THERAPEUTIC CRISIS INTERVENTION

Residential Child Care Project

Cornell University

Family Life Development Center, New York State College of Human Ecology

 

A child in crisis needs help!

What kind of help and how it is given make a crucial difference between the child's learning from the experience or being set back.

This train-the-trainer program for child and youth care staff present a crisis prevention and intervention model designed to help staff assist children to learn constructive ways to handle crisis.

ACTIONS SPEAK LOUDER THAN WORDS......

By their example, child and youth care staff shape the behavior and influence the growth of the young people in their care.

At no time is this issue more important than during periods of crisis and upset. The skills, knowledge and professional judgment of staff in reacting to crises are critical in helping children learn constructive and adaptive ways to deal with frustration, failure, anger rejection, hurt and depression. The ability of the entire organization to respond effectively to staff and children in crisis situations is critical in establishing not only a safe environment but one that promotes growth and development. The purpose of this project is to provide a crisis prevention and management system for residential child care facilites which will assist the organization in:

 

What is Therapeutic Crisis Intervention?

TCI is a model for crisis prevention and intervention that gives child and youth care staff:

 

To Establish TCI at Your Organization

THE TCI PROGRAM IS AVAILABLE IN TWO FORMATS

TCI ASSESSSMENT AND IMPLEMENTAION PACKAGE: A COMPREHENSIVE APPROACH

TCI TRAIN-THE-TRAINER PROGRAM

 

TCI Assessment and Implementation Package: A Comprehensive Approach to Implementing the TCI Model for Residential Child Care Organizations, Agencies, and Local Districts

CONTENTS

This comprehensive TCI ASSESSMENT AND IMPLEMENTATION PACKAGE will include:

 

OUTCOMES OF ESTABLISHING TCI

 

INTENDED AUDIENCE

State agencies, child care associations, local districts, residential child care agencies

 

HOW THE PROGRAM WORKS

Over a two-year period, staff from Cornell University's Residential Child Care Project (RCCP) will work closely with the residential facility to implement the TCI model of crisis management. This includes:

 

Using a train-the-trainer approach, RCCP staff will instruct selected supervisory and training staff in the TCI Program to deliver TCI in-service training to all levels of residential child care staff. Pre/post-testing, interviews and surveys will be conducted to analyze the effectiveness of this program. Throughout the life of the project, critical incidents will be compiled in a data collection set in order to track types and numbers of incidents. An advisory group will meet with RCCP staff throughout the project to help facilitate the process and to tailor the model to meet the organization's specific needs. Technical assistance will be on-going and available throughout the life of the project. Implementation occurs in three phases:

 

SPECIAL FEATURES

 

SIGNING UP FOR THE PROGRAM

TO DISCUSS THE IMPLEMENTATION OF TCI AT YOUR ORGANIZATION, CONTACT:

Michael Nunno or Martha Holden
The Residential Child Care Project
Family Life Development Center, Cornell University
Martha Van Renssalear Hall
Ithaca, New York 14853 Tel. 607.254.5210 Fax. 607.255.4837

 

The TCI Train-the-Trainer Program: Establishing an In-House TCI Program

CONTENTS

The train-the-trainer course will provide your agency representatives with an in-house training capacity in the TCI curriculum. The program:

 

GOALS OF TRAINING

 

OUTCOMES OF THIS PROGRAM

Upon successful completion of the program participants will be able to:

 

INTENDED AUDIENCE

Personnel interested in implementing an on-going, in-service training program in TCI techniques, including:

Note: This program requires participants to be capable of moderate physical activity.

 

HOW THE PROGRAM WORKS

This intensive five-day program will provide child and youth care staff with the skills and knowledge they need to become the catalyst through which children change old habits, destructive responses, and maladaptive behavior patterns in favor of constructive ways to handle problems. The curriculum stresses crisis prevention and how to help children learn from their experiences. The program will teach:

The program will also prepare participants to conduct their own TCI training. Participants will learn how to:

Participants will have the chance to practice conducting activities to gain immediate training experience. Training techniques such as the use of role plays, small group discussions, guided fantasies, conducting practice sessions, and the use of audio-visual aids will be demonstrated.

Upon completion of the program, participants will become part of an international network of TCI trainers. This network serves to help trainers share experiences, innovations, modifications and difficulties in implementing training programs in their respective agencies. Trainers will receive a newsletter and opportunities to attend TCI Update Training.

