The Potential for Actual Management of Aggression
This post is about conflict management | personal safety | dynamis training. Twice in this article from the Herald newspaper, members of staff at a facility in Ireland mention the specific training system they are trained in — presumably for their own personal safety, for the control of violent clients, and for the protection of others.
That system is MAPA, which stands for “Management of Potential or Actual Aggression.” Workers at the residential facility initiated strike action recently over personal safety fears, and their complaints are pointed directly at how this training allegedly fails to protect them.
“Staff have repeatedly raised serious concerns over their personal safety at the facility, which included the threat of being attacked with weapons by detainees. Staff have previously been threatened with hammers, saws, knives, power drills, steel bars and boiling water.”
Arguably, any system of personal safety, control and restraint, or physical intervention would struggle to provide a guarantee of safety under those circumstances. However, there are different gradients of systems within a very varied and unregulated market of training provision in this area.
“Concern has also been expressed over the intervention procedure implemented at the Lusk facility to restrain young offenders. Workers have no riot equipment and the restraint technique we use is called MAPA, which is useless.”
In my professional experience, I have met more than one team who have had this kind of system introduced into their service. In every case, the system has come in for heavy criticism from the teams asked to apply it. Many have told me — anecdotally — that these systems are not fit for purpose and that they suffer from failure in live scenarios, where efforts to control risk have resulted in a loss of control and sometimes harm to staff or clients.
Actually, Buyer Beware
In another case from a few years ago, this kind of training in physical intervention holds was mentioned during a prosecution:
The HSE investigation found the hospital previously used restraint techniques known as MAPA — but after recommendations by the Healthcare Commission following an inspection in February 2006, Castlebeck decided to replace MAPA techniques with a different restraint method. Staff had expressed concerns that the techniques would not be adequate to deal with the risks posed.
On one online forum, a person who had completed MAPA training offered this rather alarming review:
“It is supposed to be a kinder version of restraint technique and it was used mainly for people who are deaf, as this way they can still use sign language to communicate with staff (in MAPA, hands are free). It was a five-day course when I did it.”
We see a wide variety of approaches across the different sectors we work in. Unfortunately, some have been designed by well-meaning but often under-equipped “authorities” who innovate tactics destined for rapidly unfolding, tense, and uncertain situations — situations containing a very real risk of life-changing injury.
There are people offering advice and teaching breakaway, physical intervention, and restraint techniques who have become “experts” — and remained such — through routes that left them without the systematic thinking and tools necessary to properly design training that matches the environments where it will be used. Some trainers operate from a single narrow methodology — the well-known “hammer” — which they apply blindly to all teams in all contexts: the unfortunate “nail.”
Values and Actions, in Actuality
Before anyone can accuse me of favouring an overly physical approach to the management of aggression, let me be clear about the interaction between good values and good actions.
The development of services that treat the service user with dignity and show them respect is absolutely key. The practice of verbalisation skills which underline correct values and demonstrate them to the people we look after are central to creating environments that are non-violent, safe, secure, and effective. The purpose of these facilities should be to model respect, dignity, and to provide healthy boundaries for life as a contributing person in society. That is a service with good values.
However, the values we need staff to have for safeguarding service users — dealing with them compassionately because we recognise their vulnerability — can seem counter-active when those same staff are faced with actual aggression. In these situations, a system of physical management, intervention, control, and safety must work. It must provide options that are proportionate, or else it will not promote “good actions.” Instead, like any bad design, it may get people hurt when it predictably fails. Repeatedly.
💡 Key takeaway: Systems designed to prevent or manage aggression need to know where they are strong — and where they are weak. They need to be honest with their clients about when their highly refined approach to care and de-escalation has far outperformed their system’s ability to withstand the physical chaos, mobile geometry, and pressure of colliding bodies when words alone are failing.
