Crisis Training Programs Compared

CPI, Ukeru, Safety-Care, MANDT, Right Response, TCI, PCM — philosophies, restraint use, and how to evaluate fit

Why this brief

Most U.S. schools that work with students who have significant behavioral support needs use one of several major crisis training programs. The choice between them is usually a district-level decision; paras don't typically pick. But the choice matters — programs differ in philosophy, in what physical interventions they teach, in how restraint is positioned (last resort vs. tool of choice), in time and money required, and in compatibility with trauma-informed and disability-rights frameworks. Knowing the differences helps when evaluating training, when reviewing district policy, and when surfacing concerns about implementation.

This brief compares the major programs paras encounter in U.S. schools, names what each emphasizes, and offers criteria for evaluating fit. It connects with brief 05.10 (Escalation Cycle), 05.11 (Crisis Response), 05.12 (Restraint and Seclusion), 14.01 (Burnout), and 16.14 (Witnessed Restraint).

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| Training does not equal authorizationCompleting a crisis training program teaches techniques. Authorization to use those techniques in your specific role with specific students is governed by your district's policy, your state's laws, and the student's IEP/BIP. Don't perform restraint or seclusion outside your training and authorization, even when techniques seem familiar. |

1\. The philosophical spectrum

Crisis training programs span a spectrum from comfort-based approaches (which avoid physical interventions entirely or use them only in narrow emergencies) to control-based approaches (which include more techniques and use them at lower thresholds). All current major programs claim to emphasize de-escalation and minimize restraint; they vary substantially in how they implement that claim.

| Comfort end of spectrum | Control end of spectrum |

| :-: | :-: |

| Restraint-free or near-restraint-free. | More physical techniques in standard training. |

| Soft barriers, blocking, redirection. | Holds, takedowns, prone or supine restraint included. |

| Heavy emphasis on relationship and prevention. | More emphasis on response procedures. |

| Comfort vs. control framing. | Compliance and safety framing. |

| Critical of restraint use as routine. | Restraint as one tool among several. |

| Examples: Ukeru, some adaptations of CPI. | Examples: Some traditional behavioral safety programs. |

Most major programs are in the middle of the spectrum and have evolved toward more comfort-based approaches over the past 15 years.

2\. Crisis Prevention Institute (CPI) — Nonviolent Crisis Intervention

Probably the most-used crisis training program in U.S. schools.

2.1 Philosophy

Verbal de-escalation as primary.

Physical interventions as last resort, when there's imminent danger.

"Care, Welfare, Safety, and Security" as the framework.

Has evolved over decades; current materials emphasize trauma-informed and integrated approaches.

2.2 Structure

Crisis Development Model — Behavior Levels (Anxiety, Defensive, Risk Behavior, Tension Reduction) and corresponding Staff Approaches.

Verbal Intervention emphasis.

Physical interventions taught — disengagement skills (avoiding being grabbed, hit), holding skills (Children's Control Position, transport positions). Prone restraint not part of current standard CPI training.

2.3 Levels

Foundation Course (1 day) — verbal de-escalation only.

Verbal Intervention Course (longer).

Physical Skills (additional days, full curriculum).

Advanced and trainer levels available.

Annual refresher recommended; most districts require it.

2.4 Cost and access

Districts purchase site licenses; train trainers internally.

Per-staff costs in the hundreds annually for ongoing certification.

2.5 Where it fits

General school populations, especially mainstream schools that occasionally need restraint as last resort.

Hospitals, residential settings.

Wide reach because of long-standing market presence.

3\. Ukeru Systems

Restraint-free crisis intervention model. Originated in Grafton residential program (Virginia).

3.1 Philosophy

"Comfort vs. control" — explicitly framed as alternative to restraint-based programs.

No physical restraint techniques. Soft barrier (Ukeru pad) used for blocking; redirection, environmental modification, and de-escalation are primary.

Emphasizes trauma-informed practice.

Heavy investment in prevention and relationship.

3.2 Structure

Trauma-informed framework.

Specific de-escalation protocols.

Soft barrier training (the Ukeru pad — a foam shield used for blocking).

No takedowns, holds, or restraints.

3.3 Adoption

Increasingly adopted by districts and residential programs that have moved away from restraint.

Still less common than CPI but growing.

Particularly used in autism and trauma-affected populations.

