A Theoretical Aside
This post comes from my experiences the last few weeks. I have been working with a number of students that have been a danger to themselves and others. As such, I have had to use physical restraint to ensure maintained safety of students and others around them.
Fewer people were injured because I used restraint methods, but I still feel terrible for having to use MANDT restraints after my preventative strategies proved ineffective. I have found that school teams often have difficulty in understanding why I feel like an abject failure whenever I have to restrain students. To the untrained eye, the intervention worked-and it is hard to understand why I am so disappointed.
This post is my explanation.
The Escalation / Crisis Cycle
I start with two diagrams to show that escalation is not an all or none phenomenon. We all go through several steps.
- Calm or Baseline Phase
- Triggered or Stimulation Phase
- Agitated/Acceleration or Escalation Phase
- Peak or Crisis
- De-Escalation Phase
- Recovery or Stabilization/Post Crisis Phase
The important components of this post are as follows:
The Calm or Baseline phase is not the same for everyone. In fact, in my experience, there are a surprisingly large number of children that do not have the luxury of having a true baseline level. If they have a hard home life, trauma in their past, or some conflict with and adult or other students, they may actually start the day at the Triggered phase.
The Triggered phase of the crisis cycle is deceptively named. For most people who start at a Calm baseline, the Triggered phase does not involve outward signs of agitation or stress. When a child is triggered, this sets the stage for responses to stimuli that are of a much greater amplitude than they would be had the student not been triggered.
The Agitated phase is when the child moves beyond simply being Triggered and begins to show outward signs of stress and annoyance. The child will become intolerant to stimuli they would otherwise tolerate. This is actually the phase most children are in when we erroneously say they have been Triggered.
The Acceleration phase is when the Agitated phase starts to self-perpetuate.
The Peak or Crisis stage is, in my opinion, by far the most misunderstood stage. At this stage the child is disconsolate. Meaning there is NO WAY anyone can intervene to “bring them down” – and yet this is the stage most adults start to intervene.
The De-Escalation phase is deceptively tricky. Most adults do not realize that a student fresh off a Crisis are very easy to re-escalate back into Crisis. The De-Escalation Phase is oftentimes even closer to Crisis than the Acceleration phase.
Recovery is a refractory period between Crisis and Calm. It is only at this phase that it is appropriate for an adult to intervene and discuss the Crisis with the child.
How Should We Handle a Student in Crisis?
Optimally, we don’t let things escalate this far. We back off earlier in the escalation or crisis cycle, either by anticipating the Trigger or recognizing the Agitation phase for what it is. The easiest way to do this is to back off. Give the child space. Most of the time your help is not actually helpful at this point.
That said, backing off is not an option if a student uses violence or aggression during their Agitation, Acceleration, or De-Escalation phases. In these cases, intervention is unavoidable. Below I will explain how we can intervene. But first, I will cover how our interventions are often the coup de grace or straw that breaks the camel’s back that sends the child into full-blown crisis.
What Do We All Do Wrong
The diagram below describes the cycle that adults and children get into when there is a conflict. As adults, we often fail at taking the perceptions and feelings of others into account when we work with them.
When a student is Agitated or in the Accelerating phase of the crisis cycle, they perceive intervention from an adult as a threat rather than as help. Because the child perceives a threat, the child either goes into a fight or flight mode or else they get angry. This means the student will react to the adult as an enemy rather than a friend-regardless their relationship 5 minutes or even 5 seconds earlier.
Well, because as the adult we fail to account for this side of the cycle, we react to the student’s reaction by getting escalated ourselves, and we go through the same behavioral cycle as the child. This turns into a vicious feedback cycle that results in both the adult and the child saying and doing things they will later regret and would not normally do.
How Do We Do It Right?
I distinguish the above cycle of conflict of serial reactions to stimuli from an adult taking a step back and responding appropriately. My operational definitions for these words are reaction = acting upon stimulus without prior thoughts. Response = acting upon stimulus with prior consideration of multiple options and antecedents.
When we find a student that has been Triggered, we need to take a step back and ask ourselves some questions.
- Did I just do something that triggered the student?
- Did something happen to the student at school today that might have triggered them?
- Did something happen in the student’s home life that might have triggered them?
If we do not know the answer, there are two things we can do. We can – I know this is revolutionary – ASK THE STUDENT how they are feeling. If they are unable or unwilling to answer, that is why we have phones. Reach out and communicate with the child’s family or other teachers/paraprofessionals that may have some information.
If this proves fruitless, we move onto the next step. If the student is triggered or agitated, we can still engage them in a dialogue. Importantly, the adult must take care to not take a dictatorial tone. The adult is on a fact finding mission, not on a quest to solve any problems. In fact, if an adult tries to impose a solution on the child at this point, it will likely be interpreted as either unfair, controlling, or demanding…and the child will escalate toward the Accelerating phase.
If, however, we let the student talk (and this does often involve a fair amount of cursing and swearing), they often can de-escalate themselves or else discover their own trigger. Since they are in control, they can be receptive to an adult guiding them to a Calm state. Letting the child express themselves in a free and safe environment will often naturally guide them into a Calm state, but if you, as the adult, impose yourself and try to correct their language or minimize the child’s emotions, you are not recognizing how the child feels and they will likely escalate.
Let us assume we cannot help at the Agitation phase. If a student is at the Accelerating phase (or the De-Escalation phase as they are handled the same way), BACK OFF. Literally. BACK OFF. Give the child as much space as possible and do not bother them. You can only make things worse at this point. Even proximity will result in further acceleration toward a crisis.
