PMVA Training

Prevention and Management of Violence and Aggression

Develop your team’s skills:

  • Creating an Environment of Non-Violence
  • Conflict Management and Verbalisation Skills
  • Personal Safety and Breakaway Skills
  • Last-Resort Physical Restraint Interventions
  • Teamwork for Incident Management
  • Comprehensive Risk Management
  • Restraint Reduction through Values

Training in PMVA for Your Care Team

PMVA Training helps to reduce the risks of violence and aggression in your service by developing staff knowledge, skills and attitudes to effectively employ de-escalation skills, breakaway and disengagement tactics or control and restraint interventions appropriately within the context of their service users, residents, patients and clients.   The training meets NHS Protect standards in conflict resolution and physical intervention.

Our PMVA courses develop three levels of prevention and management of violence and aggression:

  • Proactive strategies to prevent incidents of aggression or violence
  • Retro-active strategies to defuse and de-escalate an emerging situation
  • Reactive Strategies to minimise injury risk and regain control of a situation.

Your team will learn to safely apply appropriate non-restrictive or (where necessary) restrictive physical interventions as alternatives to the primary non-escalation and secondary de-escalation strategies which we will help you to put in place.

Learning Outcomes:

On completion of this PMVA training, your staff team* will be able to:

  1. Apply the legal principles of Reasonable Force to high-risk scenarios
  2. Apply the principles regarding Duty of Care to scenarios of high-risk
  3. Identify situations which may give rise to the risk of sudden death during restraint or of serious injury during an incident
  4. Understand that physical restrictive interventions are reactive strategies which are used in conjunction with proactive, preventative strategies
  5. Use tactics which encourage movement by prompting
  6. Use tactics which enable them to safely escort a compliant but unpredictable person from one place to another
  7. Employ control tactics for rapidly unfolding situations where they need to keep themselves and a vulnerable but physically-able subject subject safe from harm
  8. Employ control tactics in higher-risk situations where there is a risk that they might lose control and thereby allow harm to come to themselves, a colleague or the vulnerable (but physically capable) subject they are looking after
  9. record an incident clearly in a way that allows another person to understand their actions in the circumstances which faced them
  10. Communicate with their subject and with each other in a way which promotes the most positive outcomes in difficult and rapidly-unfolding circumstances

*Please note that we do not run “open” courses for individuals to enrol on at the current time.

Call 0844 812 9795 or Send an Enquiry to our team here:

  • What kind of course are you interested in and why? What kind of time have you allocated for it and when are you thinking of holding the training? Thank you!
  • This field is for validation purposes and should be left unchanged.

*Please note that we do not run “open” courses for individuals to enrol on at the current time.

PMVA Training for Violence Reduction

“Very approachable, knowledgable and interactive facilitator who encouraged group discussions and used personal experience to back up the theory/learning”

Children's Respite Care Centre, Peterborough City Council

“A very professionally run days training, Gerard was a very knowledgeable and relaxed instructor who put the group at ease and made the day both informative and enjoyable.”

Paramedic Clinical Supervisor, ERS Medical

“I was very nervous about this training but it was a great environment and he made us feel at ease and was encouraging. I liked how he brought in real life situations to make the training more relatable.”

Senior Carer, Four Seasons Health Care

“The training was informative & the practical sessions were very useful to learn. I have gained a good knowledge on how to manage difficult or challenging behaviour within my job role.”

Care Assistant, Brendoncare

We provide a variety of tailored PMVA Training:

  • Restraint Training in Care Homes
  • Control and Restraint training in Mental Health
  • Physical Intervention Training in Residential Care
  • Patient Restraint Techniques for Ambulance and Secure Escort Services
  • PMVA Restraint Training in Social Care
  • Healthcare Restraint Training for Nurses
  • Appropriate Restraint Training for Care Workers
  • Less-Intrusive Restraint Training for Learning Disabilities
  • …or tailored restraint training for any environment where there is a risk of violence and aggression.

PMVA Physical Interventions are Reactive Strategies.  

