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A 5 Day Training Programme to Develop Senior Practitioners in The Low Arousal Approach

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A 5 Day Training Programme to Develop Senior Practitioners in The Low Arousal Approach

The lowarousal approach is an internationally recognised and evidenced based approach to the management of severe challenging behaviours (behaviours of concern). Due to demand in 2014 Studio3 will be running specialist practitioner training courses in these approaches. These training courses will help practitioners further develop their crisis planning and deescalation skills.

 – Improve your practitioner skills: Become better at spotting meltdowns.

 – Make de-escalation a science: Greater emphasis on de-escalation skills.

 – Reduce confrontation across your organisation: How to promote an organisational approach to low arousal.

 – Improve your behaviour support skills: Become more expert at crisis support. ‘Before you try to change behaviour manage it well first’ (McDonnell, 2010).

 – Move away from physical interventions of all kinds: Making this a reality.


The low arousal approach is a behaviour management philosophy. It was originally developed in the 1980s and 1990 in the UK in adult intellectual disability services. Since this time the approach has become popular with autism and disabilities services in the UK and Europe. The low arousal approach emphasises a range of behaviour management strategies that focus on (a) the reduction of physiological arousal and manipulation of antecedent triggers (b) the prevention of aggression and crisis strategies which avoid punitive consequences and seek the least restrictive alternative behaviour solutions.

As a Clinical Psychologist in the 1980’s Dr Andrew McDonnell became increasingly interested in the area of behaviour management and in particular the development of staff training in the management of challenging behaviours. These included verbal and physical aggression.Dr Andrew McDonnell had attended many workshops and seminars on managing challenging behaviours which ranged from functional analysis through to restraint approaches. These experiences led me to realise that there was very little scientific research conducted into crisis management. Dr Andrew McDonnell realised that a scientific approach to crisis management could help practitioners and their families.

Dr Andrew McDonnell conducted more detailed research and his PhD focussed on the evaluation of staff training that included the use of physical interventions. This work led to the development of the Low Arousal Approach and a training programme used by Studio III training. The programme attempted to reduce, and in some cases eradicate, the teaching of physical restraint. Dr McDonnell has published numerous articles in this field.From his recent book titled “Managing Aggressive Behaviour In Care Setting : Understanding And Applying Low Arousal Approaches” the definition has been further redefined (McDonnell 2011).

“I would argue that such an approach can greatly enhance crisis management strategies, functional assessment, and positive behaviour support strategies. As practitioners we are often confronted with very distressed individuals and carers who can be fearful and feel out of control. A central core of the approach involves understanding arousal mechanisms.”


What is the The Low Arousal Approach?

Given that stress is an ever present part of the lives of people with autism how should we manage crisis situations where the individuals we support may be experiencing ‘meltdown’. The term low arousal approach was first used in 1994 (McDonnell, McEvoy & Dearden, 1994). McDonnell (2010) identified four key components considered central to low arousal approaches; these include both cognitive and behavioural elements.

Decreasing staff to client demands and requests so as to reduce potential points of conflict.

 – Avoidance of potentially arousing triggers.

 – Avoidance of staff ? non-verbal behaviours that may lead to conflict.

 – Challenging staff beliefs about the short-term management of challenging behaviours.

Implicit in the approach are two key guiding principles. The first principle is that the approach concentrates on altering our own behaviour in crisis situations. There is now very good evidence which indicates that many challenging behaviours are inadvertently triggered by carers (McDonnell, 2010). A key element is reflective practice (Schon, 1987; McDonnell, 2010). This literally means that a person needs to examine their on contribution to a situation and modify their behaviour accordingly.

The second principle involves the concept of trauma informed behaviour management (McDonnell, 2010). If we view a person as traumatised it has an impact on how we manage their behaviour. Quite often people who are stressed and traumatised experience panic and need to escape from situations. It has been my experience that staff and supporters often prevent a persons escape and inadvertently escalate the arousal/stress response. I think they do this to “contain”situations, whereas in reality this often exacerbates a panic response.


Where are these approaches needed?

