Presentation on theme: "De-Escalation and Pro-active Communication Skills"— Presentation transcript:
1De-Escalation and Pro-active Communication Skills How to manage aggression and hostility and move the client forward when they are acting out.A. Christine Furman MMHSDirector of Acute Care Services
2What we are going to talk about: Recognizing aggression and hostilityCommunication SkillsNon-verbal Communication SkillsDiffusion StrategiesDe-escalation techniques and skill
3Why do people escalate and become aggressive or hostile? FrustrationFeel that they have been treated unfairlyFeel that they have been humiliatedThey are immatureThere is a level of excitement they are reacting toIt works – it is a means to an endIt is part of their reputationAggression and Hostility may be symptoms of their mental illness
4How do you know when someone is feeling hostile or aggressive? They may stand tallerTheir face may reddenTheir voice may raiseThey may breath fasterThey may make prolonged, direct eye contact with you – stare you downThey may make exaggerated gesturesThey may become very tenseThey may begin to paceThey may clench their fistsThey may clench their jaw and tighten their facial musclesBehavior is different than normal
5Communication Listening Speaking, and Hearing Observe, and Interpret This is a two way process that includes:ListeningSpeaking, andHearingAs a staff member you will also need to:Observe, andInterpret
6Some things that get in the way of effective communication are: Background noise, and having tospeak loudly (are you having to yell?)Inappropriate settingLanguage barriersPerception and PrejudiceIntrusion of personal spaceTime constrainsLack of encouragement
7Twelve Roadblocks to Listening – Thomas Gordon, Ph.D. Ordering, directing, or commandingWarning or threateningGiving advice, making suggestions, or providing solutionsPersuading with logic, arguing, or lecturingMoralizing, preaching, or telling clients what they ‘should’ doDisagreeing, judging, criticizing, or blamingAgreeing, approving, or praisingShaming, ridiculing, or labelingInterpreting or analyzingReassuring, sympathizing, or consolingQuestioning or probingWithdrawing, distracting, humoring, or changing the subject
8Escalation Prevention Steps: Prevention Step #1 Staff need to be able to recognize early warning signals such as:Behavior changesQuiet people become agitatedLoud people become quietCommenting on the changes may open up conversation and minimize frustration or anger build up – giving the client an opportunity to diffuse the situation.
9Prevention Step #2Recognize that Anger is a normal emotion – we don’t always need to fix it or be afraid of it – unless the person becomes a danger.Anger is not ‘normal’ when:Anger is often used to get ones wayAnger is often used to getattentionto escape a situationto gain control of a situationAnger is used to pump one’s self up when feeling small or insecure
10Prevention Step #3Staff need to remain in touch with their emotions when dealing with an angry client. If you become angry or defensive you will not be able to help the client. If you cannot manage your emotions and remain calm and objective, you will need to get help.
11Prevention Step #4Take a deep breath, and attempt to remind yourself of the following:Avoid criticizing and finding fault with the aggressive person.Avoid being judgmental with the aggressive person.Use a calm, steady voice without and edge or sing song.Do not become involved in the conflict.Be able to try to see the situation from the angry person’s point of view.Remember that your job is the health and safety of your client.Have a plan.
12What should staff do once a client has Escalated? Take deeper breathAppear confident – but not cockyRemain calmShow that you are listeningSpeak slowly, gently and clearlyAvoid arguing and confrontationCreate space between you and the agitated personKnow how you are going to get out of the area
13Adopt a non-threatening body posture Use a calm, open posture – either sitting or standingReduce direct eye contact – do not stareAllow the person adequate personal spaceKeep both hands relaxed and visibleAvoid any sudden movementsAvoid and discourage an audience
14De-Escalation Techniques Explain your purpose or intentionGive clear, brief, assertive instructionNegotiate optionsEnsure that your non-verbal communication is non-threatening
15De-Escalation Technique #1 Just Listen Sometimes all it takes to de-escalate someone is a good ear and the time to allow the client to vent. Just listen to what they have to say and give them encouragement.
16Technique #2 Acknowledgement This is when you really listen and are able to relay back to them that you understand what they are feeling. “I understand that you are angry” “I see that you are frustrated” “You feel that you have been wronged”
17Technique #3 Allow Silence You don’t need to be the problem solver. It’s not your job to have all the answers. Give the client time to reflect, don’t fill the time with your thoughts and questions. Just be with them, calmly.
18Technique #4 ApologizeIf the situation was unjust or unfair – a sincere apology is powerful. It does not mean that you are accepting blame, it means you are acknowledging that something that occurred wasn’t right or fair.
19Technique #5 Invite Criticism Ask what you/we/the program could do better, be sincere. Don’t tell them why it won’t work or why it’s not a good idea, just listen and thank them for their input. This may intensify someone’s anger temporarily – but if you encourage them to continue and let them be heard the conversation tends to end on a more positive note.
20Technique #6 Develop a Plan You should have a plan at the ready, for example… a place for a time out, a meeting with a supervisor or case manager; however you will want to work out the options with the client.
21Never ThreatenOnce you have threatened or given an ultimatum all negotiations will cease and you will be in a win/lose situation. Try to keep options as open as possible.
22Ultimate Plan for Safety Do you have a plan if you can’t de-escalate a client?Does your agency?Does your agency have P&P regarding safety?Do you have a way to summons others for help?