LO5.3: SESSION 3 HOW TO APPLY PHYSICAL INTERVENTION?

Transcription

1 LO5.3: SESSION 3 HOW TO APPLY PHYSICAL INTERVENTION? SHORT DESCRIPTION OF THE ACTIVITY Recognizing proper ways for implementing physical intervention. The aim of the activity is providing guidance on how to apply physical intervention in the exceptional cases where it is required. KNOWLEDGES SKILLS COMPETENCES Identifying who should intervene. Choice of the least restrictive measure. Implementing it as little time as possible. Analysis and intervention on the physical environment. Action Protocol. When should finish the intervention. Filling in the record sheet of physical intervention. Emotional self-control. Empathy. Respectful attitude. Flexibility. Conviction and self-confidence. Ability to tolerate uncertainty. Performing a physical intervention properly paying attention to the safety of all users and professionals. The professional must be able to know how to implement physical intervention when facing a serious situation that requires it, with full safety for the youth and the other people involved. METHODOLOGY Tools and Methodology Individual work on a paper provided by the trainer (Paper 1) Power point. Debate. "Observation scale of aggressive behavior SOAS-R" (Paper 2) Record Sheet of physical intervention (Paper 3) Activity 1: How to carry out a physical intervention. The trainer invites participants to read Paper 1 individually. Each participant writes their points of agreement and disagreement with the document. Group discussion and sharing of opinions is done. The aim is to agree on the points referring to how to conduct a physical intervention (what can be done and what cannot be done). Pay attention to legal and cultural aspects. Activity 2: Reflections on difficulties, fears, doubts and dilemmas. After reading the former paper, the following questions are discussed and projected in a PPT: Have you ever applied physical intervention? How did you feel after applying it? Which emotions or feelings do you think would stir up in you this action (physical intervention)? Fear, anger, rage, obfuscation, blocking, anxiety, etc..? Do you feel competent when applying it? Difficulties observed.

2 Activity 3: Registration sheets Distribution and projection of physical intervention record sheets and the Observation Scale of Aggressive Behavior SOAS-R. In our everyday work we use the scale SOAS-R in those cases in which the episodes of aggressiveness are very common and usual. Over a determined period of time we record with this scale all the aggressive episodes caused by the child. With the information gathered we can elaborate a functional analysis of the aggressive behavior of the child. In this way we can know the origins of their aggressiveness, its triggers and consequences as well as the idiosyncrasy of every child. Moreover, we can, in this way, guide the performances and plan the interventions. Scales are filled out by educators present at the aggressive episodes (a record sheet for each episode) and the psychologist uses the outcomes to propose new ways of action. The results are also useful to correct inappropriate interventions and implement new ways of proceed. The aims of the activity are: Understanding the working documents in order to complete the record sheet after each physical intervention. Once ended the episode, valuing (by using records) the triggers, aggravating factors and protective factors of the environment that can be used to curb the development of the crisis and the personal resources of the youth to face by himself environmental pressures. Understanding the need for continuous assessment and monitoring of the procedure. Notes for the trainer: The intervention of more than one educator/ professional is advisable, so that while one of them performs the physical intervention, the other takes over the rest of young people and cooperates with the safety measures to be applied. Professionals should be respectful and remain calm throughout the process. Assessing at every moment the safety of the youth himself and of other people involved (young residents and educational staff), showing serenity and safety by avoiding provocative behavior. Maintaining an appeasing relationship and not an over-stimulating one. If physical intervention is used it should be employed the minimum physical intervention level necessary to ensure the safety of the youth and other people involved. The implementing period has to be the minimum required. All potentially dangerous objects would be removed. Conducting discussion sessions on the implementation of the action protocol after each episode in order to learn from experience. The intervention must respect the rights and dignity of the youth. Regular review and updating of the protocol taking as a ground the results and introducing proposals for improvement. After a crisis intervention in which the physical intervention is applied it is necessary an evaluation by the whole team aimed to detect if some point in its development has not worked as expected. This will allow introducing, if necessary, some action improvement not included previously in the protocol designed for this purpose.

3 WORKING PAPER Nº.1: How to perform a physical intervention? Physical intervention measures (interposing) and physical immobilisation. Physical intervention or immobilization of a minor shall consist in his/her fastening in order to prevent or detect a minor s action that could be dangerous for his/her physical integrity or someone else s or damaging to the center or its facilities. It will also be applied to prevent an unauthorized leaving of the center, when once failed persuasion it is not possible preventing this leaving by other means. In the event that the child do not change his/her aggressive attitude, both against himself/herself and against those around him/her and observed the lack of any possibility of dialogue or reasoning, professionals will proceed to physically restrain him/her upon previous decision of the educational team. Personal physical intervention can be used only as an exceptional measure, as a way of preventing violent behavior, self-injury or injury to other children as well as damage to the facilities of the Centre. Its purpose will be solely that of providing a physical safety control in those situations that involving an injury to the child himself/herself or to other children, the minor is not able or unwilling to control himself/herself. Physical intervention should be carried out with minimal intensity and for the minimum required time. The implementation of this strategy involves risks for children, who can develop more intense aggressive behaviors, but also seek or "look for" physical intervention by professionals. This measure consists in standing up between the youth and the person or object towards which he/she is directing the assault or in front of the youth, with direct fastening by other / s person / s, without possibility of using any object on this purpose and not being allowed, in any case, the administration of drugs on that purpose. The implementation of the aforementioned means for physical intervention would be proportional to the intended purpose and the youth s physical and moral integrity must be always guaranteed. The professional must act with confidence that it has full guarantees in the execution of his/her work. This work should be carried out with the presence of more than one professional, in order to help each other and to ensure that the action is progressing properly. Expressions of physical or verbal aggressiveness must be avoided. Implementation of physical intervention is a pre-established action that should be carried out with professionalism and without personal implications. So, the professional should not respond to insults, assaults, or any possible provocations. The Education Team is who conducts and manages the procedure. Another person from the team must look after the other children in the center, in order to maintain the right climate of coexistence. Physical intervention only will be applied if there is no other less burdensome way to achieve the aimed goal and for the time strictly necessary to ensure that the child is again in a position to control his/her own behavior and his/her relationship with other children. This intervention will be considered as completed after a gradual cool down by the youth and when the suitable coexistence climate in the center with the rest of the minors has been recovered.

4 Extreme care must be taken in the application of these measures with minor pregnant or breastfeeding mothers until six months after the completion of pregnancy. The meaning and justification of the action must be explained to the child, relating it with to his/her direct safety or indirect safety of the other children. This explanation can take place before the action, if possible, during the action or after it. The staff responsible for implementing physical intervention measures would have received specific training on this subject. WORKING PAPER Nº2: Observation Scale of Aggressive Behavior SOAS-R

5 Record sheet of physical intervention Date and Time: User: Professionals involved: Brief description of the situation: Indication of physical intervention: WORKING PAPER Nº3: Record sheet of physical intervention o Risk of injury to others o Risk of self-injury o Avoid physical damage to the environment o Other: Type of physical intervention: complete or partial Emotional state of the user: o Violent and / or aggressive o Impulsiveness o Risk of self-harm o Risk of material damage Interventions failed before physical intervention: o Verbal communication o Distraction o Conflict resolution o Defusing of intense emotions o Defusing the conflict situation Problems arisen during intervention: Youth s response to intervention: Professional s emotional state: o During the intervention : Defense, confrontation, chatty, calm, argumentative, restless, quiet, worried, tense. o After the intervention: guilty, anxious, irritable, tired, calm, worried, frightened, expectant, disconnected, dialogue...