T3C CRISIS RESPONSE TRAINING CURRICULUM

Refuge House Foster Family Homes

Version: 1.0
Effective Date: September 2025
Review Date: Annual

CURRICULUM OVERVIEW

Training Structure

This modular curriculum provides crisis response training aligned with Trust-Based Relational Intervention (TBRI®) principles and T3C Blueprint requirements. Foster families complete the Basic Crisis Response Training (60 minutes) for T3C Basic Foster Family Home Support Services credential. Additional enhancement modules are completed only when pursuing Mental & Behavioral Health or IDD/Autism package credentials.

Delivery Method

Hybrid asynchronous format:

Self-paced video modules with embedded knowledge checks
Third-party video resources from TBRI® and crisis intervention experts
Interactive scenarios and decision-making exercises
Downloadable reference materials and quick guides
Competency assessment at completion

Training Philosophy

All crisis response training integrates TBRI® principles while implementing Satori Alternatives to Managing Aggression (SAMA) as the authorized emergency behavior management program. This curriculum emphasizes prevention, de-escalation through the Assisting Process, and maintaining therapeutic relationships even during crisis situations. Physical restraint is always a last resort used only to prevent imminent harm.

MODULE 1: BASIC CRISIS RESPONSE TRAINING

Required for: All T3C Basic Foster Family Home Support Services
Duration: 60 minutes
Format: 5 video segments + scenarios + assessment

Learning Objectives

By completion, foster parents will be able to:

Recognize early warning signs of crisis escalation
Apply TBRI-informed de-escalation techniques
Ensure safety during behavioral crises
Use emergency behavior intervention appropriately per TAC §749.901
Document crisis incidents accurately
Access 24/7 crisis support from Refuge House

Segment 1: Understanding Crisis in Foster Care (10 minutes)

Video Content:

What constitutes a crisis in foster care settings
Trauma responses vs. behavioral choices
The neuroscience of dysregulation (survival brain)
How trauma history affects crisis behavior
Recognizing your own stress responses

Key Concepts:

Crisis behaviors are typically trauma-based fear responses
Children in "survival brain" cannot access reasoning skills
Caregiver regulation enables child co-regulation
Prevention through TBRI® principles reduces crisis frequency

Knowledge Check:

Scenario-based questions identifying crisis vs. challenging behavior
Self-reflection on personal triggers and stress responses

Segment 2: TBRI®-Based Crisis Prevention (12 minutes)

Video Content:

Daily connection strategies that build felt safety
Empowering principles that reduce power struggles
Recognizing early warning signs of dysregulation
Environmental modifications that prevent escalation
Routine and structure as crisis prevention

Practical Strategies:

Connecting Principles Applied:
- Regular check-ins throughout the day
- Engagement activities before demands
- Attunement to child's emotional state
- Eye contact and voice tone awareness
Empowering Principles Applied:
- Meeting physiological needs (hunger, thirst, rest, sensory)
- Offering appropriate choices
- Providing advance warnings for transitions
- Teaching coping skills during calm times

Practice Activity:

Review sample daily schedule and identify prevention strategies
Create personal "early warning signs" checklist for children in your home

Segment 3: De-escalation Techniques (15 minutes)

Video Content (includes third-party crisis de-escalation video):

The de-escalation continuum: early to late intervention
Verbal de-escalation strategies
Environmental modifications during escalation
Co-regulation techniques
When and how to give space safely

Refuge House procedure for responding to crisis situations:

If a child is unwilling to speak to the foster parent, the alternate parent (if available) will attempt to engage the child in a verbal dialogue.
If the child is unwilling to speak to either parent, the foster parent will contact the RH Case Manager or On-Call worker (if after regular business hours) in an effort to allow the child to speak with a third party who may be able to offer a more objective point of view.
If the child refuses to speak with the RH Case Manager, and continues to escalate to the point that a foster parent believes he/she is becoming a danger to him/herself, families are instructed to contact their local police department for assistance.
If, however, a child is in such an escalated state he/she is presenting an imminent risk of harm to him/herself or others, the foster parent may use one of two safe SAMA physical containments (Hug Containment or Elbow to Hip Containment) to manage a child's aggressive behavior until the child is calm and all others in the way of harm have been able to find a safe area such as another room in the home.

