What is PCM

When you are working with severe problem behavior, you need the world's most effective & humane Crisis Management System

Would you not agree that a professional crisis management system should drastically reduce the number of incidents, and when one occurs, the intervention can actually stop someone safely and your staff remains safe and be confident to intervene is an effective professional crisis management system?

Would you also agree that we want to preserve the dignity of the student and treat them as humanely as possible (that is, comfortable with no pain) even though they may be trying to harm themselves and/or others? .

This is exactly what the PCMA offers with PCM.

pain on the cement
Pushing someone in a painful position on the cement is not humane and will be counter productive in the long run

Do any of these problems look familiar?

PCM offers these solutions

Many staff find that their current systems don’t allow staff to safely contain larger, stronger individuals resulting in injuries to staff and others. Staff who feel that can’t control a student/client will tend to let the crisis continue until it stops naturally.

With PCM, most staff will be able to safely contain most individuals you serve using only least restrictive procedures (escorts), but for larger, stronger, more dangerous people staff will be able to use more restrictive yet safe procedures.

Far too often students/clients can get injured during interventions, suffering scrapes and bruises and perhaps worse. This causes great concern to all parties but especially parents and advocates.

It is impossible to guarantee no injuries at all to staff or clients whether staff intervene physically or do nothing at all. Injuries can happen in PCM as well, but they are very rare, very minor, and in most instances preventable. Part of our SPA (Staff, Parents, Administrators) coverage is explaining to parents that any student with severe behavior problems is at risk of injury until these problems are addressed. There is risk of injury with no intervention, with the wrong intervention and even with the right intervention, but the risk is always lowest with the right intervention.

Our crises sometimes go very long (over an hour) putting the individual at increased risk of injury and losing valuable educational/treatment time for possibly all individuals in the setting. These long duration crises cause us to have to pull staff from all over the facility to address the emergency.

No one can guarantee a short crisis every time, but PCM procedures were specifically designed to shorten the duration of a holds by giving feedback to the individual which in some cases can shorten the restraint to as little as 12 seconds.

Crises happen too often at our facility. Either multiple times per day for the same individual, or multiple times per day for each residential unit or classroom.

Most crises can be prevented by PCM certified staff using a combination of simple yet powerful prevention tools, and de-escalation tools for individuals who are headed towards a crisis. At first staff may need to use frequent de-escalation tools until their prevention systems are in place.

Sometimes students end up on the dirty floor or in the dirt or in unnatural positions which can be undignified and/or humiliating. This might result in lower self-esteem for students and fuel future episodes.

The PCM practitioner protects the individual dignity by ensuring that they are never placed on the floor or in an awkward unnatural position. PCM breaks the cycle of lowered self-esteem leading to future episodes.

Procedures that are highly coercive (unnecessarily forceful and painful) and may be confused for police tactics, may destroy relationships and cause retaliation and block therapeutic/educational progress

All PCM procedures are painless and use natural body positioning, therefore reducing any unnecessary coercion, breaking the cycle of crisis and retaliation. Because these procedures are as comfortable as possible students/clients no longer see teachers/staff as “the enemy

Often times staff aren’t quite certain how to proceed at the end of a crisis. For example, sometimes individuals are asked to resume previous activities that they aren’t ready for. This can result in the individual’s going right back into crisis.

PCM teaches your staff how to recognize when an individual is ready to go back to their normal routine, and also teaches your staff the right steps to take to get the individual productive again.

PCMA cycle of crisis
  1. Prevention is a set of strategies that staff/teachers use to keep individuals as stable as possible
  2. De-escalation is a set of related strategies that staff/teachers use to return the individual to stable functioning when they are on their to way to a crisis
  3. Crisis intervention is a set of highly structured physical procedures designed maximize safety yet minimize duration of restraint
  4. Reintegration is a set of procedures designed to accelerate a return to stable functioning while minimizing the risk of a second crisis.

Each set of procedures is physiologically sound with respect to the size of the individual.

Renatta Reeves MD, Oklahoma

compass to gps

We can all agree that a compass is initially far less expensive than a quality GPS, but once lost, the costs associated with getting back on track is no longer a comparison. A compass will certainly point in the right direction, but it cannot say how to get from point A to point B or how long it will take to get there

The Professional Crisis Management (PCM) model is like installing a quality GPS in your car. You will know exactly which roads to take, which ones to avoid and when you’ve arrived.

PCM drivers
Developed from the late 80's onwards and continuously improved with the latest scientific insight and practical feedback from PCMA members, the PCM system started off with the idea that interventions have to be painless yet effective by marrying the field of Natural Body Positioning with Behavioral Science. It lead to the reputation that PCM is 'good for the difficult cases'. Yet the addition of significant non physical procedures added to the wide range of behaviors, from 'mildly disruptive to severe' that can be addressed with PCM. PCM is focussed on school age individuals and individuals with special needs, As such it will adjust its physical procedures to body sizes. It is NOT intended for use in correctional facilities. It is a Crisis Management system, not a full Treatment system.

The Cycle of Crises Model explained

Prevention:

Unlike most other systems, PCM emphasizes the use of proven behavioral strategies before any signs of a crisis and even before pre-crisis behaviors. In prevention the goal is to keep stable people stable. How heavy does PCM focus on Prevention? Just one example of a behavioral strategy in this phase, just one out of 5 strategies from only one of the 12 categories of prevention strategies (maximizing relationships), is to ask an individual about their favorite hobbies. People generally love to talk about the things they love, and they will probably like you better now too. Don’t you agree that a student that likes their teacher will be easier to teach?

