Assault response training

Nick Smiar

The topic of physical intervention is an especially sensitive one right now in the United States. Public attention has been focused on deaths and injuries which have resulted from improper and out-of-control application of physical intervention by untrained or poorly trained personnel.

One of the workshops which we do is called PART (Professional Assault Response Training). PART is a safety enhancement/risk management program for agencies and personnel who work with potentially volatile clients. It is research-based and is continually updated on the base of current research and practice. I thought I might share with you some of my thoughts, in response to your questions.

1. Models of physical intervention
It is not wise to speak of training in physical intervention. We now know that such training, offered without a wider context of professionalism and alternative approaches, will lead to over-application of the physical interventions. “If the only thing you have is a hammer, everything else is a nail." Injuries which occur within physical interventions are most often the result of loss of control by the professionals applying the physical intervention, the lack of training in critical thinking in a crisis to ensure application of the safest and most effective intervention, and the lack of training in a systematic model of intervention (along with regular supervision, reinforcement of training, and well written and strictly enforced policies regarding physical intervention).

2. There are many models or curriculawhich address this issue
PART is one of them, and, in my opinion, the best of the models/curricula. The theme which I use in PART training is “Safety and Dignity Through Problem Solving." If you would like more information about PART, please send me your snail mail address, and I will forward to you a brochure from the partnership. PART training is done in Canada on a regular basis. Perhaps we could put you in touch with an agency which has experience with it.

PART has been adopted in South Africa; the National Association of Child Care Workers (South Africa) is the organization authorized to deliver the training there. More than 5,000 persons have been trained in PART in South Africa. The training is integrated into the training for all Child and Youth Care workers there. PART is becoming common in Germany and has been done in Russia; we may be doing it in Sweden in the coming year. I do training in Germany at least once a year. But PART is best known on the western coast of the United States.

3. PART, and all of the models I know of,address the topic of report-writing, againin the context of the intervention
Report-writing serves three functions:

review of the incident by the report writer(s),
a record for the team so that more can be learned about the client and about effective methods of intervention, and
a legal record of events, for the protection of staff and agency.

4. The philosophy of PART is: safety anddignity through problem solving
PART is a systematic, team-centered approach which stresses professionalism, preparation, skills in identification, good decision-making in the selection of interventions, SAFE-DIGNIFIED-EFFECTIVE physical interventions, and adequate recording of the events. The principles of PART are based on the risks which are posed. PART is a team-based, problem-solving, client-centered approach. It is applied by asking critical questions, beginning with “IS THE BEHAVIOR DANGEROUS?" Only immediate, imminent, potentially seriously injurious behavior warrants physical restraint; this is especially true when other, less intrusive methods could be applied, including verbal interventions and evasion.

5. Seclusion rooms
The decision to use or not to use seclusion rooms arises from the individual program's model and decisions made within that program as well as external constraints on the use of such methods, e.g., state regulations. Our observation, however, is that seclusion rooms tend to be misused and overused, often for staff convenience or as retribution. Sometimes, seclusion rooms are used when they are not needed because the incident and the threat are past; they are used simply because there is an agency policy that when such and such an incident occurs, the client must go to seclusion for a pre-determined period of time. Current legislation before our Congress is addressing both physical restraints and the use of seclusion rooms. The legislation will put severe constraints on the use of either method.