Professional Crisis Management (PCM): How We Handle Problem Behaviors

May 17, 2017 7:41 pm Published by Leave your thoughts

Professional Crisis Management or PCM is a system of procedures and guiding principles to maintain the safety of our clients and our staff during crisis situations. PCM is a safe, comprehensive, and effective crisis management solution that is guided by a respect for human dignity and freedom of choice. The PCM system has evolved from decades of practical experience with severely aggressive children and adults. The strategies utilized in PCM are based on scientifically verified principles and they address a wide range of behaviors.

PCM isn’t just physical interventions during crisis situations. The system has specific protocols for preventing and de-escalating crisis situations as well. Most of the non-physical strategies in PCM coincide with a child’s behavior plan and may include certain changes in environment or how we approach a child in the first place. These alterations can often stop, or at least reduce, problematic behaviors from happening in the first place. When problem behaviors do occur, the behavior plan will outline the steps taken to support the child and address those behaviors. PCM is used in very specific situations when very specific criteria are met.

PCM is only ever utilized when a child is demonstrating continuous aggression towards another child or adult, continuous self-injury, or continuous high magnitude disruptions (e.g. throwing chairs or toppling over book cases). If these behaviors are non-continuous, PCM physical procedures will not be used. If these behaviors are continuous but of a low magnitude and have no potential for harm, PCM physical procedures will not be used. These physical procedures are a last resort for our therapists and we always use the least intrusive, but most effective procedure within the hierarchy.

PCM physical procedures start with personal safety, which involves safe maneuvers for a therapist to utilize if, for instance, a child pulls their hair or clothing. If problem behaviors continue to escalate we will transport the child to a more neutral environment. This is done to remove the child out of a potentially dangerous environment where they may hurt themselves or another child and to move them to a more calm environment with the intent to possibly reduce the child’s problem behaviors. If the problem behaviors continue or intensify we may utilize vertical immobilization or horizontal/prone immobilization. Vertical immobilization is done during transportation and is simply ceasing movement until the child calms down or the therapists can safely transport the child again. Horizontal/Prone immobilization is done when vertical immobilization does not work and the child is still demonstrating those continuous behaviors mentioned before.

Throughout this hierarchy of physical interventions, our therapists adhere to a strict principle called, “biofeedback.” What this means is that as the child relaxes and calms down, our holds will become looser. We reinforce relaxing and show the child that they have the choice to stop the procedure at any time. As the child becomes calm and ceases crisis behaviors, the therapists will loosen and stop the intervention.

Ultimately, these procedures are used infrequently across our clinics. They are put in place to protect the safety of all of the children we serve and our staff! Each BCOTB clinic has multiple PCM certified practitioners and the company has 2 certified PCM instructors. If you ever have more specific questions or a desire to see the interventions, please reach out to us!

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