Crisis Intervention & Negotiation Flashcards
(404 cards)
1
Q
Is a planned or unplanned siege easier to negotiate?
A
Unplanned.
2
Q
What is the difference between an instrumental and expressive hostage?
A
An instrumental hostage is up for trade as a means of resolving the situation. An expressive hostage is the direct object of the hostage taker’s anger.
3
Q
What is an incidental third party?
A
Someone who’s in the crisis site but is neither an instrumental or expressive hostage (and might not even be a hostage at all).
4
Q
What are the 12 elements that indicate a likelihood for a successful negotiation?
A
Containment
Desire to live by the subject
A substantive demand
Singular message by law enforcement
Time
A trained negotiator
Understanding subject motivation
Accurate assessment of the incident
Negotiator viewed as an instrument of help
Negotiator can speak to the primary decision maker
Low risk of violence
Deliberate strategy between the negotiation and tac teams.
5
Q
What are the 3 C’s of initial violence risk?
A
Containment, communication, and context (was there violence before CNT arrived?)
6
Q
What are the 3 elements of communication during a negotiation?
A
The communicators, the message, and the environment
7
Q
What are the 5 steps in the Behavioral Influence Stairway Model?
A
Active listening, empathy, rapport, influence, and behavior change
8
Q
What are the 3 elements of rapport?
A
Mutual attention, mutual positivity, and coordination/cooperation
9
Q
What are 5 barriers to successful communication?
A
Filtering
Judging
The drive to be victorious
Problem solving
Appeasing (minimal encouragers without actually listening)
10
Q
What is the most effective active listening skill for someone who is shouting at you, threatening you, or demeaning you?
A
Silence. They’ll stop and ask, “You there?” Then, you reflect and move on.
11
Q
What are 4 indicators that rapport has been built?
A
Them using your words, asking you for advice, doing things you ask them to (especially if they were resistant earlier), and “If I did…” talk.
12
Q
What is verbal containment?
A
The concept that says if someone is talking to you, they’re not hurting themselves or someone else.
13
Q
What is a phrase you can use to minimize expectations for someone’s demand?
A
“What you’re asking for is difficult under ideal circumstances. Can we both agree these are not ideal circumstances?”
“Yes.”
“I’ll check with my command post. In the meantime, what can you do from your end to make this decision easier for them?”
14
Q
Why shouldn’t the primary watch live video footage of the subject?
A
They might see something on video that the subject hasn’t told them and then reveal it to the subject. The primary shouldn’t know that piece of info, which kills rapport.
15
Q
Why is time helpful in a negotiation?
A
Time allows the body to metabolize drugs, alcohol, and cortisol. Time also allows basic needs to build, which can be used as negotiation points.
16
Q
What are the 3 steps to respond to a demand?
A
Acknowledge, soften (if they say an AK 47 with XYZ attachment, just call it a gun when you summarize), avoid building expectations
17
Q
What do you do when a subject gives you a timeline for the demand?
A
Talk through it.
18
Q
What are signs a subject is serious about enforcing a deadline?
A
Direct threat to a hostage, not allowed previous deadlines to pass, counting down, and previous violence in the crisis
19
Q
What is the biggest risk of a TPI, and how do you mediate it?
A
Risk: the subject and the TPI don’t actually have a good relationship
Mitigation: ask the subject how they feel about the TPI (if they didn’t bring up the TPI) and get the TPI on recording instead of live
20
Q
How can MHPs help in the intelligence gathering process?
A
They can get access to medical records as a clinician themselves.
21
Q
What are some symptoms of high-THC marijuana use?
A
Psychosis (delusions and hallucinations) that is caused by brain damage and is incurable
22
Q
What is the relationship between marijuana and psych meds?
A
Marijuana negates the effects of psych meds.
23
Q
What are the 3 dynamics for someone who’s considering suicide?
A
Decreased fear of death, feelings of burdensomeness, and feeling disconnected from others
24
Q
Are people with SMIs more likely to be a victim or a suspect?
A
Victim
25
What are the 5 most common diagnoses of people involved in crisis situation?
ASPD, depression, bi-polar disorder, borderline personality disorder, and schizophrenia
26
What are 5 follow-up questions to ask if someone endorses command hallucinations?
What are they telling you?
Have they told you this before?
How long have they been telling you this?
Have you ever acted on what they're telling you?
What's stopped you from acting on them?
27
In someone's criminal history, what might indicate an ASPD diagnosis?
Serial persons crimes (murder, rape, assault, etc)
28
What are the two psychological defense mechanisms of someone with ASPD?
Projecting blame and rationalizing their behavior
29
Should you use TPIs with someone with ASPD?
No, unless it's a person of authority who can guarantee the validity of your deal.
30
What behaviors are likely manipulative if coming from someone with ASPD?
Remorse and politeness/deferentialism
31
Should you divulge personal information to someone with ASPD?
No.
"I can maybe share more with you when we're done, but we have protocols that prevent me from sharing that right now."
"My life's not that interesting. Let's talk about yours."
"I know a lot of people who have kids, but I'm most interested in your experience having kids."
32
What is the best strategy for negotiating with someone with ASPD?
Be direct, but not adversarial. Focus on what they have to gain from cooperating.
33
What is the gender breakdown for people with borderline personality disorder?
Mostly women. If there's a male stalker, he likely has borderline personality disorder.
34
What do subjects with ASPD and borderline personality disorder have in common?
Both express a lack of empathy or guilt. Both also will manipulate you, but people with ASPD do it from a position of strength, whereas people with borderline personality disorder do it from a position of weakness.
35
What are challenges in building rapport with someone with borderline personality disorder?
Rapport is slow to build because they don't trust easily due to a history of abandonment or trauma, and they may have massive emotional outbursts.
36
What is the best negotiation strategy for someone with borderline personality disorder?
Tend to their fears of alienation without promising anything you can't deliver and while enforcing strong boundaries.
37
How frequently do people with bipolar disorder cycle between mania and depression?
Every few months. More than 4 cycles per year is considered rapid.
38
What's the difference between bipolar 1 and bipolar 2?
Bipolar 1 has at least one weeklong+ period of mania with psychosis. Bipolar 2 has at least one two-week-long period of depression.
39
What is the hedonistic triad related to bipolar disorder?
When manic, people overspend (money), engage in risky sexual activities (sex), and indulge in substances (drugs).
40
When is the greatest risk of suicide for someone with bipolar disorder?
During the swing from mania to depression or vice versa
41
Why is there a risk of murder-suicide with someone with bipolar disorder?
They may want to spare others the pain of living in such a difficult world and will kill them and then themselves.
42
What might a sudden improvement in mood indicate in someone with depression?
They've decided they're ready to kill themselves.
"I'm glad you're feeling better. What's causing that change for you?" --> "I know what I need to do now" is a bad sign.
43
What is a good negotiation strategy for someone with depression?
Get them to do a small self-care thing like eating a sandwich.
44
What is violence usually motivated by in someone with schizophrenia?
Self-protection or protection of belongings
45
What gender is the most effective at negotiating with someone with schizophrenia?
Someone of the opposite sex of the subject
46
What is a common substance dependency for someone with schizophrenia?
Nicotine, to reduce medication side effects
47
Of the five most common diagnoses that appear in crisis situations, which is most likely to respond well to a TPI?
Someone with schizophrenia
48
What two elements are necessary for a crisis to occur?
A threatening situation and an inability to problem-solve that threat
49
What does it mean to uncover the precipitant?
Find what specific emotion about a specific life event led to today's crisis instead of digging through their entire psychiatric history.
Note: The precipitant is the thought or feeling aroused by the precipitating event. It's not the loss of a job, for example, it's the helplessness and uselessness that arose from it.
