
actively defying or refusing to comply with rules.
This Photo by Unknown Author is licensed under CC BY-SA
![Page 53: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/53.jpg)
Calm Yourself Before Interacting
• If you’re upset, it’s only going to escalate the situation.
• BREATHE
• Calm down and then begin to look at the situation and how you can intervene safely.
• Use a low, dull tone of voice and don’t get defensive even if the insults are directed at you.
![Page 54: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/54.jpg)
Paraverbal Communication
• Tone
• Volume
• Cadence
• Smooth and supportive
• Keep your voice at a
moderate level
• Deliver your message at
an even cadence or
rhythm
![Page 55: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/55.jpg)
Become Aware of Your Situation
• Other people in the room
• Objects such as chairs, tables, items on a table
• The space around you, like exits or openings
• If you are blocking the person so that they feel trapped.
![Page 56: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/56.jpg)
Body Language
• Appear calm and self-assured even if you don’t feel it.
• Maintain limited eye contact and be at the same eye level. Encourage the person to be seated (if you can)
• If he/she needs to stand, stand up also.
• Maintain a neutral facial expression.
• Place your hands in front of your body in an open and relaxed position.
![Page 57: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/57.jpg)
Supportive Stance
![Page 58: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/58.jpg)
Body Language
• Don’t shrug your shoulders.
• Don’t point your fingers at the person.
• Avoid excessive gesturing, pacing, fidgeting, or weight shifting.
• Maintain a public space distance.
![Page 59: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/59.jpg)
Personal Space - Proxemics
• Space around a person’s body that is seen as an extension of self
• Includes space around personal belongings
• Averages 1 ½ - 3 feet
• Pandemic = 6 feet
![Page 60: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/60.jpg)
![Page 61: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/61.jpg)
Personal Space Varies
• Gender• Relationship• Size• State of mind• Culture• Noise• History• Environment• Aura• Appearance• Smell• Title/role• Social Distancing
![Page 62: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/62.jpg)
Empathy
• Empathy needs to be shown during conflict situations.
• Even if you do not agree with the person’s position, expressing an understanding why that person feels a particular way will help resolve the conflict.
• Be nonjudgemental.
![Page 63: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/63.jpg)
Active Listening
• Clarifying, paraphrasing and open-ended questions all help to ensure that the person is aware you have understood their frustrations completely.
• Ask to take notes.
• Ask for their ideas or solutions.
• Help them talk out angry feelings rather than act on them.
![Page 64: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/64.jpg)
If de-escalation is not working, stop!.
If the situation feels unsafe, leave and call for help
![Page 65: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/65.jpg)
Contact Information
Mary Gubbe Lee, MS, LCPC, LSW
Training Consultant
4608 Newcastle Road
Rockford, Illinois 61108
815-721-2247
![Page 66: Non-Violent Crisis Intervention and How It Has Been](https://reader033.vdocuments.site/reader033/viewer/2022042522/62621473e6a41d5b080b5f54/html5/thumbnails/66.jpg)
Questions