3.4 Considerations

Programs that adopt Ukeru must commit to substantial culture change; it's not just a technique swap.

Documented reductions in restraint use following implementation, particularly when paired with broader trauma-informed transformation.

Critics argue some specific situations require physical intervention; Ukeru would say those situations either reflect insufficient prevention or call for police-level response, not staff-led restraint.

4\. QBS Safety-Care

Behavioral safety training developed by QBS Inc.

4.1 Philosophy

ABA-aligned framework.

Emphasis on prevention through positive procedures.

Physical interventions when prevention fails — emphasis on safety.

Two-person procedures emphasized.

4.2 Structure

De-escalation and prevention strategies.

Specific physical techniques for restraint when needed.

Two-person holds emphasized as safer than one-person.

Prone restraint discouraged; alternative positions taught.

4.3 Common context

Autism-specific programs.

Specialized EBD programs.

Settings where ABA framework is dominant.

5\. MANDT System

Crisis intervention program emphasizing relationship.

5.1 Philosophy

Relationship-based approach.

"Building a culture of dignity, respect, and learning."

Multiple levels — non-physical and physical interventions.

5.2 Structure

Multi-level training (non-physical, physical).

De-escalation primary.

Physical interventions when needed.

Multiple sectors — schools, healthcare, behavioral health.

6\. Right Response

Crisis training program with verbal de-escalation focus.

6.1 Philosophy

Heavy emphasis on verbal de-escalation.

Limited physical techniques.

Trauma-informed integration.

6.2 Common context

Used in some districts, particularly Pacific Northwest.

Often adopted by districts looking to move away from restraint-heavy programs.

7\. Therapeutic Crisis Intervention (TCI)

Cornell University-developed program; widely used in residential and child welfare settings; some school adoption.

7.1 Philosophy

Trauma-informed.

Emphasis on therapeutic intervention during crisis.

Strong focus on debriefing and learning.

Restraint as last resort.

7.2 Structure

Comprehensive program — pre-crisis, crisis, post-crisis.

Physical interventions taught with strict criteria for use.

LSCI (Life Space Crisis Intervention) sometimes paired with TCI.

7.3 Common context

Residential treatment, foster care.

Some specialized school programs.

8\. Professional Crisis Management (PCM)

Behavioral approach to crisis management.

8.1 Philosophy

ABA-aligned.

Prevention emphasis.

Specific protocols for physical management when needed.

8.2 Common context

Some specialized autism and ID programs.

Less common than CPI or Safety-Care in general school populations.

9\. Dimensions to compare across programs

When evaluating which program your district uses, or considering a change, several dimensions matter:

9.1 Restraint use threshold

Imminent danger only? (Most programs state this; implementation varies.)

Property destruction also? (Some programs allow; many don't.)

Non-compliance with redirection? (Should never authorize restraint, but some implementations drift.)

9.2 Specific techniques taught

Prone restraint included? (Increasingly excluded from major programs; remains in some.)

Supine? Floor holds? Blanket holds?

One-person vs. two-person?

Children's Control Position vs. specific holds?

9.3 Time limits on holds

Most programs specify time limits — typically 1-3 minutes for specific holds.

Implementation varies; drift toward longer holds is a known fidelity problem.

9.4 Documentation requirements

All major programs require documentation.

Specifics vary.

9.5 Trauma-informed integration

Increasingly central to training quality.

Older versions of programs sometimes didn't address trauma.

9.6 Anti-disability and anti-racist framing

Newer programs and updates address disproportionate restraint use.

Older or static programs sometimes don't.

9.7 Recertification cycle

Annual is most common; some programs allow longer.

Recertification rigor varies.

9.8 Cost

Site licenses, trainer training, and per-staff costs vary widely.

Total district investment can be substantial.

9.9 Time required

Initial certification — 1 day to multiple days.

Refresher — half day to full day.

This comes out of staff time.

10\. Evaluating fit

Several questions worth asking when a district considers a program:

10.1 About the population

What students are we serving? What's the realistic intensity of behaviors we encounter?

What's the current restraint use pattern? Is it appropriate, or are we using restraint as routine?

What's our trauma-informed practice currently?

10.2 About implementation

Do we have time and money for the program's training requirements?

Can we maintain annual recertification?

Will we invest in the broader practice changes (prevention, relationship, antecedents) that the program assumes?

