CPI Training

key point refresher leaders guide
For Review of the

Nonviolent Crisis
Intervention
Training Program
care, welfare, safety, and securitySM
2005 CPI (reprinted 2011). All rights reserved. This work is protected by the copyright laws of the United States and other countries and remains the sole and exclusive property
of CPI. This work may not be reproduced in any manner without the express written permission of CPI.
Important information about your license to use teaching materials.
CPI hereby grants CPI Certified Instructors a perpetual, nonexclusive, and nontransferable license to use this work in teaching this program to staff within the Certified Instructors
Base of Employment, as defined in the Instructor Manual. This license is site-specific to the Certified Instructors Base of Employment and includes the right to distribute this work
to program participants for use during this training. Any other use of this work is strictly prohibited and will be considered a breach of this license and a violation of applicable
copyright laws. Certified Instructors are not agents (implied, apparent, or otherwise) or employees of CPI and do not have any authority to act for or on behalf of CPI.
CPI and Nonviolent Crisis Intervention are registered trademarks of CPI.
Maintaining Safety in the Nonviolent Crisis

Intervention Training Program
Remember the responsibility that we have as Certified Instructors to provide our participants
with a safe learning environment. Formal refresher trainings are an opportunity to role model the
philosophy of Care, Welfare, Safety, and SecuritySM. Have your participants read the Due Care
guidelines that are listed on page 2 of their Key Point Refresher Workbook. Be sure that these
guidelines are followed during the training.
I will respect other participants as peers.
I am responsible for the safety of others with regard to my actions.
I am responsible for gauging myself with regard to any past/current injuries and my
comfort level performing any given technique. If I have any concerns, I will see my
Instructor at a break.
I will not engage in horseplay.
I will not teach other techniques.
In all role-plays/techniques, I will act only on my Instructors direction.
I will cooperate, not compete.
I will take time to warm up and stretch before performing any physical activity, and I will
drink plenty of fluids throughout the day.
I will be conscious of the space around me and always consider safety while practicing
physical techniques. I must remember that there are others who are practicing near me.
During physical exercises, any participant can ask to stop the activity at any time, for any
reason. If, while practicing physical exercises, my partner asks me to stop the activity, I
will take the request seriously and immediately discontinue the exercise.
I will inform my Instructor prior to class of any injuries or limitations.
I will report all injuries to my Instructor immediately.
Please Read Carefully:

As a Certified Instructor of the Nonviolent Crisis Intervention training program, you and your
participants will be involved in practicing intervention strategies. You should understand that some
of these methods involve physical contact and include risk of injury. It is important that you remind
participants of the Due Care guidelines of the program, as well as model them yourself.
CPI makes no warranty or representation that the skills, techniques, and methods taught in this
program comply with all local laws, rules, regulations, and ordinances that may be applicable to
persons utilizing same. CPIs physical intervention techniques should be used only in a manner that
comports with local laws. CPI assumes no liability for any bodily injury, loss, or damage caused by the
misuse or incorrect application of the skills, techniques, and methods taught in this program, or by the
illegal or inappropriate use of same, whether or not such injury, loss, or damage is foreseeable.
2005 CPI (reprinted 2011).
Introduction
Formal refreshers are an essential step in the Nonviolent Crisis Intervention Training Process.
They provide opportunities for participants to:
Develop a greater understanding of course concepts.
Problem solve and strengthen crisis intervention skills.
Receive additional supporting information.
Demonstrate ability and confidence in applying course content and skills
to real-life work experiences.
Formal refresher training courses should be
scheduled to review and expand upon the
Nonviolent Crisis Intervention training concepts.
It is recommended that all participants review
course content to refresh their skills every six to
twelve months. The formal refresher course must
be a minimum of three hours in length for training
credits to be granted.
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The Minimum Content for a Formal

Refresher Includes:
Pre-test.
Policy
Discussions
s
Formal
Refreshers
The CPI Crisis Development ModelSM.

All verbal intervention information.
A review and practice of all CPI Classroom Model Personal Safety TechniquesSM.
A review and practice of all CPI Classroom Model Nonviolent Physical Crisis
InterventionSM techniques if they were taught to staff in the original training.
Problem solving and role-playing based on staff needs.
Post-test.
Planning and preparation are necessary for making formal refreshers a positive and valuable
training experience for participants. The Instructor must keep in mind that staff members
returning to refresher classes will arrive thinking, I already know this information. Therefore,
formal refresher training must be stimulating, challenging, and engaging. Customizing the
refresher training to your participants needs and interests will make the training more meaningful
and relevant to your participants.
Introduction
Customizing Formal Refresher Training
The importance of customizing formal refresher training to the needs of each group cannot be overstated.
It requires creativity and flexibility. While it may be necessary to do some formal lectures, participants
generally appreciate a format that is highly interactive in these classes. Through discussions, exercises, and
supplemental information, formal refresher trainings should be customized to meet the needs and interests
of participants, as well as to build on the foundation laid in their original Nonviolent Crisis Intervention
training program.
Specific information regarding the needs and interests of participants can be collected through feedback
from supervisors and team leaders, incident reports, and pretraining surveys from participants.
Pretraining surveys can be designed by the Certified Instructor to establish the objectives and focus of
training. There are several ways to do a pretraining assessment; the following are just a few ideas:
In order to assess participants prior knowledge and retention from previous trainings, you might
consider having participants complete the pre-test prior to the training. It will give you a good
idea of which units you may need to spend more time on.
In order to determine how much time to plan for, specific content areas on which the greatest
emphasis should be placed, and the type of supplemental information that should be presented,
you might ask participants:

About their roles and how they use training on the job.
Topics that they would like to focus on.
If they have specific questions about applying the training to various situations.
H
ow long it has been since their last formal refresher training and since their
original training.
In order to identify areas of need, you may also consider asking staff members to rate:

