De-escalation technique
12 likes10,294 views
The document outlines de-escalation techniques presented by Dr. Tuti Iryani Mohd Daud. It defines de-escalation as techniques used to prevent harm during potential crises. The techniques aim to ensure safety, help individuals manage emotions, and avoid restraints. Key aspects of de-escalation include maintaining self-control, adopting a neutral physical stance, and having selective discussions that show empathy, set clear limits, and offer choices to resolve issues safely. If de-escalation efforts are not successful, the document advises stopping engagement and requesting help.
De-escalation technique
- 1. DE-ESCALATION TECHNIQUE Dr Tuti Iryani Mohd Daud Senior Lecturer & Psychiatrist, National University of Malaysia Medical Centre. De-escalation technique by Tuti Mohd Daud is licensed under a Creative Commons Attribution- NonCommercial 4.0 International License.
- 2. RECAP
- 3. BY THE END OF THIS LECTURE, YOU WILL BE ABLE TO: Define de-escalation technique Describe how de-escalation is carried out
- 4. Photo by Jessica Flavin https://commons.wikimedia.org/wiki/File:Anger_Controlls_Him.jpg
- 7. What is ‘de- escalation technique’? “a technique used during a potential crisis situation in an attempt to prevent a person from causing harm to us, themselves or others” (Johnson, 2011) Reference: Johnson, A. (2011). “De-escalation strategies for crisis situation” Retrieved from https://www.yumpu.com/en/document/view/21766178/de- escalation-strategies-for-crisis-situations/3
- 8. OBJECTIVES • ensure the safety of the patient, staff, and others in the area • help the patient manage his emotions and distress and maintain or regain control of his behaviour • avoid the use of restraint when at all possible • avoid coercive interventions that escalate agitation (Richmond et al, 2012) Reference: Richmond et al, J.S. (2012). “Verbal De-escalation of the Agitated Patient: Consensus Statement of the American Association for Emergency Psychiatry Project BETA De- escalation Workgroup”, Western Journal of Emergency Medicine, XIII (1), 17-25.
- 9. Trigger Escalation phase Crisis phase Recovery phase Post-crisis depression phase CYCLE OF ASSAULT (Kaplan & Wheeler,1983) Perceived as serious threat body and mind prepare for a fight Violent act body and mind relaxes fatigue, depression, and guilt. Source: Wolf,K & Knight,M. The Assault Cycle and Verbal Diffusion Handout. Retrieved from http://www.ala.org/pla/sites/ala.org.pla/files/content/onlinelearning/webinars/Assault_Cycle_Rev.pdf De-escalation technique
- 10. IMPORTANT ASPECTS DURING DE-ESCALATION Self- control: we are in control of ourselves Physical stance: how we stand (i.e. posture, non-verbal language) De- escalation Discussion: the verbal exchange Reference: Skolnik-Acker, E. Verbal De-Escalation Techniques for Defusing or Talking Down an Explosive Situation”. Retrieved from http://www.naswma.org/?page=520.
- 11. SELF CONTROL Appear calm Voice: low and monotonous Do not be defensive (even though you are being insulted by the other person) Be aware of the back up assistance available Be respectful References: 1. Johnson, A. (2011). “De-escalation strategies for crisis situation” Retrieved from https://www.yumpu.com/en/ document/view/21766178/de-escalation-strategies-for- crisis-situations/3 2. Skolnik-Acker, E. Verbal De-Escalation Techniques for Defusing or Talking Down an Explosive Situation”. Retrieved from http://www.naswma.org/?page=520.
- 12. STANCE Same eye level Distance: Extra distance (2 arms length) Door: Stand between the door & the individual Do not smile References: 1. Johnson, A. (2011). “De-escalation strategies for crisis situation” Retrieved from https://www.yumpu.com/en/ document/view/21766178/de-escalation-strategies-for- crisis-situations/3 2. Skolnik-Acker, E. Verbal De-Escalation Techniques for Defusing or Talking Down an Explosive Situation”. Retrieved from http://www.naswma.org/?page=520.
- 14. HOW SHOULD I RESPOND? Why do I need to fill in this form? Why are you lazy? Reference: Skolnik-Acker, E. Verbal De-Escalation Techniques for Defusing or Talking Down an Explosive Situation”. Retrieved from http://www.naswma.org/?page=520.
- 16. HOW SHOULD I RESPOND? Why do I need to fill in this form? Why are you lazy? Reference: Skolnik-Acker, E. Verbal De-Escalation Techniques for Defusing or Talking Down an Explosive Situation”. Retrieved from http://www.naswma.org/?page=520. Respond selectively
- 17. COMMUNICATION • Explain the rules in assertive tone of voice and respect • Give choices, where both choices are safe Example: “Would you like to continue our discussion calmly or would you prefer to stop now and talk tomorrow when things can be more relaxed?” (Skolnik- Acker, E.) • Empathy towards feelings not behaviour Example: “I understand that you have every right to feel angry, but it is not okay for you to treat myself or others this way.” (Skolnik-Acker, E.) • Suggest an alternative behaviour if appropriate Example:“Would you like to take a break and have a cup of water?”(Skolnik-Acker, E.) • Give consequences if the patient exhibits inappropriate behaviour, without showing anger References: 1. Johnson, A. (2011). “De-escalation strategies for crisis situation” Retrieved from https://www.yumpu.com/en/ document/view/21766178/de-escalation-strategies-for- crisis-situations/3 2. Skolnik-Acker, E. Verbal De-Escalation Techniques for Defusing or Talking Down an Explosive Situation”. Retrieved from http://www.naswma.org/?page=520.
- 18. 10 DOMAINS OF DE-ESCALATION (Richmond et al, 2012) 1. Respect personal space 2. Do not be provocative 3. Establish verbal contact 4. Be concise 5. Identify wants and feelings 6. Listen closely to what the patient is saying 7. Agree or agree to disagree 8. Lay down the law and set clear limits 9. Offer choices and optimism 10. De-brief the patient and staff Reference: Richmond et al, J.S. (2012). “Verbal De-escalation of the Agitated Patient: Consensus Statement of the American Association for Emergency Psychiatry Project BETA De-escalation Workgroup”, Western Journal of Emergency Medicine, XIII (1), 17-25. Retrieved from https:// escholarship.org/uc/item/55g994m6
- 19. If you think your de-escalation technique is not successful… stop leave and ask for help!
- 21. Photo by Jessica Flavin https://commons.wikimedia.org/wiki/File:Anger_Controlls_Him.jpg
- 22. SUMMARY • To reduce the anger so that discussion is possible • De-escalation technique consists of three aspects: self-control, stance and de-escalation discussion • If you think de-escalation technique is not working, leave and ask for help!
- 23. De-escalation technique by Tuti Mohd Daud is licensed under a Creative Commons Attribution- NonCommercial 4.0 International License.