Universal Crisis Package: Program-Wide Safety & Hardening

Overview

The Universal Crisis Package is a comprehensive, program-wide framework designed to standardize safety protocols, risk mitigation strategies, and response mechanisms across all 75 sessions of the “What Really Happened” (WRH) Master Curriculum. This package ensures consistent application of hardened overlays, clear communication pathways, and robust liability boundaries, particularly in high-acuity environments.

1.0 Core Components of the Crisis Package

1.1 Regulation Grounding Protocol (RGP)

The RGP is a mandatory, standardized set of physiological exercises designed to rapidly re-regulate the nervous system. It serves as the foundational safety mechanism for initiating and concluding every session, and as an immediate intervention during moments of participant dysregulation.

Application: Mandatory at session start, session end, and during any moment of participant distress.
Key Elements: 4-in/6-out breathing, feet flat on floor, hand on chest/belly, environmental awareness (yellow/red light).
Reference: Standardized Safety Language Template

1.2 Safety Planning Intervention (SPI) Handoff Protocol

The SPI Handoff Protocol defines the precise steps for transitioning a participant experiencing acute distress or suicidal ideation from the non-clinical WRH environment to qualified clinical personnel. This is a “warm handoff” to ensure continuity of care and minimize risk.

Trigger: Facilitator identifies acute distress, direct or indirect suicidal ideation, or inability to self-regulate using RGP.
Procedure:
1. Immediate, calm engagement using non-clinical safety language.
2. Activation of designated clinical support staff.
3. Facilitator provides brief, de-identified context to clinical staff.
4. Physical escort of participant to clinical support area.
5. Documentation of incident (see Section 3.0).
Reference: Standardized Safety Language Template

1.3 S-Prefix Metric Framework

The S-Prefix Metric Framework is a standardized system for quantifying and reporting safety-related incidents and participant responses. This framework ensures consistent data collection for program evaluation and continuous improvement.

Metric Prefix	Description	Example	Reporting Frequency
S-ACT	Participant Activation Level (1-5)	S-ACT-4 (High Activation)	Per incident, per session
S-REG	RGP Effectiveness (Success/Partial/Fail)	S-REG-Success	Per RGP application
S-INT	Intervention Type (Verbal/RGP/SPI)	S-INT-SPI	Per intervention
S-OUT	Outcome of Intervention (Stabilized/Handoff/Exit)	S-OUT-Handoff	Per intervention

1.4 Liability Boundary Language

Explicit language defining the non-clinical nature of the WRH curriculum and the boundaries of facilitator roles. This protects both participants and the organization by clarifying expectations and responsibilities.

Key Phrases: “This is psychoeducational, not psychotherapy.”, “We focus on system logic, not clinical diagnosis.”, “Facilitators are not clinicians.”
Application: Integrated into facilitator scripts, participant agreements, and program marketing materials.
Reference: Standardized Safety Language Template

2.0 Delivery Tiers and Acuity Models

To ensure appropriate safety measures are in place, the WRH curriculum defines distinct delivery tiers based on participant acuity and environmental context.

Delivery Tier	Acuity Level	Environment Examples	Session 12 Requirement
Tier 1 (Community)	Low-Moderate	Vet Centers, Community Groups, Outpatient Programs	Standard RGP, Basic SPI Awareness
Tier 2 (Structured)	Moderate-High	Intensive Outpatient Programs (IOP), Partial Hospitalization Programs (PHP), Residential Programs	Full RGP, SPI Handoff Protocol, S-Prefix Reporting
Tier 3 (Clinical)	High-Acute	Inpatient Psychiatric Units, Psychiatric Residential Rehabilitation Treatment Programs (PRRC)	Full RGP, SPI Handoff Protocol, S-Prefix Reporting, On-site Clinical Support, Hardened Overlays

Session 12 (Internal Behavioral Conflict Systems), due to its inherent potential for high participant activation, mandates a minimum of Tier 2 (Structured) delivery, with Tier 3 (Clinical) highly recommended for optimal safety and support. The Session 12 Pilot Portal reflects these stricter requirements.

3.0 Program-Level Adverse Event Reporting

Standardized procedures for reporting, tracking, and analyzing adverse events to ensure continuous program safety and quality improvement.

3.1 Reporting Procedure

Immediate Notification: Any adverse event (e.g., participant distress requiring SPI, significant behavioral disruption) must be reported to the Program Coordinator within 1 hour.
Detailed Incident Report: A comprehensive report, utilizing the S-Prefix Metric Framework, must be completed within 24 hours.
7-Day Follow-up: Program Coordinator conducts a follow-up with the participant (or clinical team, if handoff occurred) within 7 days to assess well-being and program impact.

3.2 De-identified CSV Export Standards

All adverse event data will be compiled and exported weekly into a de-identified Comma Separated Values (CSV) format for analysis. This ensures participant privacy while allowing for robust data-driven insights.

Data Fields: Incident ID, Date, Time, Session Number, Delivery Tier, S-Prefix Metrics (S-ACT, S-REG, S-INT, S-OUT), Brief Description (de-identified), Follow-up Status.
Anonymization: All personally identifiable information (PII) will be removed or aggregated prior to export.
Purpose: Trend analysis, risk pattern identification, program refinement, and compliance auditing.