50
True or false: it is sometimes helpful to confront clients with the unrealistic or maladaptive nature of their goals, lifestyle, or beliefs and point out the negative consequences of current behavior patterns.
True.
51
What is the danger of diagnosing in a crisis setting?
It may blind the diagnostician to the manageable critical events and instead focus them on the effects of long-term pathology.
52
What six things must a clinician assess about a client in a crisis situation?
Current level of functioning
Emotional state
Pre-morbid adjustment (how well someone functioned before the onset of symptoms, specifically psychotic symptoms)
Manner of relating
Current life stresses
Level of motivation for treatment
53
What is the relationship between socioeconomic status and clients' expectations of interventions?
Lower SES clients expect shorter, solution-focused work and may become suspicious and uncooperative if long-term treatment is suggested, and vice versa.
54
True or false: if someone is coping well with a recent traumatic event, that trauma might not be what's causing their crisis tonight.
True. Dig into other domains of their life (work, family, relationship, etc) to try and find the true precipitant. This process also works if the client doesn't know what the precipitating event was.
55
What four elements should be assessed to determine a client's psychological functioning?
Physical appearance and behaviors, speech, thought and cognition (organized thinking), and affect (mood)
56
What is the potential downside to providing psychiatric medications in a crisis intervention setting?
The client's motivation to solve the underlying problem might be reduced because they feel better.
57
When brainstorming new coping mechanisms, what's the first question you should ask?
What have you done in the past in similar situations?
58
What is behavioral task assignment?
Giving the client homework (breathing exercises, saying "no" to a difficult child, etc) to do in between interactions with you (and maybe giving them an opportunity to practice it with you)
59
If a client suddenly raises new problems or regresses in their progress right as you're about to end the interaction, what might that indicate?
Fear/sadness about the end of the interaction with you. Validate those emotions and emphasize the progress made.
60
How does someone who projects blame onto others view themselves?
As a victim
61
Is it worth trying to prove to a habitually projecting person that they are not, in fact, the victim?
No
62
What is an effective way to say "not now" instead of saying "no" while using the tool of time?
Quote rules and regulations that will complicate the process.
For example, if a subject hijacked a plan from Seattle to France, ask about a visa or passport, talk about how many refueling stops it will have to take, etc.
For another example, if he requests coffee, go into the weeds about what type, from where, how much sugar, etc.
63
What is the risk of letting someone with ASPD leave with a hostage?
People with ASPD see hostages as tools to their escape, and once their escape is achieved, the tool is no longer needed and will probably be killed or hurt.
64
True or false: calling a hostage "bitch, broad, etc" versus their name is a bad sign.
True
65
What are the best three ways of assuaging a hostage's fear?
Let them vent and tell their story of stress and fear. Assure them you are doing everything you can to get them out safely. Let them know it might take longer than expected, but that we have a long track record of getting everyone out safely.
66
What is a language cue by the hostage that indicates the beginnings of Stockholm Syndrome?
Use of "we" language - for example, "we're waiting for you to deliver the money."
67
If someone is off their meds, is it a good idea to encourage them to take their meds during a negotiation?
No. You don't know how long they've been off, what other substances they may have ingested that may have negative interactions, etc.
68
What is one way to reduce repeat suicidal subjects?
Debrief the event with the subject afterwards. What in the negotiation worked well, what could have been changed?
69
What is important about past-tense when the subject says it?
"I was a terrible father" versus "I am a terrible father" indicates increased likelihood of death.
"I wanted to die" versus "I want to die" indicates increased likelihood of life.
70
True or false: encouraging projection and blaming the victim can help build rapport in a negotiation.
True
71
What are 4 sleep hygiene practices that can reduce insomnia?
No caffeine after 2pm
Reduce the amount of intensity (ie. loud movies) in the evening
Sleep in a dark and quiet room without a TV
Reduce screen time in the evening or reduce blue-light consumption
72
In terms of hours, when is the most dangerous time in a negotiation?
First 15-45 minutes, and then the 9-10 hour mark
73
Besides the obvious, what is one benefit to using an interpreter?
Interpretation inherently takes longer, and time is one of our greatest assets.
74
How many interpreters should you use during a negotiation, and why?
Two or more, so they can double-check each other's translations and provide instantaneous updates on what's going on
75
When should a critical incident stress debriefing be offered?
24-72 hours after the event
76
What is the difference between a debriefing and a diffusing?
A diffusing covers the same content as a debriefing but in a shorter form (one hour versus three), and it takes place immediately or quickly after the event.
77
What is the difference between a diffusing and a demobilization?
They both take place immediately after the critical event, but a demobilization is used when there are 100+ people and just includes a lecture on psychoeducation and no discussion from participants.
78
True or false: expect someone with Dependent Personality Disorder to talk to the cops a lot.
False. They use silence and make others talk.
79
What are two negotiating tactics that work well with someone with Dependent Personality Disorder?
Be patient and non-directive, and build up their ego
80
Why might someone with dependent personality disorder have hostages negotiate for them?
They have a weak ego, penchant for failure, history of trouble with authority, and history of manipulating others into doing unpleasant tasks for them.
81
What gender of negotiator is best for someone with dependent personality disorder?
Someone of the opposite gender
82
Is Stockholm Syndrome more or less likely in hostages where the hostage taker has dependent personality disorder, and why?
More likely, because hostages (especially females) are likely to feel pity for them
83
What is the risk of someone with comorbid schizophrenia and ASPD?
Violent reactions to their hallucinations/delusions
84
What characteristic about someone's delusions/hallucinations increases their violence threat level?
If the delusions/hallucinations are about a specific person or group, they are more likely to be violent towards that person or group.
(For example, someone who believes she is appearing nude on the radio is less likely to be violent, but someone who believes the Monroe PD is spying on them is more likely to attack the police.)
85
If someone threatens the police, refuses to listen to commands, becomes aggressive, and caused a crime specifically to initiate law enforcement response, what do you need to worry about?
Suicide by cop
86
What are the three types of threats, and which is the most dangerous?
Unconditional, conditional offensive, and conditional defensive - unconditional is the most dangerous
87
What is an example of an unconditional threat?
"I'm going to kill her!"
88
What is an example of a conditional offensive threat?
"If you don't deliver my pizza, I'm going to kill her."
This threat attempts to spur action from law enforcement.
89
What is an example of a conditional defensive threat?
"If you don't stay out of here, I'm going to kill her."
This threat attempts to keep law enforcement out and away from the subject.
90
In what type of incident are you most likely to encounter a veteran with PTSD?
A DV incident
91
Are terrorist/extremist or criminal hostage takers generally more intelligent and sophisticated?
Criminal
92
If the subject is staying on the phone longer with you and is initiating calls to you, what is that indicative of?
Rapport being built, which increases the chances of a peaceful surrender
93
What is the most likely indicator of a successful peaceful resolution?
Rapport
94
Is an obviously depressed person who denies SI more or less dangerous than one who admits it, and why?
More, because it shows that rapport has not been built, which is indicative of a violent outcome
95
Are younger or older hostage takers more violent, and why?
Younger, because they are more impulsive
96
If a subject insists on face-to-face negotiations, what should you be aware of?
Suicide by cop
97
If a subject requests that specific relatives get their belongings after they are incarcerated following this crisis incident, what might this indicate?
Increased suicidality
98
If a subject tied/taped a weapon to themselves, what might that indicate, and why?
Increased risk for violence, because it shows premeditation
99
What mindset can negotiators help a hostage adopt to increase their chances of psychological survival?
Help them identify with a characteristic that sets them above the hostage takers - ie., "I'm a father, an American, a soldier, etc."
