CIT TRAINING

SAN ANTONIO STYLE

A Little History

• 2003 SAPD, BCSO, Austin taught by Houston

• October of 2003, our first CIT class• Now have completed 19 classes including

• Child CIT for Administrators and School Resource Officers

• We have taught 42 different municipalities to include Friendswood and Victoria

Little More History

• From 2003 to October 2009 we have trained

• SAPD Officers: 382• Outside agencies, including BCSO

and other PD: 345• Fire fighters 23• Total number of officers: 727

Class Structure

Selection of Officers 1. Voluntary2. Bulletin Announcement for

SAPD3. Email for outside agencies4. Bexar County

Class Size

• Attempt to limit class size at 60 officers

• City slots are limited to 20 - 25• County slots are limited to 15 - 20• The remaining slots are given to

other municipalities; 1 -2 slots per agency to give everyone a chance to participate

Collaboration• Since 2003

1. Center for Health Care Services 2. San Antonio Police Department 3. NAMI 4. Bexar County Sheriff’s Office

• We added:1. Area Hospitals:

o University Hospitalo La Pazo Methodist Hospital

Collaboration

2- Community Involvement (SAFCN)

• Continues to growo Police Departmentso Out patient facilities

Collaboration

We have monthly meetings Decisions are made regarding a. Class dates b. Class size is discussed c. Selection of instructors d. Current subject matter

e. Changes or new material

Meetings

• The curriculum comes from T.C.L.E.O.S.E.• All instructors are given requirements &

test material to cover in class (Latitude)• Instructors are reminded that all material is

due six weeks in advance for printing• We also discuss any current issues or

problems that have occurred, police/hospital/public safety unit

Class Preparation

Friday before the class:

• Role Players, Role play graders, role play mentors and new instructors meet to prepare and go over any changes or new material or instruction

• Go through all power points, videos, dvds, etc to make sure the system is working as well as all the above materials (sound guy)

Friday continued …

• Assemble goody bags• Examples:

1. Bags are donated2. Cups, pens, sanitary gel; all donated3. We get gift cards for highest grades 4. Small trophy for best role player5. Gift for instructors

Everyone has a role

• IT person: 1 to 2 people who know all about media material, functions

• Master of Ceremonies: 1 or more, will introduce each instructor and give short biography, will also announce breaks with time periods

• Time keeper: a) Classb) Role play

Class Requirements

• We tell everyone up front the amount of time necessary to complete the course; 10% can be missed; 40 hour course instruction

• Notify Sergeant of any court assignment• We give cell phone numbers for Sgt. and

course instructors in case of any emergency

• Give information on housekeeping and logistics

• Display up on screen

Opening Ceremony

• We recognize outstanding CIT officers• We have leadership present to show

support for the training• We have a city or county official to

hand out official certificate from the county or city

• Officers are nominated by their agency due to their outstanding action

• Vote on officers at CIT meeting by all participants

ItineraryMonday Topic

Instructor(s)

0800-0815 Purpose and History Officer Schmitz

0815-0845 VIDEO Class Discussion

0845-0900 BREAK

0900-0930 Introduction and Welcome Pub. Officials

0940-1040 Active Listening Deputy Guerrero and Officers Preyor-Johnson and Stepanik

Monday continued…Monday Topic Instructor(s)

1040-1110 DMOT Deputy Mobile Outreach Team

1110-1200 LUNCH 1200-1330 CIT Response Officers

Kasberg and Stevens

1330-1340 Break1340-1500 E/D Officers

Stevens and Kasberg

1500-1630 Active Listening Instructors Role Play(Little history: Back to back)

Active Listening Skills

M Minimal Encouragers O Open Ended Questions R Reflective / MirroringE Effective Pauses (silence)

P ParaphrasingI “I” Messages E Emotional labeling

Tuesday Tuesday Topic

Instructor (s)

