Safe Management Group (SMG) Student Orientation. At Ontario Shores Centre for Mental Health Sciences

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1 Safe Management Group (SMG) Student Orientation At Ontario Shores Centre for Mental Health Sciences

2 Safe Management Group Safe Management Group (SMG) Training Program offers generic skills & techniques to support clinical staff in the prevention & management of the crisis continuum

3 SMG versus Other Programs SMG, has a psychologically-based philosophy with a prevention focus. It was developed by psychologists and behavioural therapists and looks at the functions of behaviour. This aligns with recovery and our mental health approach to prevent and care for patient who are experiencing crisis.

4 Role of Advanced Trainers Co-facilitates SMG Training for Ontario Shores Peer support for staff practice of SMG relationship management, de-escalation skills and safe physical techniques Works as a member of the team at Code Whites to support the team in promoting staff and client safety

5 Therapeutic Relationship Model

6 Therapeutic Relationship Model The model was created to focus on emphasizing working together in collaboration with patients which will positively impact staff and patient safety Evidence supports the development of multidimensional models for the management of aggression in mental health care settings (Duxbury, 2005)

7 Therapeutic Relationship Model Promote wellbeing and strengths Positive patient outcomes Promote least restraints and least intrusive philosophy

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12 Collaborative Recovery Model Guiding Principle 1 Recovery as an individual process Guiding Principle 2 Collaboration and Autonomy Support

13 Components of the Therapeutic Relationship Model 1~ Change Enhancement 2~ Collaborative Strengths and Values Identification 3~ Collaborative Visioning and Goal Striving 4 ~ Collaborative Action and Monitoring

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15 What is the SMG Program Crisis Intervention Training Designed by Psychologists, Behaviour Consultants & Physical Intervention Specialists Approved for use with children & adults by Ministry of Community & Social Services in 2003

16 Ontario Shores adopted SMG in 2008 to ensure staff are trained in a CERTIFIED program to support best practice

17 Approach Prevention of aggressive incidents Least intrusive Effective use of safe techniques

18 Risk Management

19 Summary of Risk Management What is a Behavioural crisis Two types of behavioural crisis: Predictable vs. Unpredictable Effective Prevention of behaviour crises: Plan for the predictable Know the response to the unpredictable

20 Risk Management Risk management includes: System Preparation e.g. Policies and Procedures Preventative Planning e.g. Plan of Care Functions of behaviour i.e. What the patient needs or wants

21 Summary of Risk Management Environmental preparation Enviroscan Staff preparation Aware of our own internal processes Stress management

22 Positive Self-Management Positive Thoughts Positive Feelings Positive Outcomes Positive Behaviour

23 Relationship Management

24 Summary of Relationship Power & equity Management Technique: Provide greater choices in areas of insufficient self-determination Social Exchange & Reciprocity Technique: Create balance; plan more positive experiences & reduce unnecessary negative experiences

25 Summary of Relationship Management Empathy, Caring, Acceptance Technique: Active listening, attention to verbal & non-verbal cues, inclusion of patient Genuineness & Openness Technique: Disclose appropriate feelings, personal thoughts & information

26 Summary of Relationship Management Responding to Emotions Technique: Allow patient to express emotions instead of interrupting patient during this process; use active listening skills. Meet the patient where the patient is at present

27 Summary of Relationship Coercion Technique: Management Avoid giving in to coercion; redirect by active listening & problem solving Avoid presenting coercive behaviours; Provide choices and or make a plan ahead of time empower the service user. Interpersonal Boundaries Techniques: Discuss with other staff; Negotiate & compromise with others on less important rules; Write down limits & frequently review & communicate with others

28 Managing Aggression

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30 Summary of Managing Aggression Aggression usually does not happen suddenly & without warning Aggression often occurs over time & through different phases There are NO set number of stages a patient will go through

31 Code White Response: Team Approach

32 Revised Code White Policy Code White responders will practice a least restraint & least intrusive philosophy & ensure alternative to restraints have been exhausted first & whenever possible There will be an identified Code White Team Leader at every Code White team response who will assign roles & responsibilities

33 Revised Code White Policy Code White team leader responsible to ensure a Safety Occurrence Report & Code White Review will be completed following the event Emotional debriefing is available for staff through Critical Incident Stress Support Team (CISS) & Employee Assistance Program (EAP)