Nonviolent Crisis Intervention® Training

About This Program

Target Population: Staff working in child welfare settings, human services, health care facilities, and educators

Program Overview

CPI’s Nonviolent Crisis Intervention® training is designed to provide learners with a framework for preventing, de-escalating, and safely responding to crisis behavior. The program focuses on what’s happening from two perspectives: the person in distress and the staff person. Participants are taught a broad range of tools to help them manage their own emotional responses and identify escalating behaviors in others. They practice approaches to keep their “emotional brain” from taking over in stressful situations. They also discover how having a plan before behavior escalates can help manage their fear and cultivate consistent practices. The philosophy of Care, Welfare, Safety, and Security℠ expands throughout the continuum of interventions necessary when working toward the reduction or elimination of restraint. The program realistically addresses the serious issue of restrictive intervention through careful assessment of risk and an evaluation of what may be considered “last resort.”

Program Goals

The goals of the Nonviolent Crisis Intervention® Training Program are:

  • Teach staff members how to defuse potentially risky behavior before an incident escalates to a crisis situation
  • Reduce the risk of injury to staff and those served by decreasing the number of physical interventions
  • Improve communication among staff by establishing a common language
  • Increase staff confidence to intervene both verbally and physically
  • Alleviate the staff's stress and anxiety associated with confusion or uncertainty in crisis moments
  • Help staff feel safer at work
  • Minimize the risk of potential liability
  • Improve staff retention by providing the skills necessary to manage difficult situations
  • Help an organization comply with legislative mandates and regulatory/accreditation guidelines
  • Create and maintain a safe, caring, and respectful environment for staff and those served
  • Help an organization demonstrate its commitment and contribution to a safer community

Logic Model

The program representative did not provide information about a Logic Model for Nonviolent Crisis Intervention® Training.

Essential Components

The essential components of Nonviolent Crisis Intervention® Training Program include:

  • The verbal and physical interventions described in the training program are intended for use with individuals experiencing a crisis moment. The techniques are not intended to be used as therapy.
  • The curriculum as noted below:
    • Introductions
      • Establishes the scope of the program while organizing the experiences of staff during moments of crisis.
      • Professional and personal values of staff are linked to the purpose of the program, its concepts, and the approaches that will be taught.
    • Unit 1: CPI Crisis Development ModelSM
      • Identify behavior using the Crisis Development Model℠ and apply the most appropriate staff approaches most effective in responding at each behavior level to prevent further escalation.
    • Unit 2: Integrated Experience
      • Explore underlying causes of behavior
      • Recognize the need to maintain consistent calm behavior in a time of crisis
      • Understand how the behavior of one person impacts the behavior of others
    • Unit 3: Communication Skills
      • Practice communication strategies
      • Observe how different approaches positively and/or negatively impact an individual’s behavior
    • Unit 4: Responding to Defensive Behaviors
      • Identify defensive behaviors in crisis situations using the Verbal Escalation Continuum
      • Use specific verbal patterns when de-escalating a crisis to develop a range of responses
      • Identify steps to prepare for a difficult conversation
    • Unit 5: Safety Interventions
      • Practice and apply skills needed to keep oneself safe when crisis escalates to risk behavior
      • Apply principles for using a coordinated and collaborative approach
    • Unit 6: Introduction to Restrictive Interventions
      • Identify restrictive interventions and explore the key legal and professional considerations when using restrictive interventions
      • Explore the Physical Skills Review Framework
    • Unit 7: Decision Making
      • Organizes thinking regarding the risks associated with different behaviors, encouraging critical analysis and rational reasoning in response decisions.
    • Unit 8: Safety Interventions: Holding Skills
      • Learn how to respond effectively when an individual is in risk behavior
      • Build the confidence of staff in their ability to keep themselves and others safe using physical holding skills
    • Unit 9: Post-Crisis
      • Introduce the COPING Model ℠, which is a framework to help guide staff and the individuals in distress through the process of establishing Therapeutic Rapport after a crisis.
    • Conclusion and Assessment
      • Reflect on new learning and complete an action plan
      • Revisit program values, person-centered care, and a culture of safety
    • Posttest/Evaluation
      • Assesses learning outcomes and gathers feedback via course evaluations.

Program Delivery

Recommended Intensity:

This program is not a client-specific intervention, but a full-system approach that targets the entire staff.

Recommended Duration:

The program contains strategies for staff to use on an ongoing basis to prevent or intervene in response to challenging behaviors.

Delivery Settings

This program is typically conducted in a(n):

  • Community Daily Living Setting
  • Foster / Kinship Care
  • Hospital
  • Outpatient Clinic
  • Community-based Agency / Organization / Provider
  • Group or Residential Care
  • Justice Setting (Juvenile Detention, Jail, Prison, Courtroom, etc.)
  • School Setting (Including: Day Care, Day Treatment Programs, etc.)
  • Shelter (Domestic Violence, Homeless, etc.)

