--- title: "De-escalation training for disability support workers" description: "What the NDIS and US direct support rules ask of disability support workers, and how providers let staff practise de-escalation before a shift." canonical: https://peopletechrevolution.com/work/industries/disability --- [Our Work](https://peopletechrevolution.com/work) / [Industries](https://peopletechrevolution.com/work/industries) # De-escalation training for disability support workers When the person you support becomes distressed, there is no colleague down the corridor. The moment ## It starts with something small A man comes home and his usual mug is not on the shelf. He asks for it, then asks again, louder. The new support worker explains the dishwasher more slowly, and now the explanation is the problem. A home kitchen, where the shift happens. Out in the community, with no backup. Eye level, voice low, in a calm room. The rules ## What providers are asked to show In Australia and the United States, the rules ask for workers who are competent on shift, and put restraint at the far end of every other option. The participant leads the planning conversation. ### Australia: the NDIS The [NDIS Practice Standards](https://www.ndiscommission.gov.au/rules-and-standards/ndis-practice-standards/verification-module) expect support from workers “who are competent in relation to their role”, and the [NDIS Code of Conduct](https://www.ndiscommission.gov.au/rules-and-standards/ndis-code-conduct) asks for supports provided “in a safe and competent manner with care and skill.” The [NDIS Commission](https://www.ndiscommission.gov.au/rules-and-standards/behaviour-support-and-restrictive-practices/understanding-behaviour-support) says restrictive practices “should only be used as a last resort to prevent harm to the person or others.” De-escalation is the response that comes long before that point. A job coach at a supported workplace. ### United States: direct support professionals The [US Department of Labor](https://www.dol.gov/agencies/odep/program-areas/individuals/DSP) describes direct support professionals as “providing necessary supports and services to people with disabilities of all ages”. The [CMS Direct Service Workforce Core Competencies](https://www.medicaid.gov/sites/default/files/2019-12/dsw-core-competencies-final-set-2014.pdf) name Crisis Prevention and Intervention, including the skill of using positive behaviour supports to prevent crisis and promote health and safety. In intermediate care facilities, [42 CFR 483.450](https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-I/section-483.450) allows physical restraint “As an emergency measure, but only if absolutely necessary to protect the client or others from injury”. Where practice fits ## The response that comes before any plan A behaviour support plan sets the strategies. Practice is how a worker is ready to use them in the moment. Listening first, before offering an answer. ### Rehearsal before the shift Workers practise the early signs: a voice that changes, a question asked twice, a routine that breaks. Then they practise the reply that settles it, such as naming what the person wants and fixing the small thing. Scenarios come from situations your team describes and can follow the strategies in a participant’s plan. See how [VR de-escalation training](https://peopletechrevolution.com/xr/vr-de-escalation-training) runs. Who practises ## Everyone who shapes the shift Support workers in homes and the community, the team leaders who induct them, and the practitioners who write the plans. A handover at the door, rehearsed first. A supervisor at a supported cafe counter. A plan meeting where the person decides. How it runs ## In a headset, or in a browser between shifts Workers rehearse in a [VR headset](https://peopletechrevolution.com/xr/virtual-reality) at team training, or with an [AI roleplay partner](https://peopletechrevolution.com/ai/ai-roleplay-practice) in a browser. Each attempt leaves a record a quality lead can read: who practised, which situations, how many attempts. A facilitator fits the headset first. An AI roleplay partner, with replies to choose. A courtyard conversation, seen through the headset. PTR’s disability work ## Awareness and inclusion, felt from the inside People experience everyday barriers first hand, then practise the conversation that follows. A beachside cafe, felt from the inside. ### Central Coast Council A VR experience that lets community members, businesses and council staff feel what everyday barriers are like. The council developed it as part of its strategy to improve disability access and inclusion. Read the [Central Coast disability awareness case study](https://peopletechrevolution.com/work/case-studies/central-coast-council-disability-awareness). A lounge conversation from Everyday Inclusion. ### Everyday Inclusion A three-part title in the [PTR VR Library](https://peopletechrevolution.com/xr/ptr-vr-library) that lets people feel unconscious bias, microaggressions and intersectionality from the inside, then practise the conversation that follows. See [Everyday Inclusion](https://peopletechrevolution.com/xr/ptr-vr-library/everyday-inclusion). Questions ## What providers ask first Short answers for providers, team leaders and quality leads. The person with disability chairs the meeting. ### How does this relate to positive behaviour support? Positive behaviour support is led by qualified practitioners and set out in a participant’s plan, and the [NDIS Commission](https://www.ndiscommission.gov.au/rules-and-standards/behaviour-support-and-restrictive-practices/understanding-behaviour-support) calls it “an evidence, values, and rights based approach.” Practice rehearses the conversations a worker has on shift, written to sit alongside those strategies. A facility manager on the stairwell landing. ### Do workers need a headset? The same rehearsal runs in a browser, which suits a workforce spread across houses and shifts. A case manager leans toward an older man. ### Can scenarios reflect the people we support? They are written from situations your team describes, with no participant name, plan or record in them. An older man at a craft table, seen through the headset. ### What about aged care and training students? Aged care shares much of this workforce: see [aged care training](https://peopletechrevolution.com/work/industries/aged-care-disability) and [dementia and changed behaviours training](https://peopletechrevolution.com/work/industries/aged-care-disability/dementia-changed-behaviours-training). Students in care qualifications practise the same moments through [simulated learning for RTOs](https://peopletechrevolution.com/work/industries/education/rto-simulated-learning). - [Occupational violence and aggression training](https://peopletechrevolution.com/xr/occupational-violence-aggression-training) - [Psychosocial hazards training](https://peopletechrevolution.com/learn/standards/psychosocial-hazards) - [Does VR training work?](https://peopletechrevolution.com/learn/does-vr-training-work) - [Talk to us about your team](https://peopletechrevolution.com/talk-to-us) Working in disability support? [Open the contact form](https://peopletechrevolution.com/work/industries/disability#contact) Ask Simon’s Digital Twin a question ## Sources Each rule in full, on the regulator’s own site. ### [NDIS Practice Standards](https://www.ndiscommission.gov.au/rules-and-standards/ndis-practice-standards) NDIS Quality and Safeguards Commission The human resource management outcome on competent, qualified workers. ### [NDIS Code of Conduct](https://www.ndiscommission.gov.au/rules-and-standards/ndis-code-conduct) NDIS Quality and Safeguards Commission Supports and services provided in a safe and competent manner, with care and skill. ### [Understanding behaviour support and restrictive practices](https://www.ndiscommission.gov.au/rules-and-standards/behaviour-support-and-restrictive-practices/understanding-behaviour-support) NDIS Quality and Safeguards Commission Restrictive practices as a last resort, and positive behaviour support. ### [Direct Support Professionals](https://www.dol.gov/agencies/odep/program-areas/individuals/DSP) US Department of Labor, Office of Disability Employment Policy Who direct support professionals are and what they provide. ### [Direct Service Workforce Core Competencies](https://www.medicaid.gov/sites/default/files/2019-12/dsw-core-competencies-final-set-2014.pdf) Medicaid.gov, CMS, United States The Crisis Prevention and Intervention competency and its skill statements. ### [Client behavior and facility practices](https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-G/part-483/subpart-I/section-483.450) Electronic Code of Federal Regulations, United States When physical restraint is permitted in intermediate care facilities.