The effective use of protective maneuvers if a child becomes aggressive:

Avoidant Techniques Policy:

Do no harm
Do not use pressure points or counter-aggression
Utilize avoidant techniques to create safe distance between self and child and to allow opportunity for verbal de-escalation

Protective Actions:

Protection from a distance
Avoiding strikes, kicks, and pushes
Protection from wrist grasps
Protection from life-threatening aggression

Segment 4: Emergency Behavior Intervention (15 minutes)

Video Content:

TAC §749.901 requirements and limitations
When physical intervention is necessary (imminent danger only)
Approved SAMA restraint techniques for Refuge House
Individual Crisis Management Plans (ICMP)
Prohibited restraint and discipline methods
Medical monitoring requirements during and after restraint

Understanding Your Child's ICMP: Each child has an Individual Crisis Management Plan that:

Identifies history of high-risk behaviors and triggers
Documents effectiveness of previous interventions
Lists psychological, social, and medical factors affecting crisis response
Specifies helpful de-escalation strategies
Identifies interventions that may NOT work due to trauma history
Is signed by foster parent, managing conservator, and case manager

Approved Emergency Interventions:

1. Short Personal Restraint (not longer than one minute):

Authorized use ONLY for:
- Protecting child from external danger causing imminent significant risk (e.g., running into street, touching hot stove)
- Must end immediately after danger is averted
- Intervening when child over 5 years old demonstrates disruptive behavior creating safety risk when other measures have failed
Duration: Maximum one (1) minute only
Release criteria: Must end immediately once danger is averted or one minute passes
Documentation: Required for all instances

2. Personal Restraint (Hug Containment or Elbow-to-Hip Containment):

Authorized use ONLY when:
- Child actively engaged in imminent harm to self, others, or significant property
- Used only as absolute last resort after all less restrictive interventions exhausted
- Child's service plan may specify this intervention is approved for protection
Maximum duration: 15 minutes for all children
Monitoring requirements:
- Continuous visual monitoring of child's face throughout restraint
- Monitor mental status, breathing, respiration continuously
- Ensure child can communicate throughout (verbal children must be able to speak; non-verbal children must have alternative communication method)
- Re-explain release criteria every 15 minutes if child doesn't understand
Release criteria:
- Child no longer poses danger to self or others
- Any signs of physical distress require immediate release and emergency medical care
- Maximum 15 minutes reached
Nutritional/hydration needs: Child must have opportunity to use bathroom when necessary, safe, and appropriate

PROHIBITED Use of Any Personal Restraints:

As punishment
For retribution or retaliation
As a means to get the child to comply
As a convenience for caregivers
As a substitute for effective treatment or habilitation
To demonstrate authority over the child
If another less restrictive alternative is available

PROHIBITED Restraint Methods:

Prone or supine restraints (on stomach or back)
Non-SAMA restraint techniques
Mechanical restraints (handcuffs, zip ties, etc.)
Chemical restraints (medication for behavior management)
Seclusion or isolation in locked rooms
Any restraint impairing breathing by pressure on torso or leaning child forward during seated restraint
Any restraint obstructing airways or impeding lung expansion
Any restraint obstructing caregiver's view of child's face
Any restraint interfering with child's ability to communicate or vocalize distress
Any restraint twisting or placing child's limbs behind their back
Use of pressure points or counter-aggression techniques
Use of escorts to move child from one location to another

Critical Requirements:

All de-escalation techniques must be exhausted before restraint
Only RH individuals certified in SAMA may administer EBI (except short personal restraint)
Foster parents must be SAMA-trained before using personal restraint
Immediate goal is to transition to programmatic intervention (cooling off, teaching self-control, problem-solving)
Child observed for minimum 15 minutes after restraint ends to ensure safety
If child refuses medication ordered by physician, take to emergency room rather than restrain

Practice Activity:

Written scenarios requiring decision on intervention level
Complete crisis response decision tree exercise

Segment 5: After the Crisis (8 minutes)

Video Content:

Post-restraint procedures and timelines
Restoration and relationship repair using TBRI®
Processing the incident with the child (within 24 hours)
Documentation and reporting requirements
Self-care for caregivers after crisis
When to contact Refuge House for support

Immediate Post-Restraint Requirements (within 2 hours):

Contact Case Manager Immediately:

