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Trauma-Informed De-escalation

Approaching each day with general attitude of equanimity is something that I have found allows me to be a successful administrator and therapist. I have been working in the behavioral health field for over ten years and the ability to approach tense times, overwhelmed employees, and escalated patient/clients is imperative. I have also learned in this time that those that may need help calming down likely have experienced, or at the very least been influenced by, some sort of trauma in their life. It is for this reason when attempting to de-escalate anyone I treat them as if they have experienced trauma. I always start any interaction with the perspective shift of, "What happened to them?" instead of, "What is wrong with them?" Once you can shift your perspective, intervention with an escalated person will likely be more successful. The following is what I have found to be the most helpful in de-escalating those with potential trauma histories:

1. An Ounce of Prevention is Worth a Pound of Cure. The best way to de-escalate someone is to never allow them to become escalated in the first place.There is a good chance that the person who needs intervention is someone you know.Always be aware of other behavior and look for anything out of the ordinary.If someone is usually gregarious and full of energy, but today you said, "hello" and they did not respond, this may be a warning sign to intervene.Likewise, if someone is usually calm and keeps to themselves but is elevated and talking or complaining to others, this would be a red flag to notice and a good time to engage this person. If you do not know the person well enough to have established a baseline, keep in mind the typical warning signs that may be observed include clenched fists, heavy breathing, tense posture, or an obvious facial expression that would suggest the person is about to show escalation.

2. Perspective Shift and Perspective Taking. As noted earlier, one of the first things to do when intervening with someone (especially with those who have experienced trauma) is to shift one's perspective to "what happened to them". Empathizing with the experiences of the person with whom you are attempting to intervene will allow you to understand their point of view better.This striving to understand will also naturally allow you to recognize what has triggered them and their current struggles.Being willing to see another's point of view also will reduce the likelihood of a power struggle or an interaction escalating.

3. Meeting People Where They Are. Once you are willing to see whatever is going on through their perspective you may be able to more accurately understand their emotions and behaviors.If we were observing a person who is yelling and digging their fingernails into their arm, we may typically describe this situation by saying, "they are attention-seeking and being self-injurious."When we look at this same situation through a trauma-informed lens, we may see them striving for connection, expressing themselves, and attempting to gain control over a portion of their life.In addition to meeting people on their emotional level, physically meeting them on whatever level they are on can be helpful as well.If someone is much shorter, or sitting and crying, sitting or physically getting on their level can be less imposing and you are willing to experience this negative time with them.

4. Plan Interventions. If you find yourself in situations where you must de-escalate others often, having a plan and being prepared to intervene may be helpful.Please keep in mind that the number one priority when intervening should be to keep everyone safe. A possible plan for how to intervene could be as follows:

  • Prevent

  • Keep environment safe and clean

  • Be mindful of your nonverbal communication

  • Keep environment free of specific triggers

  • When you begin to intervene

  • Keep calm

  • Communicate with an open posture

  • Use a low rate and calm tone of speech

  • Specific interventions

  • Ask how you can help

  • Provide any help you can

  • Listen and empathize

  • Apologize if necessary

  • Request incompatible behaviors

  • Ex: if someone is yelling, signing would be an incompatible behavior

  • Request a highly probability behavior

  • Ex: engaging a person with their preferred topics or something simple and likely to happen like a high five.

5. Do Nothing (aka maintain safety and listen). Sometimes more is less and doing nothing is something. When someone is escalated, they may not be able to think clearly and respond. Especially with those who have experienced trauma—they are more apt to be in a state of fight or flight. They will not be able to start processing or making good decisions until they feel safe and calm and can re-engage the part of their brain that is used for rational thinking. A tip to know when to "do nothing" and maintain the safe environment is when someone says, "shut up" or "please leave me alone." While we never want to leave an escalated person alone, this is a good sign that they are not yet in a state where they can calm down and have a conversation. It is a better choice to make sure the environment is safe and be there is this space with them.

6. Debrief and Encourage Post Traumatic Growth. The overview I have posed above is only a basic framework for how you may intervene with someone who is escalated.There are as many ways to intervene as there are people who need help.It only makes sense then to tailor your approach so that it fits you and the person you are helping.One way to make sure that you are always growing from these types of interactions and that you are improving your techniques is to talk with the person or the persons involved.Attempt to identify what worked well, what went poorly, and how you could improve if there is another similar interaction.Every struggle is an opportunity for growth.

References

CPI’s Top 10 De-escalation Tips

De-escalation Skills

Verbal De-escalation

De-escalation in Corrections

Video of De-escalation

©2019 by Erie Coalition for a Trauma Informed Community.
Erie County
Pennsylvania