100
True or false: for a hostage, failure to play a subordinate role to their hostage taker will lead to dangerous conflict.
True
101
True or false: humanizing yourself as a hostage and talking about the family you have to return to and care for decreases your likelihood of survival.
False
102
What are the four stages of most hostages' emotional responses?
Denial, dreaming of reprieve, busywork, and taking stock of their lives
103
Why do some hostages develop animosity towards the police?
They believe the police are keeping them stuck - "If the police would let the bad guy go, I could go home."
104
Why does humanizing oneself as a hostage increase chances of survival?
Because it's harder to kill someone you see as human
105
What is the risk if hostages are kept in a different room from the hostage taker, or hooded/faced away from the hostage taker?
It becomes increasingly difficult for hostages to humanize themselves because they'll have no positive interactions with the hostage taker, which decreases their chances of survival because it is easier to kill someone you don't see as human.
106
Why is it important for the surrender to include face-saving elements for the subject?
To prevent excessive humiliation or frustration that may trigger violence
107
What are the 3 primary roles of the MHP on a negotiation team?
Assess and monitor the subject, monitor stress levels among negotiators, and aid in the intelligence gathering process (specifically in the acquisition of medical records)
108
Why do most prisoners take hostages?
To protest living conditions within the prison
109
Why do criminals caught in the act (like in the middle of a robbery) take hostages?
To ensure their own safety, because they failed to escape before police arrived
110
What are 4 reasons a political terrorist will take hostages?
To show that the government cannot protect its citizens
To get media coverage for their cause
In hopes that the government will overreact, place too strict of restrictions on its people, and therefore cause civil discontent
To demand release of incarcerated individuals within their group
111
What is the danger of having hostages in a separate room from the subject during an incident?
Separation of subjects reduces the likelihood of Stockholm Syndrome developing, which if reciprocated, can act as a protective measure for hostages
112
What is important to note about the relationship between time and personality disordered individuals?
They are less likely to calm down and metabolize their crisis over time because their condition is their baseline.
113
What is the benefit of an emotional age estimate to a negotiation?
It tells you how much behavioral improvement you can expect with the passage of time.
114
How do you negotiate with someone with an emotional age of 2?
Take a firm, reality-based approach and try to redirect their anger from hostages to the authorities.
115
At what emotional age will active listening skills start to work?
4
116
How do you negotiate with someone at an emotional age of 4?
Ignore exaggerated attempts to push boundaries and look for opportunities to build the positive relationship between the negotiator and the subject.
117
How do you negotiate with someone at an emotional age of 6?
Compliment them personally, avoid forcing them to take responsibility, and avoid a commanding approach.
118
How can the SWAT MHP be helpful in gathering intelligence from friends and family members?
The MHP is often viewed as warmer and friendlier than LE, and therefore friends and family members might be more forthcoming with information.
119
What is an ethical consideration you need to be aware of when using a TPI?
The emotional impact on the TPI if negotiations fail and the subject is harmed or killed
For example, getting a daughter to record a TPI tape and then having her dad shoot himself could do a lot of harm to that kid.
120
Do you want the subject to know there's an MHP on the negotiation team listening to the conversation, and why?
It depends, but likely not, because you don't know how the subject feels about MHPs. They might aggravate him because of a bad history with ITAs, for example.
121
True or false: subjects find it difficult to sustain a suicide/hostage execution plan as time goes on.
True
122
What two emotions usually underlie a schizophrenic individual's taking of hostages?
Fear and anger
123
What is an effective negotiating technique for someone with schizophrenia and why?
Let them talk, as many need to vent their beliefs and frustrations
124
What is the best and worst case scenario if a subject asks to speak to an MHP?
Best: they've had a great experience with an MHP in the past, and that person could be crucial in resolving the crisis
Worst: they want to put on a violent and dramatic display in front of the MHP, which could result in suicide or death of a hostage
125
True or false: it is a good idea to play into someone's delusions and hallucinations because they'll feel heard and understood.
False. They're very keen on when someone is bullshitting them, and it'll erode trust and rapport.
126
What are two keys to successful negotiations with a paranoid subject?
Calmness and straightforwardness
127
What is the risk of being too warm and amiable with a paranoid subject?
They may see your attempts at rapport-building as attempts to control, harm, or manipulate them.
128
What two archetypes are helpful for the negotiator to take with a depressed subject who has nothing left to live for?
Nurturing parental figure or supportive authority figure
129
How should you pace the conversation with a depressed/suicidal subject?
Start at a slow tempo, give lots of time for pauses before responses, and slowly pick up the pace as you go
130
If a depressed/suicidal subject starts to harp on a negative thing from the past, what should you do?
Gently redirect them to the positive aspects of the present moment
131
True or false: comments like, "Think of how your kids will feel," are effective at talking someone out of suicide.
False. They already feel like shit, and this type of comment doesn't help.
132
Should jokes and irony be used with someone in an acute manic state, and why or why not?
No, because they may be too concrete in their thinking to get it and may feel like you're making fun of them.
133
How do you convince someone with ASPD to spare hostages?
Convince him sparing hostages is the easiest way to achieve his objectives. For example, tell him that a goodwill gesture of releasing hostages may result in a lighter penalty and will prevent tac from coming in there and shooting him.
134
What does a negotiation with someone with ASPD look like?
A legit negotiation, like a business deal. There's no empathy or rapport there.
135
What type of tone do you want when negotiating with someone with ASPD?
Even-keeled: calm enough to not play into their need for power trips and thrills, but not too boring that they feel the need to commit violence to "spice things up."
136
What type of crisis do people with BPD usually find themselves in?
Some sort of relationship-based crisis, like going to the house of a lover who scorned them.
137
What is the underlying emotion driving the taking of hostages for someone with BPD?
White-hot, righteous anger
138
What type of demands should you expect from someone with BPD?
No demands (they just want their expressive hostage to suffer) or completely unreasonable demands (an oath of undying devotion, all of the material possessions of their expressive hostage, etc)
139
Do you want to encourage Stockholm Syndrome in a hostage situation with a subject with BPD, and why or why not?
No, because the subject already has heated interpersonal relationships with those hostages, and you want to keep their attention focused on you and resolving the crisis.
140
What is important to note about a BPD person's pattern of over-idealizing and then devaluing others?
That cycle can happen multiple times during a negotiation, and you may have to switch negotiators.
Be aware that they may go from loving you to hating you with equal passion in the blink of an eye.
141
What is the best negotiating tactic for someone with histrionic personality disorder?
Tell them that a peaceful resolution to the crisis is the one most likely to be admired by others (family, police, media, etc).
142
Why do most people with narcissistic personality disorder get themselves into trouble?
They believe the rules don't apply to them because they're so superior.
143
If someone with narcissistic personality disorder feels they aren't getting the respect they deserve, what might happen?
They get angry.
144
What generally lies underneath someone with narcissistic personality disorder's clinical presentation, and how is that relevant to negotiations?
A sense of inferiority and insecurity. They will often begrudgingly defer to someone with real power in an attempt to sidle up to them and build up their own ego.
145
How do you know you've built "rapport" with someone with narcissistic personality disorder?
They say something that implies you share an equal status or common bond: "I have a brother in Atlanta who's a cop."
146
If someone with narcissistic personality disorder becomes enraged at not being treated like the special snowflake they think they are, how should you handle it?
Be deferential, but don't degrade your own dignity, and reassert the need for your actions/what you're asking for.
“We understand, sir, but it’s necessary that we maintain this perimeter for everyone’s safety until this situation can be resolved. Thanks for working with us on this.”
147
Why might someone with avoidant-dependent personality disorder take a hostage?
They feel slighted or rejected by that person and will do anything to get them back, including taking them hostage.