 

SPECIAL FEATURES

Five days of intensive participatory training conducted by two RCCP faculty members

A trainer's manual which contains course materials for 30 hours of in-service training and includes the following training aids for each module:

A two-hour video package which corresponds to the trainer's manual

A student workbook which can be used to conduct in-service training at your agency

A certificate of completion and an opportunity to register with the Residential Child Care Project as a TCI trainer and become part of an international network of TCI trainers

 

SIGNING UP FOR THE PROGRAM

 

The TCI Curriculum Outline

The TCI Curriculum includes five modules:

DAY ONE
DAY TWO
DAY THREE
DAY FOUR
DAY FIVE
1
2
3
4
5
CRISIS AS OPPORTUNITY
AWARENESS
EARLY INTERVENTION
THERAPEUTIC PHYSICAL INTERVENTION
RECOVERY

Defines crisis and identifies how adults can intervene in a crisis situation to help the child learn better ways of coping with traumatic events.

Teaches how to maintain self control in preventing or handling a crisis through awareness of personal feelings and values, the child's needs and wants, and environmental effects on behavior.

Presents verbal and non-verbal techniques which, if used before a situation escalates to crisis stage, can return an upset child to normal functioning.

Explains the rationale for physical restraint and when it should and should not be used, and demonstrates the safe use of various physical intervention techniques.

Explains what to do after the physical restraint in order to help the child learn that there are better ways of dealing with difficult situations than losing control.

  • The stress model of crisis
  • Intervention approaches

  • Awareness of self
  • Dealing with anger in a crisis
  • Awareness of the child
  • Awareness of the environment
  • Crisis prevention in the cottage setting

  • Behavior management techniques
  • Active listening
  • Life space interviewing
  • Conflict resolution

  • Rationale for restraint
  • Making the decision to restrain
  • Non-verbal communication
  • Team restraint
  • Single person restraint
  • Baskethold
  • Self-protection
  • Letting go

  • Life space interview during recovery
  • Recovery for staff
  • Life space interview as a supervision tool
  • Recovery for the agency

 

The Residential Child Care Project

The Residential Child Care Project (RCCP) is an international outreach and training organization established in 1982 as part of the Family Life Development Center at Cornell University to disseminate model techniques in the prevention of institutional child abuse and neglect.

World-wide, there have been over 3000 professionals trained as TCI trainers. These trainers are located in 40 states throughout the United States, Puerto Rico, Canada, the United Kingdom, Ireland, Australia, Russia and Finland.

 

RESEARCH UNDERLYING THE TCI PROGRAM

Through a grant from the National Center of Child Abuse and Neglect (NCCAN) in 1979, a study of child abuse and neglect in New York State foster care institutions was undertaken to assess the nature and extent of child abuse and neglect when it occurs in the institutional setting, and to identify those factors associated with its incidence. Factors associated with the incidence of abuse and neglect included the inappropriate use of discipline, isolation and restraint, and poor management practices. The Family Life Development Center staff spent many months researching other crisis intervention curriculums, meeting with child care experts, and visiting child care agencies in order to develop a comprehensive training program that addressed the issues outlined in the research. Therapeutic Crisis Intervention training was developed and pilot-tested at approximately eight facilities from the study sample of sixteen. Concurrently, the entire sample was involved in the testing of a model response system in reporting and investigating child abuse. From 1981 to 1982, child abuse reports (not instances of abuse) in those facilities which had pilot-tested the Cornell curriculum decreased by forty percent. In those sample facilities which were not exposed to the new training materials reporting increased by more than two hundred percent. (Note: By virtue of being in the sample, all of these agencies were much more sensitive to reporting issues and, therefore, more likely to make a report.)

 

SURVEY OF TCI EFFECTIVENESS

Two surveys of TCI trainers and agencies have been completed since 1991 to help determine the effectiveness of the program, and to learn how the TCI model has been implemented. Over 300 agency representatives from throughout North American, the United Kingdom, Ireland and Australia responded to these surveys. The results show that agencies and trainers perceive TCI training improving their staff's ability to respond to crises in safe and therapeutic ways. More importantly, this training enables staff to avoid the crisis in many situations using communication, awareness, and management skills learned in the TCI program. Staff confidence levels rise and their need to intervene physically decreased.

 

EVALUATION OF TCI EFFECTIVENESS

From 1994-1997, the RCCP and child caring agencies in Northeastern United States and the United Kingdom, conducted joint evaluation projects which introduced TCI into residential treatment settings and evaluated its effect on the organizations. Throughout the life of this project, critical incidents were collected and an advisory group from the agencies met with Cornell staff. Other data collection methods were pre- and post-tests, and interviews with staff supervisors and children. All levels of residential child care personnel attended TCI training (five-day offerings) conducted by the child caring agencies TCI trainers. Supervisors attended the TCI update, Recovery for Staff, to assist them in monitoring and supporting the model.

