november 2012 managing resistive behaviour.. november 2012

November 2012

Managing Resistive Behaviour

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November 2012

November 2012www.staysafeip.com

Occupational Health & Safety Act Revision Bill 168


Seminar Objectives:

(1) To define the term “crisis.”(2) To define and articulate what

constitutes “precipitating factors.”

(3) To identify and articulate what constitutes “indicators of

crisis.”(4) To identify and articulate the

four (4) “stages of crisis.”


Seminar Objectives:

(5) To articulate and perform suggested “responses to crisis.”

(6) To utilize effective strategies for “questioning challenges.”

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Crisis - Definition

A circumstance or set of circumstances, perceived or real, internal or external, that causes personal change.


Components of Crisis

(1) Crisis is individually based.

(2) Intensity of a crisis depends upon the individual’s ability to cope and manage circumstances.

(3) Effects dependant upon the individual’s life experience.

(4) Lack of personal control or power.


Precipitating Factors of Crisis

(1) Unwanted Change.

(2) Effects of grief.

(3) Effects of fear.

(4) Emotional challenges.

(5) Physical challenges.


Precipitating Factors of Crisis

(6) Financial challenges.

(7) Relationship challenges.


Indicators of Crisis

(1) Screaming.

(2) Yelling.

(3) Profuse Sweating.

(4) Fidgeting.

(5) Skin Tone Change.

(6) Heart Rate Increase.

(7) Pacing Back and Forth.

(8) Shaking / Adrenaline Surge.



(9) Nervousness.(10) Paranoia.(11) Kicking-Out.(12) Biting.(13) Throwing Items.(14) Punching (Self

or Others).(15) Rude Remarks.(16) Spitting.



(17) Threatening. (18) Weight Loss.(19) Weight Gain.(20)

Sleeplessness.(21) Bullying.(22) Self-

Mutilation.(23) Loss of

Personal Hygiene.



(24) Crying.

(25) Remorse.

(26) Nervous Laughter.

(27) Inappropriate Humour.

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The “Indicators of Crisis” may lead you to believe:

(1) A person is in a crisis situation.

(2) The level that the crisis situation has escalated

to.


The 4 Stages of Crisis

There are four (4) basic stages to Crisis

1. The Anxiety Stage.2. The Defensive Stage.3. The Physically Acting-Out Stage. 4. The Tension Reduction Stage.

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The Anxiety Stage

Anxiety is best described as any noticeable change in an individual’s perceived normal behaviour.

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The Defensive Stage

The stage of crisis where an individual begins to lose their rational thought and becomes verbally or passively resistant.

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The Defensive Stage

individual may become belligerent and begin to challenge you or the authority that you represent.

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The Physically Acting Out Stage

The stage of crisis where an individual begins to lose physical control and starts to physically act out.

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The Physically Acting Out Stage

This physical action may be directed toward oneself, against others, or against property.


The Tension Reduction Stage

The stage of crisis where the tension of the situation begins to diffuse and the individual begins to regain control, regaining some rational and cognitive thought.


The Tension Reduction Stage

The individual may show remorse and take some responsibility for their actions or behaviour.


Responses to Crisis

Anxiety Stage

Defensive Stage

Physically Acting Out Stage

Tension Reduction Stage

Supportive Response

Directive Response

Physical Restraint Response

Restorative Interaction Phase


Supportive Response - Steps

1. When observing signs of anxiety, respond with a display of a supportive attitude.

2. This includes “effective communication” that is intended to reduce the person’s anxiety level.


Supportive Response - Steps

3. It is important to display empathy with the individual.

4. It is important to attempt to form a professional “rapport” with the individual.


Directive Response - Steps

1. One should attempt to utilize communications that gains verbal control over the situation.

2. If the subject becomes argumentative, do not argue back with them.


Directive Response - Steps

3. It is important to remain professional at all times and attempt to verbally manage the situation to a calmer climate.



1. As the individual has lost control over their situation and has become physically active, it may become necessary to consider physical control options.