148
What is important about the resolution plan for someone with avoidant-dependent personality disorder, and how can you facilitate this?
Make a resolution plan that doesn't feel like a failure to the subject, lest they try to do something violent to show their capability.
Let initial surrender ideas come from the subject, refine with your own suggestions, and include mentor-like praise.
149
What is a good negotiating tactic for someone with avoidant-dependent personality disorder?
Make every positive thing that happens feel like it was the subject's idea.
150
What two negotiating techniques are most effective for someone with dementia?
Keep sentences short, simple, and direct.
Really emphasize your desire to keep everyone safe/the "safety" aspect.
151
What is the most likely reason you'll have to go tactical when negotiating with someone with dementia?
Health-related issues, like the hostage (often a spouse) is having difficulty breathing
152
Why is the threat level changed with a political hostage taker/barricaded subject, and is it higher or lower than with other types of subjects?
Higher, because they are willing to kill and die for their cause.
153
Why is the threat level changed with a prison hostage taker, and is it higher or lower than "normal?"
Higher, because they may feel like they have nothing to lose.
154
True or false: if there is a hostage with medical needs and a doctor among the hostages, the doctor should be called upon to render care to the other hostage.
No, because the subject knowing their identity is dangerous for them and makes them more of a target.
155
Why might it be advantageous to plan to use 2 negotiators for someone with ASPD?
Let the subject verbally abuse the first negotiator, then input a second negotiator to bring it home.
156
What 4 things should the MHP be assessing for in the subject while listening to the negotiation?
Presence of mental illness
Presence of suicidal ideation
Motivations
Intoxication
157
True or false: the MHP should always be monitoring for changes in thought patterns, violence levels, and intoxication in the subject.
True
158
What 3 groups of people is the MHP monitoring stress levels in during a negotiation?
Subject, hostages, and negotiation team members
159
What is the root of anger, and why is that important for crisis de-escalation?
An unmet need, usually from childhood. This is relevant, because you're not only de-escalating the immediate crisis, but a history of unmet needs.
160
If you have a person who had few opportunities to play, explore, and be creative in childhood, will they have more or less natural conflict resolution and anger management skills?
Fewer.
161
What is the fear underlying the emotional trigger "survival," and what is the underlying unmet need?
Fear: life and limb (DV, gangs, wars, etc)
Need: safety
162
What is the fear underlying the emotional trigger "abandonment," and what is the underlying unmet need?
Fear: being left alone (sexual abuse, addiction, loss of a loved one)
Need: connection
163
What is the fear underlying the emotional trigger "impotence," and what is the underlying unmet need?
Fear: powerlessness (terminally sick loved one, incarceration, CPS)
Need: control
164
What is the fear underlying the emotional trigger "shame," and what is the underlying unmet need?
Fear: unworthiness or disrespect ("this is how it should be")
Need: (self-)respect
165
What is the fear underlying the emotional trigger "seething," and what is the underlying unmet need?
Fear: political or advocacy aggression
Need: justice or acknowledgment
166
What are the five core emotional injuries?
Shame, impotence, abandonment, seething, and survival
167
Why do you need to have your emotional needs met/emotional wounds healed before working with a client in crisis?
Because you'll subconsciously expect the person in crisis to meet your needs - which they can't, because they're in crisis - and you'll react emotionally to their problematic behaviors.
168
What is the quickest way to stimulate the vagus nerve?
Cold - ice cubes, ice pack, etc (especially behind the neck)
169
Why is the vagus nerve so relevant for crisis intervention?
It is the largest nerve in the parasympathetic nervous system, so stimulating it calms people down.
170
What are 4 ways you can stimulate the vagus nerve?
Breathwork (box breathing, Huberman's double intake, etc)
Cold
Humming/singing
Gargling
171
What should you know about yawning in crisis de-escalation?
Yawning stimulates the vagus nerve. You shouldn't do it in front of clients for obvious reasons, but if they yawn, that's a good sign that they're de-escalating.
172
What's the problem with: "You're standing in the park without your clothes on. That's not allowed."
You're not following it up with what they COULD be doing. "You could be sitting down with me, wrapping a blanket around you, and telling me how I can help."
173
What is a more productive way you can phrase "You need to..." demands?
"How about we...?"
174
For what two diagnoses are closed-ended questions more effective than open-ended questions?
Schizophrenia (specifically with active hallucinations) and severe depression/SI
175
True or false: Stockholm Syndrome is protective for hostages when the hostage taker has ASPD.
False. Though the hostages may easily develop rapport with the subject because of his charisma, someone with ASPD is incapable of returning that authentic rapport.
176
What are the 5 phases of a CISD?
Introduction (purpose and process)
Facts about the event
Thoughts about the event
Feelings about the event
Education about potential future symptoms/reactions and coping strategies
177
What's the problem with statements like, "You can't urinate in the park."
It sets up a "me vs you" scenario. Instead, try blaming a third-party by saying something like, "Public urination is against the law."
178
What two types of deferrals can you use to tell someone they can't keep doing what they're doing?
Deferral to laws/rules/policies and deferral to universal ideals/values
179
In the EDGE approach, why do we use deferrals?
It provides a target the client can't be mad at (instead of blaming the neighbor who called 911 on them, for example) and it creates an "us vs third party" relationship.
180
True or false: "Everyone deserves to feel appreciated" and "Education is important for the future" are examples of deferrals to ideals/valies.
True.
181
According to the EDGE approach, how do you work with choices and consequences?
Start with positive choices: "How about we go outside and take a walk?"
(They don't want to.)
Insert consequence: "If you don't leave the building, law enforcement is going to have to physically remove you..."
Return to positive choices: "...but if you come outside and take a walk with me right now, we can discuss options for other places you can sleep for the night."
**This happens after Empathy and Deferrals.
182
What are two very soft ways you can introduce a Guiding in EDGE?
"How about you/we..." and "Would you be willing to..."
183
What do "but," "however," and "unfortunately" do in a conversation?
They negate the phrase that came before it. This can be good if you want to minimize the impact of what you said previously, but if you use it after an empathy statement, it will reduce the power of your empathy.
184
How do you use the threat of law enforcement as an EDGE consequence without villainizing law enforcement?
Say the person will be charged with XYZ crime or say that force will have to be used
185
How should active shooter incidents and their perpetrators be described in the media?
As "shooter incidents" and "attacker/assailant/offender," not as "active shooter" or "lone wolf" to avoid sensationalizing their actions. Additionally, extensive media coverage with their photos, names, and life stories should be avoided.
186
Are most mass shootings planned or unplanned?
Planned and targeted
187
What is the intimacy effect?
The concept that threats of violence are more strongly indicative of violence the closer the relationship is between the threatener and the threatenee.
188
True or false: all stalking behaviors, historical and current, should be considered as part of any threat assessment, regardless of whether the stalking has anything to do with the person of concern’s identified grievance.
True
189
What three things do you need to assess when considering past history of stalking behavior as it pertains to evaluating a current threat?
Recency, frequency, and severity
190
Are threatening Tweets in and of themselves statistically indicative of future physical violence?
No
191
If someone denies intent to harm others when confronted about their threats of violence, what do you need to be aware of?
Denial, rationalization, and minimization are ways for the perpetrator to get off the hook and/or manipulate the situation for their enjoyment.
192
What dates should you look at when conducting a threat assessment?
Any dates of note between the threatener and the threatenee - anniversaries, birthdates, breakup dates, etc
193
According to the BAU, what are the five motivators underpinning targeted violence?
Revenge for perceived grievance
Quest for justice
Desire for notoriety
Desire to solve an unbearable problem
Desire to kill or be killed
194
What do you need to be aware of if a formerly angry, depressed, or menacing person has a sudden emotional turnaround?
