De-escalation Techniques in Healthcare

Core De-escalation Techniques

Healthcare environments involve high levels of stress and people who are going through difficult physical and mental health situations. All of this can create tension and potentially lead to violence. De-escalation techniques in healthcare can help address these challenges with some core strategies. 

Verbal Communication 

One of the most essential de-escalation techniques in healthcare is verbal communication. This involves using a calm and neutral tone of voice, though not a flat affect. It’s important to sound connected to the person and to speak clearly and slowly. 

Choosing your words carefully makes a difference, too. Avoid statements like “You’re overreacting” or “calm down,” since they can make the person feel like their emotions don’t matter. 

I Language

Use “I” statements so that you avoid sounding like you’re accusing the person. Keep your message as simple and concise as possible. An example would be “I understand that you’re upset, and I’m concerned for your safety.”

Active Listening

Active listening gives the person undivided attention, making them feel heard. It’s a de-escalation technique that involves strategies like paraphrasing what the other person has said to let them know that you’ve understood. It’s also helpful to use open-ended questions and avoid interrupting them as they speak. 

Active listening also involves using subtle physical cues, like nodding as the person speaks. This helps to create a non-threatening environment. 

Non-Verbal Strategy

Some of the most effective de-escalation techniques in healthcare don’t involve saying a word. Instead, you can use non-verbal cues to put the other person at ease. 

Try an open physical posture, like keeping your arms at your sides instead of crossing them over your chest or standing with your weight balanced on both feet to avoid appearing threatening. 

You could also try leaning in slightly as you listen. Ensure you’re not looming over the person, however, since that can have the opposite effect of what you’re looking for. 

Avoid sudden and rapid movements. If you need to walk, do so slowly. When possible, taking a seat can quickly lower the emotional temperature in the room because it shows that you’re not a threat while also letting the other person know that you’re there to listen. 

Maintain an appropriate level of eye contact. Don’t stare, since this can be seen as aggressive. To soften the pose, tilt your head slightly. 

Boundary Setting

Setting clear boundaries on what is and isn’t acceptable behavior is also an effective way of de-escalating the situation. The goal is to let the person know there are limits without shutting down all communication. 

For example, you may let them know that threats or shouting won’t be accepted in the conversation, since they offer nothing constructive. 

It’s essential to be calm and assertive. Don’t raise your voice, but set clear expectations. Put a focus on mutual respect, and connect the boundary you have set with a reason for it. 

For example, you can state that you want to help them, but it can be hard to understand them if they scream. Be ready to enforce the boundary, too, though not aggressively. 

Environmental Adjustments

De-escalation techniques in healthcare should also include making adjustments to the environment to diminish tension. It’s helpful to remove objects that could be used as weapons and even make an offer to the person to go into another room. 

If there are noises, remove as many as you can. Turn televisions off and ask other people to leave. If the person is disoriented, use familiar objects to ground them. It’s always helpful to offer options, such as going to another room, taking a seat, or getting a drink of water. 

Make sure to also provide space. Don’t make the person feel crowded. 

Trauma-Informed Care Approaches

In healthcare settings, many escalations occur as a result of a person responding to past trauma. You must consider whether traumatic experiences are fueling the aggression and take steps to avoid replicating the trauma, including not using force or yelling. 

Encourage the other person to focus on their breathing. Speak in a calm and supportive tone and, if it’s safe to do so, sit next to the person or crouch in front of them to make yourself less of a threat. 

Someone who has reacted out of past trauma will be in an agitated state, so let them know everything you’re going to do before you do it. If you’re planning on getting closer, tell them so. 

When to Use These Techniques

Knowing what techniques to use is essential, but so is knowing when to put them to work. 

Look for early signs of agitation. These can be physical, like pacing, clenching their hands into fists, or fidgeting, or they can involve excessive talking or being uncooperative. As soon as you notice these signs, it’s time to use de-escalation techniques. 

Someone having a mental health crisis is much more likely to escalate a situation into aggression. Someone who’s crying, speaking about self-harm, or seeming not to recognize where they are can benefit from all of the above de-escalation techniques. 

These techniques can be helpful in overstimulated environments, too. People can become agitated if there’s too much noise, movement, or light. By encouraging them to express what they’re feeling and removing some of those triggers, you can prevent the issue from getting worse. 

De-escalation techniques in healthcare situations can work well in family conflicts, too. You can rely on all of these strategies to help loved ones communicate better with one another.

How Organizations Can Improve Their Approach

Healthcare facilities can improve the way they address difficult situations that could lead to workplace violence. With facility-wide training, there can be a consensus on the right steps to take if a problem arises. Knowing how to de-escalate to a safe state can make everyone in the team feel more in control of their environment. 

It’s important to have leadership involvement when it comes to healthcare workplace violence prevention. This can ensure there are clear protocols in place and that an effort is made for continuous improvement.