Physical Interventions are what we do to reactively manage potentially harmful behaviour  – when it happens – to keep people safe and get things back to a baseline level of communication and coping as soon as possible when a person becomes distressed.  These reactive strategies are only ever used as a last resort and are used together with proactive interventions.

Proactive interventions are a range of changes we can make in the person’s environment, in the ways that we communicate, in staff attitudes and in risky situations to reduce the need for the behaviour through which the person is communicating.  When considering using Reactive Strategies as a last resort, consideration should be given to using the Least Restrictive Options wherever possible and only for the amount of time they are needed for.

Restrictive Interventions

Where possible (in planned interventions) a thorough risk assessment must address:

  • any physical health problems and physiological contraindications to the use of restrictive interventions, in particular manual and mechanical restraint
  • any psychological risks associated with the intervention, such as a history of abuse
  • any known biomechanical risks, such as musculoskeletal risks
  • any sensory sensitivities, such as a high or low threshold for touch.
  • A restrictive intervention should also have a restrictive intervention reduction programme as part of a long-term behaviour support plan.
  • The training course from Dynamis fulfilled or exceeded expectations 99.6% 99.6%
  • Our Dynamis instructor had a very good or excellent level of knowledge and competence 98.2% 98.2%
  • The theory and knowledge components helped me professionally 98.9% 98.9%
  • The techniques and tactics were appropriate to real scenarios in our work 98.6% 98.6%
  • Our Dynamis trainer observed good Health and Safety practices 100% 100%
  • The Dynamis training course was of the right duration to gain the skills and knowledge I needed 91.2% 91.2%
PMVA Training for Violence Reduction

“Trainer had a wealth of experience in the subject and was an ideal fit for what we were looking for, as were all aspects of the training.”

Director, UK Event Medical Services Limited

PMVA Skills Development:

  • Duty of Care:  Understanding where the duty begins and ends and who carries responsibility for restraint during an intervention.
  • Breakaway / Restraint Use of Force Rules:  Understanding Reasonable Force for Control and Restraint Interventions
  • Risk Awareness:  What are the risks of physical restraint intervention and how to reduce or avoid them
  • Government Guidance:  What is expected by the national authorities who advise on best practice for restraint interventions and restrictive practices (e.g. Department of Health, NICE Guidance, Relevant Codes of Practice)
  • Teamwork:  Working in cooperation with team-mates in high-risk restraint and non-restraint situations
  • Physical Tactics:   Reliable and Robust methods for last-resort physical intervention resolution of high-risk conflict situations
    • Managing Proximity and Body Language Effectively (Proxemics)
    • Low-Level Breakaway Skills from Common Assaults (grabbing)
    • Functional Breakaway Skills from More Serious Assaults (impacts)
    • Safe Prompting and Guiding Skills for use with unpredictable service users
    • Control Tactics for early-stage engagement with a resistant or violent person
    • Holding and Escorting Skills for use with disoriented persons
    • Restraint Skills for more serious incidents requiring robust stabilisation (only where necessary)
    • the use of restraint devices such as the Soft Restraint System (only where necessary)

PMVA Training Formats

IMPORTANT:  To properly control risk and to manage your liability exposure as a responsible employer, the training you provide to your staff should match the needs of your teams and the levels of risk to which they are exposed.    

At Dynamis, leveraging our online training system which has been successfully used since 2014 for a variety of teams, we can maximise the  in-person contact time needed to create positive learning experiences for learners.   We have, for example, been able to provide 2-, 3-, 4- and 5-day courses which develop broad competencies for PMVA and meet the specific needs of teams.

Broadly speaking, each core element of PMVA training should take one day of introduction and practice, interspersed with the knowledge and guidance elements of the course content:

  • Conflict Management and Verbal Skills for Dealing with Distress/Aggression (1 day)
  • Personal Safety/Breakaway Skills for disengagement from Violence (1 day)
  • Interventions for Prompting, Escorting, Holding at a Lower Risk Level (1 day)
  • Options for Holding, Control and Restraint at a Higher Risk Level (1 day)
  • Control Tactics for High-Risk Contexts including Restraint Equipment (1 day)

Each stage of this training builds on the previous phase of training and experience in order to best contribute to overall performance capability, both in terms of the team and the individual.