That they've decided violence is the acceptable or only means of resolving their problems and have now decided to do it
195
What are the 6 steps of the pathway to violence?
Grievance, ideation, research/planning, preparation, breach, and attack
196
True or false: mental illness is the driving force in most violent offenders?
False. Mental illness is PRESENT in most violent offenders, but that doesn't mean it's the driving force.
197
According to the Safe Schools Initiative, what percentage of targeted mass attackers exhibited a history of suicide attempts or SI?
78%
198
What is the danger of most clinicians' suicide and homicide risk assessments, as opposed to a true violence risk assessment?
Clinicians' risk assessments are subjective and dependent on the honesty and insight of the subject. Violence risk assessments take into account interviews with others, police reports, and psychological testing, too.
199
What are the 5 categories of violence risk factors?
Hx of violence
Mental health
Weapons
Problematic behaviors (stalking, non-compliance with boundaries, etc)
Poor social supports and interactions
200
What four psychotic symptoms increase the risk of violence?
Command hallucinations, persecutory delusions, hostility, and grandiosity
201
What are three examples someone might exhibit of a history of non-compliance with limits and boundaries?
Violating protection orders, trespassing, and non-compliance with rules at work
202
Define "breach" as it lies on the pathway to violence?
Circumvention of security measures, like testing security at the target location or conducting dry runs.
203
What three violence warning signs + two other signs are most indicative of imminence?
Energy burst behavior, end of life planning, and last resort behavior
Sudden cessation of substance use/medications (beyond clinical medication non-compliance)
Sudden withdrawal from life patterns and social interactions
204
What are 6 protective factors to evaluate when assessing violence risk?
Pursuit of appropriate conflict resolution methods
Sense of humor
Positive goals
Social supports
Healthy coping mechanisms
Access and receptiveness to assistance
205
What is a howler?
Someone who makes repeated threats of violence while also pursuing legal methods of conflict resolution
206
When do you need to take a howler's threats of violence seriously?
When they've exhausted all their legal methods of conflict resolution
207
What are three reasons opportunistic victims might be harmed during a targeted violence event?
Convenience/availability, visibility/"shock value," and because the desired target is unavailable
208
True or false: someone with schizophrenia is not capable of organized thought enough to plan and carry out a targeted violence attack.
False
209
What 8 intelligence pieces should be gathered to perform a threat assessment?
Law enforcement history
Education history
Employment history, including military records
Medical/mental health history, including substance use and abuse
Life and relationship history, including hobbies and membership in groups
Financial history
Personal electronic devices
Weapons history
210
What is the risk of removing a potential violent offender from school or work?
Their behaviors are now shielded from oversight and may escalate into actual violence without anyone knowing or being able to stop it.
211
What are the five steps to appropriate threat management?
Watch, make contact, offer resources, set boundaries, and enforce consequences
(Consequences range all the way from a write-up at work to jail time)
212
True or false: addressing the potential violent offender's grievance (such as by waiving fees if that's what he's pissed about) is not a good idea because it indulges him and enables his behavior.
False. It can be an effective threat management technique to reduce tensions and therefore violence.
213
What two threat management techniques can be effective to address the SITUATION aspect of the potential violent event?
Dual-phase termination/expulsion
Addressing or remedying the grievance
214
What two threat management techniques can be effective to address the SETTING aspect of the potential violent event?
Organizational culture modifications
Target hardening
215
What are common negative reactions from targets of potential violent events?
Impatience with and/or nonadherence to the threat management process
216
True or false: zero tolerance policies are effective at encouraging reporting of bad behavior and at reducing bad behavior.
False. Zero tolerance policies do not increase reporting for fear of retaliation, and they often aggravate the offender or remove optics/intervention opportunities.
217
True or false: threat managers should be mindful at all times about inadvertently creating an additional grievance or becoming a person of concern’s “last straw.”
True
218
True or false: Tarasoff duties can become a tool to persuade mental health providers to offer critical feedback during high-risk cases when the person of concern is in treatment.
True
219
What are the five levels of concern according to FBI threat assessment?
Low, moderate, elevated, high, and imminent
220
What are the three main types of suicide-by-cop scenarios?
Direct confrontation, disturbed intervention, and criminal intervention
221
What is a direct confrontation SBC scenario?
When suicidal subjects initiate attacks on police to prompt police to kill them
222
What is a disturbed intervention SBC scenario?
When suicidal subjects take advantage of police intervention to try and force police to kill them
223
What is a criminal intervention SBC scenario?
When subjects facing arrest prefer death to incarceration and prompt police to kill them
224
Are criminal intervention SBCs more likely to occur with subjects facing arrest for minor or major crimes, and what does that mean about the subject's priorities?
Equal distribution, which means they care more about going to jail period (shame, aversion to arrest, etc) than how LONG they'll be in jail for
225
Which of the three types of SBC is most common?
Disturbed intervention
226
If you have a subject who is exhibiting inconsistent escape behavior, what should you be worried about?
Suicide by cop
227
If your subject has killed someone already, how should you advise the media to focus their messaging, and why?
On anything BUT the murder (for example, it could be on the recovery of someone who was shot but not killed), because it will insert a hostile perspective into the negotiation and potentially convince the subject that he has no other way out besides more violence.
228
If a subject uses "they and I" to describe him and his hostages instead of "we," what does that indicate?
Depersonalization, lack of empathy, and potentially increased risk of violence towards the hostages
229
What does a subject's rigid adherence to an unrealistic demand (or one that has already been denied) say about his cognitive state, and how does it affect negotiations?
It says he is unable to look at things objectively or from another perspective than his own, which makes negotiations harder.
230
What is a violent promise keeper, and what are their actions often mistaken for?
Someone who makes a promise of violence if XYZ happens again, and then follows through on that violence when XYZ happens. Their actions are often mistaken for impulsivity.
231
If mutual empathy begins to develop between a hostage and a subject when the subject is someone who has no personal relationships in their daily life, what worry should you be considering?
That the hostage will become so important to the subject that they refuse to give them up
232
What three things does the tactical team need to consider when enacting a rescue for hostages who have developed Stockholm Syndrome?
The hostages may not want to leave the subject, may interfere with the arrest, and may obey commands from the subject.
233
True or false: all elements of your threat assessment should be shared with the negotiators and tactical elements, regardless of whether the threat assessment results are actionable or not.
False. Communication of threat assessment results should always have an actionable strategy attached to them.
234
What is one challenge with intel gathering during threat assessment in a crisis setting?
Accuracy of intel is less because everything is moving so rapidly
235
How do you get clients to stop the cycle of emotional trigger to massive violent/emotional outburst?
Get them to recognize the pause between the moment of the trigger and the moment of reaction - start with labeling/recognizing it, then identify what leads up to it (responses and scenarios).
236
What two themes are used in theme-based communication?
Communication themes and resolution themes
237
When are communication themes used?
After rapport is built
238
When are resolution themes built?
After influence is built
239
What are the two questions you always want to ask yourself when approaching someone in crisis?
Why here? Why now?
240
What is the formula for creating a communication theme?
Motivation + values, needs, hopes, and fears + context = theme
241
In regards to the communication themes formula, what is context?
An individual's personal history and its influence on their current behavior
242
When there is no clear motivation for someone's crisis, what should the negotiator focus on?
Triggering events
This is likely going to be the case in a "last straw" scenario or when someone snaps out of the blue
243
True or false: with empathy-impaired individuals, guilt-based strategies (such as asking the subject how they think their behavior affects hostages, neighbors, or LE) are likely to fail.
True
244
What does it mean to ask tac to be your eyes during a negotiation?