Homework

This program does not include a homework component.

Languages

Nonviolent Crisis Intervention® Training has materials available in languages other than English:

French, Spanish

For information on which materials are available in these languages, please check on the program's website or contact the program representative (contact information is listed at the bottom of this page).

Resources Needed to Run Program

The typical resources for implementing the program are:

  • Staff needs to be trained in the techniques (see training section for more details).
  • Techniques can be performed anywhere, no additional room requirements or resources are needed.

Manuals and Training

Prerequisite/Minimum Provider Qualifications

The program is open to all staff members regardless of degree, who work within a Certified Instructor's Base of Employment.

Manual Information

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

Program Manual(s)

Program manual details:

  • CPI. (2020). Instructor manual for the Nonviolent Crisis Intervention training. Author.

All instructors are provided an Instructor Guide that aids in facilitating and growing training at their organization. This instructor guide is handed out in person to all instructors and is used during the training program to become familiar with CPI’s philosophies and concepts. During the training, learners become familiar using the instructor guide and information in the guide. Additional resources are available to instructors via crisisprevention.com. Instructors can login to their account to access training videos, electronic presentations, and resources to prepare for training. All of these physical and electronic resources are created by CPI’s team of instructional professionals.

Training Information

There is training available for this program.

Training Contact:
Training Type/Location:

The program is taught using a train-the-trainer model. Individuals from organizations interested in using the program send prospective Instructors to be certified during a four-day Instructor Certification Program. CPI offers over 300 regularly scheduled courses per year in cities throughout the world. Training is also conducted onsite and customized for specific audiences. Program availability is continuously updated at www.crisisprevention.com. Organizations may also enroll their staff in a non-instructor training program. The same concepts noted in the Essential Components section are still covered. The only difference is that the adult learning theory and instructor certification program concepts are not covered.

Number of days/hours:

CPI’s provides training options to meet the needs of interested organizations. The main training differences include an option for train-the-trainer or non-instructor training and attending hybrid or in-person training. Depending on the training options selected the length of the program will vary, however the main concepts and philosophies of CPI remain the same.

Hybrid Training (Total Time for Instructors: 19.5 hours; Total Time for Non-Instructors: 8.5 hours)

  • Part One - Online Training Modules (available for: Instructors, Non-Instructors): This self-paced online learning modules cover topics such as prevention and de-escalation strategies, decision making, and an introduction to CPI’s disengagement skills for managing behavioral risk.
  • Part Two - Day-One Classroom Training (available for: Instructors, Non-Instructors): Learn to organize your thinking about how behavior escalates and how to respond appropriately during moments of escalating crisis. Practice applying physical holding skills. Build confidence in keeping self and others safe in a crisis.
  • Part Three- Day-Two and Day-Three Classroom Training (available for Instructors): Build on content from Part One and Part Two, introduce adult learning principles, reinforce preventative techniques, and practice the principles of nonharmful physical interventions. Gain the skills and confidence to teach the program to staff at your facility.

Classroom Training (Total Time for Instructors: 30 hours; Total Time for Non-Instructors: 16 hours)

  • Part One - Day-One Classroom Training (available for: Instructors, Non-Instructors): Learn to organize your thinking about how behavior escalates and how to respond appropriately during moments of escalating crisis. Build confidence in keeping self and others safe in a crisis.
  • Day-Two Classroom Training (available for: Instructors, Non-Instructors): Continue to discuss training concepts from day one. Introduction to practicing and applying physical holding skills. Learn to organize your thinking about how behavior escalates and how to respond appropriately during moments of escalating crisis. Build confidence in keeping self and others safe in a crisis.
  • Part Two - Day Three and Day-Four (available for Instructors): Build on content from Part One and Part Two, introduce adult learning principles. Reinforce preventative techniques and practice the principles of non-harmful physical interventions. Gain the skills and confidence to teach the program to staff at your facility.

The Certified Instructor would then, in turn, be able to deliver the program to others within the organization in a format that is typically between 8-12 hours over one or two days. They would follow these guidelines when training staff at their organization:

  • Only active Certified Instructors certified by CPI teach the program.
  • Only authorized participants from the Certified Instructor's Base of Employment attend the program.
  • Only original CPI training materials are used.
  • Units I–VII are adequately covered prior to teaching any physical interventions.
  • All units of the program are taught in sequence.
  • Safe Participation Guidelines is provided to participants by following the Procedural Safety Outline in the Instructor Manual.
  • Adequate space is used for training. (For 15–25 participants, a minimum of 1500 square feet is recommended.)
  • Every participant uses a program training workbook.
  • Class size must not exceed 40 participants.