Their perception of internal staff cohesiveness/teamwork.
Their level of confidence on the job.
Their assessment of how safe they feel at work.
This data can later be used to measure the ongoing impact of training.
Input from questions such as these will be useful in customizing the training to meet the needs and interests
of your participants and help them effectively apply skills to on-the-job situations. Additional options for
customized formal refreshers are available to Certified Instructors after completing advanced training
programs such as Autism Spectrum Disorders: Applications of Nonviolent Crisis Intervention Training,
Supporting Individuals With Dementia and Related Cognitive Challenges, Enhancing Verbal Skills:
Applications of Life Space Crisis InterventionSM, Applied Physical TrainingSM, and Trauma-Informed Care:
Implications for CPIs Crisis Development ModelSM.
The Teaching Notes throughout this Leaders Guide will guide you through the basic content of the
Nonviolent Crisis Intervention Key Point Refresher Course. Be creative in your presentation. Challenge the
group. Engage the group. Remember, they think they already know this information. Surprise them by showing
them that there is more to learn and that their skills and confidence can continue to grow. The goal is to
inspire further learning, problem solving, and a renewed commitment to Care, Welfare, Safety, and SecuritySM.
Introduction
How to Use the Key Point Refresher Leaders Guide
Page numbers are provided at the top of each Leaders Guide page for easy reference to the participants
Key Point Refresher Workbooks. Encourage participants to take notes. This will help with further retention.
The information shown in this bold italic font is the basic (minimal) information that should be addressed
by discussion, visuals, exercises, etc. In addition, Teaching Notes are identified by a shaded box.
You will notice that this Key Point Refresher Leaders Guide is organized differently than the workbook.
This allows the Certified Instructor flexibility and the ability to focus participants on a broad view of
crisis as it relates to the CPI Crisis Development ModelSM. The CPI Crisis Development ModelSM is the
foundation of the Nonviolent Crisis Intervention training program. All of the concepts discussed during
training expand on the various levels of behavior and staff interventions. As such, the Key Point Refresher
Workbook is designed to highlight this. For example:
Page 6 allows you to review the basic
behavioral levels and corresponding staff
approaches along with their definitions. It is
useful to engage participants in developing
a list of examples of each behavior and
approach.
Page 9 presents an overview of how

Precipitating Factors and Rational
Detachment affect the Integrated
Experience that occurs within the CPI
Crisis Development ModelSM.
Page 7 expands on the Anxiety/Supportive

level of the CPI Crisis Development
ModelSM. The workbook is organized so that
you can address how Proxemics, Kinesics,
the CPI Supportive StanceSM, and Paraverbal
Communication relate to both clients and
staff members.
Page 10 expands on the Acting-Out

Person/Nonviolent Physical Crisis
InterventionSM level of the CPI Crisis
Development ModelSM. It focuses on
the continuum of acting-out behaviors
and the continuum of physical
intervention strategies ranging from the
least restrictive all the way to restraint
as a last resort. Team intervention
strategies are also included as a key
aspect of this level.
Page 8 expands on the Defensive/Directive

level of the CPI Crisis Development ModelSM.
The CPI Verbal Escalation ContinuumSM is
positioned along the client side because it
represents a variety of defensive behaviors.
Along the staff side, the appropriate
interventions are discussed. Empathic
Listening covers both sides because it is an
active process that occurs between staff
members and the individuals in their care.
Page 18 expands on the fourth level of

the CPI Crisis Development ModelSM:
Tension Reduction/Therapeutic
Rapport. The workbook and Leaders
Guide are designed to allow you to
review the Postvention process as it
relates to both clients and staff.
This Leaders Guide can be used in conjunction with your Nonviolent Crisis Intervention Instructor Manual.
Although the Leaders Guide repeats base content from the core training, what is most important is that you are
able to discuss and apply this information at your facility. You are encouraged and authorized to spend more time
on applying the content as opposed to simply reteaching it.
Notes:
Key Point Refresher
Pre-Test
Introducing the Formal Refresher Training

Craft a positive and concise welcome and introduction. Include:
Validation for knowledge, skills, and prior training.
An example of the positive impact ongoing training is having.
A reminder of the organizations commitment to Care, Welfare, Safety, and SecuritySM.
An overview of training objectives (workbook page 3).
Logistics information (parking and lunch arrangements, breaks, emergency exits, requirements
for successful completion of formal refresher training, etc.).
Pre-test.
The Pre-Test (workbook page 4)

As with all pre-tests, this one provides the Instructor with information about the knowledge base of
participants. It gets participants thinking about and remembering earlier training and their experiences
implementing the training. Allow 712 minutes for participants to complete the pre-test (individually or
in pairs), then discuss their responses. Each pre-test question is designed to foreshadow content that
will be addressed within the training. Therefore, it is not necessary to examine each question in depth
at this time. Bridge back to the pre-test questions and participants responses throughout the formal
refresher training.
Workbook page 4
Key Point Refresher
Pre-Test
Name__________________________________________________ Date___________________________________
Title___________________________________________________________________________________________
Facility__________________________________________________ Phone (______)__________________________
Facility Address_________________________________________________________________________________
City_________________________________ State/Province__________ Zip/Postal Code____________________
Country ____________________________ Email______________________________________________________
1. What is the philosophy of the Nonviolent Crisis Intervention training program?

Care, Welfare, Safety, and SecuritySM
2. Complete the CPI Verbal Escalation ContinuumSM using the terms below.
3. Release
Intimidation
Questioning
Tension Reduction
4. Intimidation
2. Refusal
Refusal
Release
5. Tension Reduction
1. Questioning
3. When should you use Nonviolent Physical Crisis InterventionSM?

As a last resort.
4. Match each CPI model to the appropriate definition:
c. This model is used to guide staff through the

a. The CPI Crisis Development ModelSM
____

process of establishing Therapeutic Rapport

and staff debriefing after a crisis incident.
____
b. The CPI Verbal Escalation ContinuumSM
a. This model assists staff members to recognize

a clients behavior level and intervene early
and appropriately.
b. This model demonstrates defensive behaviors

____
c. The CPI COPINGModelSM

and staff interventions for each behavior.
This final pre-test question reminds participants of the key models that will be discussed in the
Nonviolent Crisis Intervention Key Point Refresher training and serves as a smooth transition to the
CPICrisis Development ModelSM, which is discussed next.
The CPI Crisis Development Model SM

Teaching Notes (workbook page 6)
This page allows you to review the basic terms in the CPI Crisis Development ModelSM before you
begin to expand on each. Please review all basic definitions and have participants provide workrelated examples of how each pertains to their work experience. Encourage them to come up with
examples of observable behaviors and staff approaches based on their observations and experiences
since their last training.
Sample discussion questions:
What is the Integrated Experience? What is its significance during crisis development?
Do individuals always exhibit the behaviors in the order of the model? If not, what is the value
of the model?
In small groups, participants may prepare and present role-plays that demonstrate
individuals escalating in the order of the model/not in the order of the model. Are both types
of escalations realistic?
Can you think of examples of situations in which behavior levels have overlapped?
Are there circumstances that make the behavior levels easier or harder to identify?
Workbook page 6
The CPI Crisis Development Model SM
Crisis Development/Behavior Levels
Staff Attitudes/Approaches
1. Anxiety
1. Supportive
Definition: A noticeable change or increase in

behavior.
Definition: An empathic, nonjudgmental

approach.
Examples: pacing, withdrawal, tapping
Examples: listening, offering reassurance
2. Defensive
2. Directive
Definition: The beginning stage of loss

of rationality.
Definition: An approach in which a staff member

takes control of a potentially escalating situation
by setting limits.
Examples: challenging authority,
Examples: explaining options and

consequences to the individual
becoming belligerent
3. Nonviolent Physical Crisis

