Postive Options - Consultancy :: Training

Management of Actual or Potential Aggression – the MAPA^® model.

Wherever physical interventions are unavoidable to manage risk, it is important that staff are able to employ methods that can meet their professional, ethical and moral obligations in order to preserve the therapeutic alliance with children, young people or adults, whilst also maintaining a legal justification.

The most acceptable and effective strategy for supporting children, young people and adults is one where staff are able to form and develop a therapeutic alliance that is based upon mutual involvement, respect and understanding. Although it is perhaps unrealistic to expect that this will be possible in all situations, it is more than reasonable to expect that the use of any physical interventions will always represent the least restrictive and least harmful practice, and that it is used in a way that complements the existing non-physical and interactive strategies.

As a risk reduction strategy, it is implausible to expect that children, young people or adults will never sustain injuries as a consequence of the use of physical interventions. Nor is it possible to assert that staff will never be injured as a consequence of the child’s, young person’s or adult’s behaviour, or as a consequence of the physical intervention(s) employed. Nevertheless, it is reasonable to expect that every effort should be made to reduce the risk and severity of injuries to the lowest practicable level. Importantly, if any injuries are sustained, it is imperative that they are promptly and appropriately treated e.g. first aid or medical treatment, and accurately reported and recorded, with the reasons for the injuries accounted for.

Staff who employ MAPA^® holding or disengagement skills should always ensure their actions constitute an act of care in the best interests of the child, young person or adult, and others affected by their behaviour. The primary aim of holding is to maintain ‘safety and care’ incorporating the principles of de-escalation and other non-physical intervention strategies. Consequently, staff should not use pain or pain compliant techniques.

Positive Options advocate that the MAPA^® restrictive physical intervention skills should only be used:

following consultation and involvement of the child, young person or adult, their parents, carers, guardians or significant others.
when other non-physical strategies have been attempted and failed, or the presenting risk is so immediate that non-physical strategies are inappropriate.
when the risks associated with the proposed restrictive physical intervention(s) are less than those associated with not physically intervening.
following an assessment of risk and an analysis of the child’s, young person’s or adult’s behaviour. Where physical strategies are part of an agreed and planned intervention, they should be based upon knowledge of the individual, their known or predicable behaviour(s) and an assessment of actual or potential risk of harm. Additionally, it is important that an assessment should be undertaken regarding any risks that the physical intervention(s) might present to the child, young person or adult.
within a multidisciplinary agreement written specifically for the child, young person or adult as part of their Individual Education Plan, Behaviour Management Plan, Individual Handling Plan, or Care Plan.
in emergency situations, where staff may be required to respond to unforeseen events when they have a responsibility for the health, safety and welfare of others. In such circumstances it is feasible that staff might be required to use restrictive physical interventions that are not identified within an agreed plan. However, it is important that an assessment of risk and the further development of an appropriate individualised plan to account for any recurrence should be completed immediately after such incidents.
within the Positive Options ‘Least Restrictive RESPONSE^© Strategy’ and the Positive Options ‘Least Restrictive HOLDING^© Strategy’.
for the shortest time possible.