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Safe Management

Safe management Crisis Intervention program was approved by the Ministry of Community and Social Services in 2003 for agencies serving children, youth and adults with developmental disabilities. In 2012 the Specialized Development Network Team along with the Ministry of Community and Social Services reviewed and recommended this program for staff supporting adults, youth and children.

The Safe Management Crisis Intervention training program was developed in 1990 for staff working in agencies that serviced adults with developmental disabilities. It was developed by psychologists, Behaviour Analysts/therapists, physical intervention specialists and martial arts experts to address the unique needs and challenges posed by individuals with unsafe aggressive/violent behaviour. Clinical experience suggested that a high proportion of this behaviour was predictable and therefore, potentially preventable if appropriate information was obtained and used within a behavioural management system. Experience also suggested that a more extensive physical intervention techniques were often required to safely manage the aggressive behaviour that was more commonly seen.

The training program was designed to integrate behavioural management principles, strategies and techniques with new, improved state-of-the-art physical intervention techniques, reflecting the diverse professional skills of the designers and the unique needs of the clients, while emphasizing least restrictive, least intrusive philosophy of care.

Safe Management teaches 5 components of support:

  1. Risk Management - Teaches staff supporting individuals with challenging behaviours about the two types of behavioural crises "Predictable and unpredictable", how to identify, support and plan for both. The different types of risks to the person, the home and the agency. Stress management, nutrition and medication. And finally focusing on Prevention for families, the environment and the topography of the client’s physical behaviour.
  2. Relationship Management - The greatest tool to use when supporting an individual with challenging behaviour. This component of Safe Management is a critical component in the prevention of predictable and unpredictable crises by focusing on 7 different principles of Relationship Management as good communication is the foundation for any relationship:
    1. Power and Equity
    2. Social Exchange and Reciprocity
    3. c. Empathy, Caring and Acceptance
    4. Genuineness and Openness
    5. Reading and Responding to Emotions
    6. Avoiding Coercion
    7. Communication Interpersonal Boundaries and Limits
  3. Behaviour Management - Further focus on environmental planning, the five functions of behaviour, anger managements and behaviour profiles
  4. Aggression Management - Focuses on the physiological stages that a client will go through during a behavioural crisis and how to respond to said crises. How and when to debrief and how to respond to a situation when a weapon is involved.
  5. Physical Intervention Concepts - For the safety, security and support of people who are supported, physical intervention concepts are utilized as an absolute last resort and only when the client has put their own life or the life of others in danger.

We ensure that intrusive intervention procedures are appropriately approved and reviewed on an on going basis. We have a stringent accountability. Intrusive Intervention procedures such as physical restraints, are regulated and MUST be:

  1. Documented in writing;
  2. Approved prior to use
  3. Monitored carefully on an ongoing basis after they have been approved.

In all plans that use physical intervention procedures, document:

  • That the individual(s) parent’s, guardian(s) or substitute decision maker(s) have provided consent
  • A method of reviewing and evaluating the procedures with appropriate personnel (e.g., directors, supervisors, etc.) and other specialists in behavioural consulting (e.g., behavioural therapists, psychologists)
  • Approvals from staff, supervisors and other individuals or committees deemed important to the integrity of the plan (e.g., a Behavioural Ethics Review Committee, the individual’s physician). The Physician’s opinion is absolutely necessary before and intrusive technique can be implemented.
  • Training and evaluation of staff in the physical techniques which have been approved to manage a behavioural crisis; and
  • Regular monitoring of staff’s competence in implementing approved physical intervention procedures.