Tac can provide feedback on the subject’s body language as you’re implementing a theme.
245
What are the five most common barriers to resolution?
Crisis brain
Lack of trust they won’t get pummeled by LE
Fear consequences (jail, hospital, etc)
Fear of the unknown
Fear of losing face (especially as it goes on and they’ve dug their heels in, double-especially in correctional settings)
246
It’s better to ask the subject to come up with a resolution than to suggest one. With that in mind, how would you reframe: “How about you come out the back door so you feel safer?”
How would you feel safe coming out?
247
What are the three types of resolution themes?
Rationalizing, projecting, and minimizing
248
True or false: using RPM resolution themes does not justify their behavior, but it provides a way to save face during the surrender.
True
249
What is one rationalization that can address the fear of consequences?
“Anyone who hears your side of the story is going to see that your reaction was understandable given the situation.” (Implies that a DA or judge would see their actions as rational and factor that into the sentencing decision)
250
What is one way to use rationalization to minimize the fear of losing face?
Focus on how the standoff and/or the negotiated resolution has improved their situation, such as generating attention for an important issue.
251
True or false: when you use projections, always think about who you’re projecting ONTO to think about how to craft your projections.
True
252
Is it better to project onto someTHING or someONE, and why?
SomeTHING, because there’s less of a risk of targeted violence against a thing than a person
253
What are the two risks with using minimization in a negotiation?
1: not knowing the full extent of what the subject did and minimizing that they ONLY did XYZ when in fact they did something more can heighten their fear of consequences
2: being too optimistic in your minimization with someone who knows the system and knows you’re full of shit
254
What is one way to use a minimization to say that there are a lot of chances for them to beat the criminal system between now and arrest?
“There are a lot of steps between you coming out and any sort of jail sentence.”
255
Is it better to say “this isn’t something you planned” or “you didn’t plan this?”
“This isn’t something you planned,” because it characterizes their actions as a mistake and implies weakened culpability.
256
What is contributory risk?
The risk we bring to the scenario – training, skill, equipment, personnel, etc
257
When someone makes a demand, what is the one question you always want to ask yourself?
What is the need underneath that demand?
258
True or false: there’s a fine line between humanizing the hostage and overbuilding the value of the hostage?
True
259
What is the risk of asking hostages to do things on behalf of LE, like unlock the back door?
You don’t know what they’ll do – will they comply, tell the subject, etc?
260
What two things should you always tell a hostage if you get on the phone with them, and why?
Tell them LE is doing everything they can to make sure everyone will be okay and encourage them to remain as calm and compliant as possible.
This promotes behavior that is likely to save their lives, and it can also increase their confidence in LE.
261
What are two ways that you can build empathy for the hostages in the eyes of the subject?
Personalize the hostages by using names and sharing certain details of their lives and get the subject to meet the hostages’ needs (food, bathroom breaks, meds, etc).
“Hey, can you let Sarah know that her husband picked the kids up from school, just so she doesn’t worry too much?” This is an example that could humanize Sarah, especially if we know the subject is a parent or cares about good parenting
262
On what percentage of calls will you actually use a TPI recording?
10%
263
What are two reasons – one good, one bad – that a subject may request to speak to a specific person?
To gain their reassurance, guidance, or encouragement (good) or to deliver a final message before killing themselves (bad)
264
What are four risks of using a TPI?
Nuances in the conversation are lost, the bond between the subject and negotiator can be broken, verbal containment can be lost, and the TPI may unknowingly surrender valuable information
265
What are four benefits to using a TPI?
Deliver LE’s message from a credible source, reality check that the subject does need to come out, interrupt a dangerous cycle/rut, talk through a deadline
266
True or false: you don’t want to ask the subject what they think of a potential TPI because it could tip them off to your plan.
False. Always ask them because they may hate the TPI and therefore using the TPI would have made everything worse.
267
True or false: weave communication themes into the TPI message.
True
268
Why do you want to get the TPI on your side before you let them talk to the subject?
If you don’t use them as a TPI and they call the subject directly or go rogue during the call with the subject, you want them to say good things about LE to the subject.
269
What are the three pieces of a TPI recording script?
Introduction using common names between the TPI and the subject, using ALS/communication themes, instruction of what LE wants them to do
270
What should ideally follow a TPI message?
The subject’s surrender
271
True or false: always review the TPI recording before playing it for the subject
True
272
Should friends or family members be interpreters, and why?
No, because they’ll insert their own commentary and questions.
273
Why do you want to have two independent interpreters (ie. One in person and the language line listening in)?
To make sure that the first interpreter is actually doing their job correctly
274
If you only have one Spanish-speaking (for example) negotiator on the team, what role should they be in?
Interpreter, not primary, so everyone can hear and understand the conversation
275
What two things can interpreters provide beyond literal interpretation?
Cultural context (ie. This culture doesn’t speak to women) and notes on slang (ie. This word translated into this language is really offensive)
276
What two responses will a subject have if they don’t feel like they’re being listened to?
Shut down or re-escalate/retaliate
277
What’s a question you can ask to get someone to come to their own conclusion that releasing a hostage is a good idea?
“How do you think releasing someone will affect your situation?”
278
When someone indicates the need to speak to someone, what two questions can you follow up with?
“What would that person say to you?” and “What would you say to them?”
279
What are contradictions in what the subject says indicative of?
Them lying or hiding something
280
If a subject starts making less and less contradictions over the course of a negotiation, what is that indicative of?
Progress in the negotiation
281
What might asking repeatedly about others in the crisis site indicate to the subject?
That the negotiator cares more about the hostages than they do about the subject
282
What is an example of offering a positive alternative in response to a demand you have to say no to?
“Command will not allow beer to be sent in there. How about a glass of sweet tea instead since you said you’re thirsty?”
283
What is an example of substituting a yes for a no in response to a demand you have to say no to?
“You can absolutely talk to your son as soon as you come out.”
“You can talk to her. The sooner we resolve this, the sooner you can talk to her.”
“Absolutely. You can talk to her. As a matter of fact, she’ll meet us at my office as soon as we’re done here.”
284
What is an example of explaining the problem in response to a demand you have to say no to?
“We have a strict policy that prevents us from doing that.”
“I’ve never seen something like this approved before.”
285
What is an example of providing information/updates in response to a request for an update on a demand?
“We are getting you some iced tea from XYZ restaurant right now.”
“Laurie is not answering her phone for us, so we are sending officers to her house.”
286
What are bunches of five?
Bunches of five responses that should be prepared in advance to respond to commonly asked questions
287
What are two predictable questions/objections subjects ask at the beginning of the negotiation?
“Go away!”
“You’re only here because it’s your job.”
288
What are two predictable questions subjects ask in the middle of a negotiation?
“I want to talk to XYZ.”
“Where is the _____ I asked for?”
289
When someone starts to ask questions about whether the person they shot is okay, how many police are out there, and whether it’s on the news, what does that indicate about their psychological state?
They’re starting to reach equilibrium and asking questions about the reality of their situation.
290
When someone starts to ask questions about whether they’re going to jail, whether tac will hurt them when they come out, and whether the negotiator will be keeping their word, what does that indicate about their psychological status?
They’re considering surrendering.
291
What three things do you want to ask tac for at the beginning of every negotiation?
Release plans, resolution plans, and delivery plans
292
If you do too much or too little action as LE, what might that cause in the mind of the subject?
Too little action causes overconfidence, too much action can cause an aggressive reaction
293
What is the one scenario in which a crisis should not be negotiated?
Active shooter incident
294
What happens if there are multiple subjects and we don’t like the one who’s in charge?
