*Model Begins Here* Neg.

Coping Examples
Verbal Threats Intimidation Physical Threats Assaults Damage to Property Damage Others Stuff Elopement Avoidance Denying Minimizing Externalizing/ Blaming Brooding/ Sulking Isolation Magnification of Small Issues Lack of Sympathy Arguing Antagonizing Staff Splitting Physical threat to damage property if outcome does not change

Stressor: Frustration due to desire not being satisfied

Triggers:
Delayed gratification; guilt; victimization; anxious; feeling belittled; jealousy; arousal; bored; depressed/broody, etc.

Healthy Self-Efficacy & Confidence Confidence that a more constructive approach to get desires satisfied will be effective Replacement behavior utilized Constructive approach attempted Destructive approach avoided Reinforcement of constructive approach increased Future use of constructive approach is increased Therapeutic Relationship(s) maintained/improved

Internal Thinking: Confident or Unconfident that constructive approach will be effective

STAFF REINFORCE CONFIDENCE

Confident

Unconfident

Destructive Coping Strategy Applied Strategy used ignores consequences and focuses on immediate gratification

S T A F F D E C R E A S E U N C O N F I D E N C E

Typical Skills That Can Be Reinforced to Replace Negative Behaviors

Asking for help Apologizing Validating Asking Questions Offering to Help Willing to Wait Sympathy/ Empathy w/others Accepting Help Problem Solving Accepting Feedback Compromising Accommodating Listening Taking Turns in Conversation Patience Respect

Negative Consequences Occur Accepting or NotAccepting of support to minimize consequences

Accepting
STAFF REINFORCE ACCEPTANCE

Opportunity to learn constructive coping skills increased Opportunity to unlearn destructive coping skills decreased Increased confidence to get own needs met Increased confidence to use skills that were previously successful to address future problems Improved participation in resolving issues

Denying Responsibility for Actions Avoids and/or externalizes blame onto others

Typical Intervention Skills: Current & Future Goals

Help Problem Solve Role Model Patience & Respect Help Implement Solution/ Expectations Remove Items/Maintain Separate Client From Safety Others Medication Review Reflective Listening When Appropriate Ask Helpful Questions Redirection & Distraction Provide Validation When Possible Create Fun Activity to do Action Planning 1:1 Debriefing Reinforce Boundaries Build Upon Previous Discuss Later Successes Discuss Natural Consequences

Requires External Assistance to Resolve/Mitigate Current Escalation Escalation continues and the client skills needed to wind-things-down is not present. External support is required to insure safety. Cognitive Retraining Factors
Identify Assumptions Identify Beliefs Evaluate Assumptions Evaluate Beliefs & Expectations Evaluate Pros & Cons of Current Approach/Plan Evaluate Pros & Cons of Alternate Approaches/Plans **Identifying Triggers & Developing Plans to Avoid Then **Anticipate Needing Time to Master New Skills Differentiate Needs from Wants Improve Self Monitoring Capacity (mood, beliefs, reactions, etc) Recognize Your Emotions Can Not Hurt You This model is based on the following bibliographical sources: Healthy Self-Talk

STAFF REINFORCE SAFETY

The Foundation: Stabilizing Factors That Require Reinforcement to Avoid Future Crisis

Skill Dev Factors

How toCalm Down Improve Your Mood Assertiveness Ask For Help & Planning Build Upon Past Skills That Were Successful & Rehearse Them Time Management

Lifestyle Factors
IncreaseRelaxation Relationships Social Opportunities Recreation Opportunities Health Power & Choice

t.barker 2012

Marlatt, A., & George, W. (2012). Relapse prevention: Introduction and overview of the model. Manuscript submitted for publication, Department of Psychology, University of Washington, Seattle, Washington. Prisgrov, P. (2012). A relapse prevention model to reducing aggressive behavior. Manuscript submitted for publication, Department of Corrective Services, University of Australia, Australia. Note, the relapse prevention model has three stages: 1st Stage: Commitment to Change, 2nd Stage: Implementation of Replacement Strategies: 3rd Stage: Maintenance of Successful Learning. The model above best addresses Instrumental Aggression that is used to achieve a desired outcome. By contrast, Reactive Aggression seeks to retaliate. Both types of aggression fail to consider the consequences of their strategies.