Call within 2 hours of any restraint
Case manager will ask about possible child injury and may speak with child directly
Case manager will debrief foster parent about:
- Foster parent's current emotional and physical state
- Assessment of triggering events leading to restraint
- All interventions that occurred prior to restraint
- Any procedural changes needed to avoid future incidents
Case manager notifies Treatment Director within 2 hours
Case manager contacts managing conservator within one business day

Medical Assessment:

If any injury to child during incident or restraint: Case manager determines if medical care needed
If medical care obtained: Physician's orders will be followed in care of the child
If signs of distress during restraint (breathing difficulty, disorientation, consciousness change): Immediately terminate restraint and initiate emergency medical care

Child Processing Session (within 24 hours):

Foster parent provides child opportunity to discuss the situation. The purpose is threefold:

Allow child to identify:
- Their behavior and precipitating circumstances
- Strategies attempted before restraint and reaction to those strategies
- The restraint itself and their reaction to it
- How caregivers can assist and what child can do to regain self-control and avoid future EBI
Assess child's emotional and physical wellbeing:
- Determine need for additional supports (counseling, medical care, etc.)
Begin relationship repair:
- Return child to normal routine
- Not required to return to previous group activities if not in child's best interest or other children's interests
- Must engage child in alternative routine activity

Restoration Process Using TBRI®:

Ensure Regulation: Both caregiver and child are calm (wait for survival brain to shift)
Reconnect: "We're okay. I still care about you."
Review Simply: What happened? What was hard? (Child's perspective)
Validate Feelings: Acknowledge the difficulty without judgment
Teach: What can we do differently next time?
Practice: Role-play appropriate response when calm
Restore Relationship: Return to normal routine with connection activity

Observation Period:

Child must be observed for minimum 15 minutes after restraint ends
Monitor for physical or emotional concerns
Document child's status post-restraint

Documentation Requirements:

Foster parent completes Physical Restraint Form within 24 hours and submits to case manager. Form includes:

Name of child
Description and assessment of precipitating circumstances and specific behaviors constituting emergency
Alternative strategies attempted before restraint and child's reaction
Date/time restraint began and time released
Names of foster parent(s) or caregivers participating and persons who observed
Specific restraint techniques used (Hug Containment or Elbow-to-Hip Containment)
De-escalating strategies employed during restraint
Total length of time restrained with verification of continuous visual monitoring
All attempts to explain to child what behaviors were necessary for release
Any injury child sustained and care/treatment provided
Actions foster parent took to facilitate child's return to normal activities
Child's reaction to opportunity to discuss situation (date/time offered, date/time took place, actual discussion, foster parent's reaction)

Case Manager submits documentation to:

Child's managing conservator (within 72 hours)
Form placed in child's record
Copy provided to RCCL upon request (unless reportable serious event)
Copy kept in locked Treatment Director file or secured Radius file

Service Plan Review Trigger:

If 4 or more personal restraints occur within 7-day period
Service plan team must conduct review within 30 days of 4th restraint
Review must include records/orders of EBI, potential medical/psychiatric contraindications, and exploration of alternatives

24/7 Crisis Support Access:

When to call during crisis: Immediate danger, uncertainty about intervention, need for backup, child refuses to speak with foster parent
When to call after crisis: Questions about post-restraint procedures, concerns about child's wellbeing, need for debriefing support
Who to contact: Case manager or on-call worker
What happens: Phone support, video consultation, or in-person response
No judgment: Always better to ask for help

MODULE 1 COMPETENCY ASSESSMENT

Format: 20-question assessment (passing score: 85%)

Assessment Components:

Multiple choice questions on crisis recognition and TBRI® principles (10 questions)
Scenario-based questions requiring application of de-escalation techniques (5 questions)
True/False on TAC §749.901 requirements and prohibited practices (5 questions)

Remediation: Foster parents scoring below 85% receive individualized coaching and may retake assessment after review

Certification: Upon passing, foster parents receive "Basic Crisis Response Training" certificate valid for 12 months

ENHANCEMENT MODULE 2A: MENTAL & BEHAVIORAL HEALTH CRISIS RESPONSE

Required for: Mental & Behavioral Health Support Services package only
Duration: 45 minutes
Prerequisites: Module 1 completion