0800-0930 Intro to Dr. John PriceMental Illness

09:30-0940 BREAK

0940-1030 Developmental Dr. Melissa Disorders Graham

1040-1140 Psychosis & Dr. Joseph Schizophrenia Simpson

1140-1230 LUNCH

Tuesday continued…Tuesday Topic

Instructor(s)

1230-1300 VIDEO 1300-1315 BREAK

1315-1415 Cognitive Dr. Melissa Graham

Disorders/Alzheimer’s

1415-1445 Adult Abuse Colleen Phillips

1445-1500 BREAK

1500-1630 Role-play: Psychosis Instructors

WednesdayWednesday Topic Instructor(s)0800-0930 Substance Abuse/ Dr. Maria Felix-

Dual Diagnosis Ortiz

0930-0940 Break

0940-1140 Mood Disorders, Dr. Melissa Graham

Anxiety Disorders, Dep. Stanfield-Mims

and Suicide Jeanie Paradise-LPC

1140-1150 BREAK

1150-1300 COMMUNITY RESOURCES/PANEL

WORKING LUNCH

Community Panel

• Introduction by CHCS• Professionals• Medical Facilities• Judges• Crisis Care Center• Each describes what they are in

charge of• Open for questions

Wednesday, Continued…

Wednesday Topic Instructor(s)

1300-1310 BREAK

1310-1440 Child and Dr. Jeannie Adolescent Issues Von Stultz

1445-1645 Role-play: Suicide Instructors

Thursday Thursday Topic Instructor(s)

0800-0845 Crisis, Public Jeanie ParadiseInebriates, and Aaron DiazDetox Center Kathryn Jones

0845-0915 Homeless Issues Dr. Ann Meyers

0915-1030 Post Traumatic Dr. Robert JimenezStress Disorder

1030-1040 BREAK

1040-1110 Child Abuse Melissa Tijerina

1110-1120 BREAK

Thursday, continued… Topic

Instructor(s)

1120-1210 Psychotropic Dr. John Price Medications

1210-1300 LUNCH 1300-1400 The Consumer’s Perspective NAMI

“In Our Own Voice”

1400-1405 BREAK

1405-1505 Family’s Perspective Kym Bolado

1505-1635 Mental Retardation Ms. Barbara Campbell-LPC

Friday (Test Day)

Friday Topic Instructor(s)0800-0900 Excited Delirium Sgt. Butch

Matjeka

0900-1000 Review and Instructors

Written Test

1030-1630 Skills Test Instructors

Rules for Role PlayingStructured Role Play

Role player does have latitude, however everyone is told ahead of time

• No touching• No weapons on the person (officer and role

player)• We changed the way we first handled role play

due to injuries; fake weapons but not on person

Mentor’s Responsibilities

Objective - The purpose of this is to establish consistency in the area of mentoring. The mentor is responsible for guidance and personal instruction of the students assigned to them during the week of training to ensure that CIT skills are being utilized in a positive and encouraging manner.

• Assist students during role plays / give guidance through the week for individual improvement.

• Summarize groups strengths / suggestions of more effective application.

Mentor’s Responsibilities cont’d…

• Mentors shall establish both handling and cover officer assignments prior to role plays. This will ensure that officers are partnered with someone that will compliment their skills.

• Mentors will give constructive advice to officers and give them insight to any challenging areas observed in current or prior role plays.

• Mentors shall take notes of any positive applications of CIT skills and/or areas allowing for improvement.

Mentor’s Summary Sheet

Mentors observations of needed improvement:

___________________________________________________________________________________________________

Mentors suggestions given:

___________________________________________________________________________________________________

Officer ____________Signature ____________Department ____________

Grader Responsibilities

Objective: Purpose of this is to establish a consistency in the area of grading. This will ensure a positive and constructive learning environment for every student.

Graders should be objective and open

minded with regards to:

• Officer responses – Introduction/approaches

• Tactics - distance/proximities/barriers used

• Postures – standing/kneeling/sitting

Graders Responsibilities, cont’d…

•Grader shall switch handling/cover officer when either time has been met or objectives fulfilled.