InterventionSM
3. Acting-Out Person
Definition: The total loss of rational control
that results in a physical acting-out episode.
Examples: presenting a danger to self or others
by hitting, biting, kicking, throwing objects, etc.
Definition: Safe, nonharmful restraint positions to

control an individual until he can regain control of
his own behavior. Used only as a LASTRESORT.
Examples: CPI Childrens Control PositionSM, CPI
Team Control PositionSM, etc.
4. Therapeutic Rapport
Definition: A decrease in physical and

emotional energy.
Definition: An approach used to re-establish

communication.
Examples: showing signs of relaxation, normal
Examples: listening, showing interest and
breathing
concern
10
Level 1
1. Anxiety
1. Supportive
2. Defensive
2. Directive
3. Nonviolent Physical Crisis InterventionSM

Explain to participants that you will now begin to expand on each level of the CPI Crisis Development
ModelSM, beginning with an examination of the Anxiety/Supportive level. The workbook and Leaders
Guide are organized so that you can address how each key concept relates to both clients and staff
members. For example:

Proxemics: Discuss the relationship between anxiety and a clients need for personal space as
well as what a staff member can do to be supportive.

Kinesics: Discuss kinesic signs of anxiety that may be visible in an individual and supportive
kinesics that can be used by the staff member.

CPI Supportive StanceSM: Discuss how staff members can use the stance and why it is
advantageous.

Paraverbal Communication: Discuss how crisis situations can affect the paraverbal
communication of both clients and staff and what staff members can do to maintain a more
supportive environment through the use of their voice.
Nonverbal and paraverbal communication are concepts that can easily be understood but are
sometimes forgotten during a crisis situation. As staff members develop a greater appreciation for their
significance, they are less likely to be forgotten. Encourage participants to remember that all of these
concepts extend to all levels of the CPI Crisis Development ModelSM and should be utilized in all their
interventions. Involve participants in a discussion that will help them become more attentive to nonverbal
and paraverbal communication.
Can you think of an individual you work with who communicates more with nonverbals and
paraverbals than with words?
Can you think of a time when you gave mixed messages? What happened?
What have you done (or could you do) to become more attentive to nonverbal and
paraverbal communication?
11
Workbook page 7
Level 1
1. Anxiety
1. Supportive
Proxemics: Personal space. An area surrounding the body, approximately 1.5 to three feet (depending
on the context of the situation) in length. Personal space is considered an extension of self, and invasion
can escalate anxiety.
Individual
Discuss reasons why an individual may
want more or less personal space.
Disregard is likely to cause escalation.
Staff Member
Must try to respect/accommodate
personal space needs.
Discuss ways staff can do this.
Kinesics: The nonverbal message transmitted by the motion and posture of the body.
Individual
Fidgeting, glaring, head down, worried look,
muscle tension.

Staff Member
Open body posture, interested facial
expression, nonthreatening gestures,
and eye contact.
CPI Supportive StanceSM: Body positioned
at least one leg-length away and at an angle.

Reasons for using:

1. Respect (honors personal space).

2. Nonthreatening.
3. Safety.
Paraverbal Communication: The vocal part of speech, excluding the actual words one uses.
Three key components are tone, volume, and cadence of speech.

Individual
Tone may be angry, aggressive, sarcastic.
Volume may be loud. Cadence may be
choppy, fast at times.
Staff Member
Tone should be calm, reassuring. Volume
should be controlled, appropriate for the
setting. Cadence should be smooth.
12
Level 2
1. Anxiety
1. Supportive
2. Defensive
2. Directive

This page expands on the Defensive/Directive level of the CPI Crisis Development ModelSM. The CPI
Verbal Escalation ContinuumSM is positioned along the client side because it represents a variety
of defensive behaviors a client may exhibit. Along the staff side, the appropriate interventions are
discussed. Empathic Listening covers both sides because it is an active process that occurs between
staff members and the individuals in their care.
Many staff members have a great deal of experience responding to verbal escalations, and yet verbal
escalations can still be uncomfortable and frightening. Facilitate participation in this part of the formal
refresher course to allow staff to practice verbal strategies and receive feedback from others. This team
approach to learning can strengthen individual confidence.
What is the difference between setting limits and threatening an individual? Give examples.
What is our organizations policy with regard to responding to threats?
What have you done (or could you do) to build confidence in your verbal intervention skills?
Use creativity in presenting the section on Empathic Listening. Encourage participants to focus on
applying the skills in real-life work situations. Feel free to create an activity that allows staff to discuss
strategies for Empathic Listening. One way to do this is to divide participants into small groups. Assign
each group one of the Empathic Listening skills (e.g., providing undivided attention) and ask each group
to discuss:
Why the skill is important.
What might happen if staff members do not use that skill.
Strategies/ways that staff members can implement the skill.
Examples of situations in which NOT listening to an individual caused a problem to worsen.
Have the small groups present their thoughts to the full group.
13
Workbook page 8
Level 2
2. Defensive
2. Directive
The CPI Verbal Escalation ContinuumSM
Interventions:
1. Questioning
Information-seeking: Give a rational response.
Challenging: Redirect; avoid a power struggle.
2. Refusal: Set limits.
3. Release
3. Release
Allow individual to let off steam.

4. Intimidation
2. Refusal
Remove audience.
State nonthreatening directives.
Use an understanding, reasonable approach.
Enforce any limits you set.
4. Intimidation
Seek assistance.
Wait for team.

Avoid individual intervention.
Establish Therapeutic Rapport.
Re-establish communication.
( This stage is expanded upon later in
the course.)
1. Questioning
Setting Limits: The result of recognizing that

you cannot force individuals to act appropriately.
Effective limit setting means offering choices, stating
the consequences of those choices, and stating the
positive choice first.
Keys
1. Simple and clear
2.
Reasonable
3.
Enforceable
Empathic Listening: An active process to discern what a person is saying.

