Handle with Care Behavior Management System®
The information in this program outline is provided by the program representative and edited by the CEBC staff. This program has been reviewed by the CEBC in the following Topic Areas:
About This Program
Target Population: Providers and staff working with children and adolescents (age 3 years and up) across the entire spectrum of human services including schools, child welfare, hospitals, mental health, developmental disabilities, community programs, group homes, residential, social services, and autistic programs; foster parents, grandparents, guardians, and parents can also be trained
The Handle With Care Behavior Management System® is designed to train professionals on safely managing behaviorally challenged children and adults, including those with disruptive, aggressive and self-destructive behaviors. The program teaches staff to develop and use their management and relationship skills to reduce tension, and create and maintain a calm and safe environment for all. This verbal de-escalation and physical intervention program includes a patented restraint technique that is designed to be effective, safe and require fewer staff to safely manage a crisis than other restraint training programs. Handle With Care Behavior Management System® complies with all Federal and State laws and is accredited by all major professional regulatory bodies.
The goals of the Handle With Care Behavior Management System® are:
- Create and maintain safer, more caring environments
- Decrease need for physical restraint through preventative actions
- Minimize injuries to children, adolescents, clients, staff, parents and family members through the use of prompt, skillful and appropriate intervention (including physical restraint when necessary)
- Create an environment of physical and psychological safety
The essential components of the Handle With Care Behavior Management System® include:
- Verbal Intervention & De-escalation Training
- This verbal program is based on two theoretical models.
- Tension/Tension Reduction Cycle: The T/TRC Model is a “timing” model for when to use Support, Limit Setting and, if necessary, Physical Restraint. It explains and illustrates the dynamics of escalating and de-escalating tension. This enables faculty to recognize and adapt to a wide range of dynamic situations and to adjust their approach in a way that is calibrated and appropriate to the behavior being presented.
- Solid Object Relationship Model: SORM is a relationship-centered approach that enables staff to develop and utilize their relationship skills to provide children/clients with emotional and environmental support in a manner that conveys trust, security and safety
- Training in the use of verbal, nonverbal (i.e. body language) and paraverbal (i.e. tone) de-escalation techniques and role plays
- Physical Skills Training
- 6 main components
- Understanding personal space
- Self-defense and defense of others
- Physical restraint
- Letting go and debriefing
- Specialized interventions
- Personal Defense System: Components
- Escapes: Grabs, chokes, hair pulls, bites
- Use of personal space and maintaining safety
- Blocking: punches, kicks, thrown objects
- 3rd person saves (when the assault is against another staff or child, or the child/client is engaging in self-harm)
- Physical Intervention and Restraint Training
- The Primary Restraint Technique® (“PRT”):
- The PRT® is designed to be an easy-to-teach, orthopedically sound physical hold that offers unprecedented advantage without pain or injury.
- Standing Seated and Floor Holds
- The PRT can be used as a standing hold, a seated hold or a floor hold
- The Handle With Care Behavior Management System® restraint training and techniques have been evaluated by medical doctors (MDs) and other external professionals in various fields.
- PRT is patented for its safeguards to prevent positional asphyxia. These safeguards are additionally designed to prevent any other type of medical emergency.
- Postcrisis Assessment & Review:
- Debriefing and incident review: This is a feedback system designed to keep accountability and enable staff to learn from the intervention. It provides staff and supervisors the opportunity to review the incident and see whether any changes need to be made regarding the intervention or behavior plan.
- Life Space Interview (LSI) is an interactive therapeutic strategy for turning crisis situations into learning opportunities for children and youth.
- Specialized Physical Interventions:
- Pregnant females
- Special orthopedic medical and physical conditions
- Team interventions
- 3rd person saves
- Breaking up fights
- Personal defense interface
- Modified PRT for Smaller Children™
- Preschool thru Early Elementary School Program (ages 3 through ≥ 8):
- Program for ages 3 through ≥ 8 which is taught as part of the Handle With Care Behavior Management System® or as a standalone program for people working with this age group exclusively:
- Includes 2 hours of verbal de-escalation training
- The holding method is "The Modified PRT for Smaller Children™." This proprietary hold has none of the basket hold's orthopedic issues, (i.e., traction placed on the wrists, elbows and shoulders). Unlike the basket hold, it has no inherent fatal malfunction mode if it destabilizes. There is also an engineered safe carry method.
- 24/7 Technical Support and Expert Analysis:
- Clients and participants have direct access to the creator and President of Handle With Care (HWC) for any technical questions, training questions, or “how to” questions posed by phone or by email - 24/7. “Frame-by-frame” video and/or incident analysis for any critical event, incident, or investigation can be provided. Expert testimony can also be provided if it is ever needed for a civil or criminal proceeding.
Handle with Care Behavior Management System® directly provides services to parents/caregivers and addresses the following:
- Parents and caregivers of behaviorally challenged adolescents and children, including those with disruptive, aggressive and self-destructive behaviors
The program techniques are used as needed.
The program techniques are used as needed.
This program is typically conducted in a(n):
- Community Agency
- Outpatient Clinic
- Residential Care Facility
This program does not include a homework component.
Handle with Care Behavior Management System® does not have materials available in a language other than English.
Resources Needed to Run Program
The typical resources for implementing the program are:
Trained staff and a suitable space
Minimum Provider Qualifications
Staff receives training by a certified HWC trainer from their organization. HWC certifies the trainer in a Train-the-Trainer program.
Education and Training Resources
There is a manual that describes how to implement this program, and there is training available for this program.
- Hilary Adler
phone: (845) 255-4031
fax: (845) 256-0094
Training is obtained:
Public seminars that are conducted across the United States Agencies can also contract to have a HWC Training delivered on-site.
Number of days/hours:
Initial Instructor Certification is 24-32 hours depending on the number of participants. This consists of: 1 Day Verbal; 1 Day Basic Physical; 1-2 Days Instructor Certification Training (generally 1 day).
Trainers are recertified annually (1-2 Days depending on class size, generally 1 Day).
Relevant Published, Peer-Reviewed Research
This program has been reviewed and it was determined that this program lacks the type of published, peer-reviewed research that meets the CEBC criteria for a scientific rating of 1 – 5. Therefore, the program has been given the classification of "NR - Not able to be Rated." It was reviewed because it was identified by the topic expert as a program being used in the field, or it is being marketed and/or used in California with children receiving services from child welfare or related systems and their parents/caregivers. Some programs that are not rated may have published, peer-reviewed research that does not meet the above stated criteria or may have eligible studies that have not yet been published in the peer-reviewed literature. For more information on the "NR - Not able to be Rated" classification, please see the Scientific Rating Scale.
Currently, there are no published, peer-reviewed research studies for Handle with Care Behavior Management System®.
Chapman, B. (2015). How HWC holding methods create a calm mind state – faster. Retrieved from http://handlewithcare.com/how-hwc-holding-methods-create-a-calm-mind-state-faster
Handle With Care. (2003-2016). Legal synopses of restraint law by state. Available through the program representative below.
Handle With Care. (1984-2016). Instructor Manual, Participant, Manual, Instructor Manual Early Childhood Program and Participant Manual Early Childhood Program. Available through the program representative below.
Date Research Evidence Last Reviewed by CEBC: September 2016
Date Program Content Last Reviewed by Program Staff: November 2016
Date Program Originally Loaded onto CEBC: December 2016