Learning Objectives

By completion, foster parents will be able to:

Recognize mental health crisis indicators specific to DSM-5 diagnoses
Apply crisis intervention for children with depression, anxiety, PTSD, conduct disorders
Manage medication-related behavioral changes
Coordinate with Licensed Therapists during crisis
Recognize when emergency psychiatric services are needed

Segment 2A-1: Mental Health Crisis Recognition (12 minutes)

Video Content:

Distinguishing behavioral crisis from psychiatric crisis
Diagnosis-specific crisis presentations (depression, anxiety, PTSD, conduct disorders)
Medication side effects that may trigger crisis
Suicide risk assessment basics
Self-harm behaviors vs. suicidal intent

Crisis Indicators by Diagnosis:

Depression-Related Crisis:

Hopelessness statements ("Nothing will get better")
Social withdrawal beyond baseline
Giving away possessions
Sudden mood improvement after severe depression (risk indicator)
Sleep and appetite changes

Anxiety-Related Crisis:

Panic attacks (rapid heartbeat, hyperventilation, feeling of impending doom)
Severe avoidance behaviors
Physical symptoms (chest pain, dizziness, nausea)
Inability to attend school or activities due to anxiety

PTSD-Related Crisis:

Flashbacks or dissociative episodes
Severe triggered response to trauma reminders
Nightmares followed by daytime dysregulation
Hypervigilance preventing daily functioning

Conduct Disorder-Related Crisis:

Escalation of aggressive or destructive behaviors
Running away or threats to run
Violence toward people or animals
Property destruction beyond typical behavioral issues

Knowledge Check:

Video scenarios showing mental health crisis presentations
Identify diagnosis-related factors in crisis situations

Segment 2A-2: Suicide Risk Assessment and Response (15 minutes)

Video Content (includes third-party suicide prevention video):

Warning signs requiring immediate action
How to ask directly about suicidal thoughts
Safety planning with children who express suicidal ideation
Means restriction in the home
When to call 911, crisis line, or therapist

Safety Planning Process:

Recognize warning signs: Child's personal indicators
Internal coping strategies: What helps child feel better
Social contacts: Who can provide distraction/support
Professional contacts: Therapist, psychiatrist, case manager numbers
Means restriction: Remove access to lethal means
Safety commitment: Not a "contract," but reinforcing reasons for living

Immediate Response Protocol:

NEVER leave child alone if expressing imminent intent
Call case manager immediately (24/7 line)
If immediate danger: Call 911 and then case manager
Remove all potential means (medications, sharp objects, cords)
Stay calm and connected: "I'm glad you told me. We'll keep you safe."
Do not promise confidentiality: "I need to tell people who can help"

Home Safety Modifications:

Lock medications (including over-the-counter)
Secure sharp objects and potential weapons
Lock cleaning supplies and chemicals
Remove cords from bedrooms
Consider room changes if risk factors present

Practice Activity:

Role-play asking child about suicidal thoughts
Complete home safety checklist for suicide prevention

Segment 2A-3: Crisis De-escalation for Mental Health Symptoms (10 minutes)

Video Content:

Adapting TBRI® for children with mental health diagnoses
Managing panic attacks
Responding to dissociative episodes
De-escalating rage related to conduct disorders
Therapeutic communication during crisis

Specialized De-escalation Techniques:

For Panic Attacks:

Ground child in present moment (5-4-3-2-1 sensory technique)
Breathing exercises (box breathing, belly breathing)
Reassure that panic will pass (typically 10-20 minutes)
Avoid saying "calm down" - use "let's breathe together"

For Dissociative Episodes:

Speak calmly and consistently
Use grounding techniques (touch textures, name objects in room)
Don't force eye contact
Allow time for child to return to present
Avoid physical touch unless child initiates

For Conduct Disorder Escalation:

Set clear, firm limits while maintaining connection
Remove audience if possible (peer attention reinforces behavior)
Natural consequences rather than power struggles
Maintain safety without engaging in argument
Follow through consistently

For Depression-Related Shutdown:

Validate feelings without trying to "fix"
Offer low-demand connection activities
Allow appropriate space but maintain safety monitoring
Small, achievable requests only
Express hope without dismissing pain

Practice Activity:

Apply appropriate technique to mental health crisis scenarios
Identify when to call therapist vs. when to manage with support

