Therapeutic crisis intervention system in residential care for children and youth: Staff knowledge, attitudes, and coping styles

About ten years ago, several residential treatment facilities for children and youth in Israel were given approval to use the Therapeutic Crisis Intervention System (TCI, ‘holding’) technique in order to proactively restrain violent behavior. The purpose of the current study was to examine attitudes toward TCI among staff of residential facilities for children and youth and the association between staff attitudes and between their knowledge and coping strategies with stressful daily situations. A unique aspect of this study is its emphasis on the staff's coping style in stressful situations and the relationship between their coping style and their use of TCI. The research population consisted of staff members who work in residential facilities for children and youth at risk (n=100), half of whom had been trained to perform TCI and to implement the method in their work. No differences in knowledge were found between participants who had been trained and those who had not, while the former even displayed incomplete knowledge and unwillingness to perform TCI when necessary. In addition, the more problem-oriented the coping style the less positive the attitude toward use of TCI and the less the tool was used. No relationship was found between emotion-oriented coping style and attitudes and frequency of using TCI as a means of intervention. The study shows the complexity involved in introducing the method of TCI as well as the necessary caution that must be taken before deciding to use it.