Sometimes body blocking is necessary, so we do it. But it is obligatory we KEEP OUR MOUTHS SHUT. If we have to take something away from the student, we do so SILENTLY or just say with a flat affect, “Not an option”. Nothing more. Even this runs a major risk of driving a student toward crisis. We cannot give any emotional fuel to the hell fire in potentia.
If the student has an option of a safe space, dark spot, or quiet corner, this is a good time to remind a student (REMIND, never demand), that they have the option of separating themselves into their special space. Again, if we demand the student do this or tell them to go over there to cool off, we probably just ticked them off. The Accelerating phase is typified by a defiant attitude and self-preservation – not taking advice.
Now to the hard part. Crisis. What do we do when there is crisis. I wish I could say, “Run away”, but that is not always an option.
So, if running away and giving oodles of space fails, we are left with one of the hardest things we can do. KEEPING A CHILD IN CRISIS SAFE. Most of the time this takes the form of clearing the classroom or else getting the student to a safe space where they cannot hurt anyone.
Amazingly, that is the easy part.
If the above fails, we have another responsibility-and this is the hardest bit-we have to make sure the student does not hurt themselves or others. This is where restraint methods come in. And the probability of both the adult and the child getting seriously hurt goes off the scale.
Restraint is not to be taken lightly and is the absolute last resort in any crisis situation. Touching a student in crisis is often not a great idea and is almost always dangerous, both to the adults and to the child. This is why every other option needs to be employed prior to even considering restraint. In fact, even grabbing a student’s hand or using an arm to prevent an elopement can cause problems.
I say backing off and letting the kid blow off steam is the easy part because it does not involve a physical interaction, Whenever a child is escalated, even if they are in the Accelerating or De-Escalating phase, touch will often send them from 0-100 in a microsecond.
This video below shows one of my behaviorist heroes, Cesar Milan, making a mistake of touching an animal in crisis. Everyone was safe until he touched the dog. Cesar carefully took the dog through the escalation cycle from Calm, to Triggered, to Agitated, to Acceleration, to Crisis, and to De-escalating phases. However, even though it was during the De-escalating phase, as soon as Cesar touched the dog, everything became complicated. I particularly like this video because it explains the dog behavior along the Escalation/Crisis cycle.
I Feel Terrible When I Lose Control Of The Situation
Whenever I restrain a student, I lose. They lose. We all lose. The student ends up a sweaty mess of emotions and snot, and I often end up bruised and bitten. I have to use restraint, I feel like Cesar in the above video explaining to the people around him how he screwed up and missed something. Then Cesar had to walk away and lick his wounds. Additionally, the dog learned nothing from the experience other than he was able to bite Cesar (which will increase the probability of it happening again).
I feel terrible for all the reasons displayed in this video. Cesar missed something because he was distracted and it resulted in injury to himself and complete loss of control of a situation. I always ask myself, “What did I miss? What could I have done to prevent this? Where did I screw up?” immediately followed by an, “is the student okay? Are they hurt? Are they still freaking out? DO they understand what just happened?”. Then I ruminate and perseverate on the experience for a few hours.
EVERY. SINGLE. TIME. I have to use restraint methods I am able to find something that I missed during the escalation/crisis cycle that would have prevented further escalation. There is always something I did not notice. Some tone of voice I missed. Some frustration I accidentally projected. Some accidental sarcasm on my part. An eye roll. A smirk. A mistake. An oversight. A lack of control over my surroundings that resulted in an additional trigger.
How Do I Do Better?
I have spent a lot of time mulling over in my mind what I can do better to help de-escalate kids when they are not in control of themselves. By applying my background as a behaviorist to the situation, I have a few notes for myself – and I hope they will be helpful to others. When one has to restrain or seclude students for their own or other’s physical safety:
- Never invalidate a student’s emotions. They are feeling what they are feeling, there is no point telling them they are wrong or shouldn’t feel a certain way.
- Never hover over a student. If a student is on the floor or in a chair, do not use your mass to intimidate them. It is intimidating.
- Never repeatedly bring up a student’s mistake. Move on. You are only going to make them self-conscious and reduce their self-esteem.
- If a student asks for space, GIVE IT TO THEM so long as it is safe.
- Do not chase/run after a student if they elope. Follow SLOWLY and at a distance. Catching the student does not earn any prizes.
- Watch your tone of voice. The student is paying attention. They know if your tone is aggressive they are unsafe.
- Never use sarcasm. If words do not match the tone of voice, you are confusing the student.
- Never dictate terms. The student will balk at orders when escalated and become defiant on principle.
- Never lie to the student. They will call you on it. They will remember. They will hate you for it.
- Never talk about the student in a negative way in front of them to another teacher. In fact, this is NOT the time to give an update on behavior unless you are handing off responsibility for the student to a specialist.
- Never give ultimatum. These never work, less so when a child is escalated.
- Never give an emotional response to swearing or physical aggression. The student is not entirely in control of themselves and trying to get the adult to move away from them, by whatever means necessary.
- Never argue with the student. They will contradict and defy you. Don’t take the bait.
- In fact, Never try to start a conversation. This will not end well. There is nothing you can say that will fix the situation.
- Never touch the student to calm them down (pat on back, etc.). This will be misinterpreted.
- Never distract yourself with a phone, etc. You will miss important signs.
- Never show frustration, anger, etc. Your emotions are not helpful. They do not contribute anything other than fuel to the already highly combustible situation.
- Never, Ever, under any circumstances retaliate against any of the violence committed by a student being restrained. I wish this went without saying. It doesn’t. I am saying it. We are the adult. We MUST act like it.
Some of these may seem counterintuitive, but they are all important. The best advice I can have for anyone is to avoid restraint or seclusion as consequences for behavior.
The solution is for us to focus on prevention instead. Help the student meet their needs before we turn the escalation cycle into an escalation spiral.