Segment 2A-4: Coordination with Mental Health Professionals (8 minutes)

Video Content:

When to contact child's therapist outside scheduled sessions
Emergency psychiatric services: when and how to access
Medication concerns requiring immediate provider contact
Hospital psychiatric admission process
Documentation for mental health providers

Communication Protocol:

Contact Therapist When:

New or worsening suicidal ideation
Significant behavior changes
Crisis patterns emerging
Questions about implementing behavioral strategies
Before making major placement or family changes

Call Case Manager 24/7 When:

Immediate safety concerns
Need for emergency psychiatric evaluation
Medication side effects causing distress
Running away or threats to run
Hospital admission being considered

Call 911 When:

Active suicide attempt in progress
Violence beyond household management capacity
Medical emergency related to self-harm
Child states intent and has means immediately available

Documentation for Providers:

Symptom patterns and triggers observed
Medication compliance and any side effects
Crisis frequency and antecedents
What interventions help or don't help
Changes in sleep, appetite, social functioning

ENHANCEMENT MODULE 2A COMPETENCY ASSESSMENT

Format: 15-question assessment (passing score: 85%)

Assessment Components:

Mental health crisis recognition scenarios (5 questions)
Suicide risk assessment and response (5 questions)
Coordination with mental health professionals (5 questions)

Certification: "Mental & Behavioral Health Crisis Response" certificate valid for 12 months

ENHANCEMENT MODULE 2B: IDD/AUTISM CRISIS RESPONSE

Required for: IDD/Autism Spectrum Disorder Support Services package only
Duration: 50 minutes
Prerequisites: Module 1 completion

Learning Objectives

By completion, foster parents will be able to:

Recognize autism-specific and IDD-related crisis triggers
Apply sensory-based de-escalation strategies
Use communication supports during crisis
Implement developmental disability-adapted emergency interventions
Coordinate with RN for medical-related behavioral crises

Segment 2B-1: Understanding Crisis in IDD/Autism (12 minutes)

Video Content:

Neurodevelopmental differences affecting crisis response
Sensory overload vs. behavioral challenge
Communication barriers during dysregulation
Medical conditions mimicking behavioral crisis (seizures, pain, illness)
Why typical de-escalation may not work

IDD/Autism-Specific Crisis Triggers:

Sensory Overload:

Too much noise, light, touch, smell, or visual stimulation
Unexpected sensory experiences
Inability to escape overwhelming sensory input
Physical discomfort not effectively communicated

Communication Frustration:

Cannot express needs or wants
Not understood by others
Demands beyond language ability
Loss of communication tools or systems

Routine Disruption:

Unexpected changes in schedule
Transitions without preparation
New environments or people
Loss of predictability

Unrecognized Medical Issues:

Pain (dental, ear infections, constipation, headaches)
Seizure activity
Medication side effects
Illness symptoms not clearly expressed

Developmental Task Mismatches:

Demands beyond current ability level
Social expectations causing anxiety
Academic or behavioral requirements not developmentally appropriate

Knowledge Check:

Identify IDD/autism crisis triggers in video scenarios
Distinguish sensory overload from behavioral crisis

Segment 2B-2: Sensory-Based Crisis Intervention (15 minutes)

Video Content (includes occupational therapy video on sensory regulation):

Understanding sensory processing differences
Creating sensory-friendly crisis response
Proprioceptive and deep pressure techniques
Environmental modifications during crisis
Sensory tools and strategies

Sensory De-escalation Strategies:

Visual Supports:

Use visual schedules showing "what's happening now"
Choice boards with pictures
"Feelings thermometer" with visual scale
Social stories for crisis situations practiced when calm

Auditory Modifications:

Reduce noise level immediately
Speak in quiet, calm voice with simple language
Offer noise-canceling headphones or earplugs
Use consistent verbal cues practiced previously

Tactile/Proprioceptive Input:

Deep pressure through weighted blankets or compression vests
Joint compressions if child accepts touch
Heavy work activities (pushing, pulling, carrying)
Allow stimming or self-soothing behaviors

Environmental Adjustments:

Dim lights or move to quieter space
Remove visual clutter
Create physical space/reduce crowding
Offer sensory-safe space with calming items

Movement-Based Regulation:

Rocking or swinging (if available and safe)
Pacing or walking
Jumping on trampoline
Yoga or stretching

Sensory Tool Kit for Crisis:

Fidget items (stress balls, putty, textured objects)
Chewable jewelry or gum for oral sensory needs
Noise-reducing headphones
Sunglasses for light sensitivity
Compression clothing
Preferred calming music or sounds

Practice Activity:

Build personalized sensory crisis kit for child
Match sensory strategies to individual sensory profile

Segment 2B-3: Communication During IDD/Autism Crisis (10 minutes)

Video Content:

Adapting communication for developmental level
Using AAC (Augmentative and Alternative Communication) during crisis
Non-verbal communication cues
Reducing language demands when dysregulated
Visual supports for emotional regulation

Adapted Communication Strategies:

Simplify Language:

Use 1-3 word phrases only
Remove explanations and reasoning
Direct, concrete language
Match child's receptive language level (often lower during crisis)

Visual Communication:

Picture cards showing choices
"First/Then" visual boards
Feelings charts with faces
Visual timer showing duration

AAC Access:

Keep communication device available during crisis
Offer picture cards if device too complex in moment
Accept alternative communication (pointing, leading, gestures)
Don't require verbal communication to de-escalate

Non-Verbal Cues:

Respect personal space needs (may need more distance)
Read body language for regulation status
Use calm body posture and movements
Reduce eye contact demands if aversive

Practice Activity:

Create visual crisis communication tools
Role-play simplified communication during escalation

Segment 2B-4: Physical Intervention Adaptations for IDD/Autism (8 minutes)

Video Content:

Modifications to restraint techniques for sensory sensitivities
When physical touch may escalate rather than de-escalate
Working with rigidity or resistance related to autism
Medical fragility considerations
Coordination with RN for medical monitoring

Special Considerations:

Touch Sensitivity:

Some children with autism find restraint more dysregulating
Test tolerance for supportive touch during calm times
May need to maintain safety through environmental modification rather than restraint
Respect communication about "don't touch" even during crisis

Physical Differences:

Children with IDD may have decreased muscle tone or increased flexibility
Some have accompanying medical conditions (seizures, heart conditions)
Coordination challenges may increase fall risk during restraint
Pain sensitivity may be increased or decreased

Medical Monitoring by RN:

Contact RN if restraint needed for child with medical conditions
Monitor for seizure activity during crisis
RN consultation for medication-related behavior changes
Health protocols take precedence over behavioral interventions

Alternative Safety Strategies:

Clear dangerous space rather than restrain if possible
Use barriers (furniture, gates) to maintain safety
Have second adult present for higher support needs
Call crisis management staff earlier rather than attempting restraint

Segment 2B-5: Medical vs. Behavioral Crisis (5 minutes)

Video Content:

Recognizing seizure activity
Pain behaviors that may look like behavioral crisis
Illness symptoms in non-verbal or minimally verbal children
Medication side effects
When to contact RN immediately

Medical Red Flags During "Behavioral" Crisis:

Sudden onset with no identifiable trigger
Loss of consciousness or altered consciousness
Repetitive movements or blank staring
Fever, vomiting, or other illness symptoms
Head injury or fall prior to behavior change
Medication change in past 72 hours
Child indicates or gestures toward body part (possible pain)

Immediate RN Contact Required:

First-time seizure or seizure lasting over 5 minutes
Head injury with behavior change
Severe self-injury causing bleeding or potential fracture
Suspected poisoning or medication overdose
Choking, difficulty breathing, or cyanosis
Any medical concern during crisis

Practice Activity:

Distinguish medical emergency from behavioral crisis in scenarios
Complete decision tree: behavioral intervention vs. medical response

ENHANCEMENT MODULE 2B COMPETENCY ASSESSMENT

Format: 15-question assessment (passing score: 85%)

Assessment Components:

IDD/autism crisis triggers and recognition (5 questions)
Sensory-based intervention application (5 questions)
Medical vs. behavioral crisis differentiation (5 questions)

Certification: "IDD/Autism Crisis Response" certificate valid for 12 months

SUPPLEMENTARY RESOURCES

Video Library

All foster parents receive access to on-demand video library including:

