	Behavior Support and Management

Introduction

Administration and Management

Service Delivery Administration Standards

Service Standards

PA-BSM 6: Documentation and Debriefing*

The agency assesses restrictive behavior management incidents and effects to reduce future preventable occurrences and untoward consequences.

Interpretation: The agency should develop protocols for foster parents that use manual restraint to address documentation and debriefing.

NA The agency does not employ restrictive behavior management interventions.

PA-BSM 6.01

The use of restrictive behavior management interventions is documented, including:

the justification, use, circumstances, and length of application in the individual’s case record; and
names of the service recipient and personnel involved, reasons for the intervention, length of intervention, and verification of continuous visual observation in a log.

PA-BSM 6.02

Debriefing occurs in a safe, confidential setting within 24 hours of the incident and includes the service recipient, appropriate personnel, the foster parents, and parents or legal guardian to:

evaluate physical and emotional well-being;
identify the need for counseling, medical care, or other services related to the incident;
identify antecedent behaviors and modify the service plan as appropriate; and
facilitate the person’s reentry into routine activities.

Interpretation: When agencies serving youth in the juvenile justice system use mechanical restraints to prevent escape during transport, rather than in response to an incident, it may not be relevant to identify antecedent behaviors and modify the service plan, as referenced in element (c) of the standard. However, elements (a), (b), and (d) are still relevant.

Note: Agencies serving youth involved with the juvenile justice system should refer to the Interpretation to PA-BSM 2.01 regarding the involvement of youths' parents or legal guardians.

PA-BSM 6.03

Personnel and foster parents involved in the incident are debriefed to assess:

their current physical and emotional status;
the precipitating events; and
how the incident was handled and necessary changes to procedures and/or training to avoid future incidents.

Interpretation: When agencies serving youth in the juvenile justice system routinely use mechanical restraints to prevent escape during transport, rather than in response to an incident, it may not be relevant to assess precipitating events or address how future incidents might be avoided, as referenced in elements (b) and (c) of the standard.

PA-BSM 6.04

Any other person involved in or witness to the incident is debriefed to identify possible injuries and emotional reactions.

Interpretation: Debriefing can include a discussion of factors that led up to the incident and other appropriate responses for future situations. Emphasis should be placed on returning the environment to pre-incident condition and resuming the normal program routine.

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	PURPOSE: The agency’s behavior support and management policies and practices promote positive behavior and protect the safety of service recipients and staff.

RELATED FILES


	BEHAVIOR SUPPORT AND MANAGEMENT The use of specialized interventions to guide, control, and redirect client behaviors. Examples of behavior management approaches used in residential treatment settings include mediation, time out, locked seclusion, and physical restraint.


	PRACTICE Established actions or ways of proceeding in the regular performance of organizational duties. Policies and procedures often guide practice.


	SERVICE RECIPIENT The individuals, groups, organizations, or communities that use, receive, or benefit from programs and services. Service recipients can include consumers, patients, family members, legal guardians, advocates, public/private organizations, employers, and purchasers. All are regarded as significant stakeholders served in a variety of agencies and practice settings.


	RESTRICTIVE BEHAVIOR MANAGEMENT Interventions that restrict, limit, or curtail a person's freedom of movement to prevent harm to self or others. These interventions include isolation, manual or mechanical restraint, and locked isolation.


	PROTOCOLS Instruments and procedures used to accomplish a particular goal, activity, or purpose.


	FOSTER PARENTS State- or county-licensed adults who provide a temporary home for children whose birth parents are unable to care for them. Foster parents are not considered employees or personnel and are specifically referenced in all relevant standards.


	MANUAL RESTRAINT The practice of physically holding a person's arms, legs, or head to prevent harm to self and others.


	CASE RECORD A written compilation that describes the client and the services delivered. Records can be in hard copy and/or electronic format. The case record can be used as a source of information for quality improvement or other evaluation activities, for research purposes, or to demonstrate accountability to funding bodies.


	PERSONNEL The body of employees and/or volunteers that carries out the organization's tasks under the organization's administration and/or supervision. This definition does not include foster parents who are specifically referenced in relevant standards


	PARENTS Parents can include: birth, foster, kinship, and adoptive parents. Please see service standards for more specific information about use of this term.


	SERVICE One or more organization-operated programs or activities that have a common general objective and deploy the organization's material and human resources in a planned and systematic manner. An organization that publicly promotes or identifies itself in writing as offering a service, is licensed to deliver a service, assigns personnel and/or space to a service, or allocates financial resources to a service is considered to offer that service.


	SERVICE PLAN A written plan of action based on the assessment of consumer needs and strengths that identifies problems, sets goals, and describes a strategy for achieving those goals and engaging in joint problem solving with the consumer. Also known as a "treatment plan".


	MECHANICAL RESTRAINT The use of any physical device to limit movement and prevent harm to self or others, not including devises such as prescribed orthopedic devices, surgical dressings or bandages, protective helmets, or any other methods that involve physical holding of an individual for the purpose of conducting routine physical examinations, conducting tests, protecting the child from falling out of bed, or to permit the child to participate in activities without the risk of physical harm.


	TRAINING Instruction so as to make fit, qualified, or proficient in a skill or body of knowledge.


	LEGAL GUARDIAN A person who has legal responsibility for the care and management of a person incapable of administering his/her own affairs. In the case of a minor child, the guardian is charged with the legal responsibility for the care and management of the child and of the minor child's estate.


	PROGRAM A system of services offered by an organization. For example, an organization providing a mental health service may offer several mental health programs to different populations, e.g., a mental health program for adolescent teens. The word "program" can be used interchangeably with the word "service" or to describe specific programs.