Handle with Care Behavior Management System®

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

For parents/caregivers of children ages: 3 – 17

Program Overview

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.

Program Goals

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

Logic Model

The program representative did not provide information about a Logic Model for Handle with Care Behavior Management System®.

Essential Components

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
      • Escort/Transport
      • 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
    • Wheelchairs
    • 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 to 8):
    • Program for ages 3 to 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.

Program Delivery

Parent/Caregiver Services

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

Recommended Intensity:

The program techniques are used as needed.

Recommended Duration:

The program techniques are used as needed.

Delivery Settings

This program is typically conducted in a(n):

  • Hospital
  • Outpatient Clinic
  • Community-based Agency / Organization / Provider
  • Group or Residential Care
  • School Setting (Including: Day Care, Day Treatment Programs, etc.)


This program does not include a homework component.

Resources Needed to Run Program

The typical resources for implementing the program are:

Trained staff and a suitable space

Manuals and Training

Prerequisite/Minimum Provider Qualifications

Staff receives training by a certified HWC trainer from their organization. HWC certifies the trainer in a Train-the-Trainer program.

Manual Information

There is a manual that describes how to deliver this program.

Training Information

There is training available for this program.

Training Contact:
Training Type/Location:

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

Currently, there are no published, peer-reviewed research studies for Handle with Care Behavior Management System®.

Additional References

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.

Contact Information

Hilary Adler, Esq.
Title: VP
Agency/Affiliation: Handle With Care Behavior Management System, Inc.
Website: www.handlewithcare.com
Phone: (845) 255-4031
Fax: (845) 256-0094

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