An Electronic Presentation and other training aids that Instructors may choose to use with the program are available at crisisprevention.com.

The program is best implemented utilizing an ongoing training process, and as such, outside of initial training and formal recertification training, it is recommended that Certified Instructors implement a training cycle that includes Situational Applications, Policy Discussions, Reviews, Practices, and Rehearsals.

Organizations using the training program have the option of implementing the course in a blended learning (partially via computer, partially via classroom) version. The blended learning version allows staff to learn many of the basic elements of the program from the comfort of their computers outside of a class via the internet, then learning how to apply the information in a classroom environment.

Relevant Published, Peer-Reviewed Research

Jonikas, J., Cook, J., Rosen, C., Laris, A., & Kim, J. (2004). A program to reduce use of physical restraint in psychiatric inpatient facilities. Psychiatric Services, 55, 818–820.

Type of Study: One group pretest/posttest design
Number of Participants: 227

Population:

  • Age — 12-17 years
  • Race/Ethnicity — 62% African American (remaining not specified)
  • Gender — 66% Female and 44% Male
  • Status — Participants were adolescents in an adolescent psychiatric ward with a diagnosis of major depression or other depressive disorders, adjustment disorders, conduct disorders, schizophrenia or psychotic disorders.

Location/Institution: Adolescent psychiatric unit at a university hospital

Summary: (To include basic study design, measures, results, and notable limitations)
The study evaluated whether training staff members in crisis de-escalation and nonviolent intervention (Nonviolent Crisis Intervention® Training Program) would decrease adolescent patients' self-reported stress triggers and personal crisis management strategies. Staff studied a comprehensive training manual, viewed a 90-minute training video part of a seclusion and restraint reduction toolkit, and participated in a one-day training session. Staff members conducted brief interviews at intake or within the first 24 hours of admission to elicit patients' crisis triggers and to determine de-escalation strategies. Patients' restraint histories were elicited along with their medication preferences. Each plan was reviewed on a weekly basis. The adolescent unit experienced a 48 percent decrease in the restraint rate one quarter after training occurred and a 98 percent decrease two quarters after the training and remained low throughout the final two quarters of the year. The primary limitation is the lack of a control group.

Length of controlled postintervention follow-up: 1 year.

Ryan, J. B., Peterson, R. L., Tetreault, G., & Van der Hagen, E. (2007). Reducing seclusion timeout and restraint procedures with at-risk youth. Journal of At-Risk Issues, 13, 7-12.

Type of Study: One group pretest/posttest design
Number of Participants: 42

Population:

  • Age — 7-15 years
  • Race/Ethnicity — 37 Caucasian, 3 American Indian, and 2 African American
  • Gender — 40 Male and 2 Female
  • Status — Participants were students from the surrounding public school districts and a local residential facility on both a short- and long-term basis due to inappropriate behaviors.

Location/Institution: Minnesota public day school

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of this pilot study was to review the effects of professional staff training in crisis management (Nonviolent Crisis Intervention® Training Program) and de-escalation techniques on the use of seclusion timeout and restraint procedures with at-risk students in a K-12 special day school. Measures utilized include a teacher self-questionnaire, incident reports, and staff surveys. Results indicated professional staff training was effective in reducing (a) seclusion timeout procedures by more than one-third (39.4%) and (b) physical restraints (17.6%). This study also found staff members were not initiating seclusion timeout procedures primarily for the reasons they were trained (e.g., physical aggression) but rather for nonviolent behaviors such as leaving an assigned area and disrupting the classroom environment. Limitations included the use of a convenience sample, lack of control group, and concerns about generalizability to other ethnic populations.

Length of controlled postintervention follow-up: Unclear – training occurred throughout the school year.

Additional References

Chau, C. (2010). Restraint use: A culture of assumptions. Retrieved from http://www.crisisprevention.com/Blog/January-2012/Restraint-Use-Culture-of-Assumptions

CPI. (2005). Instructor manual for the Nonviolent Crisis Intervention training program. Milwaukee, WI: Author.

Lafond, R. (2009). Reducing seclusion and restraint for improved patient and staff safety. Retrieved from https://www.crisisprevention.com/CPI/media/Media/Blogs/Reducing-Seclusion-and-Restraint-for-Improved-Patient-and-Staff-Safety.pdf

Contact Information

Bridget Mangan, BSW
Website: www.crisisprevention.com
Email:
Phone: (800) 558-8976

Date Research Evidence Last Reviewed by CEBC: February 2015

Date Program Content Last Reviewed by Program Staff: May 2024

Date Program Originally Loaded onto CEBC: January 2011