Category Archives: Safety

The Top Priority in IFPS

The highest priority in IFPS is safety—safety for family members, safety for the IFPS therapist and safety for others in the environment.

The following case example shows how the IFPS therapist dealt with a high risk incident. Key elements of the IFPS therapist’s response included:

Critical thinking about risk/danger
De-escalation and contingency management
Feedback to the mother

The Situation

A 16-year-old male client (diagnosed with Pervasive Developmental Disorder) gave the therapist the finger and repeatedly gestured angrily towards her and then towards the door. When she did not immediately leave, the boy made threatening gestures with a plastic baseball bat and a push pin, threatened to “end” the therapist, called her a “whore,” tried to take her bag from her, threw an apple on the floor, threw paper napkins at her, and grabbed the chair that she was sitting on. He also grabbed his mother by the wrist to try to prevent her from re-hanging a corkboard he tore down.

Critical Thinking about Risk/Danger

The boy had a history of making threats when frustrated, but no history of ever harming anyone that the therapist knew of.

Because his threats occurred immediately after he gestured for the therapist to leave, she believed that leaving or retreating in response to his threats might reinforce this problematic behavior. This clinical assessment factored into her decision-making. She was able and prepared to leave if needed and she actively assessed for her own and the clients’ safety.

During the incident, she sat in a chair beside the door so that she could immediately leave if she felt a sincere threat. She made sure that the boy never stood between her and the door except when he removed the corkboard from the wall. Her cell phone was in her back pocket.

She assessed that the items the boy used to threaten the therapist (a hollow plastic baseball bat and a push pin) were unlikely to cause serious injury. She remained far enough away while he held the items that he could not easily make contact with them. He put down each of these items after holding them for a matter of seconds.

She noted that each time the boy came closer than a few feet from the therapist, he soon stepped back. She also noted that the boy’s gestures were increasingly less threatening. When the boy grabbed her chair and her bag she was forced to stand up, but later sat down again in an attempt to project calm control without force.

De-escalation and Contingency Management

The therapist remained calm throughout the incident and repeatedly reflected the boy’s anger. Her reflections and statements included:

She could see he was angry and he seemed to want her to know this.
It seemed he was trying to get the therapist to leave by making threats, but she didn’t really think he wanted to hurt anyone.
He didn’t seem to have the words to express himself when he was angry and this must be frustrating.
Making threats, even when it was successful in frightening people, seemed to be causing problems for him.
She hoped she could help him learn other ways to communicate and to manage his frustration.

When the boy grabbed his mother’s wrists to prevent her from re-hanging the corkboard, the therapist told him clearly that if she thought there was any chance he might hurt anyone, even accidentally, she would call the police, and he let go of his mother immediately.

The boy’s behaviors progressively de-escalated to gestures of anger that were not directed towards others (e.g., throwing an apple on the floor, throwing paper napkins on the floor). He calmed down after approximately 10-15 minutes. When he chose safer expressions of anger she told him she was glad he was making safer decisions.

When the boy’s mood seemed to change from anger to frustration to sadness, she reflected this. When he calmed down she noted how impressed she was that he was able to calm down. She told the boy that she hoped she could help him find new ways to express his anger.

She also told him that she was very glad that he spoke to her, even though he was angry and said some things she didn’t like. She told him she wouldn’t hold a grudge because she knew how hard it can be to be angry and not be able to say so, and that she hoped he would talk with her again.

Feedback to the Mother

The following day the therapist reviewed the incident with the boy’s mother. She explained that because his threats seemed to be intended to make the therapist leave, and because she did not think he would cause injury, she chose not to leave in this instance because she didn’t want him to learn that he could get what he wants by making threats.

While the boy wanted the therapist to go away, he wanted his mom with him. The therapist clarified that if the mom were to leave in response to his threats, this would not be a reward for him. She therefore encouraged the mom to leave promptly if he made threats towards her in the future, as this would both keep her safe and would provide a disincentive for making threats. She also encouraged her to call the police if she ever felt that anyone was in danger in the future.

She told the mom that they would complete a written safety plan the next time they met.

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Posted by Bethany Rice, IFPS Therapist, Institute for Family Development

What Can Supervisors Do To Keep Workers Safe?

ifps-safety2 In the last article, we discussed how IFPS practitioners can keep themselves safe while in the field. In this post, we would like to focus on what supervisors can do to assist their workers in staying safe in the field.

