@article{ref1,
title="Strategies for the prevention of physical assault among emotionally disturbed youths  (P.A.A.R.R.)",
journal="Child and youth services",
year="1987",
author="Kuster, Timothy and Rowland, George and Schaffner, Timothy and Kupfersmid, Joel",
volume="10",
number="1",
pages="85-99",
abstract="VioLit summary: OBJECTIVE:The intent of this chapter by Kuster et al. was to describe the techniques that reduced potential for assaultiveness among emotionally disturbed youth.METHODOLOGY:The authors employed a non-experimental design by reviewing the Physical Aggression-Avoidance-Response-Remediation technique (PAARR) which provided general approaches to dealing with adolescents during their behavioral episodes. The authors also described eight preventive intervention strategies and three physical intervention techniques. Therapeutic intervention was defined as the act of teaching children more acceptable ways of meeting their desires, given what is acceptable to others in their environment or community. This chapter focused primarily on the first phase of the program, the techniques used in preventing physical acting out, with a brief overview of a remediation process.FINDINGS/DISCUSSION:PAARR was developed at Sagamore Hills Children's Psychiatric Hospital in northeastern Ohio. Techniques included in the PAARR program were reinforcing acceptable behaviors, terminating unacceptable behaviors, verbalizing the consequences of negative behaviors and assisting in the development of alternative behaviors. General guidelines for intervention by staff were: 1) Voice and body language that was evenly modulated, relaxed, and nonthreatening. 2) Limit setting that would determine the precise expectations of the youth. 3) Reducing guilt by addressing the behavior of the youth and not their entire character. 4) Allowing youths to save face even in the midst of intervention. 5) Allowing space such that individuals could define their own parameters of distance from people. 6) Providing a clear determination of the leader in a limit-setting episode in the event that more than one staff member was present. 7) Communication to youth and staff such that the leader provided directions for fellow staff members as well as the youth. The eleven techniques for dealing with negative behavior were: Maintaining eye contact, providing facial expressions, adjusting physical proximity, allowing for youth initiated time-outs, reminding individuals about expectations, providing verbal directions, removing the youth from a threatening situation with a staff-initiated time-out, directive touching to assist youth in moving in the right direction, physical restraint in the event of immediate danger, seclusion if the danger persisted, mechanical restrains if the danger was extreme. The authors then identified remediation as a process through which staff members helped youth develop more acceptable modes of behavior. The five steps to this part of the process were: having the youth accept responsibility for his or her behavior, helping the youth understand the dilemma inherent in the behavior, clarifying the events which led to the behavior, providing alternatives for future incidents, and encouraging the youth to experiment with healthier behaviors.AUTHORS' RECOMMENDATIONS:Because aggressive responses on the part of staff members only served as an unhealthy model for the youth, the authors suggested that the total milieu be considered as a learning experience. They also suggested that positive alternatives to behaviors be systematically and patiently approached in the knowledge that negative behaviors were learned as a powerful coping strategy for the youth; the process of changing negative behaviors to positive behaviors was one the authors warned might take considerable time.(CSPV Abstract - Copyright © 1992-2007 by the Center for the Study and Prevention of Violence, Institute of Behavioral Science, Regents of the University of Colorado)Note:This article has also been published as a chapter in: Kupfersmid, J. & Monkman, R. (1988). Assaultive Youth: Responding to Physical Assaultiveness in Residential, Community and Health Care Settings. Binghamton, NY: Haworth Press.KW  - OhioKW  - Violence PreventionKW  - Juvenile OffenderKW  - Juvenile AggressionKW  - Juvenile ViolenceKW  - Mentally Ill OffenderKW  - Mentally Ill JuvenileKW  - Mental IllnessKW  - Physical Assault PreventionKW  - Physical Assault OffenderKW  - Physical AggressionKW  - Aggression PreventionKW  - Aggression InterventionKW  - Physical Assault InterventionKW  - Violence InterventionKW  - Intervention RecommendationsKW  - Prevention RecommendationsKW  - Aggression TreatmentKW  - Violence TreatmentKW  - Physical Assault TreatmentKW  - Juvenile TreatmentKW  - Offender TreatmentKW  - Patient TreatmentKW  - Patient ViolenceKW  - Mental Health InstitutionKW  - Mental Health Patient<p />",
language="",
issn="0145-935X",
doi="",
url="http://dx.doi.org/"
}