TBRI® crisis intervention demonstrations (Karyn Purvis Institute)
De-escalation techniques from Crisis Prevention Institute (CPI)
Suicide prevention training from Trevor Project
Sensory regulation strategies from occupational therapists
AAC use during crisis from speech pathologists
Parent testimonials managing crisis successfully

Reference Materials (Downloadable PDFs)

TBRI® Connection Before Correction Reference Card
Crisis De-escalation Continuum Quick Guide
TAC §749.901 Restraint Requirements Summary
Emergency Contact List Template
Crisis Documentation Form
Safety Plan Template (suicide prevention)
Sensory Crisis Kit Checklist
Visual Communication Supports Library
Medical Emergency vs. Behavioral Crisis Decision Tree

Third-Party Resources

National Suicide Prevention Lifeline: 988
Crisis Text Line: Text HOME to 741741
Autism Crisis Response Training (selected modules from Autism Safety Coalition)
IDD Crisis Supports from The Arc
TBRI® Caregiver Training videos (selected segments)

TRAINING DOCUMENTATION AND TRACKING

Initial Training Completion

Module 1 required before first placement for all foster families
Enhancement modules required before accepting placement in that package
Certificate issued upon passing competency assessment
Training completion documented in foster parent file and Radius system

Annual Refresher Requirements

Module 1: Annual 30-minute refresher required
Enhancement modules: Annual 20-minute update required if actively serving that population
Refresher includes: Policy updates, skills practice, lessons learned from program data

Remediation Process

Foster parents failing initial assessment receive one-on-one coaching from Case Manager
Review missed content areas and re-watch relevant segments
Retake assessment after remediation (unlimited attempts)
If unable to demonstrate competency after 3 attempts, additional support provided before placement

Ongoing Competency Monitoring

Case managers observe crisis management during home visits
Foster parents complete brief crisis response reflection after any incident requiring intervention
Quarterly review of crisis documentation for quality improvement
Additional training provided if patterns indicate need

TRAINING SCHEDULE AND LOGISTICS

Implementation Timeline

Module 1: Required within 30 days of application approval, before any placement
Enhancement 2A/2B: Required within 30 days of notification of credential award, before first placement in that package
Refresher Training: Due annually from date of initial completion

Access and Technical Requirements

Training delivered through Refuge House LMS platform
Compatible with computers, tablets, smartphones
Internet connection required for video streaming
Videos include closed captioning
Spanish language versions available for all modules
Technical support available through Refuge House IT helpdesk

Training Support

Case managers available to answer questions during training
Weekly virtual "office hours" for foster parents completing training
Discussion forum for peer support and questions
On-site training sessions available for foster parents preferring in-person format

QUALITY ASSURANCE AND CONTINUOUS IMPROVEMENT

Training Effectiveness Measures

Pre/post knowledge assessment scores
Crisis incident frequency after training implementation
Restraint usage rates and appropriateness
Foster parent confidence ratings
Placement stability for children with high behavioral needs

Annual Curriculum Review

Incorporate lessons learned from crisis incidents
Update to reflect regulatory changes
Add emerging best practices
Respond to foster parent feedback
Align with treatment model enhancements

Feedback Mechanisms

Post-training survey (completion satisfaction)
90-day follow-up survey (application and usefulness)
Focus groups with experienced foster parents
Case manager input on observed skill application
Treatment Director review of clinical alignment

APPENDIX: TRAINING ALIGNMENT WITH REGULATORY REQUIREMENTS

TAC §749.901 - Emergency Behavior Intervention

This training curriculum fulfills all requirements for emergency behavior intervention training including:

Types of approved restraints and proper application
Prohibited restraint methods
Release criteria and monitoring
Documentation requirements
Medical evaluation protocols

T3C Blueprint Requirements

This curriculum addresses all T3C crisis management training requirements:

Crisis intervention training for all caregivers
De-escalation techniques
Emergency behavior intervention
24/7 crisis response coordination
Treatment model integration (TBRI®)
Package-specific enhancements for mental health and IDD/autism

RCC Contract Requirements

Training documentation supports RCC requirements:

Initial and annual training completion
Training hours tracking
Competency assessment results
Training content aligned with approved treatment model
Crisis response protocol implementation

Document Control:

Approved By: Executive Director
Training Coordinator: [HR Manager Name]
Next Review Date: September 2026
Revision History: Version 1.0 - Initial Release