Many systems of communication, de-escalation, and defusing are now taught by seasoned professionals — experts in care, compassion, and working with vulnerable groups — who have refined their approach through repeated testing and review. However, the physical systems taught as alternatives to these communication programmes have often not kept pace with improvement and refinement.
“Where staff are attempting to communicate with a distressed person and elicit positive behaviours, but have no confidence in what happens next if words alone fail and physical alternatives become necessary, then the culture of compassionate care is empty, vacuous, and ineffective. Staff will have fears, doubts, and hesitations which will be clear to the person they are interacting with — and therefore undermine the entire exercise.”
I cannot emphasise this point enough. Note the comments from the staff at Oberstown, who may be attempting to use such a fragile physical intervention methodology:
“It is only effective against small kids but, because of the PC brigade, staff are forced to use it. The prison service use C&R (Control and Restraint), which is more effective. There are so many injuries to staff because we are forced to use MAPA.”
Does it sound as if the physical system has been properly designed for this environment? Has it been properly designed for any environment? Does it sound like the de-escalation and communication system is up to the challenge here? Do you think the children in this facility are being cared for in an appropriate, safe, secure environment?
Conflict Management | Personal Safety | Dynamis Training: The Irony of Forcing a Use-of-Force System
There is a bitter irony here: staff are being “forced” to use a system that is failing to create safety — raising serious problems for management around liability, competence, risk assessment compliance, and moral integrity.
To put the injury rate in that facility in context:
📊 By the numbers: At the time of the industrial action, unions cited official figures showing more than 100 violent incidents in 2015 — almost half classified as critical — and 65 staff on sick leave. Impact official Tom Hoare said there was a “daily risk of serious assault” which left many staff “literally in fear of their lives.”
Questionable restraint advice and even worse practice will do that to a team. Restraining a violently resisting young person, to stop them hurting themselves or another person, is one of the most physically demanding activities a person can do in any line of work. Without adequate time in practice, mental preparation for making good decisions, a strong culture of debriefing, and the correct attitudes throughout a team, botched interventions and injured staff and children are bound to be the results.
There can be a culture of abuse which sometimes grows in these facilities — and again, it is rooted in the training, development, and practice of staff.
The manager in charge of this facility is making changes, and in his comments one can see a swing towards more suitable systems:
“Last November, I issued a memo to all staff that physical interventions they used were to stop. I could not understand the amount of injuries the staff had. It meant three people could not get through a door carrying the person. They were hitting off doors and radiators. Historically, it was the approach taken here. Now, if someone needs restraining, staff do it properly and do not try and lift, but restrain the person with their bodies until they calm down. If the offender has a weapon, staff are told not to engage, to bide their time, and close the door behind the person.”
However, months later, staff are still asking for PPE and adequate training to manage violence and aggression. Oberstown is the last resort in managing young people edging towards criminality as a way of life — and violence is often a feature of their behaviour.
In the face of a widespread culture of violence, there needs to be a reframing. With some of the most troubled, emotionally unstable, unpredictable children in our care system, there exists not a risk of violence, but an immediate reality of violence — an actuality of aggression.
The question raised by this case — and the ongoing national-level reports for this facility — is whether organisational attitudes to training and management of work-related violence need to change. Where a system “only works for small children” but is being mandated and resulting in injuries and loss of control, the staffing shortages, recruiting problems, industrial disputes, media attention, and other negative effects will continue.
To keep up with the Oberstown story, visit: http://www.thejournal.ie/oberstown/news/
Gerard O’Dea provides tailored Prevention and Management of Violence and Aggression (PMVA) and Conflict Resolution training courses for education, care, health, and hospital service providers around the UK, so that service users and staff are treated with dignity and shown respect, even in their most difficult moments. Combining respectful verbalisation skills with last-resort physical alternatives for true, full-spectrum patient care has been his specialty for over ten years as director of training for Dynamis.
This guide on conflict management | personal safety | dynamis training is part of our ongoing work with schools and academies.