Therapeutic Crisis Intervention (TCI) Edition Seven

Comprehensive vocabulary flashcards covering key definitions, theories, techniques, and procedures in Therapeutic Crisis Intervention (TCI) Edition Seven.

Trauma-Informed Organization

An organizational system that ensures staff understand trauma and its systemic impacts, recognize behaviors and patterns reflecting past or present trauma, and respond in ways that avoid re-traumatization.

Developmental Relationships

Relationships that foster positive development, characterized by four essential elements: attachment, reciprocity, progressive complexity, and balance of power.

Therapeutic Milieu

The combination of people, emotions, attitudes, and objects that create a sense of safety, respect, belonging, care, and accountability.

What are the 5 Spaces Within the Therapeutic Milieu?

Social, physical, ideological, cultural, and emotional spaces.

Setting Conditions

Any thing that makes challenging behavior or traumatic stress responses more or less likely to occur.

Ideological Space

The milieu dimension that communicates a philosophy of care, supports developmentally appropriate practice, involves children and families in decision-making, and creates a learning organization.

Physical Space

The milieu dimension encompassing the physical surroundings; it should feel safe, clean, orderly, and nurturing, with appropriate lighting, low noise levels, and age-appropriate furnishings.

Cultural Space

The milieu dimension that develops culturally competent staff, accepts and celebrates cultural differences, and supports family connections and involvement.

Social Space

The milieu dimension that values attachments, balances structure and flexibility to meet individual and group needs, and creates opportunities to practice important life skills.

Emotional Space

The milieu dimension that considers the effects of trauma, facilitates an atmosphere of safety and acceptance, encourages warm relationships, and promotes co-regulation and self-regulation skills.

Foundations for Intentional Use of Self

The four core competencies of personal care practice: self-awareness, self-regulation, relationship skills and attunement, and self-care.

Thinking Brain (Neocortex)

The part of the triune brain responsible for higher cognitive functions such as reasoning, language, creativity, and abstract thought.

Emotional Brain (Limbic System)

The center for emotions, emotional behavior, and motivation; it includes the amygdala (the sentry), which determines whether a stimulus poses a threat.

Survival Brain (Brain Stem)

Also called the reptilian brain, this system manages bodily functions that do not require conscious thought, including breathing, heart rate, and circulation.

Pain-Based Behavior

Behaviors resulting from emotional and psychological pain, such as impulsive outbursts, inability to regulate emotions, overreactions, trauma re-enactment, defiance, running away, self-injury, and withdrawal.

Crisis (TCI Definition)

A state in which a child's fight, flight, or freeze response is activated and they are unable to regulate their emotions and behaviors.

Two Goals of Crisis Intervention

Support (providing immediate emotional and environmental support to reduce stress and risk and increase the child's sense of safety) and Teach (helping children learn and practice emotional regulation and coping skills).

Stress Model of Crisis

A framework mapping the progression of a crisis across time and stress levels through four phases: Baseline, Trigger/Escalation, Outburst, and Recovery.

Recovery Phase Outcomes

The three possible outcomes following a crisis: Higher (the child learns new coping skills), No Change (the crisis was weathered but nothing was learned), or Lower (the child was damaged or traumatized by the intervention).

Four Questions in a Crisis Situation

The self-reflective assessment questions staff must ask: 1. What am I feeling now? 2. What does this child feel, need, expect, or want? 3. How is the environment affecting the situation? 4. How do I best respond?

Amygdala Hijack

A process where intense anger or fear prompts the amygdala to send a threat signal directly to the survival brain, activating the fight, flight, or freeze response and undermining objectivity and rational thinking.

Active Listening

A de-escalation communication method that helps children express thoughts and feelings, reduces defensiveness, communicates understanding, and helps children talk out rather than act out.

Minimal Encouragements

Brief, neutral vocal responses used during active listening (such as "Uh-huh," "Go on," or "I see") to prompt the child to keep talking.

Door Openers

Open invitations used to encourage a child to speak, such as "I'd like to hear more" or "Tell me about that."

Reflective Responses

Statements that connect with and mirror the child's feelings, such as "You look upset" or "You sound angry."

Empathic Responses

Statements that validate and connect with the child's experience, such as "This is really hard for you, isn't it?" or "It must be awful to feel like that."

Behavior Support Techniques

Eight non-punitive strategies used to de-escalate behavior: Managing the Environment, Prompting, Caring Gesture, Hurdle Help, Redirection and Distractions, Proximity, Directive Statements, and Time Away.

Time Away

A behavior support technique where an escalating child who has demonstrated self-regulation skills goes to a quiet place to relax and quiet their emotions; it is never to be used as punishment.

Emotional First Aid

A quick-response intervention designed to provide immediate support to reduce emotional intensity, resolve underlying concerns, and keep the child engaged in the activity.

Elements of a Potentially Violent Situation

The four interrelated risk factors in a crisis: the spark, the target, the weapon, and the level of stress or motivation.

Crisis Co-Regulation

A crisis management strategy designed to provide support in a way that reduces stress and risk and increases the child's sense of safety through intentional thinking, nonverbal calmness, and minimal verbal communication.

Post-Crisis Multi-Level Response Timeline

A structured 5-step organizational response following a crisis: 1. Immediate Response, 2. LSI with the Child, 3. Documentation, 4. Incident Review with Staff, and 5. Incident Review with Team.

Life Space Interview (LSI)

A structured verbal process conducted by a trusted adult to turn a crisis event into a meaningful learning experience for the child.

I-ESCAPE

The seven sequential steps of a Life Space Interview: Identify place and time to talk, Explore child's view, Summarize feelings and content, Connect trigger to feelings to behavior, Alternative responses discussed, Plan developed/Practice, and Enter child back into routine.

Acute Physical Behavior

Behavior likely to result in physical injury where the child, staff members, peers, or others are at imminent risk of physical harm.

Physical Restraint

The use of trained and competent staff members to hold a child in order to contain acute physical behavior.

Criteria for Using Physical Restraint

A high-consequence safety intervention permitted only when three conditions are concurrently met: agency policies/regulations allow it, the child's ICSP prescribes it, and professional dynamic risk assessment indicates it.

Duty of Candor

The professional obligation to tell the child and family when something has gone wrong, apologize, offer appropriate remedies, and fully explain the short- and long-term effects.

Duty of Care

The legal and ethical obligation to always act in the best interests of individuals, avoid acts or omissions that result in harm, act within one's competence, and never take on actions that cannot be done safely.

Asphyxia

The fatal or pathological deprivation of oxygen to living cells.

Positional Asphyxia

Fatal respiratory arrest occurring when the positioning of a person's body compromises their ability to breathe.

Individual Crisis Support Plan (ICSP)

An individualized plan created with input from the young person, family, care team, and clinicians that outlines specific strategies to prevent, de-escalate, and manage potential crises.