Results from the projects included a decrease in physical restraint episodes, fighting incidents, physical assaults, runaways, and verbal threats. Results also indicated that after attending TCI training staff felt more confident in their ability to manage any crisis situation, work effectively with co-workers, and help children learn to cope more successfully with life crisis. Staff were less afraid to manage crisis situations and were more child focused. They also reported an increase in knowledge about agency policy and procedures for crisis management.

 

OTHER PROGRAMS

Other components of the RCCP include regular TCI Updates on topics such as:

 

The Resdiential Child Care Project

Faculty and Consultants

 

Michael Nunno, D.S.W., Principal Investigator Dr. Nunno, formerly a Child Protective Services caseworker and supervisor, is the RCCP's Principal Investigator. He provides consultation and technical assistance to state, national and international organizations and agencies on child protective services training and on the development of effective preventive approaches and intervention responses to the abuse of children in out-of-home care.

 

Martha Holden, M.S., Project Director Ms. Holden, previously an associate director of a residential treatment center, is the Project Director of the Residential Child Care Project. She provides curriculum development, training and technical assistance in crisis management and violence prevention in residential child care facilities, foster care and educational settings internationally.

 

Greg Wise, M.A., Field Instructor Mr. Wise, having formerly worked as a residential child care supervisor and with the developmentally disadvantaged and mentally ill, is an instructor in the Therapeutic Crisis Intervention program. He delivers TCI training and TCI Updates and provides technical assistance to residential facilities throughout New York State.

 

Eugene Saville, Program Assistant Mr. Saville provides logistical support to the Residential Child Care Project. He is responsible for scheduling, registration, marketing and administrative support.

 

Kristen Carlison, Research Support Aide, Evaluation Project Analyst. Ms. Carlison provides evaluation and research support to the Residential Child Care Project. She provides programming and data systems development and management.

 

Marsha Kleine, Administrative & Conference Assistant. Ms. Kleine provides administrative support to the Residential Child Care Project. She provides conference assistance to the Project Director and Principal Investigator.

 

Beth Laddin, M.S.W., Instructor Ms. Laddin, formerly a risk assessment project coordinator and quality control monitor for residential facilities, is a social worker in an elementary school in Albany, NY.

 

Andrea Mooney, M.Ed., JD, Instructor Ms. Mooney, previously the program manager of the RCCP, a teacher and trainer, is a co-author of the TCI program and TCI Updates. Presently, she is the law guardian in Tompkins County, New York.

 

Jack C. Holden, M.S., Instructor Mr. Holden, formerly a child care worker and supervisor, is president of Mueller Holden and Associates, a consultant/training firm. He is a co-author of TCI Update.

 

I. Franklin Kuhn, Jr. Ph.D, Instructor Dr. Kuhn is a licensed clinical psychologist and private consultant and provides training and consultation to residential centers nationally.

 

Carla Sockwell Morgan, M.Ed., Instructor Ms. Sockwell is the Clinical Director for the Northern Region of the Lutheran Family Services in North Carolina where she provides training and consultation to all levels of residential child care staff.

 

Raymond Taylor, M.S.W., Instructor Mr. Taylor is responsible for the administration and delivery of training resources to child welfare and residential workers throughout the Falkirk region in Central Scotland.

 

Nick Pidgeon, M.S.W., Instructor Mr. Pidgeon is a private consultant in Scotland. Mr. Pidgeon delivers training programs to child welfare and residential workers in a variety of topics including crisis management.

 

Doug Bidleman, B.A., Instructor Mr. Bidleman is the coordinator for the Sociotherapy Training at Hillside Children Center in Rochester, NY. Mr. Bidleman specializes in crisis intervention and physical restraint training techniques.

 

Mary Ruberti, M.S.W., Instructor Ms. Ruberti, formerly a residential worker, is presently providing transitional case management services for the preventative services department at St. Joseph's Villa in Rochester, NY. Ms. Ruberti is also working on her M.S.W.

 

Phil Ishmael, B.A., Instructor Mr. Ishmael is a private consultant in NY, providing training and consultation to schools and residential centers

 

Diane Genco, M.A., C.P.C., Instructor . Ms. Genco works with D&G Milieu Consultants in Mesa, AZ. She specializes in training and crisis intervention services.

 

Sandy Patterson, M.S., Instructor. Mr. Patterson is principal at High Close School near London, England where he oversees residential and educational services for troubled children.

 

Angela Stanton-Greenwood, M.A., Instructor. Ms. Stanton-Greenwood is a trainer and social worker at a residential center for learning disabled children and adults in Yorkshire, England.