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Appendix - Instructor’s DVD Handouts


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Sign in Sheet

School Violence: School violence is any mean word, look, sign, or act that hurts a person’s body, feelings, or things.  Any mean or hurtful word includes any threats, put-downs, racial slurs name calling, sarcasm, joking, teasing, taunting, or ridiculing. Any mean or hurtful look includes any demeaning facial expression, eye rolling, starting, sticking out the tongue, and any sexual looks. Any mean or hurtful signs includes nasty gestures, threatening with a fist or a weapon, touching oneself or someone else in a sexual manner to cause embarrassment, and exposing one’s private parts. Any mean or hurtful overt acts includes slapping, pinching, hitting, punching, shoving, pulling, poking, kicking, tripping, stomping, petting, hair pulling, or beating. Any mean or hurtful covert acts includes ignoring or violating a person’s wishes or rights, silent threats, ostracizing, isolating others, standing in front of someone else who is standing in line, and manipulating friendships.

Bullying: Bullying occurs when anyone intentionally, repeatedly, commits one or more of these violent acts again and again against a specific individual, and over time, inflicts, or even threatens to inflict, physical or emotional injury or discomfort upon another person’s body, feelings, or possessions.

 

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Life Skills Worksheet


(Student Consequence- Violence Level 2 or Higher)

Choices:

  1. What action did you choose that broke our school’s non-violence rule?

_____________________________________________________________________________
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  1. What was your earlier promise about not using violence? What did you mean by it?

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Consequences:

  1. How did you feel while you were breaking both your promise and the non-violence rule?

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  1. How do you think the other people feel about the violence that occurred?

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  1. How do you feel now about what happened?

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  1. What are the logical consequences of your chosen action? What are the consequences for the kind of violent behavior you engaged in?

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Contract:

  • Are you willing to follow the non-violence rule from now on? Explain why or why not.

_____________________________________________________________________________
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_________________________________________________________________
 Student’s Signature                                                                  Date

_________________________________________________________________
Staff’s Signature                                                                       Date

- Source: Johnson Institute; Respect & Protect: Violence Prevention and Intervention (Participant Manual); Hazelden: Minnesota; 1999.

 

Respect & Protect
Simple Written Contract


(Violence Level 2)

I agree to the following terms:

  1. No one is entitled to use violence in any form. Therefore, I will not use violence at school, or on any school-sponsored transportation, or at any school-sponsored activity away from school.
  2. I will complete the Life Skills Worksheet to the satisfaction of the school office.

Privileges:
Activities at school will be restricted until the Life Skills Worksheet is completed to the satisfaction of the school office.

Consequences:
If either or both terms are not met, the following will take place:

  1. Time-out (suspension) at school or at home.
  2. Parent conference.

The following may also take place:

  1. Behavioral modification contract
  2. Referral to an anger management support group

 

_________________________________________________________________
 Student’s Signature                                                                  Date

_________________________________________________________________
Staff’s Signature                                                                       Date

- Source: Johnson Institute; Respect & Protect: Violence Prevention and Intervention (Participant Manual); Hazelden: Minnesota; 1999.


Violence Thermometer

 

 


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