About the C.A.L.M. Program

About the CALM Program

Over the past few decades, very few areas of modern healthcare have been left unchanged. New technology, new medications, and a seemingly unsuccessful overhaul of the way care is delivered has wrought havoc with those responsible for writing policies and providing staff training. Behavioral health settings have not been exempt. Admission criteria has become much more strict while hospital stays have been greatly reduced. The effect has been that those clients residing in inpatient facilities are more severely ill than they were twenty years ago and stay for a fraction of the time. Dealing with sicker clients and quicker turnaround leads to more dangerous or maladaptive behaviors demonstrated in the inpatient setting.

Increased violence has also plagued hospitals, treatment centers, and education settings nationwide. In effect, new State requirements have led to stricter rules and regulations in order to better protect the safety of workers, patients, and students across the United States. Having a crisis management system in place within your facility is now becoming a mandatory requirement of State regulations and accreditation.

Therefore, Crisis Management Solutions, Inc. created The CALM program. This program consist of a system of crisis de-escalation, prevention, and safety procedures designed specifically for hospitals, nursing homes, and schools. This program has been found to be readily adaptable for use in a variety of settings including; schools, residential facilities, general medical settings, education institutions and even in the home. Educators, therapists, counselors and nurses are all excellent candidates for the Instructor course.

The CALM Program emphasizes:

• Building the Therapeutic Relationship
• Active Listening
• Early Verbal De-Escalation
• Self Protection
• Emotional Boundaries
• Control and Restraint Techniques
• Post Crisis Review
• Crisis Response Planning

This program is designed with the following ideals:

• Crisis occurs in a series of stages from verbal to physical.
  
• The most effective crisis intervention occurs during the verbal stages.
  
• With physical intervention there is a considerable risk of injury as well as emotional trauma to the client or student, as well as staff members.
  
• Physical intervention is to be the last resort, when there is imminent risk of harm to the patient, staff or others involved in the crisis.
  
• There should be an ongoing review of crisis situations including critique of staff response and a plan for performance improvement.

The CALM program's mission is to provide comprehensive, competency based training in crisis de-escalation so as to maximize the safety of all who participate in a crisis event, while providing the utmost dignity and respect to those clients, patients, and/or students who require the techniques of this program.

Prior to the development of the CALM Program, the authors examined other behavioral management programs. Existing programs seemed to fall into one of two extremes, either overly aggressive which would be inappropriate for the hospital, residential or school setting; or prohibitive of physical techniques necessary to maintain safety in certain situations.

The CALM Program also provides it clients with the proper and necessary training in dealing with restraint and seclusion procedures. Recently the use of all forms of restraint has come under a great deal of criticism. Disastrous outcomes in high profile situations have brought the entire industry under a great deal of scrutiny. If seclusion or restraints are to be utilized they need to be part of a comprehensive behavioral management program. Adequate training should be required of all staff members who have patient contact. Policies should stress the necessity of considering, “hands on methods,” as the last action to be used only when a client is at imminent risk of harming themselves or others.