1) Be nonjudgmental.
2) Give undivided attention.
3) Allow silence.
4) Use restatement to clarify.
5) Listen for underlying messages.
14
Integrated Experience
1. Anxiety
1. Supportive
2. Defensive
2. Directive

This page presents an overview of how Precipitating Factors and Rational Detachment affect the
Integrated Experience that occurs within the CPI Crisis Development ModelSM. You may wish to review
the definitions of the key concepts prior to discussion.
Note how Precipitating Factors (light gray) are more dominant in a client during crisis situationsbut
that staff members are affected by Precipitating Factors as well. Also note how Rational Detachment
(dark gray) is largely the responsibility of staff members. Notice how the balance between these
concepts affects the overall Integrated Experience.
Lead a discussion on how Precipitating Factors and staff members ability to rationally detach impact
the Integrated Experience and the crisis situation as a whole.
Can you think of real-life examples of Precipitating Factors that impacted the Integrated
Experience of a crisis situation?
What are real-life examples of positive outlets that staff members use to rationally detach and
keep the Integrated Experience balanced?
Imagine if the graphic were tilted, and staff approached a crisis situation with a lot of
Precipitating Factors and little ability to rationally detachhow might that affect the Integrated
Experience and the result of the crisis situation?
Can you think of any real-life examples of crisis situations that would have resulted differently if
the balance between Precipitating Factors and Rational Detachment was different?
How does staff fear and anxiety affect the Integrated Experience?
How can staff members stay rationally detached if an individual becomes physically aggressive?
15
Workbook page 9
the concept that behaviors
and attitudes of staff impact
behaviors and attitudes of
individuals, and vice versa.
Examples:
Fear
Displaced anger, etc.
Examples from your group
Examples:
Take a deep breath
Get a good nights sleep
Examples from your group
Precipitating Factorsinternal or
external causes of an acting-out
behavior over which a staff member
has little or no control.
Rational Detachmen
t
itating Factors
p
i
c
Pre
Loss of personal power
Rational Detachmentthe ability

to stay in control of ones own
behavior and not take acting-out
behavior personally.
16
Level 3
1. Anxiety
1. Supportive
2. Defensive
2. Directive

This page expands on the Acting-Out Person/Nonviolent Physical Crisis InterventionSM level of the CPI
Crisis Development ModelSM. It focuses on the continuum of acting-out behaviors and the continuum of
physical intervention strategies, ranging from the least restrictive all the way to restraint as a last resort.
(Note the graphic explanation along the right side of the page.)
Begin the discussion by reviewing the definitions and examples of strikes and grabs (along
the client side of the CPI Crisis Development ModelSM), as well as the CPI Personal Safety
TechniquesSM (along the staff side).
Because restraint is a last resort, discuss alternative strategies staff members might use prior
to the use of Nonviolent Physical Crisis InterventionSM. List these alternatives in the right-hand
column (staff side). (Examples of alternatives to restraints may be using a pull-through, clearing
the room, removing unsafe objects, using verbal intervention, etc.)
Involving other team members may also help prevent the need for physical intervention.
Furthermore, if physical intervention does become necessary, it is important that team members
are in place and ready to assist. Discuss essential elements of team intervention with your
participants.
Develop examples of behavior that may constitute a need for physical intervention (along the left
side). Discuss whether the examples given would truly be a last resort.
Note: If you teach only Units IVII and X, you may still wish to review alternatives to avoid
restraint and discuss team intervention strategies.
CPI Personal Safety TechniquesSM and Nonviolent Physical Crisis InterventionSM principles
and dynamics can be best understood and reinforced by reviewing and practicing the CPI
Classroom Models illustrated on pages 1925 in this Leaders Guide (workbook pages 1117).
You may want to consider competency-testing your participants on their ability to demonstrate
each of the CPI Classroom Models.
Before practicing the CPI Team Control PositionSM, review the Control Dynamics on page 23 of
this Leaders Guide (workbook page 15).
CPI also recommends that you discuss the Risks of Restraints information on pages 3235 of
this Leaders Guide (pages 2225 of the Key Point Refresher Workbook).
Who is on the Crisis Response Team that responds to escalating behaviors in your area/
department? How has that worked?
Who decides when it is necessary to use physical intervention?
Has our organizations approach to the use of physical intervention changed over the past three
years? Five years? Ten years? How and why?
How have we (or could we) improve our team interventions?
17
Workbook page 10
Level 3
3. Nonviolent Physical Crisis

InterventionSM
1. Block (or deflect) the weapon.
Examples: punch, kick
2. Move the target.
Grab: An attempt to control and/or

destroy a part of ones anatomy.
1. Gain a physiological advantage

by using:
a. The weak point of the grab.
b. Leverage.
c. Momentum.
Examples: hair pull, choke
Personal Safety
Strike: A weapon coming in contact

with a target.
least restrictive
2. To gain a psychological advantage:

a. Stay calm.
b. Have a plan.

c. Use an element of surprise or
distraction.
Team Intervention:
Benefits of a team approach.

Choosing a team leader.
Team leader duties.
Auxiliary team duties.
Hurting self or others.

Engaged in dangerous behavior and
not responding to verbal intervention.
Risks of continued behavior are greater
than the risks of restraints.
Ask participants to describe
specific examples.
Alternatives: (Examples)
Continue verbal intervention.
Clear the room and remove unsafe
objects.
Use the pull-through.
Generate a list of alternatives with
your group.
last resort
Nonviolent Physical Crisis InterventionSM is

used as a last resort.
Nonviolent Physical
Crisis InterventionSM
Behaviors that may require physical

intervention as a LAST RESORT:
18
Caution
These CPI Classroom Model diagrams are intended as a point of reference and only represent a snapshot
of the process required to execute the technique. Accordingly, these techniques should only be learned
and practiced under the supervision of a Nonviolent Crisis Intervention Certified Instructor. Attempting to
learn these techniques from the diagrams or descriptions may result in injury.
CPI KICK BLOCK
CPI ONE-HAND WRIST GRAB RELEASE
In any strike situation, you can remove the target or

deflect the weapon by placing an object between the
weapon and the target. The act of blocking or shielding
is based on your natural responsea primal reflex to
protect yourself from a strike. In this example, the bottom
of the staff members foot is used to shield or block the
oncoming kick.
Gain a physiological advantage by using leverage and

momentum to pull away from the weak area of the wrist
grab (between the thumb and four fingers). You can
increase your momentum and leverage by maintaining
a balanced stance and using your body position to
enhance your physiological advantage. At the same time,
you can gain a psychological advantage by using a verbal
distraction or an element of surprise.
Attempt to move out of the way to maintain safety.
CPI TWO-HAND WRIST GRAB RELEASE
Release and attempt to move out of the way to

maintain safety.
CPI ONE-HAND HAIR PULL RELEASE
Gain a physiological advantage by using leverage and

momentum to pull away from the weak area of the wrist
grab (between the thumbs and four fingers). You can
increase your momentum and leverage by using your free
hand to assist in pulling away from the grab, maintaining
a balanced stance, and using your body position to
enhance your physiological advantage. At the same time,
you can gain a psychological advantage by using a
verbal distraction or an element of surprise.
Immobilize this grab by securing the persons hand

