Use of Force for Right Response
RIGHT RESPONSE: A Proactive Focus on Prevention & Safety
Article provided by Right Response
The RIGHT RESPONSE is proactive, holistic, and immediately effective.
The philosophy of RIGHT RESPONSE focuses on a proactive approach to managing disruptive and/or assaultive behavior, featuring a holistic outlook to prevent future crisis.
The three guiding principles of this philosophy are:
- The intervention must meet the needs of our client.
- We must constantly reflect respect on the client.
- The safety of everyone in the environment is our highest priority.
Safety
During the use of necessary and reasonable force, a persons body is forcibly being prevented from moving freely. The person's struggle against the hold and the force we exert to maintain the physical intervention can combine to cause serious injury. Whenever possible, resolve crises without the use of force (physical intervention.)
The maintenance of safety is the only reason for initiating a therapeutic hold. It is our intention that everyone remains safe: the assaultive person, peers, family, educators, support people and the community.
Characteristics of RIGHT RESPONSE Physical Interventions:
- Non-aversive: no pressure points or hyperextension
- Balance, leverage, momentum instead of force
- Works within height/weight limitations
- Minimizes liabilities for injury or lawsuit
- Maximizes safety for everyone
- Maximizes professional relationships
Principles of Safety:
- Perform movements exactly as taught to reduce the chance of injury.
- Practice the techniques on a regular basis to maintain skill and ensure effectiveness.
- Stay in shape physically, mentally and emotionally.
- Physical intervention does increase the risk of injury, no matter how skilled you might be.
- Monitor vital signs, watching for irregular breathing, pressure on joints, or restricting circulation.
Ethical Considerations
Ethics is the skill of deciding between right and wrong. We need to decide when it is necessary and appropriate to initiate physical interventions. We must always balance the individual's rights and needs with the safety needs of the individual and others around them. When balancing Safety with the person's Rights & Needs, three different things impact our decision-making:
- Appropriate level of response
- Maintenance of personal dignity
- Adherence to regulations
The RIGHT RESPONSE philosophy regarding the use of force ensures that we communicate our regard for the individual and for ourselves at all times. We teach individuals that unsafe ways of meeting their needs are never acceptable and that we will, even in our intervention, place the highest priority on safety.
- Physical intervention techniques should only be used as a last resort to maintain safety when nonphysical de-escalation strategies fail to maintain safety. Ethical and safety considerations must be made when escorting or holding individuals. This is critical for you to manage your liabilities.
- We must choose interventions only as intrusive as necessary to adequately protect people. We must balance safety with the risk of the person's current actions. Additionally, our risk of escalating the crisis or injuring someone increases with intrusiveness.
- If you pre-plan to use a therapeutic physical intervention, it must be part of, or a supplement to, anapproved plan. This ensures the presence of informed consent and adherence to regulation.
- Prior to being allowed to use physical intervention, staff must receive RIGHT RESPONSE training.
- After a physical intervention is used, you must document its use.
Appropriate Level of Response
It is important that we choose the proper level of response when dealing with a crisis. When we use an improper level of response, we create risk for the people we are supporting and for ourselves.
We must choose interventions only as intrusive as needed to adequately protect people. We must balance safety with the risk of the person's current actions. Additionally, our risk of escalating the crisis or injuring someone increases with intrusiveness.
Use of Excessive Force Should Be Avoided:
- Use the least intrusive intervention necessary to ensure safety.
- Property damage should be prevented when the damage itself will create additional safety hazards.
- Always refer to the behavior plan to ensure that the appropriate intervention for the person is used and thatit is used consistently.
- Continue your verbal and nonverbal de-escalation skills while using physical intervention.
Dignity
The use of force can actually increase the anxiety, fear, frustration or anger which initially caused the crisis. Actions, emotions and physiological responses may all contribute to a loss of dignity for the person requiring anintervention. We must work to ensure that the person's dignity is maintained as much as is possible.
Guidelines for Maximizing Dignity During Crisis:
- Tell the person what you are doing at all times, preferably before you do it.
- Conduct yourself so as to avoid or minimize the possibility of accidentally touching private areas.
- Tell the person exactly why the hold is being done.
- Speak in a calm voice; use polite, appropriate and respectful words and voice tone.
- Always respect the individual's history and cultural background.
- Tell the person what they must do before you can release the hold.
- When a hold is being done on an abuse survivor, avoid postures that are similar to the abuse.
- Cultural considerations must be made to insure individuals or groups are not unfairly targeted by prejudice.
Adherence to Regulations
You need to be aware that there are regulations governing our interactions and services. Regulations regarding the use of force and therapeutic physical interventions are designed to ensure that the rights of the individual areprotected. They are also designed so that everyone is kept safe.
You must become familiar with the regulations that govern your work. Failure to follow these regulations, knowingly or unknowingly, may result in liability.
Training Requirements
All personnel who risk exposure to crisis or physical assault must receive regular training. Additionally, supervisory staff should also attend the training in order to ensure proper supervision of staff within established guidelines. Staff assigned to individuals with specific, planned intervention must receive training and regular practice.
Those acceptably finishing a complete RIGHT RESPONSE training by a certified instructor will receive a certificate valid for one to two years. Attendees are expected to review, practice and implement the strategies taught in RIGHT RESPONSE, particularly prevention strategies and physical interventions which are likely to be needed.
Attendees may attend a special Re-certification seminar at the end of their certification period (a 3 month grace period is allowed.)
Debriefing Procedures: Postvention
Crisis provides a learning opportunity for everyone involved. The proactive approach to crisis understanding and response includes analysis and follow-up to prevent future crises. When individuals do not take the time to assess and understand incidents, they are less likely recognize effective strategies and more likely to continue the use of ineffective strategies.
Post-Crisis Teaching:
The purpose of post-crisis teaching is to help the person in crisis learn from the crisis. Our role is to teach the person in crisis about themselves and how to better manage their emotions and problems, so that the crisis is less likely to reoccur. Post-crisis teaching is a non-judgmental process and the key is that we tune into the specific needs of the individual.
Post-Crisis Learning:
Post-crisis learning allows us, as individuals and as teams, to assess our response to the crisis in order to learn what we were doing well. The process will also help us to make plans to change any of our potentially ineffective thinking, verbal responses and behavior responses.
Documentation:
Documentation is a way to keep the important details of a situation in order to build an ongoing record. Documentation allows us to communicate the needs of the individual and provide positive behavior support.
The type of documentation may vary, but the need for clear and accurate reporting is constant. Others who were not present at the time of the crisis should be able to read your documentation and form anaccurate mental picture of what occurred.