Behavior Management

Dawn Farm has a long history of working with some of our most troubled community members at some of the worst moments of their lives. We are often asked how we manage aggressive behavior. Our response is that we rarely experience aggressive behavior and we believe the reason for this is our culture.

Dawn Farm loves addicts and alcoholics. As such, we treat them with compassion, respect and hope rather than the contempt and pessimism that they are accustomed to from professional helpers. We expect them to be recover and do well in treatment, and most of them rise to these expectations.

The strategies to communicate this positive regard include, but are not limited to:

• Affirming the client's autonomy
• Asking questions about what they want and listening intently
• Using open-ended questions
• Checking understandings
• Offering options within and outside of the Dawn Farm continuum
• Acknowledging that, though we have knowledge and experience indicating that one course or array of behaviors may be associated with a better prognosis than others, we are unable to predict the future
• When frustration occurs, reflections such as, "There's something important that I'm not understanding"
• Offering to discuss matters in setting that offer more privacy
• Explicitly expressing unconditional commitment to their recovery

POLICY

All clients are informed at intake that any violent or threatening behavior is grounds for immediate discharge. In addition, a client with a history of violence may be asked to sign a behavior contract. This is similar to a suicide contract and simply formalizes our concerns, suggests helpful behaviors and makes clear the consequences for such behavior.

Any client who is clearly violent or threatening must be discharged. The exact manner in which this is handled will vary with the exact circumstances.

Dawn Farm does not use seclusion or restraint as a means of dealing with these behaviors.

PROCEDURE

For threatening behavior or violence that has de-escalated:

1. It is always preferable to avoid a direct confrontation with a potentially violent client. Avoid being alone with the client. A group of staff is preferable to one; a large group of clients is safer than a small one. Speak calmly to the client, trying to further de-escalate the situation. Do not insist on winning the argument or convincing the client that they are wrong.
2. If the staff member(s) feel safe and comfortable, they may proceed with the discharge, preferably in a group setting. If there is only one staff person on duty they can decide, in consultation with a supervisor, to postpone the discharge until there are more staff members present.
3. If, for any reason, the staff member(s) are fearful, they may call a supervisor, who will help decide how to proceed, often calling in another staff member for support or coming in themselves.
4. If behavior escalates or if the client refuses to leave, the first priority is to protect the other client's and your well-being, not to ensure the discharge. Attempt to remove other clients and yourself from the violent client's vicinity (even if it means that all of you are locked in an office). Never hesitate to call 911.

For violent behavior that is escalating or may escalate:

1. If behavior escalates or if the client refuses to leave, the first priority is to protect the other client's and your well-being, not to ensure the discharge. Attempt to remove other clients and yourself from the violent client's vicinity (even if it means that all of you are locked in an office). Never hesitate to call 911.

PROCEDURES SPECIFIC TO RESIDENTIAL TREATMENT

A Focus Day may be issued in some cases as an alternative to a program dismissal. The following examples would warrant a Focus Day: plans changed without staff approval, phone abuse, refusal to do work tasks, noncompliance with house rules, noncompliance with treatment plan.

There are two forms of Focus Days.

a. Personal Focus Day – loss of privileges and/or added work tasks during normal free time if an individual is not behaving appropriately.

b. Group Focus Day – loss of privileges and/or added work tasks during normal free time if the group, as a whole, is not behaving appropriately.

Focus Days are of varied lengths. All Focus Days are evaluated weekly in team meetings. The resident is always informed of the reasons why s/he is given a Focus Day and what is required to have the Focus Day lifted.