Six stages of crisis

The six stages of a crisis and how to provide the right support at the right time.

Need for diversion, support and reassurance

• Behaviour - low level
  Shows signs of anxiety, hiding face in hands, bent over/under table, becoming red in the face, rocking or tapping, withdrawing from group, refusing to speak or dismissive, refusing to co-operate, using a fixed stare.
• Positive handling response - low level
  Distraction. Offer a change of scenery or a special job to do. Read the body language and the behaviour, intervene early, communicate; display calm body language, talk low, slow and quietly, offer reassurance, including positive physical prompts, assess the situation, divert and distract introducing another activity or topic. Remind about token or reward that is being worked for.

Need for diversion, reassurance, clear limits, boundaries and choices

• Behaviours - Medium level
  Displays higher tension, could be abusive, making personal and offensive remarks or swearing, talking louder, higher, quicker, adopting aggressive postures, changes in eye contact, pacing around, breaking minor rules, low level destruction, picking up objects which could be used as weapons, challenges; ‘No I wont…’, ‘Go away’ etc.May try to run/escape.
• Positive handling responses - medium level
  Continue to use level one strategies + state desired behaviours clearly, , offer alternatives and options, offer clear but limited choices – A or B, give a get out with dignity, assess the situation and consider making the environment safer and getting help, guide towards safety using a ‘big gesture’.. Give him/her space. Remove audience.

Need for possibly for physical intervention

• Behaviours - high level
  Shouting and screaming, crying, spitting, biting, head banging, scratching pulling hair damaging property, picking up objects which can be used as weapons, hurting self, grabbing or threatening others, hurting others, kicking, slapping, punching.
• Positive handling responses - high level
  Continue to use level 1 and 2 de=escalation responses and make the environment safer, Reduce your use of language, move furniture and remove weapon objects, guide assertively, hold or restrain if absolutely necessary, ensure face, voice and posture are supportive, not aggressive, use fresh face if needed. Ensure privacy. No unnecessary people present.

Need for co-ordinated letting go and reassurance

• Recovery behaviours
  May cry, go into a confined space, curl up into a ball.  Can easily be confused with anxiety stage. People may sit quietly in a hunched position, the difference is they can revert to extreme violence without the build up associated with the normal escalation in stage 2
• Recovery positive handling responses
  Support and monitor, this may not be a good time to touch as it may provoke a reversion to crisis, give space, look for signs that the person is ready to talk.

Need for observation, support and monitoring

• Recovery behaviours
  After a serious incident people can become depressed, they may not want to interact.
• Recovery positive handling responses
  Support and monitor, respond to any signs that the person may want to communicate, show concern and care but do not attempt to resolve residual disciplinary issues at this stage.

Need for listening and learning

• Follow up
  Listening and learning, recording, reporting and communicating, planning to avoid similar events in the future.
  
  
  • Listen to views of childWhat can be learned from this?
  • Keep appropriate record of incident and responses
  • Share reports as appropriate – child’s file
  • Appropriate professionals meet to discuss plan/risk assessment/care and control plan.