CITING an “increase” in the number of children entering State care with behavioural challenges, the Child Protection and Family Services Agency (CPFSA) has concluded the first round of training to equip workers to identify and deal with traumatised wards who display aggression without getting physical.

The four-day crisis management training sessions, which began last week Tuesday, saw staff from 20 residential child care facilities (RCCFs) being exposed to several tools and strategies for crisis prevention, de-escalation, intervention, and post-crisis management by instructor specialist Kathy Peterson of the United States-based Professional Crisis Management Association (PCMA).

CPFSA Chief Executive Officer Laurette Adams Thomas said the move became necessary for several reasons, chief of which was the recognition that while some staff have been trained in trauma-informed care, “not a large number of employees have the skill sets” to be able to prevent, de-escalate or even respond in the event of a crisis involving a ward.

“The CPFSA has a number of children in its care who display mild to severe behavioural challenges, and that has been the case for quite a number of years now. What we want to do is to ensure the safety of the children as well as the safety of the employees when the staff has to respond during a crisis situation,” Adams Thomas told the Jamaica Observer last Thursday following the penultimate session at the Courtleigh Hotel in St Andrew.

Noting that there are occasions in which wards will display troubling behaviours, the CPFSA CEO said the aim is to “ensure that the staff are able to readily identify the signs when a crisis is about to occur so they can prevent the crisis, and if they have seen some evidence of it starting, how they can de-escalate before it becomes a full-blown crisis; and, in the event that a crisis does occur, how to appropriately intervene in such a way that you still maintain the safety of the children as well as their personal safety.

“And once that is done, how to have the children go through post-crisis management where they will be able to slip back into the normal routine. Now that we are seeing an increase in the number of children coming to us with behavioural challenges, we felt it prudent to ensure that the staff are equipped,” she told the Sunday Observer.

The CPFSA head said the training was also a pre-emptive strike to prepare staff for the categorisation of the childcare facilities.

“What that means is that we are going to be having the facilities designated to treat with specific conditions. So you will have facilities that are designated to treat with children who have behavioural challenges as well as facilities designated to house children who are physically challenged. Other facilities will be for special-needs cases. What that will do is allow us to streamline the resources, both human and financial and otherwise, that would be needed,” she explained. She said the training will become particularly handy in facilities that will be housing children with mild to severe behavioural challenges.

Section 24 of the Childcare and Protection Act mandates the establishment of residential therapeutic centres for children with severe behavioural challenges. In the past a child who was deemed ‘uncontrollable’ would be placed with the Department of Correctional Services where they would be mixed with children who are in conflict with the law.

Thomas Adams said the move towards the establishment of residential therapeutic centres demands caregivers trained in crisis management.

“This training is really focused on equipping the team ahead of time so that when we establish these residential therapeutic spaces and when we complete the categorisation of facilities, we will have the team members ready to be assigned,” she said.

“We are not just taking it there, but these 20 persons are being trained as practitioners. So it’s like a train the trainer programme, where they will then be equipped with the knowledge and the skills to train our other employees these techniques so that we can have our full complement prepared to handle these situations with competence and confidence,” Thomas Adams said.

She said the course, which will see individuals being certified, requires recertification yearly — a cost which the CPFSA will foot.

In the meantime, she said the CPFSA has approached the Ministry of Education in seeking to have the programme brought to school officials.

“I am of the view that this will also serve to benefit the teachers to be able to predict when something might arise and how to treat with it. The ministry is looking into it as well to have their team members participate. Even without them fighting the teachers, you have children fighting each other so even within those situations you need to be able to de-escalate,” Adams Thomas pointed out.

Meanwhile, instructor specialist Peterson said professional crisis management is provided by the organisation to educators and health-care professionals, direct care staff, behavioural analysts, and many other professionals worldwide.

“PCMA was developed in the mid-80s as a way to provide crisis intervention training to individuals who work with children, adolescents and adults who exhibit escalated behaviours but, overall, our purpose is to work with anyone that is working with people. Our main goal is to keep stable people stable. We focus on preventing behaviour and then we move into de-escalation and we do teach hands-on techniques to move people from one area to another or to immobilise them to keep them safe,” she told the
Sunday Observer.

Peterson was keen to point out that the techniques taught in the course, which involves a written exam and a practical test, is focused “on safety, preserving the dignity of the client, and painless holding”.

“So we are putting people in natural body positioning. In order for us to go hands-on with anyone, they have to meet a very specific set of criteria which we call CASH — continuous aggression, self-injury or high magnitude disruption. So, typically, maybe we have a situation where someone is throwing items that can cause injury but if, for example, you have a client who is refusing to do something, we would never go hands-on. We are not trying to be coercive and force someone to do something they don’t want to do. This is only in matters of safety,” she emphasised.

Noting that PCMA has “some very safe ways to handle aggression from individuals”, Peterson said there is much emphasis on the need for staff to remain in control of their emotions

“With our programme, we do what we call repetitions in training, so we do, for example, our transportation [method of removing an irate child or adult from a space in a heated situation], we do a total of 50 repetitions over four days, that way, when they are in a crisis situation their body naturally knows what to do and so they can remain calm and not further escalate,” she explained.

Said Peterson: “We already know our clients are in crisis, if we react suddenly with fast, jerky movements it may further escalate them and so we are trying as much as possible to be calm and de-escalate them as quickly as possible.”

“For me, and I have worked with other crisis management programmes, I see the whole picture. We are not just focusing on restraints and holding, we are making sure that everyone that comes to our training has a very good understanding of the importance of building relationships, strengthening positive behaviours so that we have that great foundation, so that when there is a problem we are more likely to de-escalate and not find ourselves in a crisis,” she added.