to your head. By using one or both of your hands to
immobilize the persons hand, you can prevent further
grabbing of hair and minimize injury. Move your head
toward the person, leveraging the arm position to a
45-degree angle. The grip of the hair pull is levered
backward, reducing the strength of the grip and opening
up the weak point of the grab at the fingers. At the same
time, you can gain a psychological advantage by using a
Release and attempt to move out of the way to

maintain safety.
As your hair is released, attempt to move out of the way

to maintain safety.
19
Caution
CPI TWO-HAND HAIR PULL RELEASE

Use both of your hands to immobilize the persons hands
on your head. By securing the hands to your head, you
can prevent further grabbing of hair and minimize injury.
Move your head toward the person, leveraging the arm
position to a 45-degree angle. The grip of the hair pull is
levered backward, reducing the strength of the grip and
opening up the weak point of the grab at the fingers. At
the same time, you can gain a psychological advantage
by using a verbal distraction or an element of surprise.
As your hair is released, attempt to move out of the way
to maintain safety.
CPI FRONT CHOKE RELEASE

Raise your arms straight up for leverage. (This may also
create a distraction.) Lean away to extend the individuals
arms; this will weaken the grab. Create momentum by
turning your shoulders and arms in a rotating motion
away from the individual. Your shoulders will act as a
lever while your momentum will assist in releasing the
grab. Increase your psychological advantage by using a
CPI BITE RELEASE

CPI BACK CHOKE RELEASE
Raise your arms straight up for leverage. (This may also
create a distraction.) Lean away to extend the individuals
arms; this will weaken the grab. Create momentum by
turning your shoulders and arms in a rotating motion
away from the individual. Your shoulders will act as a
lever while your momentum will assist in releasing the
grab. Increase your psychological advantage by using a
Avoid pulling away from the bite. Instead, lean into or

feed the bite, using the minimum amount of force
necessary to cause the jaw of the person to open. You
may also want to use your finger in a vibrating motion to
stimulate the persons upper lip. This vibrating motion
may result in a parasympathetic response that causes
the mouth to open. At the same time, you can gain a
psychological advantage by using a verbal distraction or
an element of surprise.
Once the bite releases, attempt to move out of the way
to maintain safety.
20
Notes:
21
Caution
Note: For more information on the risks of restraints, see pages 3235.
Figure B
Figure A
CPI CHILDRENS CONTROL POSITIONSM

The CPI Childrens Control PositionSM is designed to be used with children. You should consider using this
position only with individuals considerably smaller than yourself.
Gain control of the childs arms from behind and cross the arms in front of the child. The arms should be
positioned high on the child and secured by locking one arm under the other. This will prevent the child from
slipping through and will minimize any pressure on the childs chest or abdomen. (Fig. A) Position yourself
behind the child while maintaining close body contact and standing to one side. This position allows you to
maintain a balanced stance while managing the child. (Fig. B)
The auxiliary team member(s) will monitor for safety and assist, if needed.
22
Caution
Figure B
Figure A
CPI TEAM CONTROL POSITIONSM

The CPI Team Control PositionSM is used to manage individuals who have
become dangerous to themselves or others. Two staff members hold the
individual as the auxiliary team member(s) continually assess the safety of all
involved and assist, if needed. During the intervention, staff members who are
holding the individual should:
Face the same direction as the acting-out person while adjusting, as
necessary, to maintain close body contact with the individual.

Keep their inside legs in front of the individual. (Fig. A)
Bring the individuals arms across their bodies, securing them to their hip
areas. (Fig. B)
Place the hands closest to the individuals shoulders in a C-shape position to
direct the shoulders forward. (Fig. C)
Control Dynamics
1.

Reduce upper-body strength by controlling the arms as weapons.

a. Turn palms up.
b. Raise arms above shoulders.
c. Anchor arm to your body (hip area).
2. Reduce lower-body strength by controlling the back incline.

a. Lower shoulders below hips.
3. Reduce mobility by close body contact.
a. Move hips close to individuals body (hug in).
b. Move individuals center of gravity forward onto toes (balls of feet).
23
Figure C
Caution
CPI TRANSPORT POSITIONSM

The CPI Transport PositionSM will assist you in safely moving an individual who is beginning to regain control.
Prior to moving an individual, assist the person into a more upright position and remove your hand from the
individuals shoulder. Reach under the individuals arm to grab your own wrist. This cross-grain grip better
secures the individual between staff during transport. Remove your leg from directly in front of the individual
prior to transport while maintaining close body contact.
It is not recommended to transport an individual who is struggling. If necessary, return to the CPI Team Control
PositionSM if the individuals and/or staffs safety is at risk.
24
Caution
Figure A
Figure B
CPI INTERIM CONTROL POSITIONSM

The CPIInterim Control PositionSM is a temporary control position that allows you to maintain control of both of
the individuals arms, if necessary, for a short time.
Starting from the CPI Transport PositionSM, maintain control of the individuals arm, but release the cross-grain
grip. Use your free arm to reach across and gain control of the opposite arm. (Fig. A) If the individual attempts to
strike, use your free arm to block, and safely move away. (Fig. B)
25
Notes:
26
Level 4
1. Anxiety
1. Supportive
2. Defensive
2. Directive

This page expands on the fourth level of the CPI Crisis Development ModelSMTension Reduction and
Therapeutic Rapport. The workbook is designed to allow you to review the Postvention process as it
relates to both clients and staff members.
Postvention is another concept that may be easy to understand and accept as important, yet staff often
lack confidence in its execution. Consider providing your participants with opportunities to practice
(and receive feedback from) being involved in debriefing with staff and re-establishing communication
with the individual. A role-play is strongly recommended to reinforce the skills participants have
learned and also to provide a lead-in to the discussion of the CPI COPINGModelSM. Remember
that role-playing in front of the whole group may be intimidating. Participation in small groups for this
exercise may make it a less stressful and more meaningful experience.
How soon after an incident can you debrief with staff? How soon after an incident can you
re-establish communication with the individual? What factors should be considered in deciding
when these things should take place?
Since your last training, who has had an experience in which Postvention has had a positive
outcome? Ask for examples that involve both debriefing with staff and re-establishing
communication with the individual.
What have we done (or could we do) to improve our Postvention efforts?
27
Workbook page 18
Level 4
4. TensionReduction
A decrease in physical and emotional energy.
Individual must be back in

physical and emotional control.
Establish the basic facts regarding
what happened. Listen to the
individual. (Be nonjudgmental.)
Look for patterns of behavior.
(What triggers the behavior?)
Investigate alternatives to the

inappropriate behavior. (What
could help in making behavioral
changes?)
Aim for reaching an agreement
about future behaviors and
consequences. (Be sure the
individual understands alternatives
to inappropriate behaviors.)
n effort to re-establish communication

A
between the individual and staff.
Control
All staff must be back in control before

discussing the incident.
Orient
Establish basic facts regarding what

happened. Exchange information and
perspectives. Document.
Patterns
Review the intervention. Are there

patterns in the ways staff respond to
crisis situations? (Which interventions
are most/least effective?)
Investigate
Look for ways to strengthen future

interventions. (Explore ways to prevent
similar situations from occurring.)
Negotiate
Agree to changes that will improve

future efforts to prevent and respond
to crises.
Give
Offer support and encouragement to

each other. Express trust and respect.
Return control to the individual.