For one-day courses, please see individual course webpages as follows:

Conflict Communications and Crisis Intervention

Breakaway and Disengagement

Physical Restraint Interventions

“Exceeded all the criteria we needed to achieve, interesting, interactive, informative and enjoyable. A really impressive course in all aspects, my team came away visibly more confident and closer as a team, I am certain the experience will give us the right foundations enabling excellent care to the patients we manage. a sincere thanks.”

Director of Care and Quality, Mental Health Secure Transport

“Gerard is very knowledgeable, makes the training enjoyable and my team now feel confident in dealing with any aggression at the Care Shelter.”

Care Shelter Manager, Bethany Christian Trust

Our approach to providing advice, training and consultancy in the prevention and management of violence and aggression (PMVA training) follows a three tier model as follows:

PMVA Primary Prevention:  understanding the causes and triggers for challenging, risky or violent behaviour and attempting to change aspects of the environment in order to reduce the risk of their occurrence.

PMVA Secondary Prevention:  selective interventions, mainly involving effective communication strategies which seek to prevent such situations, if they do occur, from escalating.

PMVA Tertiary Management:  interventions, usually including some physical component, for mitigating and reducing risk if situations escalate to the point of violence or the possibility that serious harm or injury could occur.

Dynamis offers courses which cover all three phases of the model and which emphasise both Tier 1 and Tier 2 interventions wherever possible, in line with the wider movement towards Restraint Reduction Programmes.

The Structure of Training in PMVA:

  • Tiers of Training specific to staff role & exposure
  • Placed within a Legal Context
  • Based on Formal Assessments of Risk
  • Identified using a Training Needs Analysis
  • Learning Outcomes based on Identified Need
  • Evaluated against Operational Effectiveness
PMVA Training for Violence Reduction


  • The Principles of Reasonable Force
    • Common Law
    • Criminal Law
  • Care Legislation
    • Care Act
    • Mental Health Act
    • Mental Capacity Act
    • DoLS
  • Decision-Making in regard to the Duty of Care
    • Health and Safety at Work Act
    • Management of Health and Safety at Work Regulations
    • Health and Safety Offences and Corporate Manslaughter
    • Manual Handling Operations Regulations
  • Government and National Guidance
    • NICE NG10
    • NICE NG11
    • NICE Violence: Short Term Management
    • Positive and Proactive Care (Department of Health)
  • Human Rights Act
    • Article 2
    • Article 3
    • Article 5 and others
  • Reducing the Risks of Sudden Death During Restraint
  • Positional Asphyxia and Excited Delirium
  • Recognising Warning Signs in Restraint Interventions


    • Core Person-Centred Values for Dealing with Distressed, Resistant, Dangerous Behaviour
    • Legal, medical and professional implications of incidents involving PMVA
    • Risk assessment (both formal and informal) during episodes of PMVA
    • Legal and medical implications
    • Good practice following PMVA incident management


  • The Kaplan/Wheeler Model of the Assault Cycle
  • Brain function and Aggression/Stress
  • Recognising the cues for Primal/Social behaviours
  • The SCARF Model of influences on human behaviour
  • 7-Phase model of incident management and recording


  • Treating every person with Dignity and Showing them Respect
  • Having the correct attitudes needed for conflict resolution
  • Initiating contact with patients service users, visitors and other staff in a non-escalatory way
  • Discovering and Dealing with people’s communicated needs through listening and empathy
  • Managing resistance through appropriate persuasion and influencing skills
  • Deflecting and Redirecting verbal aggression through focus on key goals
  • Working with the audience and bystanders to positively influence conflict
  • Knowing when to disengage from conflict


  • Proxemics, Prompting and Escorting
  • Fundamentals of Self-Protection
  • Survival from Common Assaults
  • Principles for Prompting and Escorting 
  • Less-Intrusive Holding and Restraint Principles
  • More Restrictive Physical Restraint Interventions
  • Disengagement Methods
  • Advanced Control Tactics (for Higher-Risk environments)
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