Try and promote a different subject to leader or cause infighting
295
True or false: describing in detail the effects of chemical agents to the subject is an effective means of causing them to make good decisions to avoid getting gassed.
Yes – sometimes it works.
296
At what time point in a negotiation does the risk of SBC decrease?
1 hour
297
What might a question of “What happens if I don’t put the knives down?” indicate?
SBC
298
What might a combination of aggression and SI indicate?
SBC
299
What percentage of SBC incidents occurred within the first 30 minutes of the interaction?
66%
300
Why is having a strong outer perimeter especially important on SBC incidents?
Because incidental third parties can easily become victims in an attempt to promote police action
301
What are three risks of high-profile containment in an SBC incident?
Amps them up, gives them an audience for their death, and hastens their suicide (“Look at all those guns, I can really do this!”)
302
How can you combat someone’s belief that SBC is a surefire way to die?
Point out that only 59% of people die in an SBC attempt, and maybe go into details about how some people get severely injured, paralyzed, have to undergo lots of surgeries, etc – make it seem like a painful, bad way to live afterwards
303
How do you combat someone’s belief that SBC is a way to get their message out there?
“Let’s find another way to get your message out.”
304
How do you combat someone’s belief that SBC is a way to die without sin (ie. A religious belief that suicide is a sin)?
Describe in detail the ways that SBC will negatively impact the officer and his family
305
Should you use suicide risk assessment/safety planning or RPMs with an SBC subject?
RPMs
306
What is Dallas SWAT’s tie-off strategy during high-element negotiations?
They tie themselves off intentionally short of being able to reach the subject, then they’ll tell them to be really careful not to move or wiggle because LE can’t reach them if they start to slip. Then the negotiator will make a comment about how hot and thirsty they are, take a swig of water, and make a comment about how they’ll give them water if they come closer.
307
If a subject in a high-element scenario moves away from you, should you move closer to them?
No. That’s a sign you were already too close for their comfort.
308
What are other reasons someone might be in a high-element scenario besides jumping?
They work there, trespassing daredevils, mania/psychosis, etc
309
What are three reasons to stop traffic during a high-element negotiation?
Officer safety (getting hit by cars), noise (ease of communication), passerbys taking pictures or encouraging them to jump
310
How can you visually support someone’s decision to go to the hospital in a high-element or face-to-face negotiation?
Back the cop cars up, put the ambulance in the subject’s line of sight, and open the back doors
311
What are two directional visual considerations during a high-element or face-to-face negotiation?
Position yourself as the negotiator in a place where the person would have to turn away from the ledge to speak with you, and make sure the subject is only looking at you instead of the 30-40 first responders who showed up.
312
What are two challenges of talking down a jumper in a correctional setting?
You train other inmates how to get what they want when you fulfill demands for a suicidal subject, and the person might be harder to talk down because they’ll be losing face in front of other inmates.
313
As the secondary in a face-to-face scenario, should you make eye contact with the subject?
No, because you might draw the subject’s attention away from the primary.
314
How can you gather intel on a jumper since you can’t run the call address?
Look for nearby parked cars with the keys and wallet nicely laid out or with a suicide note.
315
What’s a resolution challenge when it comes to jumpers in bad weather?
They may be too physically stiff to move and may need assistance getting down.
316
What do you need to tell dispatch when you have a jumper?
To be aware of people calling in and saying they know the person so we can have someone interview those RPs
317
True or false: it is never acceptable to have a lone negotiator in a face-to-face scenario.
False. Sometimes it’s necessary due to subject insistence or space constraints.
318
True or false: tell patrol to always ask why people are there when they show up on scene.
True. Sometimes family or friends with valuable intel might show up at the outer perimeter.
319
What is the core problem that Motivational Interviewing addresses and works with?
Ambivalence
320
What is ambivalence when it comes to suicidal ideation?
A simultaneous consideration of their reasons and desire to live and their reasons and desire to die
321
What percentage of highly suicidal people experienced ambivalence around their suicidal intent?
94.5%
322
What is the problem with standard suicide risk assessments from an MI perspective?
They only focus on the negative - the method, the plan, etc - not the positive - the reasons to live, protective factors, etc.
323
What is the righting reflex, and is it good or bad?
The righting reflex is the desire to fix things for the person in front of you. It is not helpful because it brings up their natural human tendency to resist persuasion.
324
Does MI change talk replace reflection and other active listening skills?
Nope. Start with standard reflection, then end with/add on change talk.
325
What are the four elements of MI?
Partnership, acceptance, compassion, and evocation
326
What is evocation in the context of MI?
Eliciting, rather then telling or installing, change talk from within the client
327
When and how do you reflect change talk when using MI in suicide prevention?
When you sense a bit of ambivalence in what they say, reflect that ambivalence:
"Sometimes it feels like it's never going to get better."
"Sometimes it feels like you're stuck in a bad place, and then sometimes there are times where you don't feel like that - when life feels better and you enjoy life."
NOTE: If they did not say "sometimes," just reflect the hopelessness. The "sometimes" is a sign of ambivalence.
328
What are two questions you can ask to evoke change talk if the client is not showing any signs of ambivalence?
In the context of SI:
When in the past have you felt a desire to life?
Before you started experiencing suicidal thoughts, when did you feel like you wanted to live?
329
What food can be used as an immediate intervention to decrease anxiety?
Super sour candy
330
What food can be used as an immediate intervention to decrease anger?
Tough, chewy candy
331
What is the mammalian dive reflex, and how can it be used in crisis intervention?
The mammalian dive reflex triggers decreased HR/resp rates when our faces and necks are submerged in water so that our bodies calm down and don't use up too much resources when we're underwater without oxygen.
Submerging our faces in cold water can trigger the same biological response when we're anxious or activated.
332
What food can be used as an immediate intervention for alcohol cravings?
Hot sauce (the capsaicin mimics the burn of alcohol going down your throat)
333
What is one verbal activity you can use as an immediate crisis intervention to break someone out of anxiety/panic?
Visualize and describe in detail a super mundane task (like making a peanut butter and jelly sandwich)
334
Is breathing through the nose or mouth better at for emotional regulation?
Nose
335
Which breathwork pattern is best for increasing mental performance?
Box breathing
336
Which breathwork pattern is best for decreasing anxiety
4-7-8 (in for 4, hold for 7, out for 8)
337
What should you do within 2 hours of a traumatic event do interrupt the neural pathways that lead to PTSD?
Play a game (card game, board game, video game, etc) for 15min
338
Is it best to take a hot or a cold shower before bed, and why?
Hot, because the cooling down of your body causes your brain to produce melatonin
339
True or false: getting sunlight in your eyes after waking up resets your circadian rhythm and leads to better sleep that night.
True
340
What is a strategy you can use to fall asleep at night if you can't turn your brain off?
Seed word chains: pick a word, then list every word you can think of that starts with each letter of that seed word. Once you get to the last word under the last letter, that last word becomes your new seed word, and you start the process over again.
341
What are two advantages to negotiating in a corrections environment versus out in the community?
Immediate intelligence and a history of trust and rapport
342
True or false: inmates are practiced manipulators and are good at the detection of manipulation.
True
343
Is video surveillance inside a prison an advantage or disadvantage from a negotiation perspective?
Both - can give you insight, but if subjects get control of a unit, they now have eyes everywhere and can see your tactical movements.
344
Why do corrections personnel make bad hostages?
They are used to being in control and make poor choices when trying to get it back.
345
When negotiating in a corrections environment with someone in a gang, will you likely be speaking to the leader of the gang? Why or why not?
No. Gangs will nominate a spokesperson instead of the actual shot caller so if someone gets in trouble and goes to solitary, it's not the actual shot caller.
346
What is an STG in a corrections setting?
