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‘Respectful, Responsible, Compassionate’

January 2014                                                                                                                                      Volume 4

Solidifying the base: Universal Interventions:

Remember the ‘PBS Triangle’?  The base of the figure represents Universal Interventions… those strategies we use with everybody who enters our programs in an effort to prevent significant behavioral problems by attending to everyone’s basic needs on a routine basis.  When you think about this it is important that you realize I am talking about not only all of the Individuals who participate in our programs, but also our Employees and Visitors!The Universal Interventions are designed to help prevent unwanted behavioral occurrences by making sure that people’s needs are being tended to in a reasonable and respectful manner.

“Huh?! Why would we want to waste time intervening with people who don’t have behavior problems, especially Staff and Visitors?  We don’t need that kind of help!”

In reality all of us need, and deserve, respect, understanding and basic compassion in order to be at our best.  Applying these universal interventions to everyone, therefore, will help us to be most effective in any given situation.Think of the last time you were really upset… In that moment do you think you were acting as effectively as you might have if you weren’t so emotionally charged?  If you are anything like me the answer to that question would be a resounding, “No!”  When we are in a highly emotional state (especially if we are feeling hurt, sad, anxious or angry) our thoughts and behavior can be easily “hijacked” by those feelings leading us to act impulsively or causing us to distort our understanding of what is happening around us. 

“I don’t know…it sounds like a lot of work if I have to intervene with everyone I meet every day!  How am I supposed to do that and get my own work done?”

The word “intervention” makes whatever is being referred to sound complicated or highly specialized, which is true in some situations but not this one.  Think of times when you have gotten frustrated, anxious, hurt, sad or angry… Oftentimes, such feelings stem from poor communication, being unsure of what you are supposed to do or what’s expected of you in a certain situation or when it seems like you’re being ignored, right?  Ever stub your toe on something on the floor that wasn’t “supposed” to be there?  Again, if you’re at all like me, you might curse the offending object and be briefly in a foul mood.  Now imagine someone trying to talk with you while you’re still in pain… how does that go? If you’re like many people, you might be a bit short-tempered at that moment and end up doing or saying something to make the situation worse.  Such reactions often get amplified in persons with Intellectual/Developmental Disabilities since they typically have less ability to process such incidents and often lack the learned, adaptive coping skills most of us acquire through our life experiences.

The goal of the Universal Interventions is to make sure the physical environment is clean and well-organized; communications are clear and non-threatening and interactions are frequent, compassionate and reflect understanding of the other person.  It’s not rocket science and does not require more than just a little thoughtfulness to carry out.  Here is the list of the Universal Interventions for RTR programs:

1.      Establish/maintain a clean, well-lit and comfortable environment.  If something’s broken, either fix it or tell the Manager about it so the item can be replaced.  Report when a light bulb is burned out (or replace the bulb, if possible to do so).  Pick up clutter as needed.

2.      Create a predictable environment: daily schedules.  Establish, communicate, and follow, daily schedules to minimize the chance of surprises occurring.  If something changes, let people know what has changed and why.

3.      Create a predictable environment by communicating expectations.  Make sure people know what the “rules” are for a given situation.  Be kind when doing so and answer questions the person might have.

4.      Demonstrate respect by allowing for regular choice-making.  No one likes to be bossed around.  Giving people the chance to make choices, even when they are limited, helps the person feel respected and self-directing.  Doing so also avoids unnecessary power struggles when none need occur.  When people choose what they are going to do they are less likely to engage in unwanted behaviors.

5.      Provide social praise when you notice the Individual doing something well/positive.  Social praise is meaningful for most people.  As such, it will usually act as a reinforcer (something that will increase the likelihood that a given behavior will occur again).  In order for the praise to act as a reinforcer for a desirable behavior two things need to occur: a) Praise needs to be specific such as, “Nice job, Diane!  The counter looks much better after you cleaned it!” and b) It should be given immediately after the desired behavior has occurred.  If you know the person might be embarrassed with a public showing of praise, be sure to do so in private.

6.      Selectively reinforce appropriate behaviors.  You are an important person in the lives of those around you.  As such, you can reinforce the behavior of others by paying attention to them and providing social praise.  As such, you can help people meet their behavioral goals simply by paying attention to them when they have engaged in a desired behavior or have made an effort to improve their behavior.  Be aware of the behaviors targeted for change for the Individuals with whom you are working.  Notice instances where the person takes a small step towards the desired behavior and immediately pay attention to and praise the person for the positive behavior. 

7.      Interrupt inappropriate behavior.  If you see someone beginning to exhibit an undesired behavior try to immediately interrupt the behavioral chain by calmly using verbal or gestural cues to redirect the person to a more appropriate activity.  Doing so can reduce the frequency of the undesired behavior at the end of the behavior chain.

8.      Initiate positive interactions with Individuals frequently.  Smile, engage in conversation, express interest, shake hands and seek out chances to have meaningful, positive interactions with the Individuals with whom you are working.  Doing so helps to build positive relationships and provides important opportunities for increasing mutual understanding and to practice appropriate social behavior.

9.      Teach new, desired skills/behaviors.  We are all teachers though most of us don’t realize that fact.  Be an intentional teacher.  Define and clarify behavioral expectations for particular situations or settings (“We’re going into the library now so remember we have to whisper when we speak”).  Model the behavior you wish to see (in other words, act the way you want the Individual to act).  Teach the person how to do things appropriately.  Practice the new behavior before you expect the Individual to use it independently.  Provide prompts or helpful hints/instructions until it is clear the person has mastered the skill.  Be kind and patient when teaching.  Learning to do something new isn’t always easy… a little patience and kind understanding can make a difficult task a bit easier.

PBS “Stars of the Month”

We have two PBS “Stars” this month, both from the Middleboro Open Roads program as nominated by their Program Director, Leila Nelson.

·         Kristen McGourthy:“Kristen has truly taken to heart the meaning of PBS and is applying it throughout her work from the writing of goals to working with Individuals presenting with challenging behaviors.”

·         Kimberly Briggs:  “Kim does a really nice job keeping the environment clean and presentable for the Individuals as part of our Universal Interventions.  She also had a recent experience where she displayed excellent understanding of the preventative aspects of PBS when she was confronted with a situation in which an Individual had become highly agitated and was threatening self-injury and to run away.  Kim shadowed this person in a non-threatening way and successfully de-escalated a situation, which could have become very dangerous given this Individual’s history.”

     Thank you Kristen and Kim!  You are displaying the understanding of PBS principles and applying them to help those we serve!!

     Well, that’s all for this month’s edition (I know you’re all disappointed but don’t worry the next edition will be out very soon!J).  Remember, we’re all in this together learning new concepts and trying to apply them in our day to day lives (hopefully at home and work!).  If something caught your attention in this edition, try to think about how you might use it and then give it a try!  I love baseball.  One of the worst things to see, though, is when a player steps into the batter’s box to hit and never swings the bat… Don’t be that person!  It doesn’t matter if you use the skill/concept “perfectly” you just want to be trying.  The more we all practice the more skilled and effective we will become!  The problem is not when we make a mistake; it is when we either don’t try in the first place or when we tried to hide our errors that are disruptive.  If we never acknowledge when we’ve made a mistake we can never learn from it to improve!

Christopher T. White, Ed.D.


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