Give responsibility, along with
support and encouragement.
Why is Postvention important for the individual?
Why is Postvention important for staff?
To teach/learn.
To strengthen the relationship.
To have closure.
To teach/learn.
To strengthen the team.
To have closure.
28
Key Point Refresher
Post-Test

Be sure to have everyone complete and submit a post-test/evaluation to you. If participants are anxious
about taking the post-test, you may want to do a brief review of content highlights. Alternatively, you may
give participants a few minutes to read over their notes. After collecting the post-tests/evaluations, close
the training by providing the post-test answers. Remind participants that the best learning occurs as
part of an ongoing Training Process. Thank them for their time, their participation, and their commitment
to Care, Welfare, Safety, and SecuritySM.
Review all completed post-tests/evaluations. Fill out a Training Roster Form and send it along with all
original post-tests/evaluations to CPI for documentation of your training hours. Please do this within 30
days of your formal refresher training.
29
All Rights Reserved

Copying Prohibited
Key Point Refresher
Post-Test
Workbook page 20
Name_________________________________________________________________ Date_____________________________
Title____________________________________________________________________________________________________
Facility________________________________________________________________ Phone____________________________
Facility Address__________________________________________________________________________________________
City____________________________________________ State/Province____________ Zip/Postal Code________________
Country __________________________ Email_________________________________________________________________
1. Match each behavior level of the CPI Crisis Development ModelSM to the corresponding interventions and
CPI models recommended at each level of behavior.
a. Anxiety/Supportive
____
d The CPI COPING ModelSM

b. Defensive/Directive
c. Acting-Out Person/Nonviolent Physical

Crisis InterventionSM
d. Tension Reduction/Therapeutic Rapport
c C
____
PI Classroom Models of CPI Personal Safety
TechniquesSM and Nonviolent Physical Crisis
InterventionSM as a last resort
____
roxemics, Kinesics, CPI Supportive StanceSM,
a P
Paraverbal Communication
____
b T he CPI Verbal Escalation ContinuumSM and
Setting Limits
2. Match each level of the CPI Verbal Escalation ContinuumSM to the recommended
staff responses for each level.
____
3 Remove audience from area; allow individual to let off steam.
1 Provide a rational response and avoid power struggles.
____
4.
____
2 Set limits.
____
5 Re-establish communication and Therapeutic Rapport.
____
4 Seek assistance from team and avoid individual intervention.
3.
2.
5.
1.
3. Why should a team approach be used?

Safety, professionalism, litigation
4. When should you use Nonviolent Physical Crisis InterventionSM?
As a last resort
5. Match each component of the Postvention process with the appropriate description.
____
1. Reach agreement on changes.
4 Control
____
Orient
2.
Establish basic facts.
2
____
3. Provide support and encouragement.
5 Patterns
____
4. Be sure everyone is calm and rational.
6 Investigate
____
5. Look for trends.
1 Negotiate
____
Give
6.
Look for alternatives.
3
6. What is the philosophy of the Nonviolent Crisis Intervention program?
Care, Welfare, Safety, and SecuritySM

30
Notes:
31
Understanding
the Risks of
Restraints
32
Understanding the Risks of Restraints

The Nonviolent Crisis Intervention training program
focuses on crisis prevention and the creation of
restraint-free environments through a commitment
to Care, Welfare, Safety, and SecuritySM. While
considered a last resort, physical intervention
procedures are taught as part of the program to
provide staff with skills and confidence to safely
manage emergency situations.
Any physical intervention should be used only when
all other options have been exhausted and when
an individual is a danger to self or others. Even in
those moments, an assessment is still necessary
to determine the best course of action to maintain
the Care, Welfare, Safety, and SecuritySM of all.
There may be times when other strategies, such as

continuing verbal intervention, removing dangerous
objects, using Personal Safety TechniquesSM, and
calling for further assistance would precede and
possibly prevent any physical intervention.
Remember that there are risks involved in any physical
intervention. Therefore, physical intervention should
be considered only when the danger presented by the
acting-out individual outweighs the risks of physical
intervention. Specific laws or regulations may govern
use of restraints. Be sure to check your facilitys
policies and procedures for applicable rules.
Dangers of Restraints
The events leading up to a crisis situation and the
struggling that occurs during a restraint can result
in a lot of stress for the individual being restrained.
This negative stress is sometimes called distress.
Consequently, it is not unusual for a restrained
individual to show signs of distress, both physically
and emotionally.
Always keep in mind that the acting-out person
might have health problems. Therefore, everyone
being restrained should be considered at risk. It is
also important to understand that in some cases,
restrained individuals have gone from a state of no
distress to death in a matter of moments. Policies
and procedures should reflect how staff can monitor
these signs of distress and identify what protocol
should be followed.
There is also a psychological danger in using
restraints. Being restrained can be a frightening
even traumaticexperience. Restraints can interfere
with the relationship between caregivers and the
person being restrained. In fact, if people are
restrained too often, they may begin to feel that they
have no control over their lives.
33
For these reasons and others, restraints should

be used only when a persons behavior is MORE
dangerous than the danger of using restraints.
Some restraints are more dangerous than others.
For example, facedown (prone) floor restraints and
positions in which a person is bent over in such
a way that it is difficult to breathe are extremely
dangerous. This includes a seated or kneeling
position in which the person being restrained is bent
over at the waist and any facedown position on a
bed or mat.
Restraint-related positional asphyxia occurs when
the person being restrained is placed in a position
in which he cannot breathe properly and is not able
to take in enough oxygen. Death can result from this
lack of oxygen and consequent disturbance in the
rhythm of the heart.
Staff members must be especially careful not to use
their own bodies in ways that restrict the restrained
persons ability to breathe. This includes sitting or
lying across a persons back or stomach. When
someone is lying facedown, even pressure to the
arms and legs can impact that persons ability to
breathe effectively.
Examples of High-Risk Positions for Restraint-Related Positional

