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Managing Signs of Distress

Studio 3's Managing Signs of Distress (formerly Managing Challenging Behaviour or MCB) course is a three-day BILD ACT certificated programme which promotes a person-centred approach to crisis management. Our philosophy is to approach behaviours of concern in a gentle and dignified way by providing a better understanding and insight into what causes an individual to become distressed, and through the use of Low Arousal Approaches and gentle physical skills. In essence, we provide de-escalation training which not only seeks to control crisis situations, but avoid them altogether. We also deliver 1-2 day refresher courses in Managing Signs of Distress.

We provide physical interventions training on an individualised basis once a training needs analysis (TNA) has been carried out, whilst working to reduce the unnecessary use of physical restraint amongst carers and family members alike. Our trainers work with course participants to tailor the course to suit the needs of individual services, and to ensure the needs of these services are met. ​

Man struggling to manage a crisis situation

Course Information

Our approach to managing distressed behaviour can be applied to carers working with a wide variety of individuals, and focuses on non-aversive de-escalation strategies such as Low Arousal Approaches and gentle physical skills as opposed to restrictive practices. The key goal of this course is to better understand the causes of distressed behaviour, and to examine our role as practitioners with the aim of preventing re-occurrence.

This course is based on applied academic research carried out in a wide range of care settings. We aim to enable carers to confidently manage crisis situations without excessive force, and with the ability to be reflective about how future situations could be prevented. This de-escalation training is not focused on moments of crisis, but on understanding the wider world of behaviour, and looking beyond that to create environments where stress is managed and well-being improved – for both client and carer. There is a strong focus on empathy and building positive relationships with individuals. We have found that after completing this short course, carers feel more confident in their work and experience less stress.

We want to emphasise that the philosophy of the course is to use physical interventions as little as possible and that often, if we know what to do, we can back off and defuse an incident. Any time that we use physical methods is an admission that we have run out of other things to do.

Course Structure 

Managing Signs of Distress is a 3-day course with a 1-2 day refresher follow-up session every 12-15 months.

Day 1: A Framework for Understanding Distressed Behaviours

  • Legal issues (including the implications of the European convention of Human Rights) and the role of policies

  • Qualitative differences in the nature of violence

  • Carer's levels of tolerance and reactions to distressed behaviour

  • Causes of distressed behaviour

  • An Introduction to Low Arousal Approaches (including interaction, defusion, and distraction strategies)

  • An intoduction to debriefing (why it is necessary and how to do it)

  • Coping with distressed behaviour

  • Managing versus changing behaviours

Day 2: Gentle Physical Skills and Restraint Reduction

  • Group Participation Exercises

  • The Principles of Non-aversive Physical Skills

  • Physical Avoidance Skills

  • Non-physical and Physical Low Arousal Skills in Practice

  • Roleplay – Defusing skills

  • The Acceptability of Physical Restraint Procedures

Day 3: Low Arousal Approaches in Practice

  • ​Practicing gentle physical skills, such as the ‘walk around’ method and planned escape routes

  • Using movement to defuse a situation 

  • Allowing time to calm down

  • Preventing the escalation of stressful situations via non-verbal communication (eye contact, body language, gesture)

  • Roleplay activities to test the various skills learnt on the course and necessitate the use of restraint

  • Looking beyond crisis management 

Training Objectives:

  1. To increase staff confidence in the management of distressed behaviours

  2. To instill in staff the principles and benefits of working within a non-aversive framework

  3. To demonstrate to staff the importance of understanding how their own behaviours can affect others due to the transactional nature of stress

  4. To provide staff with the skills and confidence to defuse challenging situations with the aim of negating the need for physical intervention

  5. To help staff understand that crisis management goes beyond de-escalation in the moment

  6. To enable staff to identify some of the causes of challenging behaviour and that individuals are not always in control of their actions

  7. To make staff aware of the importance of working within the law and the need for and use of policies

  8. To emphasise the importance of de-briefing after incidents

  9. To provide staff with a range of physical intervention skills which are safe and acceptable to both staff and service users alike

  10. To help staff understand that crisis management foes beyong de-escalation in the moment 

Refresher/Follow-up Training

Every 12 to 15 months there will be an opportunity for staff to undergo a refresher session of 1-2 days in duration to renew and update their skills.

Additional Support 

This course is designed to help staff cope with the vast majority of crisis situations, but there will always be incidents that fall outside the remit of the basic course. When there are individuals who are so distressed that additional support is needed, we are happy to make our trainers or clinical team available to your service. This can include bespoke training, putting together individualised plans, and carrying out assessments and reports, in addition to specialised support and advice. 

This course is BILD ACT certificated. To discuss hosting this course for your organisation or employees, please contact our office on 01225 334 111 or

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