Security threat group, AKA a gang
347
What is the Group Violence Reduction Strategy (GVRS) in a corrections setting?
A policy that was implemented where all known associates of an inmate who commits a violent crime get punished, even if they weren't directly involved in the violent crime
348
What unit do you need to call to get access to STG data and affiliations if you're negotiating at a DOC facility or with someone who's ex-DOC?
Internal investigations unit (IIU)
349
How do you access the internal investigations unit (IIU) for DOC-related intelligence?
Any DOC staff can call IIU for you
350
In a corrections setting, is prison staff safety or preventing escape held at a higher priority?
Preventing escape. If a staff member is held at knifepoint and lets an inmate escape, they are criminally liable for the escape and any crimes the inmate commits post-escape.
351
Are inmates generally ready to make demands right away when a negotiation begins? If not, what do they want to do instead and why?
No. They're usually more interested in expressing anger/frustration because they're surprised they even made it that far.
352
If an inmate's demands are stable over time and there is minimal property damage, what does that mean about the demands, and what does that mean about the trajectory of the negotiation?
It means the demands are for all inmates, and it means the subject is willing to go further because he has the tailwinds of a righteous cause.
353
If an inmate's demands change, relate to personal/emotional issues, and there is significant property damage, what does that mean about the demands?
They are usually self-serving.
354
What is the most common cause of prison violence?
Improved living conditions (food, visiting time, etc)
355
What are three examples of expressive demands in a corrections setting?
Getting reporters on site, release, and getting records expunged
356
Are most prison riots expressive or instrumental in their demands?
They start expressive and turn instrumental once emotions have been spent.
357
If your inmate subject is calm and collected, what type of demands will they likely have?
Instrumental
358
If an inmate subject's demands are things like food, water, cigarettes, etc, what should you be thinking?
They're stocking up for the long haul, so prepare for negotiator relief early on.
359
True or false: if an inmate is in your unit and you know them, you should be primary because of a history of rapport.
False, as sometimes their grievance is with you.
360
Does giving commands in a corrections negotiation work well? Why or why not?
Usually not. Inmates feel like they've lost their control with incarceration, so stripping away their control during a negotiation can erode rapport.
361
Is loss of inmate leadership during a negotiation a good or bad thing?
Depends. It can either solve the problem because inmates give up without a clear leader, or it can escalate chaos in a power vacuum.
362
What is a way that negotiators can reinforce the inmate leader's status in the eyes of their peers early in the negotiation, assuming the leader is one the negotiators like?
Make early, minor concessions.
"Wow, Bob got us this! He must really know what he's doing as a leader!"
363
What two characteristics should you look for in an inmate that you're trying to position as the inmate leader during a riot?
A positive relationship with the inmates and a propensity to be reasonable
364
What is important to know about lying during a corrections negotiation?
Lying is a form of disrespect, and respect is currency in a corrections setting.
365
Is "punk" an okay word to use in a corrections setting?
No. It's a huge insult and will get you assaulted.
366
If the inmate only speaks broken English, should you procure a translator? Why or why not?
No, because the mental effort it takes for the inmate to speak their second language forces them to calm down and slow down.
367
What percentage of corrections suicides occur within the first 12 hours after incarceration?
50%
368
What ages of inmates are at highest risk for suicide?
Ages 17-29, especially those that are housed in the adult facility
369
What is the most common suicide attempt method in a corrections environment?
Cutting of wrists
370
What is the most common suicide method in a corrections environment?
Hanging
371
What are four reasons suicide risk is increased in a corrections setting?
Lack of control, dehumanization, social isolation, and shame
372
What is recall in a corrections setting?
Putting all inmates back in their cells and doing a census of every inmate and staff member
373
Why is it a bad idea to bargain with inmates during a negotiation?
They're not actually agreeing to what you think they are.
For example, if you tell them to tuck in their shirt, that implies the whole shirt, but they'll tuck in a corner and claim they complied.
374
What three things should you ask IIU for if you have a DOC-related negotiation?
Phone calls, comments on motivation*, and a profile breakdown**
* - comments on motivation are tracked in OMNI every time they see a social worker and can tell you what their goals/values are.
** - this gives you EVERYTHING about a person
375
How do you find out if someone has an out-of-state DOC history?
Conduct an NCIC search
376
What are two reasons closed questions are useful when someone is in an acute crisis?
Allows people to feel confident in simple answers and brings arousal states down
377
What are two other communication styles besides words you can use in a crisis?
Writing and body language
378
If you're looking to determine how ready to make change someone is, what's a question you can ask?
"Where should we go from here?"
379
What are two questions to ask to invoke Partnership in motivational interviewing?
What have you tried thus far?
I have an idea; would you like to hear it?
380
The four stages of motivational interviewing are Engaging, Focusing, Evoking, and Planning. What are the question types that correspond with each stage?
Engage: Permission ("Can we?")
Focus: WHAT is the goal? WHERE are we going?
Evoke: WHY would you go there?
Planning: HOW will you get there?
381
Which stage of motivational intervinewing includes change talk?
Evoking
382
How do you move someone from precontemplation to contemplation in the transtheoretical stages of change?
Active listening (Engaging if you're in MI)
383
Where in the transtheoretical stages of change does MI end?
Preparation (the Planning stage of MI)
384
What is the focus of the Planning stage of MI for most crisis settings?
Safety planning
385
What are some key "Change Talk" words to pick up on from a client?
I want, I would, I wish, and I hope
386
True or false: a client complaining about everything and refusing to want to live indicates ambivalence?
True, because they're still talking to me.
387
What are the four types of preparatory change talk (DARN)?
Desire, ability, reason, and need
388
What are the three types of mobilizing change talk (CAT)?
Commitment, activation, taking steps
389
True or false: Calling around to detox facilities to see which one they like is a type of Taking Steps (mobilizing change talk)?
True - it's essentially shaping with dog training
390
What are the two types of scaling questions in motivational interviewing?
How important is it to you?
How confident are you that you can do it?
391
If someone says a low number in response to a confidence scaling question, what should you do?
Offer skill-building solutions
392
If you get a lot of "I don't know" responses from people when you ask them questions, what should you do?
Stop asking questions and go back to reflection.
393
What are your two follow-up questions to a scaling question?
Wow, why didn't you say a lower number?
What would it take to get you to a higher number?
394
Why do affirmations in motivational interviewing work?
You're highlighting and reflecting their strengths, which builds confidence, which builds motivation.
395
What is the Ask-Offer-Ask concept in motivational interviewing?
Ask someone's permission to share an idea you have, offer the idea, then ask how it landed.
396
TO REVIEW: Four great questions to evoke change talk
What concerns you about your situation?
What is the best thing that could happen if you made a change?
What is the first step you can take to make that change?
What is the one thing right now you could do to move toward that goal?
397
True or false: evaluating pros and cons of making a change with clients is productive.
Research on it is mixed. It should only be introduced during the planning stage.
398
What does it mean to continue the paragraph as a reflection?
Continuing the person's sentence with something completely yet unsaid.
"I got home from school after a bad day and my mom took away all my toys."
"And that made you feel angry."
399
What is a double-sided reflection?
Where you reflect both sides of the conflict/ambivalence: "On one hand, __________. On the other hand, ____________."
400
What might happen if you understate the level of someone's emotions?
They might divulge more.
401
When using a double-sided reflection, should you use "and" or "but?"
And
402
When using a double-sided reflection, should your reflection of their desire to change come first or last?
Last
403
If you overstate the level of someone's emotions, what might that invoke?
They might back down from that position.
404
How can a summary statement be used strategically in motivational interviewing?
To move from engaging to focusing
"You've told me all these struggles and things you want to change. What might you want to do first?"
