Training Workshop Accreditation Options

Below:

Academic

American Academy of Child & Adolescent Psychiatry

The RIGHT RESPONSE Workshop meets the Practice Parameter for the Prevention and Management of Aggressive Behavior in Child and Adolescent Psychiatric Institutions, With Special Reference to Seclusion and Restraint. This includes:

  • Prevention of Aggressive Behavior
  • Staff Training
  • De-escalation Strategies
  • Indications for the Use of Seclusion and Restraint (should not be used as punishment nor for convenience)
  • Ordering and Monitoring Seclusion and Restraint (must be made by professionally trained staff)
  • Processing Strategies (should be followed by a debriefing discussion (Postvention))
  • Administrative Oversight

Practice Parameter for the Prevention and Management of Aggressive Behavior in Child and Adolescent Psychiatric Institutions, With Special Reference to Seclusion and Restraint. Journal of the American Academy of Child & Adolescent Psychiatry - February 2002 (Vol. 41, Issue 2, Supplement, Pages 4S-25S

Affiliations

Contrary to popular belief, large accreditation agencies like CARF and the Joint Commission (formerly JCAHO) do not directly endorse training programs. Rather, these organizations produce guidelines for standards of intervention and training.

The RIGHT RESPONSE Workshop demonstrates tight adherence to the Standards of the Joint Commission and CARF. This is especially true with the spirit of the Standard's call for prevention and mitigation of the need for interventions as well as the maximization of dignity and respect.

How does the RIGHT RESPONSE Workshop compare to the Joint Commission Standards (PC.03.02 and PC.03.03)?

Joint Commission (excerpts)

  • commitment to prevent, reduce, and work to eliminate the use of restraint and seclusion
  • prevent emergencies that have the potential to lead to the use of restraint or seclusion
  • use of non-physical interventions as the preferred interventions
  • limitation of the use of restraint and seclusion to emergencies involving imminent risk of a patient causing self harm or harm to others, including staff
  • responsibility to discontinue restraint or seclusion as soon as possible
  • raise awareness among staff about what restraint or seclusion may feel like to the patient
  • preservation of the patient's safety and dignity when restraint or seclusion is used

RIGHT RESPONSE Workshop

  • prevent aggression and behavioral problems when crisis is not occurring
  • The RIGHT RESPONSE is proactive, holistic, and immediately effective
  • resolve crises without the use of physical intervention
  • only use physical intervention for the purpose of maintaining safety when safety is compromised and endangering the person or others in the environment
  • choose interventions only as intrusive as needed to adequately protect people
  • workshop attendees practice each intervention and are subject to the experience first-hand
  • work to ensure that the person's dignity is maintained as much as is possible
  • 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 that it is used consistently.
  • Continue your verbal and nonverbal de-escalation skills while using physical intervention.

How does the RIGHT RESPONSE Workshop compare to the CARF Standards (Section 5.C. Nonviolent Practices)?

CARF Standards (excerpts)

  • The organization demonstrates commitment to a system that nurtures personal growth and dignity, and it supports the use of positive approaches and supports.
  • Staff members are trained to recognize and respond to these signs through de-escalation, changes to physical environmental, implementation of meaningful and engaging activities…
  • On the rare occasions when these interventions are not successful and there is imminent danger of serious harm, seclusion or restraint may be used to ensure safety.
  • The use of seclusion and restraint must always be followed by a full review, as part of the process to eliminate the use of these in the future.
  • The goal is to eliminate the use of seclusion and restraint

RIGHT RESPONSE Workshop

  • prevent aggression and behavioral problems when crisis is not occurring
  • The RIGHT RESPONSE is proactive, holistic, and immediately effective
  • resolve crises without the use of physical intervention
  • only use physical intervention for the purpose of maintaining safety when safety is compromised and endangering the person or others in the environment
  • choose interventions only as intrusive as needed to adequately protect people
  • workshop attendees practice each intervention and are subject to the experience first-hand
  • work to ensure that the person's dignity is maintained as much as is possible
  • Use the least intrusive intervention necessary to ensure safety.
  • Postvention is the process of learning from an incident in order to prevent it from occurring in the future

How does the RIGHT RESPONSE Workshop compare to the COA Council on Accreditation Standards for Behavior Support and Management (BSM)?