10.3 About fit

Does the program's philosophy match what we want to be doing?

Is the program adopted by similar districts and producing the outcomes we want?

Are there critiques of this program we should take seriously?

10.4 About change

If we're switching programs, are we doing the broader practice change that makes the switch meaningful?

Or are we just replacing one set of techniques with another and continuing the same practice?

11\. Concerns about training programs broadly

11.1 Training does not produce safe practice without infrastructure

Even excellent training fails when:

Staffing is inadequate.

BIPs are weak or absent.

Antecedent strategies aren't in place.

Trauma-informed practice isn't integrated.

Recertification lapses.

Drift accumulates without correction.

Disproportionate use isn't tracked.

The program is one input. Practice quality requires the surrounding infrastructure.

11.2 Restraint reduction comes from system change

Districts that have substantially reduced restraint use have done so through:

Strong Tier 1 PBIS or comparable systems.

Trauma-informed culture change.

Robust antecedent strategies and BIPs.

Adequate staffing during predictable hot spots.

Leadership commitment and tracking.

Crisis training program choice contributes; it's not the primary lever.

11.3 Equity tracking

Restraint and seclusion data shows persistent disproportionality. The program your district uses doesn't matter as much as whether your district is tracking and responding to the disparities.

11.4 Beyond the techniques

The training programs spend significant time on physical techniques. The actual high-impact work in most schools is the de-escalation, the antecedent work, the relationship building, the trauma-informed culture. The techniques are the infrequent emergency response; the rest is the daily work that determines whether emergencies happen.

12\. The para's role

12.1 In your training

Take it seriously. Practice the verbal de-escalation; it's most of what you'll use.

Practice the physical techniques to mastery if your role requires them.

Maintain certification.

Speak up if training feels inadequate.

12.2 In daily practice

Use de-escalation.

Run antecedent strategies (cross-ref 05.04).

Build relationship.

Document.

Don't perform restraint or seclusion outside your training and authorization.

12.3 When the program isn't working

If you're seeing patterns where the program your district uses isn't producing the outcomes you'd expect:

Surface to supervising teacher and admin.

Document patterns.

Consider whether structural issues (staffing, BIPs, prevention) are the actual cause.

Engage union or professional associations if needed.

12.4 Self-care

Crisis work is hard. Cross-ref 14.01 (Burnout) and 14.03 (Vicarious Trauma). Sustainable practice requires sustainable workers.

13\. Equity considerations

Training quality varies; districts with fewer resources often have less robust training.

All major programs have evolved on disproportionate restraint use; the field has progress to make.

Restraint and seclusion of Black students, students with disabilities, and Black students with disabilities specifically remains disproportionate regardless of program choice — the structural patterns require structural responses.

Some programs are more explicit about anti-racism and anti-ableism than others; verify.

OCR and federal civil rights data document persistent disparity; tracking matters.

14\. Common pitfalls

Treating training as a substitute for system infrastructure.

Performing techniques outside authorized training.

Letting recertification lapse.

Treating physical techniques as the substance of the program.

Ignoring drift.

Not tracking disproportionate use.

Ignoring critiques of the program.

Treating the choice as fixed and unchangeable when patterns suggest reconsidering.

Treating workers as the problem when system underinvestment is the actual cause.

15\. Resources

Major programs

Crisis Prevention Institute (CPI) — crisisprevention.com

Ukeru Systems — ukerusystems.com

QBS Safety-Care — qbs.com

MANDT System — mandtsystem.com

Right Response — rightresponse.org

Therapeutic Crisis Intervention (Cornell) — rccp.cornell.edu

Professional Crisis Management — pcma.com

Federal and equity

DOE Restraint and Seclusion Resource Document (2012) — ed.gov

Civil Rights Data Collection — Restraint and Seclusion data — ocrdata.ed.gov

Disability Rights Education and Defense Fund (DREDF) — dredf.org

ASAN — Stop Hurting Kids — autisticadvocacy.org

Cross-references

Brief 05.10 — Escalation Cycle — this library

Brief 05.11 — Crisis Response — this library

Brief 05.12 — Restraint and Seclusion — this library

Brief 14.01 — Burnout and Compassion Fatigue — this library

Brief 14.03 — Vicarious Trauma — this library

Brief 16.14 — I Witnessed a Restraint That Concerned Me — this library

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