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Army Medical Command training program teaches patient calming skills

By David DeKunder | 502nd Air Base Wing Public Affairs | April 21, 2017

JOINT BASE SAN ANTONIO-FORT SAM HOUSTON, Texas --

Military medical professionals learned techniques for helping calm patients in crisis during a training program held April 11-14 at the U.S. Army Medical Department Center and School at Joint Base San Antonio-Fort Sam Houston.

Students who participated in the Tri-Service Behavioral Health Training Program were taught skills in de-escalation and therapeutic containment, known as Prevention and Management of Disrupted Behavior-Military, which are used by military medical professionals to help calm and settle down patients at military treatment facilities.

The training program was hosted by U.S. Army Medical Command, or MEDCOM, Office of Surgeon General Behavioral Health Service Line.

Thirty-six military medical professionals who work at military treatment facilities throughout the world participated in the training program, said Capt. Yosef Fufa, Medical Education Training Campus behavioral health instructor/writer at JBSA-Fort Sam Houston.

Fufa was one of 13 instructors who taught students both verbal and hands-on skills for helping patients in crisis.

“The main focus of our training is de-escalation; how to use our verbal skills to de-escalate our potentially aggressive patients,” he said.

Fufa said therapeutic containment are hands-on techniques military medical professionals use when it is necessary to restrain a patient and is utilized as a last resort.

Both de-escalation and therapeutic containment training emphasize skills that are proven to be safe for patients in crisis and military medical professionals who come in contact with them, Fufa said.

Students who completed the program at the AMEDDC&S earned their certification as master trainers in de-escalation and therapeutic containment techniques. With this certification, they will be able to train their co-workers at the military treatment facilities they work at.

“They will be able to train their in-patient behavioral health staff with the de-escalation and therapeutic containment skills they will have learned here,” Fufa said. “And that increases our ability to train even more individuals at their respective military treatment facilities.”

The Tri-Service Behavioral Health Training Program is a collaborative effort between three service branches – Army, Navy and Air Force – and the Veterans Health Administration, or VHA, a branch of the U.S. Department of Veterans Affairs, to standardize practices for de-escalation and therapeutic containment at all military treatment facilities, said Lt. Col. JoEllen Schimmels, MEDCOM Office of Surgeon General in-patient behavioral health program manager.

“We are standardizing our crisis intervention model in behavioral health,” Schimmels said. “The Army, Navy and Air Force are standardizing it across the military health system. When patients are in crisis our goal is to actually prevent, to intervene early enough where we are preventing potentially aggressive behaviors.”

Schimmels said the military started standardizing de-escalation and therapeutic procedures in 2016, when the first session to instruct master trainers in the standardized PMDB was held at a Marine Corps base in San Diego.

The PMDB-M training that took place at AMEDDC&S was the first to take place at an Army site under the standardized procedures.

The military is working with the VHA in conducting PMDB-M training because the agency has used and standardized PMDB-M techniques in its treatment facilities since 1978.

Previously, medical professionals at military treatment facilities were trained in de-escalation and therapeutic containment skills by private organizations. This led to each military treatment facility having their own de-escalation and therapeutic containment training.

Fufa said standardizing PMDB-M procedures at military treatment facilities will help improve patient care because military medical professionals at each facility will be utilizing the same de-escalation and therapeutic containment skills on a consistent basis, minimizing the deviation in care provided by medical professionals.

Providing in-house PMDB-M training at military installations and treatment facilities – instead of having private organizations manage it – will provide a cost savings to the military of up to $7,000 per year at each military treatment facility, said Fufa.

Capt. Wayne Ealey, PMDB-M training manager for the Army and lead coordinator of the training program that took place at AMEDDC&S, said the training also focuses on the well-being of military medical professionals and patients.

“There is a whole component on the co-worker,” Ealey said. “It focuses on relationships – how you develop those, how to identify stress and issues among co-workers that they have, how to reduce the effects of co-worker strain and stress, which makes for better patient outcomes, and how to communicate.”

Ealey, who is the clinical nurse officer in charge for in-patient behavioral health at Fort Campbell, Ky., said the PMDB-M training program’s emphasis on role playing exercises, in which one student pretends to be a patient in crisis and the other student a medical professional, helps the students develop their skills.

“The very literal interaction forces you to work on those skills and it often demonstrates that we all need to work and we all need to improve,” he said.

Ellisha Jones, Family Advocacy Program clinical social worker at Winn Army Community Hospital, Fort Stewart, Ga., participated in the training program. Jones said the training she received will help prepare her for the time when she may have to use de-escalation or therapeutic containment on a patient in crisis.

“It’s designed where it minimizes injuries because it focuses on prevention,” Jones said. “I think the instructors are awesome. They haven’t been afraid to correct us if we are not doing it correctly, which is important because people could get hurt. They have been able to integrate different experience levels and keep it where we are all still learning. It’s been a great learning environment.”

Prevention and Management of Disrupted Behavior-Military U.S. Army Medical Department Center and School