• Completion of contracts, paperwork and establish goals of the training.
• Demonstration of the MAB lecture portion of the class to be taught in order to develop a sense of content and pacing that help make up am effective training.
• Evaluation of the class by each participant to see how the training applies to their specific facility or organization.
• Develop individual and team plans for the remainder of the training in order to fully customize the class for each of their facilities or organizations.
• Wrap up of the day and preview for the next day's events.

• Understand the concept of when and whether employees have the legal right to step in physically when faced with an aggressive, or potentially assaultive individual, as well as realize that a gray area exists between each employee's interpretation of their own level of perceived threat which dictates their response to the aggressive individual.

• Understand the concept that every intervention or response between the employee and an individual threatening, or inflicting violence, needs to involve the team approach and reaction, rather than a singular one if the outcome is to be a successful and therapeutic conclusion and that this approach is essential to creating and strengthening the team within the facility. Students will also examine the importance of thinking preventatively.

• Understand the concepts forged from standard crisis negotiation training, of focusing on what is behind any aggressive behavior instead of focusing on the behavior itself, in order to create an understanding of the root causes of the situation instead of the situation itself. Once this concept has been established and demonstrated, the participants will be able to help direct the incident from a volatile one, into a calmer and therapeutic intervention that will not simply end as a "controlled" incident, but instead, one in which the aggressive individual actually benefits therapeutically from the process.

• Understand their own reactions to assaultive or potentially assaultive behavior in a therapeutic way that is beneficial for both themselves and the aggressive individual by examining their recognition, reactions and response to violence or aggression.

• Understand the three important elements of the custom-developed, "Intervention Triad," which include concepts and examples of Teamwork, Communication and effective Plan of Action, known to all employees involved in the response when dealing with an escalating, aggressive, or violent encounter in order to help ensure a successful and therapeutic resolution to the situation.

• Understand the importance of utilizing one experienced Team Leader when responding to an escalated, aggressive, or assaultive situation and that only the Team Leader either chosen or elected, should be the one communicating with the escalated or hostile individual, so as to direct, or re-direct the focus between the employee and the client and therefore better lead the encounter to a more successful and therapeutic resolution.

• Wrap up of the day and preview for the next day's events.

• Understand the five phases of the Assault Cycle and how it maps out and explains both physical, emotional and psychological behavior responses and how that applies to the clients, employees and the facility's milieu.

• Understand both internal and external factors responsible for triggering escalation and assaultive behavior and how to effectively assess and respond to the individual situation to help calm and resolve the encounter to help prevent a physical response.

• Understand the importance of body language, both exhibited by clients and employees.

• Understand the crisis negotiation-based concept of using re-direction and/or distraction techniques when confronted with an escalated, aggressive or assaultive interaction between employees and clients, or unknown individuals when facility resources offering assistance might not be available yet and so how to utilize either singular and/or a team-oriented response in order to de-escalate and protect oneself in the process.

• Understand the twelve elements of Active Listening during the negotiating process.

• Understand and demonstrate the concepts and importance of a distinct Plan A, Plan B and Plan C protocol during a team-oriented effort, as well as the Crisis Negotiation-based twelve step Active Listening Format to help ensure the staff are negotiating correctly and creating an environment of calm instead of chaos. Students will be able to map out the steps for their own, in order to build a better team and therapeutic outcome to the crisis, as well as to help the patient realize a healthier decision making process.

• Understand the importance and content of an appropriate and therapeutic dialogue between the employee and the escalated, aggressive or assaultive individual during the de-escalation or physical containment process and how this either can calm or fuel a situation. Examples will be learned of what dialogue to offer and how to deliver that dialogue so the escalated or aggressive encounter will be more likely to resolve within a successful and therapeutic outcome.

