Frequently Asked Questions

Why should our staff be trained in Therapeutic Options™?

Because it makes sense.

In 1998, the Hartford Courant published a series of investigative articles entitled “Deadly Restraint” in which it exposed hundreds of tragic deaths as a result of physical or mechanical restraint in institutions and other human services centers across the country.

These numbers do not even begin to account for the incidence of non-fatal injuries suffered by individuals in mental health, mental retardation, and educational care settings. The Courant cites inadequate training as one of the most common factors in these tragic deaths, and proper training as one of the simplest, most cost effective solutions to this widespread problem.

In addition to the human cost, the financial cost of staff or service recipient injury can be exorbitant once the medical, compensatory, staff re-deployment, rehabilitation, environmental restoration, and investigative expenses are factored in. Add to these the potential cost of litigation and it’s not hard to see how a single serious incident can financially level an agency or facility. When compared to the enormous costs of a serious injury or death, the comparatively modest price of providing quality training is a wise investment.

Are there any data that empirically show that Therapeutic Options™ is effective in increasing safety and reducing seclusion and restraint?

Glad you asked that question! In September 2000 Therapeutic Options, Inc. conducted an instructor training program at a large residential habilitation center in Washington State. As part of its ongoing risk management system, the center keeps comprehensive statistics on assaults, resident and staff injuries, workers compensation claims, etc. The center reported a 70% reduction in assaults, a 50% reduction in back injuries, and a 48% reduction in time-loss compensation claims.

Because Therapeutic Options™ training was part of a comprehensive and thoughtful plan to increase staff and client safety, the huge reductions in assaults, injuries, and compensation claims cannot be attributed to the training alone, but clinical and administrative staff at the facility credit much of the improvement to their implementation of Therapeutic Options™.

The state of Virginia uses Therapeutic Options™ in all of its state facilities and reports a significant reduction in seclusion and restraint across the system since adopting the curriculum in 2002. Again, Therapeutic Options™ training was only one feature of a host of targeted system responses to increase safety and reduce coercive practices, but administrative staff cite Therapeutic Options™ training as a critical variable in moving their system forward.

For what kind of service setting is Therapeutic Options™ most appropriate?

Because the curriculum is founded upon the fundamental concepts of respect, support, prevention, and the therapeutic relationship, Therapeutic Options™ can be used in virtually any setting where aggression or violence places people at risk. Therapeutic Options™ is being used by staff in group homes, hospitals, classrooms, habilitation centers, and in community settings. The curriculum can be easily tailored to meet the specific needs of particular setting.

We are implementing Psychiatric Rehabilitation at our hospital. How does the Therapeutic Options™ program fit in with Psych Rehab?

Therapeutic Options™ is completely compatible with the Psychiatric Rehabilitation model, and shares many key concepts and philosophies. Both Psychiatric Rehabilitation and Therapeutic Options™ stress merging perspectives, serving the whole person, supporting role recovery, building skill repertoires, and developing environmental supports. Therapeutic Options™ also believes strongly in the growth potential of persons receiving services, in partnering with persons served, and in respecting people's choices and preferences.

Our system has adopted person-centered planning. Does Therapeutic Options™ support this philosophy of service delivery?

Therapeutic Options, Inc. believes strongly that person-centered and recovery-based approaches are the only responsible way to provide supports and services to people with developmental or psychiatric disabilities, and enthusiastically endorses any such planning process that provides meaningful outcomes for people’s lives.

We are an inpatient psychiatric hospital with an acute care (admissions) unit and a secure forensic unit. Despite our best efforts at prevention, sometimes a patient becomes violent. How effective is Therapeutic Options™ at managing seriously violent behavior?

In addition to providing a practical theoretical framework and methodology for understanding and preventing aggression and violence, Therapeutic Options™ provides staff with an array of effective physical control skills that are designed to (1) prevent injury to staff and people receiving services, and (2) preserve the helping alliance. All the physical skills have been extensively field tested and proven to be both safe and effective. Because the training explicates the body mechanics and attack dynamics present in violent encounters, participants acquire meaningful personal protection and physical control skills in an efficient way.

Who makes the best Therapeutic Options™ Instructor? How should my agency select a person to provide this training to our staff? Does the person have to be credentialed? Do they have to be athletic?

Because the safety of people receiving services as well as staff providing services is paramount and potential liabilities of injury so profound, agencies are strongly encouraged to give careful consideration to the individuals they select to receive instructor certification. Therapeutic Options™ instructors often play key roles in advancing positive approaches within an agency and supporting an environment of respect and inclusion.

Professional licensure or credentials are not necessary, nor is a particular level of formal education. Therapeutic Options™ instructors include direct service, administrative support, and paraprofessional staff, as well as psychiatrists, psychologists, nurses, occupational and recreational therapists, social workers, program managers, classroom teachers, and others.

While there is no specific educational requirement, instructors should be able to understand the program concepts and be able to convey them clearly to others. Instructors should be effective communicators, have experience providing services and supports, be strong advocates for people receiving services, have sound judgment, and be committed to using positive approaches and non-coercive practices.

Instructors do not need to be particularly athletic but should be able to perform the physical techniques well enough to provide clear and credible demonstrations for their students. That said, some of the most effective and insightful instructors we know have physical disabilities that make demonstrating some physical techniques difficult. By co teaching with other instructors during the physical skills portion of the curriculum, these individuals have provided powerful and meaningful training experiences for their agency staff.