Asphyxia
Illustrations based on information from various individuals and resources. See Additional Resources and References on page 37.
All of these positions may interfere with a persons

ability to breathe. While they are different, these
positions share a common factor: When forcefully
maintained, each of them could prevent the
diaphragm (the largest muscle of respiration) from
working. If the diaphragm is not allowed to move
down into the abdomen, breathing is seriously
restricted. In fact, when a forcefully maintained
position hinders both chest and abdomen

movementthe result can be fatal.
When confronted with an emergency situation,
always consider the option of disengaging. If the
person is not a danger to self or others while on the
floor, staff may make the decision to move away and
give a clear directive.
34
Reducing the Risks of Restraints

There are ways to minimize risks involved in any
physical intervention. The very best way to avoid
injury is to avoid the need to restrain in the first
place. Get to know the people in your care. Be
aware of changes in their behavior that can be
warning signs of anxiety. Intervene early. Learn
to set limits effectively. Avoid being drawn into
power struggles. Work as hard at learning verbal
intervention skills as you do at learning physical
intervention skills. Treat everyone with dignity
and respect.
Staff members should be trained in and regularly
practice safer ways of restraining. The physical
intervention procedures taught in the Nonviolent
Crisis Intervention training program are designed
to maximize safety and offer a safer alternative
to techniques that involve the floor to restrain an
individual. A physical restraint is an emergency
procedure comparable to CPR or first aid. As with
any emergency response procedure, staff members
need to practice these skills on a regular basis.
Educate yourself and others on the risks and
dangers of using restraints. Some restraints are
more dangerous than others. By choosing safer
restraint techniques, you and your facility can reduce
the possibility of serious injury and even death. In
particular, you should avoid positions that can lead to
restraint-related positional asphyxia.
35
CPIs Nonviolent Physical Crisis InterventionSM

techniques are designed for safety and allow for a
Therapeutic Rapport to be re-established with the
individual who has lost control. Key elements of
Nonviolent Physical Crisis InterventionSM
responses include:
No element of pain is involved.
The intent is to calm the individual.
The individual is not restrained on the floor,
thus reducing risks of restraint-related
positional asphyxia and other injuries.
Team interventions are used when necessary.
Nonviolent Physical Crisis InterventionSM
is used only as a last resort when someone
presents a danger.
Nonviolent Physical Crisis InterventionSM is
used to protectnot to punish.
The goal is for staff to continually assess for signs
of Tension Reduction and identify opportunities to
re-establish a Therapeutic Rapport with the
individual.
Remember, the best way to eliminate the dangers
of restraintsto you and to those in your careis to
eliminate the need for restraints at all.
Glossary of CPI Terms

Acting-Out Personthe total loss of control, which results
in a physical acting-out episode. It is the third level in the
CPI Crisis Development ModelSM. Individuals in this level are
presenting a danger to themselves or others.
Anxietya noticeable increase or change in behavior. A
nondirected expenditure of energy; e.g., pacing, finger
drumming, wringing of the hands, or staring. It is the first level
in the CPI Crisis Development ModelSM.
Challenge Positiona body position in which one individual
is face-to-face, toe-to-toe, and eye-to-eye in relation to
another individual. This position is often perceived as a
challenge and tends to escalate a crisis situation.
CPI Classroom Modela standardized way of demonstrating
personal safety and Nonviolent Physical Crisis InterventionSM
methods in order to show the application of basic principles.
CPI COPING ModelSMa model that staff members can use
to guide them through the process of establishing Therapeutic
Rapport with an individual after a crisis incident. The CPI
COPING ModelSM can also be used as a way to structure a
staff debriefing.
CPI Crisis Development ModelSMa series of recognizable
behavior levels an individual may go through in a crisis, and
corresponding Staff Attitudes/Approaches used for crisis
intervention.
Defensive Levelthe beginning stage of loss of rationality.
At this stage, an individual often becomes belligerent and
challenges authority. It is the second level in the CPI Crisis
Development ModelSM.
Directive Staff Attitude/Approachan approach in which
a staff member takes control of a potentially escalating
situation by setting limits. It is the recommended Staff Attitude/
Approach to an individual at the Defensive level.
Empathic Listeningan active process to discern what a
person is saying.
Integrated Experiencethe concept that behaviors and
attitudes of staff impact behaviors and attitudes of individuals,
and vice versa.
Kinesicsthe nonverbal message transmitted by the motion
and posture of the body.
Limit Settinga verbal intervention technique in which a
person is offered choices and consequences. Limits should be
clear, simple, reasonable, and enforceable.
Nonviolent Physical Crisis InterventionSMused only as a

last resort when a person is a danger to self or others. This
involves the use of safe, nonharmful control and restraint
positions to safely control an individual until he can regain
control of his behavior.
Paraverbal Communicationthe vocal part of speech,
excluding the actual words one uses. Three key components
are tone, volume, and cadence of speech.
Precipitating Factorsthe internal or external causes of an
acting-out behavior over which a staff member has little or
no control.
Proxemicspersonal space. An area surrounding the body,
approximately 1.5 to three feet in length, which is considered
an extension of self.
Rational Detachmentthe ability to stay in control of ones
own behavior and not take acting-out behavior personally.
Supportive Staff Attitude/Approachan empathic,
nonjudgmental approach attempting to alleviate anxiety. It is the
recommended Staff Attitude/Approach to an individual at the
Anxiety level.
CPI Supportive StanceSMthe suggested body position for a
staff member to maintain when intervening with a potentially
out-of-control or acting-out individual. The CPI Supportive
StanceSM is maintained by keeping a distance of one leg-length
from the person and by remaining at an angle.
Tension Reductiona decrease in physical and emotional
energy that occurs after a person has acted out, characterized
by the regaining of rationality. It is the fourth level in the CPI
Crisis Development ModelSM.
Therapeutic Rapportan approach used to re-establish
communication with an individual who is experiencing
Tension Reduction.
Training Processa format for identifying ongoing learning
opportunities to ensure training concepts expand upon course
content through practical application. In addition to initial
training, components include Formal Refreshers, Reviews,
Policy Discussions, Practice, Situational Applications, and
Rehearsals/Drills.
CPI Verbal Escalation ContinuumSMa model demonstrating
a variety of defensive behaviors that are often seen when
individuals are in the Defensive level of the CPI Crisis
Development ModelSM. This model includes suggested staff
interventions for each behavior.
Nonviolent Crisis Intervention Programa safe, nonharmful

behavior management system designed to aid staff members
in maintaining the best possible Care, Welfare, Safety, and
SecuritySM for agitated or out-of-control individuals even during
their most violent moments.
36
Additional Resources and References