COA Standards (excerpts)

  • promote a safe and therapeutic environment
  • comply with federal, state, and local legal and regulatory requirements
  • maintain safe environment and prevent need for restrictive behavior management interventions
  • prohibits excessive or inappropriate use of restrictive behavior management interventions as form of discipline or compliance, or for the convenience of staff or foster parents
  • prohibit use of restrictive behavior management interventions in response to property damage that does not involve imminent danger to self or others
  • service recipients assessed for factors that could put the person at risk
  • Training addresses methods for de-escalating volatile situations
  • personnel are trained and evaluated on an annual basis
  • personnel receive ongoing training on permitted interventions
  • training covers recognizing and assessing
  • personnel receive a post-test and are observed in practice to ensure competency

RIGHT RESPONSE Workshop

  • prevent aggression and behavioral problems when crisis is not occurring
  • RIGHT RESPONSE does not usurp regulations
  • resolve crises without the use of physical intervention
  • only use physical intervention for the purpose of maintaining safety when safety is compromised and endangering the person or others in the environment
  • property damage should be prevented when the damage itself will create additional safety hazards.
  • continually Assess, Adapt and Attend to need
  • continue verbal and nonverbal de-escalation skills while using physical intervention.
  • use the least intrusive intervention necessary to ensure safety.
  • choose interventions only as intrusive as needed to adequately protect people
  • Always refer to the behavior plan to ensure that the appropriate intervention for the person is used and that it is used consistently.
  • use post-test and instructor observation
  • workshop attendees practice each intervention and are subject to the experience first-hand

Federal

Hospitals

Centers for Medicare and Medicaid Services (CMS) in 2007 created 42 C.F.R § 482.13(e)(1)(i)-(ii) which applies to all hospitals participating in the Medicare and Medicaid programs and which guides standards of patient care. The RIGHT RESPONSE Workshop is in compliance with these rules, including:

  • Restraint or seclusion may only be used when less restrictive interventions have been determined to be ineffective to protect the patient a staff member or others from harm.
  • The type or technique of restraint or seclusion used must be the least restrictive intervention that will be effective to protect the patient, a staff member, or others from harm.
  • Each order for restraint used to ensure the physical safety of the non- violent or non-self-destructive patient may be renewed as authorized by hospital policy.
  • Restraint or seclusion must be discontinued at the earliest possible time, regardless of the length of time identified in the order.
  • When restraint or seclusion is used, there must be documentation in the patient's medical record
  • Staff training requirements. The patient has the right to safe implementation of restraint or seclusion by trained staff.
  • Training intervals. Staff must be trained and able to demonstrate competency in the application of restraints, implementation of seclusion, monitoring, assessment, and providing care for a patient in restraint or seclusion
  • Training content. The hospital must require appropriate staff to have education, training, and demonstrated knowledge based on the specific needs of the patient population in at least the following:
    • (i) Techniques to identify staff and patient behaviors, events, and environmental factors that may trigger circumstances that require the use of a restraint or seclusion.
    • (ii) The use of nonphysical intervention skills.
    • (iii) Choosing the least restrictive intervention based on an individualized assessment of the patient's medical, or behavioral status or condition.
    • (iv) The safe application and use of all types of restraint or seclusion used in the hospital, including training in how to recognize and respond to signs of physical and psychological distress (for example, positional asphyxia);
    • (v) Clinical identification of specific behavioral changes that indicate that restraint or seclusion is no longer necessary.
  • Trainer requirements. Individuals providing staff training must be qualified as evidenced by education, training, and experience in techniques used to address patients' behaviors.
  • Training documentation. The hospital must document in the staff personnel records that the training and demonstration of competency were successfully completed.

Mental Health

The National Technical Assistance Center (NTAC) at the National Association of State Mental Health Program Directors (NASMHPD) produced the Six Core Strategies to Reduce the Use of Seclusion and Restraint Planning Tool in order to achieve violence free and coercion free mental health treatment environments. Their position is that seclusion and restraint should never be used for the purposes of discipline, coercion, or staff convenience, or as a replacement for adequate levels of staff or active treatment. There are six goals:

  1. GOAL ONE: To reduce the use of seclusion and restraint by defining and articulating a mission, philosophy of care, guiding values, and assuring for the development of a S/R reduction plan and plan implementation. The guidance, direction, participation and ongoing review by executive leadership is clearly demonstrated throughout the S/R reduction project.
  2. GOAL TWO: To reduce the use of S/R by using data in an empirical, non-punitive, manner. Includes using data to analyze characteristics of facility usage by unit, shift day, and staff member; identifying facility baseline; setting improvement goals and comparatively monitoring use over time in all care areas, units and/or state system's like facilities.
  3. GOAL THREE: To create a treatment environment whose policy, procedures, and practices are grounded in and directed by a thorough understanding of the neurological, biological, psychological and social effects of trauma and violence on humans and the prevalence of these experiences in persons who receive mental health services and the experiences of our staff. Includes an understanding of the characteristics and principles of trauma informed care systems. Also includes the principles of recovery-oriented systems of care such as person-centered care, choice, respect, dignity, partnerships, self-management, and full inclusion. This intervention is designed to create an environment that is less likely to be coercive or conflictual. It is implemented primarily through staff training and education and HRD activities. Includes safe S/R application training, choice of vendors and the inclusion of technical and attitudinal competencies in job descriptions and performance evaluations. Also includes the provision of effective and person centered psychosocial or psychiatric rehabilitation like treatment activities on a daily basis that are designed to teach life skills (See Goal One).
  4. GOAL FOUR: To reduce the use of S/R through the use of a variety of tools and assessments that are integrated into each individual consumer's treatment stay. Includes the use of assessment tools to identify risk factors for violence and seclusion and restraint history; use of a trauma assessment; tools to identify persons with risk factors for death and injury; the use of de-escalation or safety surveys and contracts; and environmental changes to include comfort and sensory rooms and other meaningful clinical interventions that assist people in emotional self management.
  5. GOAL FIVE: To assure for the full and formal inclusion of consumers or people in recovery in a variety of roles in the organization to assist in the reduction of S/R.
  6. GOAL SIX: To reduce the use of S/R through knowledge gained from a rigorous analysis of S/R events and the use of this knowledge to inform policy, procedures, and practices to avoid repeats in the future. A secondary goal of this intervention is to attempt to mitigate to the extent possible the adverse and potentially traumatizing effects of a S/R event for involved staff and consumers and all witnesses to the event.It is imperative that senior clinical and medical staff, including the medical director, participate in these events.

Preschool - EACEAP and Head Start

Head Start, An Office of the Administration for Children and FamiliesEarly Childhood Learning & Knowledge Center (ECLKC), provides the following policy for Dealing with Aggressive Behaviors:

  • Aggressive behavior in children is disruptive in nature and indicates a lack of self-control. It creates feelings of fear, insecurity, and anxiety in a child. Examples of aggressive behaviors include: yelling, biting, scratching, kicking, hitting, fighting, bullying, and name-calling. During these times, children often find that they are unable to problem solve, communicate effectively, or respect others (45 CFR 1304.21(a)(3)(i)(c)).
  • Children who are exposed to unrealistic expectations or confusing situations are likely to react aggressively towards adults and other children. Therefore, adults need to be highly observant of children and anticipate their needs. No child should be left alone unsupervised (45 CFR 1304.52(h)(iii)). By redirecting children through clear and consistent language and realistic expectations, adults may help children avoid an outburst of aggression.
  • Use positive methods of child guidance without engaging in corporal punishment, emotional or physical abuse, or humiliation (45 CFR 1304.52(h)(1)(iv)).

See below for specific State policies.

Public Schools

Note: At this time, there are no federal statutes that apply to public or private schools with respect to the us of seclusion or restraint. You might be interested in our involvement in the development of model policy and procedure for the use of force in public school. [link]

State

Idaho

The RIGHT RESPONSE Workshop is on the recommended training list provided by the Idaho Department of Health and Welfare.

Indiana

In 2014, the State of Indiana Law Enforcement Training Board approved RIGHT RESPONSE as a Training Provider, authorizing us to provide crisis intervention, de-escalation and behavior management training to Indiana's law enforcement professionals.

Maine

In 2012, The Department of Education in Maine listed RIGHT RESPONSE Workshop as an Approved Training Programs in the use of restraints and seclusion.

Maryland

In 2009, The Maryland Governor's Office for Children approved the RIGHT RESPONSE Workshop for use with their state's residential programs for youth. Only programs that pass rigorous requirements and a written application are approved. The process also required the appearance of the Project Manager for a personal interview and demonstration of all 60+ physical intervention techniques.

Oregon

In June of 2013, the RIGHT RESPONSE Workshop was approved for use in Oregon public education programs.

OAR 581-021-0566 Required Use of Approved Restraint and Seclusion Programs - On or after July 1, 2012, a Public Education Program may only use training programs on physical restraint and seclusion that are approved by the Department of Education under OAR 581-021-0563. Public Education Programs are required to select a training program from an approved list compiled by the Oregon Department of Education, and provide de-escalation, restraint and seclusion training to school staff working with students in a public education program starting July 1, 2012.

Washington

Service Alternatives supports roughly 75% of the 295 Washington State school districts with the RIGHT RESPONSE Workshop, including 16 of the top 25 districts as measured by student population. Additionally, RIGHT RESPONSE is the training program of choice for seven of the state's nine Educational Service Districts (analogous to School Divisions on a larger scale) and all three of the third-party insurance providers for Washington Schools. One risk management group has been providing its members scholarship funding for years and another has trained several of their own instructors in order to provide the training directly to their pool members in several states.

