Practical 3–5-day training in prevention, de-escalation, personal safety and last-resort protective interventions, tailored to your healthcare setting.
Prevention First
Recognise distress early and reduce avoidable escalation.
Dignity Throughout
Protect patients’ rights, choices and individual needs.
Coordinated Responses
Build shared standards for communication and protective intervention.
Lasting Capability
Practise, assess and reinforce skills beyond the training room.
When care becomes difficult
A patient becomes frightened during personal care. Someone in the emergency department feels ignored and begins threatening staff. A person on a mental health ward becomes increasingly distressed while other patients gather nearby.
Your team needs more than a collection of holds. They need to recognise what is happening, communicate without adding pressure, and decide when to step back, call for help or take protective action.
“If the training makes staff better at holding people but no better at preventing the need to hold, the programme is incomplete.”
The principle behind every Dynamis PMVA programme
Keep care at the centre of your response
PMVA means Prevention and Management of Violence and Aggression. Prevention is not an introduction to the physical skills. It runs through the whole course.
Primary prevention
Understand individual needs, recognise triggers and improve the conditions in which care takes place.
Early intervention
Respond to distress, use de-escalation and support people before risk becomes an emergency.
Protective responses
Disengage or intervene when necessary, using the least restrictive lawful option and ending restriction as soon as it is safe.
The aim is not to make people comply at any cost. It is to protect patients, colleagues and others from harm.
Why professionals choose Dynamis
Expert led
Practitioner-designed content, with clinical and legal review behind the syllabus.
Scenario based
SCENA: scenario-based, coaching-led, non-linear learning with assessment for learning.
Legally sound
Necessity, proportionality and least-restrictive decision-making practised, not just described.
Skills that stick
Coached repetition, assessment and refresher planning beyond the training room.
Built around your clinical setting
Nurses, healthcare assistants, support workers, allied health professionals, healthcare security staff and clinical leaders whose roles involve foreseeable risks of aggression or violence.
The physical content follows the role, patient population and assessed risk. A frail patient resisting personal care does not present the same training need as a team responding to serious violence in a psychiatric intensive care unit.
- Inpatient mental health wards and psychiatric intensive care units
- Emergency departments and acute hospital services
- Learning disability and specialist healthcare services
- Older people’s services, including dementia care
- Community healthcare and teams working alone
- Healthcare transport and secure escort services
Course facts
| Course title | PMVA for Healthcare: Prevention, De-escalation and Protective Interventions |
|---|---|
| Duration | 3–5 days, agreed following training needs analysis |
| Delivery | Facilitated, scenario-driven training with coached physical practice and assessment |
| Course aim | Equip healthcare staff with the knowledge, understanding and practical skills to prevent and manage violence and aggression, protect dignity, reduce restrictive practice and respond proportionately when there is a risk of harm. |
- Recognise distress and intervene earlier
- Communicate calmly under pressure
- Make lawful, person-centred decisions
- Disengage or intervene proportionately
- Provide aftercare, record and learn
Full course content
1. Understanding distress, behaviour and escalation
Staff explore the person behind the behaviour: what has changed, what they may be experiencing, and what the team can do differently.
- Baseline behaviour, triggering cues, and the phases of crisis, recovery and re-entry
- Unmet needs, positive behaviour support and person-centred care planning
- Trauma history, perceived threat, stress responses and perceptual narrowing
- Status, certainty, autonomy, relatedness and fairness in an encounter
- Adapting communication for cognitive impairment, dementia, delirium and learning disability
- Advance statements or directives, where applicable
2. Professional communication and de-escalation
The first approach can change the direction of an encounter. Staff practise introducing themselves, listening, explaining and setting boundaries without creating confrontation.
- Dignity and respect as observable professional behaviours
- Preparing to engage and maintaining emotional equilibrium
- Tone, body language, positioning and personal space
- Redirection, persuasion, clear explanations and meaningful options
- Responding to abuse, threats, complaints and refusal
- First-responder responsibilities and team coordination
3. Legal decisions, duty of care and restraint reduction
Staff practise explaining not just what they did, but why it was necessary.
- Duty of care for patients, colleagues and others
- Human rights, equality, mental capacity and mental health law
- Lawful authority, honest belief, necessity and proportionality
- Recognising restraint and restrictive practice, including clinical holding
- Withdrawal, containment and seclusion, including their safeguards
- Reporting, safeguarding, aftercare and duties of candour
4. Personal safety and breakaway
Protecting yourself, creating space and seeking assistance without turning disengagement into an unnecessary restraint.