Allen, D., & Tynan, H. (2000). Responding to aggressive behavior: Impact of training on staff members knowledge and
confidence. Mental Retardation, 38(2).
Allen, J. D. (1997). Whos driving this bus anyway? Empowering drivers. School Business Affairs, 63(1).
American Academy of Family Physicians. (1997). Use of physical restraints in children. American Family Physician, 55(6).
Bair, B., Toth, W., Johnson, M. A., Rosenberg, C., & Hurdle, J. F. (1999). Interventions for disruptive behaviors: Use and success.
Journal of Gerontological Nursing, 25(1).
Chou, K., Kaas, M., & Richie, M. (1996). Assaultive behavior in geriatric patients. Journal of Gerontological Nursing, 22(11).
Cooper, A., Anthony, R., & Saxe-Braithwaite, M. (1996, June). Verbal abuse of hospital staff. The Canadian Nurse, 92(6).
CPI. (2006). Instructor manual for the Nonviolent Crisis Intervention training program. Milwaukee, WI: Author.
Dattillo, F., Beck, A., & Freeman, A. (Eds.). (2000). Cognitive-behavioral strategies in crisis intervention (2nd ed.). New York:
Guilford Publications.
Everly, G., & Mitchell, J. (1999). Critical incident stress management (CISM): A new era and standard of care in crisis
intervention. Ellicott City, MD: Chevron Publishing Corporation.
Fletcher, K. (1996). Use of restraints in the elderly. AACN Clinical Issues, 7(4).
Leger-Krall, S. (1994, March). When restraints become abusive. Nursing 94, 24(3).
Maier, G. (1996). Managing threatening behavior: The role of talk down and talk up. Journal of Psychosocial Nursing, 34(6).
Miller, C. D. (2002). Silent killer: Death by restraint. Milwaukee, WI: CPI.
Miller, L. (1999). Workplace violence: Prevention, response, and recovery. Psychotherapy, 36(2).
Nelson, J., et al. (1999). Positive discipline AZ: From toddlers to teens, 1001 solutions to everyday parenting problems
(2nd ed.). Rocklin, CA: Prima Publishing.
Noesner, G., & Webster, M. (1997, August). Crisis intervention: Using active listening skills in negotiations. FBI Law Enforcement
Bulletin, 66(8).
OHalloran, R. L., & Frank, J. G. (2000). Asphyxial death during prone restraint. American Journal of Forensic Medicine and
Pathology, 21(1), 3952.
Patterson, B., Leadbetter, D., & McComish, A. (1998). Restraint and sudden death from asphyxia. Nursing Times, 94(44).
Pitcher, G. D., & Poland, S. (1992). Crisis intervention in the schools. New York: Guilford Publications.
Pollanen, M., Chiasson, D., Cairns, J., & Young, J. (1998). Unexpected death related to restraint for excited delirium: A
retrospective study of deaths in police custody and in the community. Canadian Medical Association Journal, 158(12).
Reak, K. (1996, June). Cocaine, restraints and sudden death. The Police Chief.
Reay, D. (1996, May). Suspect restraint and sudden death. FBI Law Enforcement Bulletin, 65(5).
Weiss, E. M. (1998, October 1115). Deadly restraint: A nationwide pattern of death. Hartford Courant.
Wright, S. (1999). Physical restraint in the management of violence and aggression in in-patient settings: A review of issues.
Journal of Mental Health, 8(5).
37
The staff of CPI thank you for your participation in our program. If we can be of any other assistance
to you, your facility, or your colleagues, please do not hesitate to contact our office.
CPI
10850 W. Park Place
Suite 600
Milwaukee, WI 53224
t 877.877.5390
f 414.979.7098
tty 888.758.6048 (Deaf, hard of hearing, or speech impaired)
instructor@crisisprevention.com
crisisprevention.com
PWKB0043
11-NCI-KPR-008
11/11

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key point refresher leaders guide

For Review of the

care, welfare, safety, and securitySM

Maintaining Safety in the Nonviolent Crisis

Please Read Carefully:

2005 CPI (reprinted 2011).

The Minimum Content for a Formal

The CPI Crisis Development ModelSM.

2005 CPI (reprinted 2011).

Topics that they would like to focus on.

Their perception of internal staff cohesiveness/teamwork.

Their level of confidence on the job.

Their assessment of how safe they feel at work.

Page 9 presents an overview of how

Page 7 expands on the Anxiety/Supportive

Page 10 expands on the Acting-Out

Page 8 expands on the Defensive/Directive

Page 18 expands on the fourth level of

2005 CPI (reprinted 2011).

Key Point Refresher

Introducing the Formal Refresher Training

The Pre-Test (workbook page 4)

2005 CPI (reprinted 2011).

Key Point Refresher

Care, Welfare, Safety, and SecuritySM

3. When should you use Nonviolent Physical Crisis InterventionSM?

4. Match each CPI model to the appropriate definition:

c. This model is used to guide staff through the

b. This model demonstrates defensive behaviors

The CPI Crisis Development Model SM

2005 CPI (reprinted 2011).

The CPI Crisis Development Model SM

Crisis Development/Behavior Levels

Definition: A noticeable change or increase in

Definition: An empathic, nonjudgmental

Examples: pacing, withdrawal, tapping

Examples: listening, offering reassurance

Definition: The beginning stage of loss

Definition: An approach in which a staff member

Examples: challenging authority,

Examples: explaining options and

3. Nonviolent Physical Crisis

by hitting, biting, kicking, throwing objects, etc.

Definition: Safe, nonharmful restraint positions to

Team Control PositionSM, etc.

Definition: A decrease in physical and

Definition: An approach used to re-establish

Examples: showing signs of relaxation, normal

Examples: listening, showing interest and

2005 CPI (reprinted 2011).

Crisis Development/Behavior Levels

3. Nonviolent Physical Crisis InterventionSM

Teaching Notes (workbook page 7)

2005 CPI (reprinted 2011).

Crisis Development/Behavior Levels

CPI Supportive StanceSM: Body positioned

at least one leg-length away and at an angle.

1. Respect (honors personal space).

2005 CPI (reprinted 2011).

Crisis Development/Behavior Levels

3. Nonviolent Physical Crisis InterventionSM

Teaching Notes (workbook page 8)

2005 CPI (reprinted 2011).

Crisis Development/Behavior Levels

3. Nonviolent Physical Crisis

The CPI Verbal Escalation ContinuumSM

3. Nonviolent Physical Crisis

1. Gain a physiological advantage

A decrease in physical and emotional energy.

n effort to re-establish communication