Dr Andrew McDonnell and his colleagues noticed that that low arousal approaches did appear to have a significant impact on crisis management. It was also very clear even in the early 1990s that low arousal approaches would have application to a whole range of fields, such as ADHD and children and young people with various forms of trauma.

The approach is needed in many areas where people are working with behaviours of concern. Good crisis management is always a core component of any positive approach to behaviours. Behaviour management strategies are an integral part of any support plan; Ted Carr put this succinctly when he wrote:

“It is a mistake to think that once an intervention is underway, you no longer need to worry about serious outbursts and the necessity for crisis management” (Carr et al. 1994, p.14).

What are the benefits of Low Arousal Approaches?

There are a number of benefits of supporters and families adopting low arousal approaches:

– The reduction of restrictive practices such as restraint has positive impact on both supporters and people with autism and challenging behaviours.

– Staff who are confident in managing behaviours will take more risks in managing behaviours (McDonnell, 2010). In our experience people who are more confident will make positive risk decisions, such as, he has had a bad day but he likes bowling so I will still take him because I can manage his behaviours.

– The approach tends to change the viewpoints of supporters and make them more aware of their own contribution to challenging situations.

– A greater understanding of arousal and stress mechanisms informs our practice.

– Understanding autism from a stress management perspective allows us to start a different conversation. Instead of focussing on individual behaviours we can focus on alleviating external sources of stress.

– We can also use positive language such as coping as it implies that there is something that can be done to mediate stress.

– Reducing arousal will create more opportunities for learning and enhance this learning.

The next unsurprising extension of this work Linda and Andrea have written a really popular book called “Managing Family Meltdown”. In the book Linda and Andrea gave an excellent interpretation of the approach.

“The low arousal approach is the cornerstone of the Studio 3 method of managing distressed behaviour. The approach gives a framework for managing your child (and adult?). It is an approach which, in some ways is counter intuitive in that in goes against most of the rules we have for parenting children and young people. It starts with us looking how we operate around the young person. It questions all our assumptions and examines our values and beliefs, and forces us to look inward and take control of the way we react and respond to distressed behaviour. Therefore, it does not come easy. It is worth persevering, remember it is a skill like any other and therefore it has to be practised!”

The Low Arousal Practitioner Qualification

Studio3 have developed an intensive practitioner training programme to help improve low arousal practice.


The training course is 5 days in duration.


The programme has three distinct elements. The first element of the training course concentrates on practical skills about the approach. The second focuses on the application of the methods in everyday environments. The third element involves the skills surrounding communication and teaching about low arousal. Participants will be provided with teaching materials and aides and in addition will havel information provided from our website (www.lowarousal.com).

Upon completion of this training participants will be able to deliver both one day and half day low arousal training and entitled to describe themselves as licensed Low Arousal Trainer and will be registered on the lowarousal website.

Day one

• Introduction to the history and development of the approach.

• Why is ethical behaviour management so important?

• Creating more reflective practitioners.

Day Two

• What are the skills involved in low arousal approaches and what do we teach?

Day Three

• Practicing the low arousal approach (use of role play and practice exercise

• Key elements in teaching low arousal approach.

Day Four

• Applying low arousal in care environments. (including case examples and role play).

• Writing reactive strategies

Day Five

Training staff in the approach.


All course participants will be evaluated on the programme and feedback provided.

Evaluation will consist of the following:

a) Direct observations of participants delivering elements of low arousal training.

b) A knowledge based assessment of low arousal approaches.

Coaching and Mentoring

Coaching and mentoring is provided to participants for the first 6 months post training

Refresher training and CPD

This will consist of 1 day between 12 post training.


The cost of the 5 day programme (non residential) is £1500 plus VAT. This includes post training coaching and mentoring. An annual CPD fee of £400 covers mentoring and the refresher day.


There are 3 programmes in 2014

• Week beginning Monday 9th June

• Week beginning Monday 15th September

• Week beginning Monday 24th November


Andrew McDonnell, PhD. October 2014


Download a Pdf with this information here


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