How Direct Support Professionals (DSPs) Can Use Crisis Prevention and Intervention

While we typically think of DSPs helping clients to perform everyday tasks or live as independently as possible, they often work with clients in crisis. In fact, the work of direct support professionals (DSPs) is often tied directly to crisis prevention and intervention. DSPs routinely provide positive behavior supports to help mitigate behavioral health crises, and when necessary, navigate the aftermath of large-scale events, such as natural disasters or pandemics.

The outbreak of COVID-19 underscored how the need for DSPs to understand and practice crisis prevention and intervention techniques has grown. To properly train your DSPs in these practices, it’s first necessary to understand the role that trauma plays in crisis and crisis recovery and how trauma-informed care intersects with crisis prevention and intervention.

Crisis and Trauma Informed Care

When we talk about crisis, we’re talking about an event that has the potential to cause trauma. And unfortunately, studies have shown that individuals with IDD are more likely to experience trauma. Some studies have reported upwards of 90% of their study population experiencing abuse, neglect, or exploitation at some point in their life. Therefore, to properly care for their clients, DSPs need to take training in trauma informed care (TIC) and understand how to apply it to persons served.

Empowering staff to practice TIC toward the people they serve can yield many benefits. Several studies have found that when IDD organizations implement and train direct support staff on TIC, they see several positive outcomes, including:

• Increased client satisfaction with services
• Increased staff consistency in implementing counter-aggressive actions between persons served and staff
• Increased staff ability to effectively support persons served with trauma histories

To effectively implement TIC when working with persons served, it’s important that DSPs take a person-centered approach. This involves getting to know the client, understanding any trauma they’ve experienced, and how that trauma continues to affect them. In this way, DSPs can proactively work to prevent crisis situations before they happen.

How DSPs Can Use Crisis Prevention and Intervention for a Behavioral Health Crisis

First and foremost, DSPs should aim for crisis prevention rather than crisis intervention. By proactively working to prevent re-traumatization, DSPs can help individuals avoid crisis situations, mitigating further trauma.

Some crisis prevention techniques that DSPs can employ include:

• Creating a safe, stable, and healthy environment for their clients
• Aiding their clients in learning self-care skills, such as exercise routines, healthy eating habits, and attending therapy
• Helping their clients to identify and practice positive coping mechanisms for stress or triggering events

Sometimes, though, a behavioral health crisis cannot be averted. When this happens and a client experiences a crisis, DSPs must know how to remain calm and work with their client as well as other healthcare professionals and emergency response personnel. While effective crisis intervention techniques will vary from person to person, DSPs should understand the following best practices:

• Do not use techniques that will cause further harm or feelings of crises to the individual, such as yelling or dismissing their concerns.
• If working with a diverse client-base, understand that cultural differences may affect the way individuals respond both to crisis and intervention efforts.
• Work effectively with emergency response units, accompany the individual in crisis to the hospital, and help facilitate their care with the staff at the hospital.

How DSPs Can Navigate Large-Scale Crisis

If the COVID-19 era has taught us anything, it’s that not all crises can be predicted. Having strategies to help clients deal with large-scale disasters, such as pandemics, hurricanes, and more, can help ease the burden these situations put on both DSPs and their clients.

In these types of situations, DSPs can help to mitigate feelings of panic or frustration within their clients by helping to educate them on how to handle the changes to their lives the crisis has brought on. In the wake of the COVID-19 pandemic, one DSP reported that she created flashcards to help her clients learn how to wash their hands in accordance with CDC standards. These flash cards walked her clients through the entire process, staring with turning on the water, all the way through applying hand sanitizer after thoroughly washing and drying their hands.

While helping clients navigate the ‘new normal’ that crisis situations often bring about, DSPs should help their clients and their clients’ families prepare for emergencies before they arrive. Though no one could have seen COVID-19 coming, disasters such as hurricanes are more predictable. In areas affected by natural disasters, DSPs should make sure their clients and their clients’ families have a ‘go bag’ with the following essentials:

• Face masks and hand sanitizer
• One- to two-week supply of all medications (all of which should be properly labelled according to client needs)
• A working cell phone and the means to recharge it
• Batteries for assistive devices, such as hearing aids
• Clean water and food

DSPs must also make sure to create a communication card which details how best to communicate with their clients in the event the individual needs to be taken to the hospital or an evacuation site.

Provide DSPs With Crisis Prevention and Intervention Training

For DSPs to effectively use the crisis prevention and intervention strategies discussed here, they need to receive the proper training. Studies have shown that to meet this need, adult learners are open to various training formats. By implementing a variety of learning methods, your organization can meet the diverse requirements of adult learners and ensure a high quality of training for your staff.

Blended learning is a concept that incorporates the benefits of both in-person and online learning. In a blended learning environment, learners can interact with their instructors, create and participate in peer discussion groups, have consistent access to learning materials, and get real-time feedback on their progress through online assessments. Interestingly, research has shown that adult learners who enrolled in blended learning outperformed learners who attended in-person instruction.

Microlearning is another increasingly popular training module type among adult learners. Much like its name suggests, microlearning breaks up learning material into small chunks, often between five and 30 minutes. This allows learners to consume information quickly and effectively in a time and place of their choosing. These modules can supplement longer training module topics and help reinforce learning topics over time.

Any learning solution you adopt needs to help improve the clinical performance of your staff. One specific feature that can help you achieve this goal is simulation-based training. Simulation courses center around the application of new knowledge in a virtual environment.

By training your DSPs using real-world scenarios and then giving them a simulated, life-like environment in which to practice, they can hone their crisis prevention and intervention skills without solely relying on in-person experience with clients. This will lead to higher confidence among your staff and drive better overall performance.