The COMPASS (Centre for Collaborative Child and Family Treatment) team has found that implementing collaborative approaches for understanding and addressing challenging/aggressive behaviors has a significant impact on patient and staff safety, as well as client and family recovery, and the quality of the staff’s work life. Although there are times in which seclusion is required in order to promote physical safety for all, the team recognizes that intervening proactively to prevent the use of seclusion is the best practice for preventing injury. The use of collaborative approaches has provided a framework for recognizing triggers for aggression, and intervening proactively to prevent aggression. It has also helped establish partnerships between clients and families so that they may better understand the unique situations of the children and families who access services. Implementing collaborative approaches for addressing aggression has contributed to an 80 per cent decrease in seclusion rates. However, the impact of collaborative approaches extends beyond seclusion rates. Staff confidence and competence in managing challenging situations has improved significantly and staff members also feel better about the quality of care and treatment they are providing to clients and their families. Clients have expressed improved outcomes from collaborative approaches to addressing aggression. They feel listened to, respected, cared for, and empowered as participants in their own care. They have also said that they feel better able to handle real life situations as a result of the support of the team. Team members also notice that as clients become familiar with the principles of collaborative approaches, clients are better able to recognize potentially challenging situations and partner with their parents/team members to resolve potentially problematic situations. Finally, collaborative approaches have also had a positive impact on parents and families. Parents feel respected and important as their unique stories are valued and provide the base from which the team supports recovery. Parents learn to view their child’s behavior in a different light in which they seek to understand the trigger for their child’s behavior, rather blaming the child and expecting them to know better. This has a positive impact on the parent-child relationship. In summary, using collaborative approaches to address aggression is a leading practice as it has had a positive impact on patient and staff safety, the quality of care delivered, and treatment outcomes at Compass. This practice requires a philosophical shift in thinking, from traditional reward-consequence approaches to collaborative approaches for understanding and addressing challenging/aggressive behavior. Collaborative approaches allow team members to partner with clients/families to better understand the client’s episodes of aggression, build problem solving skills so they are better able to manage challenging situations that are unique to the client, and proactively discuss future situations that may be difficult for the client. This approach is an individualized approach to care. It is a foundational model that is shared between the team, clients, and families. This approach supports a blame free culture where a child’s behavior is understood in terms of skills that require building, rather than finding blame, with the client and/or parent. By working with parents, schools and other external partners, staff from COMPASS, are building capacity to understand and address aggressive behavior within the authority figures in the client’s life. To enhance this approach, COMPASS has developed their own resource material, in the form of presentations, handouts, scenarios, etc. to support parents/schools understanding of collaborative approaches. In particular, COMPASS developed a 100 page-parenting manual, as well as file folders for each school participant (that houses take away information for the participant).
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