What are the "DE-ESCALATION TECHNIQUES" IN A CRISIS SITUATION?

What are the "DE-ESCALATION TECHNIQUES" IN A CRISIS SITUATION?in a Mental Health Facility?
Are there VERBAL ones??

Answer by Scott
There are many techniques for verbal de-escalation of crisis situations, in various scenarios, including a mental health facility.

Here is a partial list of de-escalation techniques that experienced mental health nurses find to be helpful in a crisis:

- Assess the situation promptly. If you see signs and symptoms of a person entering into crisis, intervene early.
- Maintain a calm demeanor and voice.
- Use problem solving with the individual -- ask "What will help now?"
- Be empathetic.
- Reassure individual that no harm will come to him or to others.
- Avoid an argumentative stance.
- Offer to help.
- Engage the individual.
- Use stress management or relaxation techniques such as breathing exercises.
- Don't crowd the individual; give him or her space.
- Be aware of yourself -- your look, your tone.
- Offer choices.
- Use open-ended questions.
- Give the individual time to think.
- Decrease the tension with relaxation techniques.
- Ignore challenges; redirect challenging questions.
- Tell them what you can do to help them.
- Allow venting.
- Allow pacing.
- Don't say "you must."
- Avoid power struggles.
- Set limits and tell them what the expectation is.
- Be careful with your nonverbal behavior.
- Be aware of the individual's nonverbal behaviors.
- Be clear; use simple language.
- Language -- follow the rule of 5 (no more than 5 words in sentence, 5 letters in a word -- eg, "Would you like a chair?")
- Use reflective technique -- "Am I hearing you?"
- Agree to disagree.
- Be willing to break the rules.
- Consider using sensory modalities such as weighted blankets or calming rooms with stress reduction tools.

Guidelines to maintain safety of both yourself and others during situations of potential violence include:

- Take a position just outside the individual's personal reach (out of arm's reach) on the nondominant side.
- Maintain an open posture.
- Keep the individual in visual range.
- Make certain the room's door is readily accessible; avoid letting the individual get between you and the door.
- Summon help if the individual's aggression escalates to violence.
- If other patients are in the vicinity, ask them to leave the room to decrease distractions and protect the person's dignity.

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