The document provides guidance for staff on responding to outbursts from consumers with disabilities. It discusses potential causes of outbursts including outside issues in a consumer's life, changes in routine or medication, and being in a new environment away from home. It emphasizes the importance of the first responder establishing rapport and communicating directly with the consumer. It also outlines non-verbal and verbal de-escalation techniques including maintaining a calm tone, showing empathy, and giving choices to help resolve the situation.

1. CDPVTC Mission
Statement
• To assist Kentuckians with
disabilities to achieve suitable
employment and independence.

2. What Can Cause an Outburst
• Outside Issues
Often we are unaware of a consumers home life.
Abuse, mental or physical or can even be
emotional. Also we have consumers that have been
neglected for many years, making it difficult for
them to conform to our rules and the over all
setting of this large facility. Many of our consumers
are used to small class rooms and just seeing the
same few people most of the day.

3. • Our consumers may act out if there's a death
in the family or the close friend. Just a change
in someone's routine can cause issues to arise.
A change in medication, or just being away
from home for the first time.
All of these issues and so many more we face
and understanding the consumers needs will
help us in assisting those needs. As well as the
behavior that the outburst can trigger.

4. First
Responder
• Reasons why.
Better understanding
When you’re the May have better rapport
first staff
Something may be lost in
member to
arrive, you
communicating it to others
should be the
Easier on the consumer ( to
primary staff
many staff may cause
interacting with
the
confusion)
consumer, unless
May intimidate consumer
it becomes to
emotional for
with many staff present
yourself.

5. Public Outburst
• If a consumer is in a public setting if you can’t
get them away from the situation then it is
often best to clear the area if possible.
• This will take away the audience and tends to
lead them to cooperate with less stress on the
consumer.
• This also will help the consumers private
information from being exposed to other
consumers.

6. Don’t Be This Guy

7. • It is important to be sincere when dealing with
a consumer. They can pick up on being “fake”.
• This can make the issue escalate even further
and cause the consumer to lose trust in staff.
• Consumers will be more likely to discuss
further issues with you as opposed to other
consumers.

8. Rapport
• Building rapport can assist you when there is a
crisis later on.
• Consumers are more likely to discuss issues with
staff they feel comfortable with.
• Rapport can be established by remembering a
first name or taking an interest in their hobbies.
• Congratulate them on any milestone no matter
how big or small. (i.e Birthdays, passing
test, completing training)

9. • De-escalation Techniques

10. Verbal and Non-Verbal Deescalation Techniques

11. Non-verbal Intervention
• When a person begins acting out we can
sometimes intervene without speaking a
word.
• Making eye contact-allows the person to know
we see what they are doing.
• We want to appear neutral, not nervous; we
want to come across as natural and not fake.

12. • Proxemics- we want to be three to four feet
from client, standing to the side of them.*
• We want our movements to not be jerky or
fast.
• No clinched fists or pointing. Hands should not
be in pockets and arms should not be crossed.
• Moving closer to acting out individual or
group can sometimes be enough to bring the
situation under control.
•
Adapted from http:// crisis prevention.com

13. Para-Verbal Communication
Para-verbal communication simply means how we
say things; it has 3 components:
*Tone-inflection of voice
*Cadence-rate of speech
*Volume-lowering or raising of our voice.
93% of communication is non-verbal according to
an UCLA study
* Adapted from http://crisisprevention.com

14. Verbal Intervention
* In a verbal intervention we want to show the
individual that we care.
* We want to show empathy
*Be calm, but confident
*Don’t confuse the individual with lengthy or
elaborate directions
*Get individual into new environment
especially if you are in an open area with an
audience.

15. What not to do in a De-escalation
Situation
T.A.C.O.S
Do Not:
Threaten the individual
Argue or contradict individual
Challenge the individual
Order or command
Shame or disrespect
* Fink, S. (1986) Crisis Management for the inevitable

16. Behavior Curve
Four areas of acting out behavior
* Prodromal
* Crisis Breakout
* Chronic
* Resolution

17. Prodromal
Is beginning phase; person may be:
*Fidgeting *
* Pacing
* Name calling
We want to exhibit:
* Self –control
* Be supportive
* Don’t be defensive
* Adapted from de-escalation strategies for crisis situations, page 16

18. Crisis Breakout
* Individual goes from anxious to actual rule
breaking.
* We don’t want to:
*turn our backs
*we want to know where the door is and place
ourselves between it and the individual
*Remain calm
* Give the individual choices
* Adapted from De-escalation strategies for Crisis situations, Page 17

19. Chronic
* Height of acting out behavior when person is
doing harm to themselves or others.
* Explain limits; be firm but respectful
*Empathize with the individual
* Suggest alternatives

20. Resolution
* The individual has calmed and may appear
tired
* If individual is able we can explain
consequences of the behavior
*If individual is tired we may allow them time
to be alone

21. Things to remember
• It is important to not take acting out
individual personally; Their behavior is usually
not about you, you just become the focus
when you intervene
• “When you’re a hammer, everything looks
like a nail…” By Bernard Baruch