2. This involves the use of techniques that manage the physical actions of a subject and provide an element of safety for all involved persons.


Restorative Interaction Response

1. In order to bring about tension reduction, begin “Restorative Interaction” as soon as you arrive at the situation.


Restorative Interaction Response

2. One should use words (communications) that is designed and intended to de-escalate the tension of the situation and maintain safety for all persons involved.


Interaction with the “Defensive Stage”

1. The “defensive stage”

is challenging to manage.

2. You should realize that verbalization is not

personally directed towards you.



3. The “defensive stage” is verbal in nature and displays four (4)

stages of verbal escalation.



Stage #1: Questioning

Stage #2: Refusal

Stage #3: Venting

Stage #4: Threatening



4. The categories are

escalating but do not have a divisible line between each.

5.You may experience one or a combination of the stages.



6. You must remain aware and always maintain or

obtain appropriate distance.


Stages of Verbal Escalation

Questioning Phase• During the Questioning Phase, there are

two types of questions.

1. Information Type Questions.

2. Challenging Type Questions.



Information Type Questions

1. Subjects often ask open or closed information type questions.

2. The subject requires information to enable the decision making process to kick in.



Information Type Questions3. If the subject requires

information they will ask questions of you.

4. If you know the answer to the question, you should always be honest and truthful with your response.



Challenging Type Questions

1. Challenging type questioning may be used by a subject to put you on the defensive.

2. This may alter your intended goal or strategy.



Challenging Type Questions• There are essentially two types

of Challenging Questions.

1. Illegitimate.

2. Legitimate.



Goals - Effective Communications1. To Instill Professionalism.

2. To Obtain Management of the Incident.

3. To De-escalate the Incident.

4. To Create Positive Witnesses.

5. To Create Subject Accountability.

6. To Allow for Justification of Your Actions.


Responses to Illegitimate Challenges

1. To Deflect the Challenge.

2. To Sidestep the Challenge.


Deflect the Challenge

The theory behind the use of deflection is to allow the subject their dignity. The right to think, have an opinion and to voice that opinion is important to us all.


Deflect the Challenge

Examples- I can appreciate why you say that,

but…

- That may be so, but....

- I’m sorry you feel that but...


Deflecting the Challenge

• These phrases display “empathy” for subject’s position.

• Permit you to “direct the conversation” back to the issues at hand.


Sidestep the Challenge

The Sidestep is very similar to the Deflection process except that you do not acknowledge the original comments of the subject and go on about your task.



• You require to be directive and put forward the reason for your interaction.

• Explain why you are here and make good use of effective communications.



• You are being professional.• You are being sensitive and are

creating positive witnesses.• You are creating a position of

safety for all persons present.


Refusal Phase

1) The next phase of the Defensive Stage of Crisis is the subject’s refusal.

2) This may be a very frustrating stage in the Crisis. Many expect that the subject should or will obey our commands.


Refusal Phase

3) When a subject refuses to comply, the management of the situation changes momentarily.

4) What occurs with change and loss of power?

A Crisis.


Refusal Phase

(5) When the power or authority changes sides during an interaction, who enters a Crisis?

• You or the participant?

You


Refusal Phase

6) This stage of the crisis can be brief, unless you don’t have a coping or directive mechanism ready to use.

7) What techniques will work in this situation to ensure you regain control, de-escalate the situation and make the subject responsible for their actions?


Refusal Phase

8) For the subject who is displaying passive resistance and refusing to obey requests, try to utilize the technique of “Setting Limits”.

November 2012

Managing Resistive Behaviour

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november 2012 managing resistive behaviour.. november 2012

Documents

crisis situation

term crisis

crisisthe indicators

crisisthe anxiety stage

personal change

com16the anxiety stage

emotional challenges

relationship challenges