•Graders shall end the scenario with positive statements with regards to areas graded, as well as constructive criticism. Any areas needing improvement should be addressed with helpful suggestions.

Grade Scale1 = Student does not meet expectations of specific

categories

2 = Student lacks the proficiency/inability to apply skills

 3 = Applied the use of CIT skills but there is room for improvement

 4 = Had the understanding of CIT skills and demonstrated the ability to apply these skills

5 = Identified all areas of CIT skills and applied in a significant and meaningful manner

Friday role plays

• Every officer goes through a role play• Each officer is graded• At least one role player is assigned to a

scenario requiring an emergency detention

• All officers are advised that they are to take notes at the designated emergency detention role play scenario

• All officers are to write an ED based on above role play

Friday Grading

Officers are graded on:

1.Officer’s initial approach to the consumer: 1 2 3 4 5

2.Officer was aware of his safety and tactics: 1 2 3 4 5

3. Officer utilized active listening skills: 1 2 3 4 5

   

Friday Grading4. Officer gathered the appropriate information:

1 2 3 4 5

5. Officer was able to develop a rapport: 1 2 3 4 5

6. Officer made determination for E.D.: 1 2 3 4 5

Each section has an area for comments

**MUST HAVE A TOTAL OF 18 PTS TO PASS

Friday GradingEmergency Detentions

• Each officer must write an emergency detention

• Rotated role play sessions; a session for writing the emergency detention

• We have a judge, psychiatrist, or doctor who goes over the written emergency detention and makes sure that the officer articulates all necessary criteria that is helpful to facility and/or doctor

Role Play

Graduation• We ham it up• Try to bring the Chiefs back to hand out

certificates• Certificates are designed to show

collaboration• We announce what is necessary to

become Mental Health Peace Officers• Hand out partially filled Mental Health

Peace Officer applications and instructions for the officers to submit to TCLEOSE for certification

Graduation

Certificate Example

Another Example

A New Collaboration

• Fire and EMS personnel• They brought a new perspective• We asked about searching,

proximity; tactics• They were appalled we have no

life or safety skills• When paired with an officer at

role play, perfect scenarios

A few Incidentals

For Instructors:• 1- All officer instructors are asked to

wear their uniform on Monday & Friday• 2- If an officer has a class to instruct,

he/she wears a uniform.• 3- Critiques are handed out on Monday

for the student to fill out throughout the class.

Making it our own

• On Monday, students are issued their goody bags and a class manual

• Cop cards

Manual Table of Contents

Purpose and History…………………..7In the Line of Duty .......................13 Active Listening ............................15 Deputy Mobile Outreach Team .....21 CIT Response ...............................23 Emergency Detention ...................33 Introduction to Mental Illness ......49 Developmental Disorders .............59

More Table of ContentsPsychosis and Schizophrenia ............. 65 Cognitive Disorders/Alzheimer’s ....... 69 Adult Abuse ........................ …………….73 Alcohol, Substance Abuse, Dual

Diagnosis ......................................................... 77

Child and Adolescent Issues............... 95 Community Resources...................... 107 Mood Disorders, Anxiety, Suicide …. 109

More Table of Contents

Crisis, Public Inebriates, Detox ...... 123 Homeless Issues .............................125 PTSD .................................... ……….127 Child Abuse ...............................…..137 Psychotropic Medications .............. 143 Consumer Perspective .............…….147 The Family’s Point of View ..............149

More Table of Contents

Mental Retardation ................. 151 Excited Delirium ......................155 Supplemental Materials............157 Drug Reference ........................175

Bottom of each page:

“Never sacrifice safety for rapport.”

Making it our own

Making it our own

Critique Summary

Psychosis and Schizophrenia  • SAPD: Technical language was reduced to

comprehendible terminology- examples: Thank you; made sense of word origins.

• BCSO: Informative.

