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Safe Management Group (SMG) Student Orientation · Safe Management Group (SMG) Student Orientation...
Transcript of Safe Management Group (SMG) Student Orientation · Safe Management Group (SMG) Student Orientation...
Safe Management Group
(SMG)
Student Orientation
At Ontario Shores Centre for
Mental Health Sciences
Safe Management Group
• Safe Management Group (SMG)
Training Program offers generic skills &
techniques to support clinical staff in the
prevention & management of the crisis
continuum
SMG versus Other
Programs
• SMG, has a psychologically-based
philosophy with a prevention focus. It
was developed by psychologists and
behavioural therapists and looks at the
functions of behaviour. This aligns with
recovery and our mental health
approach to prevent and care for patient
who are experiencing crisis.
Role of Advanced Trainers
• Co-facilitates SMG Training for Ontario Shores
• Peer support for staff practice of SMG relationship management, de-escalation skills and safe physical techniques
• Works as a member of the team at Code Whites to support the team in promoting staff and client safety
Therapeutic
Relationship
Model
Therapeutic Relationship Model
• The model was created to focus on emphasizing working together in collaboration with patients which will positively impact staff and patient safety
• Evidence supports the development of multidimensional models for the management of aggression in mental health care settings (Duxbury, 2005)
Therapeutic Relationship
Model • Promote wellbeing and strengths
• Positive patient outcomes
• Promote least restraints and least intrusive
philosophy
Collaborative Recovery Model
• Guiding Principle 1 Recovery as an individual process
• Guiding Principle 2
• Collaboration and Autonomy Support
Components of the Therapeutic
Relationship Model
1~ Change Enhancement
2~ Collaborative Strengths and Values
Identification
3~ Collaborative Visioning and Goal
Striving
4 ~ Collaborative Action and Monitoring
What is the SMG Program
• Crisis Intervention Training
• Designed by Psychologists, Behaviour
Consultants & Physical Intervention
Specialists
• Approved for use with children & adults
by Ministry of Community & Social
Services in 2003
• Ontario Shores’ adopted SMG in 2008
to ensure staff are trained in a
CERTIFIED program to support best
practice
Approach
• Prevention of aggressive incidents
• Least intrusive
• Effective use of safe techniques
Risk Management
Summary of Risk
Management
• What is a Behavioural crisis
• Two types of behavioural crisis: Predictable vs. Unpredictable
• Effective Prevention of behaviour crises:
Plan for the predictable
Know the response to the unpredictable
Risk Management
Risk management includes:
• System Preparation
e.g. Policies and Procedures
• Preventative Planning
e.g. Plan of Care
• Functions of behaviour
i.e. What the patient needs or wants
Summary of Risk
Management
• Environmental preparation
– Enviroscan
• Staff preparation
– Aware of our own internal processes
– Stress management
Positive Feelings
Positive Behaviour Positive Outcomes
Positive Thoughts
Positive Self-Management
Relationship Management
Summary of Relationship
Management
• Power & equity
– Technique: Provide greater choices in
areas of insufficient self-determination
• Social Exchange & Reciprocity
– Technique: Create balance; plan more
positive experiences & reduce
unnecessary negative experiences
Summary of Relationship
Management
• Empathy, Caring, Acceptance
– Technique: Active listening, attention to
verbal & non-verbal cues, inclusion of
patient
• Genuineness & Openness
– Technique: Disclose appropriate feelings,
personal thoughts & information
Summary of Relationship
Management
• Responding to Emotions
– Technique: Allow patient to express
emotions instead of interrupting patient
during this process; use active listening
skills.
• “Meet the patient where the patient is
at present”
Summary of Relationship
Management
• Coercion
– Technique:
– Avoid giving in to coercion; redirect by active listening
& problem solving
– Avoid presenting coercive behaviours; Provide choices
and or make a plan ahead of time – empower the
service user.
• Interpersonal Boundaries
– Techniques: Discuss with other staff; Negotiate &
compromise with others on less important rules; Write
down limits & frequently review & communicate with
others
Managing Aggression
Summary of Managing
Aggression
• Aggression usually does not
happen suddenly & without warning
• Aggression often occurs over time
& through different phases
• There are NO set number of stages
a patient will go through
Code White Response:
Team Approach
Revised Code White Policy
• Code White responders will practice a least
restraint & least intrusive philosophy & ensure
alternative to restraints have been exhausted
first & whenever possible
• There will be an identified Code White Team
Leader at every Code White team response
who will assign roles & responsibilities
Revised Code White Policy
• Code White team leader responsible to ensure a Safety Occurrence Report & Code White Review will be completed following the event
• Emotional debriefing is available for staff through Critical Incident Stress Support Team (CISS) & Employee Assistance Program (EAP)