- Stance, movement, balance and protective frames
- Protection from head impacts and risks to the head and neck
- Disengagement from wrist, clothing and hair grabs
- Body grabs, bear hugs, throat grabs and headlocks
- Responses to biting and kicking
- Two-person breakaway and team disengagement
5. Lower-level protective interventions (PI-Lo)
Lower-level contact still requires a lawful justification. Staff practise when guidance is appropriate, when contact may increase distress, and when to release.
- Transition from verbal engagement to physical guidance
- Prompting, guiding and escorting, front and rear approaches
- Single-staff and coordinated two-staff escorts
- Humerus contact and control, clothing grips, wrist and straight-arm holds
- Seated guidance and kneeling adaptations
- Coordinated release and stepping down restriction
6. Higher-risk and specialist interventions (PI-Hi)
Where the needs analysis identifies a role for higher-risk interventions, teams practise coordinated responses with explicit attention to clinical risk, communication and earliest release.
- Arm-wrap and protective-frame interventions
- Team assistance when a colleague is at risk
- Higher-risk seated stabilisation; emergency wall stabilisation
- Emergency floor stabilisation and transitions
- Clinical holding on a bed, and with a Safety Pod where approved
- Vehicle intervention, seclusion entry and exit for authorised services
These are specialist components, not blanket permissions. Inclusion depends on service policy, lawful authority, clinical governance, staffing, equipment and demonstrated competence.
7. Restraint-related risk and medical emergencies
- Physical injury and psychological harm to patients and staff
- Positional and compressional asphyxia; high-risk positions to avoid
- Warning signs of deterioration, including severe agitation
- Monitoring, clear team roles and escalation
- Ending or adapting an intervention when safety requires it
- Post-restraint assessment, recovery positioning and observation
8. Aftercare, recording and learning
- Supporting physical recovery and identifying injuries
- Restoring dignity and rebuilding communication
- Recording observable facts, timings, risks and alternatives attempted
- Meeting reporting, safeguarding and candour requirements
- Reviewing incidents to improve care plans and team responses
What staff know, understand and can do
Know
- The phases of crisis and recovery
- The legal requirements governing intervention
- The difference between support, restraint, clinical holding and seclusion
- Responsibilities for monitoring, aftercare and review
Understand
- How trauma and perceived threat shape an encounter
- When a person needs clinical assessment rather than persuasion
- Why a familiar technique may be unsuitable for a patient or space
- How culture and incident learning reduce restraint
Be able to do
- Recognise change and respond before risk escalates
- De-escalate and adapt communication to need
- Assess risk, call for assistance and coordinate roles
- Release at the earliest safe opportunity and record factually
Practical outcomes apply to the techniques and specialist procedures actually taught and assessed, not every option listed in the wider syllabus.
Why 3–5 days?
Course length follows the assessed need, not a fixed collection of techniques.
A defined core programme combining prevention, communication, legal decisions, personal safety and the agreed protective skills.
Additional practice and assessment for teams requiring a broader intervention repertoire or more complex clinical scenarios.
An extended programme for higher-risk teams, with greater depth in coordinated responses, specialist procedures and integrated assessment.
The full PI-Lo and PI-Hi range is not compressed into a three-day course by reducing practice time. Where the proposed scope exceeds what learners can practise and demonstrate within five days, additional training is agreed.
Practise the encounters your team actually faces
Dynamis uses SCENA: Scenario-based, Coaching-led, Engaging, Non-linear learning and Assessment for learning. Learners work through realistic encounters, receive coaching and try again with different scenario factors.
Review your incidents, patient population, policies, environment and staff responsibilities.
Build and assess the skills your team needs through coached, relevant practice.
Agree reinforcement, refresher training and review arrangements that maintain capability.
Frequently asked questions
Is PMVA training mainly about restraint?
Will every participant learn every physical technique?
Can clinical and security staff train together?
Does completing the course authorise restraint?
How often should training be refreshed?
Let’s discuss your healthcare team
Tell us where your staff encounter distress, aggression or violence, and what they need to do when it happens. We will help you define a PMVA programme that fits your patients, clinical responsibilities and working environment.
Preview build — section order and dimensions mirror the live /training-solutions/ course pages. Elementor v3 document not editable yet, so this is mark-up for the template hand-off.