• SAPD: Very sincere – liked the way he broke down unknown/large words and explained the meaning – explained the root.

More CommentsSubstance Abuse and Dual Diagnosis

• SAPD: Excellent down to earth presentation that exuded credibility and interesting data/info.

• BCSO: Very informative, good presentation, knows the subject well, kept my attention.

• SAPD: Wonderful speaker – would gladly attend another lecture – great rapport and street knowledge.

More Comments• BCSO: Awesome, very educational,

enjoyed it a lot, lots of information, I would take it again, in our field we need more of it. The best part so far.

• Unk: Instructor was yelling.

• SAPD: Missing tab in manual – The PERFECT speaker for this block – I like that he has experience, being a vet himself, with PTSD which makes this block more interesting and relatable.

Newest Collaborators

Using the right language in enlisting the help of law

enforcement

Jeanie Paradise, M.A., LPC-SJune 1, 2010

Helpful tips

Keep in mind your ultimate goal which should be getting your consumer’s needs met!

Once you have offended an officer how likely is he/she going to help?

• Never tell an officer what to do• Don’t talk down to an officer • Don’t way your credentials in

his/her face• Set your own ego aside

Steps to approaching the situation1. Thank him/her for coming

Examples

Right Way:“Thank you so much for coming out here

officer, I really need your help.”

Bad Way: “Gosh we’ve been waiting over 2 hours,

thank God you finally got here!”

Steps to approach

2. Introduce yourself and your role

Examples

Right way:“Hi my name is Jeanie Paradise. I’m

the nurse in charge for the unit and this is Sally, my patient.”

Steps to approach

3. Get the officer’s name and badge number

“What was your name officer? And can I please get your badge number for my records?”

Always get the name of the officer at the beginning of the conversation.

What happens after you’ve argued and then ask for his/her name?

Steps to approach 4. Explain the situation and how you need his/her

help. Be factual, concise and honest.

Example

“I’m hoping you’ll consider an Emergency Detention for Sally as I believe she is a danger to herself. “

“Sally came in today and told me she wanted to kill herself. She said she would go home and take all of her medication which she has stored up for several months. Yesterday, her husband filed for divorce. I’m worried about her safety.”

Steps to approach

• Give the officer the opportunity to interview the patient, doctor or other credible source if he/she feels it is necessary.

• In Texas, an officer can use a credible source to obtain the information necessary for an Emergency Detention.

• Often the officer prefers to speak to the consumer directly. Unless unsafe, you should allow this to occur.

Steps to approach

• Avoid buzz words that have a different meaning for law enforcement.

• Transport is usually referred to in a court order for transportation which in our county is done by the Sheriff’s Office.

• If you feel it is unsafe for the consumer to drive him/herself to the hospital, or for you to drive them, state the reasons clearly.

Steps for approach

Example

“I’ve contacted the private hospital who has agreed to evaluate the consumer. I’m just really concerned that she will not make it there. I’m worried she will wreck her car since she is so upset.

I don’t believe it is safe for me to drive her since I’m worried she will try and jump out of the car or that she will change her mind and not sign in.”

If there is still a problem

• Sometimes despite what you believe clinically, the officer does not see for him/herself.

• In Texas, only a licensed peace officer or a Magistrate Judge can issue an Emergency Detention

• Ask politely for the officer to consider consulting with their supervisor.

Asking for a supervisor

• Example

• “Would you consider contacting your supervisor on this to get his/her opinion on what we should do because I know I’m going to have to contact my supervisor?”

• This is not the time to threaten to report the officer. There is still time to use your negotiation skills.

If you still disagree• Try asking to speak to the officer’s

supervisor yourself.

• Tread lightly and continue to negotiate.

• Stay focused on the consumer’s safety and not your own needs, such as the office is closing in 5 minutes, or your ego.

• Document the outcome with the officer well. Inform the officer that you may need to call the officer back or call the dispatch office back for further assistance.