There are three types of things supervisors can do to help their IFPS practitioners stay safe when working with families in their neighborhoods and homes:

Training and preparation
Preparation for specific family situations
Availability in emergencies

Training and Preparation

Prevention is the first line of defense. Take steps to ensure the safety of all practitioners before they are needed.
Conduct in-house training to be sure that practitioners understand the importance of keeping themselves safe and have strategies for doing so (e.g., plan an emergency escape route).
Offer ongoing training on verbal de-escalation techniques.
Identify high-crime neighborhoods.
Make sure you are approachable to so that practitioners feel comfortable talking about how they feel in the field.
Encourage practitioners to report back to you immediately if they feel they or their clients are at risk.
Keep a session log to document the practitioner’s whereabouts.
Know the types of cars that your practitioners drive.

Preparation for Specific Family Situations

Complete a risk assessment for each client family.
Plan in advance with the practitioner what safety measures are needed with each family or when going into a specific neighborhood.
Ask practitioners to check in by phone at pre-arranged times when they are in potentially risky situations.
Establish procedures if a practitioner does not call in at expected times.
Assist in the field when needed. Offer—don’t wait to be asked.
Implement a buddy system, as needed.

Availability in Emergencies

Be available to offer support during emergencies by phone or in person.
Keep your phone with you at all times.
Ask another team member to be on call if you know you won’t be available.
Offer strategies to defuse the situation.
Provide effective and clear communication in emergencies.
Don’t hesitate to call the police when necessary.

Supervisors around the nation, we would like to hear from you. Please share your experiences and your safety tips for keeping your practitioners safe. We will all benefit from your suggestions.

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Posted by Moneefah Jackson

Safety in the Field and IFPS

IFPS is a strengths-based program that focuses on keeping families together while teaching them problem resolution skills so that they can reduce the conflict in their lives and increase their overall safety.

Safety of all family members is the primary focus of IFPS. In order to help families, IFPS practitioners must also protect their own safety. Since IFPS services are provides in families’ homes and neighborhoods, IFPS practitioners sometimes find themselves in situations where their own safety is at risk.

Here are some situations IFPS practitioners have faced followed by suggestions for ways for staying safe. How do they compare to your own experiences?

Have you ever had a child stand poised to hit you, spit at you, or bite you?
Have you ever had to walk through a stairway or stand in an elevator with the décor of urine puddles or broken glass?
While driving, have you ever had to drive up on the sidewalk to get away from a police chase?
When walking to the client’s home, have you ever had to run back to your car as you feared a gang was coming after you? (But later you realize that they were just competing with each other to get to you first so as to sell you their drugs.)
Have you ever encountered a 7-year-old child running outside to catch up to you after your session was over to hand you a drug vial (just to prove that his mother was actively using), leaving you now to drive off with drug paraphernalia in your car?

What can we do to stay safe in these and other risky situations?

Here are some ideas about ways we, as IFPS practitioners, can keep ourselves safe in the field while providing the most effective services to our IFPS families.

In potentially dangerous neighborhoods:

Wear appropriate attire. Wear clothes that don’t stand out but still are professional. Avoid wearing provocative clothing.
Wear covered shoes.
Avoid wearing jewelry that will bring unnecessary attention to you.
Carry a minimum of belongings with you.
Be careful where you park. Generally, park as close to your destination as possible.

Wherever you are:

Always be alert and on guard.
If you are entering a building with an elevator, always check the elevator before getting inside. Send the elevator to the basement and wait for it to come back to you.
If you are assigned to work in a high rise or apartment building, always check your surroundings when you walk through the public areas.
Never enter a home unless you are invited in.
When you enter a client’s home, assess the surrounding areas to plan an escape route.
Keep your cell phone fully charged and close at hand.
Program emergency contact numbers into your cell phone.
Keep your gas tank full.
Check your car prior to getting into it.
Carry a spare car key and keep it close to you.
Avoid parking in front of your clients’ home.
Carry a small flash light.
Always have your agency’s identification with you.

When people are angry:

Use active listening and other diffusion techniques.
Stay calm.
Maintain a respectful and empathetic demeanor.
Set limits and clearly state expectations with clients.
Remember to always trust your gut feelings.
Do not forget to reach out to your supervisor for help.

There are a host of other safety ideas that will not be enumerated at this time. Why? Because we would like to hear from you! So please share with us your experiences and your safety tips so that we all can benefit from keeping ourselves safe in the field.