• Understand and demonstrate humane, non-injurious, regulatory agency-compliant and simple, yet effective evasive self-defense techniques when faced with an assaultive or potentially assaultive encounter, rooted from some of the oldest protective arts ever developed. This section is approached very carefully and the emphasis on defending minimally and escaping immediately in order to protect oneself and obtain assistance from support staff, is stressed heavily in order to create a safe and more effective solution to the situation. It must be understood that the evasive techniques taught within this workshop are extremely assailant-friendly and is not designed to injure the assaultive person, only evade them quickly without using an aggressive response in return, even when the individual is attempting to use deadly force.

• Demonstrate how to safely and effectively contain, restrain and transport individuals during a physical escort and transportation process, using protective and mechanical lifting processes.

• Wrap up of the day and preview for the next day's events.

• Understand and demonstrate simple, physical containment intervention techniques, utilizing two, three, four and five person team-coordinated efforts, as well as how to utilize the extra support staff who might also respond to the situations.

• Understand the concept and importance of recording assaultive incidents to meet the facility's and all outside agency's documentation requirements.

• Understand and demonstrate the debriefing process between the employees and the aggressive individual, when appropriate, or when the individual is a client of the facility. We will address this section in order to establish the possible reasons for the aggressive act and how we as staff can help to prevent a similar incident from happening in the future and to help the aggressive individual process the therapeutic value of the incident. By doing this, the employees can also learn how to read the individual's early warning signs better, as well as how the client can learn how to communicate more effectively to the employees, all with the intent of preventing a further act of aggression occurring from that individual in the future.

• Effectively utilize the debriefing process with the affected employees, to examine and forensically dissect the incident itself, so as to learn from the outcome, why the incident occurred and what staff might have done to prevent the situation in the first place.

• Demonstrate and practice within one or more videotaped role-play situations of effective de-escalation and negotiation techniques for several different types of patient behavior, utilizing individual and team-oriented interactions by the participants. Once presented with the escalated, aggressive, or assaultive situations, then students will be able to respond appropriately, either individually or within the team-oriented approach to de-escalate or physically contain the situation arriving at the best solution while doing so. Following the role-play scenarios, participants will then review the videos in order to discuss ways that the staff correctly, or incorrectly reacted to and resolved the situation, how they might have been ineffective, what they did to help the incident, or how they contributed to the escalation process.

• Discuss how each participant can help to develop their own teaching style and also how to effectively embrace and deal with challenging participants with teaching.

• Discuss what each participant learned from the workshop, along with ways to develop and enhance the teamwork within the facility, as well as to examining their own issues and responsibilities of how to create a more compassionate, effective and therapeutic staff.

• Discuss the MABPRO materials for the classes that they each will be using for their individual facilities and how to apply what they have learned in order to merge the two together for the training, as well as the follow up process to maintain their certifications.

• Wrap up and final thoughts and instructions.

• For those who are continuing on to the 5th Day Seclusion and Restraint Certification Training, there will be a preview of the next day's events.

• Discuss and examine the legal aspects of the Seclusion and Restraint process as it relates to each individual facility that the participants belong to.
• Examine the definition of Seclusion and Restraints and how it relates to healthcare.
• Discuss the laws that apply to Seclusion and Restraint and how it relates to healthcare.
• Discuss the different types of restraints and what each participant's facility or organization uses, or does not use.
• Demonstrate hands-on application of restraints and how to use them.
• Demonstrate and practice within one or more videotaped role-play situations of effective de-escalation and negotiation techniques for several different types of patient behavior, utilizing individual and team-oriented interactions by the participants. Once presented with the escalated, aggressive, or assaultive situations, then students will be able to respond appropriately, either individually or within the team-oriented approach to de-escalate or physically contain the situation arriving at the best solution while doing so, then apply restraints within the situation when necessary. Following the role-play scenarios, participants will then review the videos in order to discuss ways that the staff correctly, or incorrectly reacted to and resolved the situation, how they might have been ineffective, what they did to help the incident, or how they contributed to the escalation process.
• Wrap up and final thoughts and instructions for how to use the lessons learned toward their individual facilities or organizations.

MABPRO^®

PROFESSIONAL CRISIS PREVENTION TRAINING SERVICES