How can I use de-escalation techniques to manage a person in a mental health crisis?

De-escalation techniques are therapeutic interventions that are frequently used to prevent a person from emotionally escalating from feeling frustration/irritation to violence and/or aggression. Effective de-escalation strategies can help reduce the level of stress and frustration that a person is experiencing.

Most of the communication in a crisis is nonverbal. 55% is body language, 38% is the voice tone and 7% is the actual words spoken. Becoming self-aware, practicing non-verbal skills, and responding with wisdom can assist in reducing stress during a crisis.

Active listening is critical during a crisis. When done effectively it helps the person feel understood and validated. In addition, active listening demonstrates that you are present, builds trust, and is naturally calming. A good question to ask ourselves is, “Am I listening to understand or to respond?” Effective listening incorporates the following nonverbal techniques and responsive techniques:

• Silence: Don’t rush to fill the void, allow the person to take the time and collect their thoughts before speaking.
• Voice tone: If needed, we should speak in a calm, respectful, and non-threatening tone.
• Facial expressions: Should demonstrate genuine interest.  Be mindful of your facial gestures and hand movements.
• Minimal encouragers: Encourage the person to continue speaking by saying, “Uh-huh” or “Go on” or nodding your head.
• Door openers: Encourage the person to share or expand on the topic.  You can say, “Tell me more about that” or “That makes a lot of sense.”
• Reflective responses: Short statements that demonstrate understanding and helps the person connect with their feelings.  For example: “Seems like you are disappointed” or “You sound defeated.”  Reflective responses are intended to make emotional insight and not just to repeat what they are saying.
• Empathic statements: These statements validate the person’s experiences and/or feelings.  For example: “That must be hard for you” or “I can see how that was frustrating.”

Once the person has calmed down and returned to their emotional baseline, we can offer some support in the following ways:

• Assist: Help the individual with the task that may be causing stress to try to reduce the stress. You can say, “Do you mind if I help you with that application?”
• Sympathetic Signal: Expressing genuine care or concern for the individual by providing descriptive praise. This can be as simple as a smile or a high five.
• Distraction: Encourage the individual to engage in a substitute activity to distract. You can say, “Lets go for a walk.”
• Steam off: Using active listening skills and validation you can help the individual express and drain off their feelings by simply talking it out. You can say, “I’m here to listen, feel free to share what made you feel frustrated.”
• Appeal to Self Interest: Remind the individual of their goal and encourage the engagement of their thinking brain. You can say, “You were frustrated with that job application because you really wanted the job. Let’s work on the application together.”

SMI Adviser will hold two webinars on Crisis De-escalation Strategies. Part I will be on February 3, 2022. Part II will be on February 17, 2022. During those webinars we will share additional details and strategies to help you manage crisis. Please sign up for our newsletter to be notified when they are open for registration.