Crisis Intervention Training

Flashcards covering ITA basics, minor considerations, crisis response, CPR suicide intervention, and related policies in Washington State.

What does ITA stand for?

Involuntary Treatment Act.

What are the four prongs of ITA?

Danger to self; Danger to others; Danger to property; Gravely disabled.

Under ITA, who determines detention and transports the subject to a facility?

Law enforcement (LE) determines detention and transports to an appropriate facility, with involvement of the Designated Crisis Responders (DCRs) and medical staff as needed.

According to RCW 71.05.153, when may a peace officer deliver a person to a crisis facility?

When there is reasonable cause to believe the person has a behavioral health disorder and presents an imminent likelihood of serious harm or is gravely disabled (or as otherwise allowed by subsections (1) or (2)).

ITA considerations for minors: 12 and under

Should only be considered under extreme conditions; ITA process discussed with parent; ultimate decision made by DCR/LE.

ITA considerations for minors: 13-17

ITA process can be discussed with parent; ultimate decision made by LE.

What does Gravely Disabled mean in ITA terms?

A condition in which a person cannot meet essential health or safety needs due to a behavioral health disorder and is in danger of serious harm or deterioration, and is not receiving essential care.

Danger to self (ITA) definition

A substantial risk of harm indicated by threats or attempts to commit suicide or self-harm; suicidality may involve referrals to a Designated Crisis Responder under Sheena’s Law.

Danger to others (ITA)

Behavior that harms or places others at reasonable risk of harm; can be written, verbal, or actual assaultive acts.

Danger to property (ITA)

Behavior which has caused substantial loss or damage to the property of others (including community property).

What is Sheena’s Law (SSH B 1448) referenced in these slides?

Law that allows LE to refer suicidality cases to a Designated Crisis Responder.

What is Joel’s Law (SSB 5269) and when can families petition the court?

Joel’s Law allows families to petition the court, but only after DCR denial of the 120-hour hold/commitment.

What is the 3-S crisis response model?

Scene Control (Threat Assessment and making the scene safe); Start Dialogue (body language, active listening, OPEN model); Solution (incident resolution).

What are the components of Start Dialogue?

Establishing presence, greeting/introduction, observation, and opening question to build rapport.

What does the OPEN model refer to in crisis dialogue?

A framework for using open-ended questions to gather information and build rapport during dialogue with the subject.

What are the key elements of Active Listening?

Respond to content, paraphrase for clarity, allow pauses, and help direct and control the conversation.

What is Empathy / Emotional Labeling in Start Dialogue?

Use feeling statements to identify emotions observed, avoiding assumptions; label only what is observed.

What is the purpose of the Speedometer model in crisis intervention?

Describes the behavioral progression and helps guide de-escalation from calm to escalating behavior.

What are the behavioral zones in the Speedometer model?

Baseline; Danger; Behavior (direct assault); Aggressive behavior (directed anger); Anxiety; Defensive behavior (general anger).

In suicide intervention CPR, what does CPR stand for and what are example prompts?

C - Current Plan (e.g., 'Do you have a plan?'); P - Past Behavior (e.g., 'Have you tried to kill yourself before?'); R - Resources (e.g., 'Do you have a therapist?').

What is the role of Designated Crisis Responders (DCRs)?

DCRs are county employees and mental health professionals who respond to crisis, evaluate the situation, and help determine ITA authority; they may replace the former DMHP.

What is the Crisis line number?

988