De-escalation:

Many systems claim to teach prevention, but they are actually starting at de-escalation. In PCM, de-escalation means to help return an individual who is almost in a crisis to a stable condition. Unlike other systems, PCM recognizes off-task and disengaged behavior (PCM calls this pre-crisis level 1) as a pre-cursor to crisis. Therefore, we have numerous strategies to stop and redirect these off-task behaviors before they can turn into a crisis. We teach you to identify 3 different levels of pre-crisis behavior each with their own specialized set of strategies.

Crisis intervention:

In those rare cases where prevention and de-escalation were not enough, and a real crisis occurs then we crisis intervention procedures. The Professional Crisis Management system incorporates a unique methodology known as Dynamic Holding. Most people look at restraint as an “all or none” decision, but using dynamic holding, staff will learn how to change procedures in real-time to give feedback to the individual. This feedback allows the individual to learn how to relax and quickly end the procedure. This dynamic gives the individual a feeling of control over the situation. Now that the individual has relaxed, staff can systematically begin releasing which takes as little as 12 seconds. Another reason individuals can relax quickly is that PCM uses only natural body positioning thereby avoiding all awkward, potentially painful/humiliating procedures. People who are secured in a natural, comfortable position can relax much more quickly.

Reintegration:

When a crisis has resolved, the next goal is to get the individual back into the classroom/treatment area as quickly as possible to minimize lost educational or treatment time. Staff who don’t understand how to check for an individual’s readiness to resume activities can easily find themselves facing a crisis again. The PCM system guides your staff through 2 levels of post-crisis strategies. The first set of strategies focuses on the time immediately after a crisis where staff use systematic checks for cooperation. A second set of strategies focuses on checking for interest in typical activities, looking for key changes in affect and trying some simple and familiar activities to confirm that the individual is ready to be productive once again.

Our Training Solutions

crisis severity matrix

Not every crisis is the same (see our page on 'what crisis are we talking about' ) and therefore PCMA does not offer a 'one size fits all' crisis management solution either.

In fact, there are five different type of crisis management certifications offered by the PCM Association.

Some organizations never face any situation that requires true physical crisis intervention at all! They would be fine with our 'Every Day Behavior Tools' training. For more information on each type of certification see below

EveryDay BehaviorTools

This ABA-based training is appropriate for staff who must adopt a “hands-off” approach to crisis management and shows them how to prevent crisis by dramatically improving their relationships with their clients/students. This training is especially useful for individuals who are higher functioning with good language skills and who may present nuisance/disruptive behaviors such as non-compliance, “mouthiness” or pushing the buttons of staff.

EveryDay BehaviorTools is a stand-alone training, but it is also an excellent complement to the PCM training.

The model it is based on was originally developed and subsequently adapted by a dedicated team of Board Certified Behavior Analysts and is based on the landmark work of Dr. Glenn Latham, a prominent Psychologist, Behavior Analyst, Author and Presenter.

PCM Basic Practitioner

This training is essentially PCM without the physical component. It is appropriate for staff who work with and support others who are PCM certified. It provides information on preventing crisis and de-escalating pre-crisis behavior as well as information on reintegration.

PCM Basic Practitioner Plus

This training is an advanced version of the PCM Basic Practitioner certification level. It covers the same curriculum, which provides information on prevention, de-escalation, and reintegration strategies. This course also teaches participants how to implement our personal safety techniques (i.e. hair release, bite release, etc.). It is appropriate for staff who work with and support others who are PCM certified, or those that work in an environment where more restrictive procedures are prohibited.

PCM Practitioner

This level certification is appropriate for staff who are working with individuals in Level 2 of the Crisis Severity Matrix. Practitioners will learn all the non-physical strategies (prevention, de-escalation, re-integration). They will also learn personal safety techniques (bite release) and transportation procedures (escorts).

PCM Practitioner 1

This level of certification is appropriate for staff who are working with individuals in Level 3 of the Crisis Severity Matrix. Practitioners will learn all the non-physical strategies (prevention, de-escalation, re-integration). They will also learn personal safety techniques (bite release), transportation procedures (escorts) AND vertical (standing) immobilizations.

PCM Practitioner 2

This level of certification is appropriate for staff who are working with individuals in Levels 3 OR 4 of the Crisis Severity Matrix. Practitioners will learn all the non-physical strategies (prevention, de-escalation, re-integration). They will also learn personal safety techniques (bite release), transportation procedures (escorts), vertical (standing) immobilizations AND horizontal immobilizations (lying prone or supine on a mat)

Testimonial

"I have been a trainer in CPI, Safety Care, TCI, Mandt, and Professional Crisis Management. I can say with 15 years of experience implementing each of these procedures, that Professional Crisis Management is by far the most effective methodology in keeping folks safe, and decreasing crises. It also is the only form of crisis management that has peer reviewed publications evidencing demonstrated reduction in restraints, injuries (both to staff and consumers), and promotes pro-active procedures to reduce the likelihood physical intervention is needed. Also, with Professional Crisis Management, there are no pain causing holds, or any holds that hold the person off balance, or put undue pressure on joints."

Travis Blevins Executive Director

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A sample of the Applied Behavior Analysis Associations we participate with:

FABA Logo