Since 2006, the Washington State Office of the Superintendent of Public Instruction's School Safety Center has chosen RIGHT RESPONSE as the training of choice to provide de-escalation and intervention techniques to School Safety Officers throughout the state. The training was chosen over other nationally-available programs as well as the state's police academy training.

State of Washington Department of Early Learning provides the following Performance Standards for Early Childhood Education & Assistance Program (ECEAP). If restraint is used, contractors must meet all of the following criteria:

  • Staff have received training in limited restraint procedures.
  • Staff restrain a child only as a last resort to prevent serious injury to persons, serious property damage, or to obtain possession of a dangerous object.
  • Staff do not restrain a child longer than it takes to achieve the safety goal.
  • Staff do not use restraint as punishment or to force a child to comply.
  • Staff document all instances of restraint.
  • Staff notify the parent of the restrained child following the intervention.

Attention Long-Term Care Workers in Washington State:

Initiative 1163 enacted increased training and certification requirements for workers hired on or after January 7, 2012. Most new direct care workers (now called long-term care workers) must take 75 hours of training within 120 days of hire. Also, most long-term care workers must become certified home care aides within 150 days of hire.

Long-Term Care Workers includes all persons who are long-term care workers for the elderly or persons with disabilities, including but not limited to individual providers of home care services, direct care employees of home care agencies, providers of home care services to persons with developmental disabilities under Title 71 RCW, all direct care workers in state-licensed boarding homes, assisted living facilities, and adult family homes, respite care providers, community residential service providers (training requirements exempt until 2016), and any other direct care worker providing home or community-based services to the elderly or persons with functional disabilities or developmental disabilities.

See DSHS Training Requirements, Information, and Application Forms for:
Continuing Education (CE) Requirements

As of 7/1/2012, all long term care workers (LTC) must complete 12 hours of Continuing Education (CE). Learn more about who is required to take CE and when.

Meeting your Population Specific and Continuing Education needs:

Service Alternatives Training Institute is approved by DSHS as a Community Instructor to provide Population Specific and Continuing Education training classes. The following trainings are approved to meet your Long-Term Care Worker training requirements:

There are 4 levels of the workshop to give you just the amount of training you need: Primer, Elements, Elements+ and Advanced. Find more details about this de-escalation and behavior intervention training on the RIGHT RESPONSE Workshop Curriculum page.

Certified RIGHT RESPONSE Instructors:

Certified RIGHT RESPONSE Workshop Instructors who are interested in offer the training to Long-Term Care Workers need to follow these instructions to get approved by ALTSA.

Continuing Education (CEU) Clock Hours for Public School Educators in Washington State

Seattle Pacific University School of Education logoAcquire Continuing Education Credits for attending
RIGHT RESPONSE® Workshops.

Continuing Education credits and clock hours
are available through our Educational Partner, Seattle Pacific University.

  • Clock Hours/ Continuing Education Units (CEUs)
  • Graduate-level College Credit
Course Version Clock Hours CEUs Credits
Advanced 14 hrs $20 1.4 units $20 2 credits $90
Elements+ 11 hrs $20 1.1 units $20 1 credits $45
Elements 7 hrs $15 .7 units $15 1 credit $45
Advanced Recertification 7 hrs $15 .7 units $15 1 credit $45
RIGHT RESPONSE Instructor Certification Course 28 hrs $40 2.8 units $40 3 credits $135

Download the SPIRAL Chart (PDF).

Please notify us of your interest in obtaining Clock Hours or Credit at least 2 weeks prior to the start of the Workshop.

Credit and Clock Hour Reference:

  • 1 Credit Hour = 10 Classroom hours or 20 lab, practicum or out-of-class assignment hours.
  • 1 Continuing Education Unit (CEU) = 10 Classroom hours.
  • 1 Clock Hour = 10 Classroom hours (or .1 CEU)

CEU/Clock Hours apply to personnel with valid educational, counseling or administrative certificates including but not limited to individuals designated in a supervisory role at a school district, educational service district, college/university or superintendent of public instruction. Please note: Clock Hours are valid in Washington state only are not transferable to other states.

Credits are 5000 graduate level however these do not count toward a graduate degree, just continuing education. Please note: Credits are transferable to other states.

Students will only receive the CEU/Clock Hours or Credits by attending all sessions of the course.

Certified RIGHT RESPONSE Instructors:

Adjunct Faculty instructions for how to offer continuing education credits for the classes you teach.