Monday, November 7, 2011

De-escalation and Communication-"But.."

Imagine someone-- a coworker, supervisor, or significant other-- approaches you as says, "You've been doing a great job, but..." What comes after the but? Most likely nothing good.

"But" is a trigger word for escalating anxiety. Additionally, there are a number of common "pre-but" phrases that can trigger escalation. For example, the customer service apology ("I'm sorry that you've had the wait so long...) followed by a "but" that negates the apology or precedes an excuse. Additionally, there is the but that follows "our policy.."

"But" is a perfectly useful word when used well. Here is the key to using "but": use it to expand options, not to limit them. For example, "You've been doing a great job, but..I wonder  if you been   given as much recognition as you deserve, " or "I'm sorry you've had to wait so long, but... is there anything I can do to make you wait more pleasant, such as a drink of water, something to read...?" In   these examples what follows the "but" opens new options.

What about situations where "but" is appropriate as a limiter? Leave it out. Instead of, "I'm sorry_____, but or policy______," a more acceptable way to state it is, "I'm sorry_____. [Pause] Unfortunately our policy________."

"But" is a small word, but it can make a big difference.

Wednesday, August 31, 2011

De-escalation and Social Influence- Reciprocity

When people receive something from others, they are naturally inclined to repay the act. This is true in all cultures. This is true even of  unsolicited gifts. Giving something increases compliance with future requests. Example: In one research study, a $5 check included with a survey produced more responses than the promise of $50 after responding.

Reciprocal Concessions: Rejection-Then-Retreat

The rule of reciprocity also applies to non-material gifts. So that if you make a large request, are refused, and then make a smaller request as a concession, you are three times more likely to get compliance than if you asked for what you wanted straight away.

Reciprocity can be initiated in a number of ways. The interaction with the agitated person can be framed as "giving time or attention." When de-escalating an aggressive situation concessions can be offered to the angry person in the form of time, or options.

Example:

A staff person  approaches an angry client.

"Mr Jones I can see that this is really an upsetting situation... Let me give you this (hands client his card) it has my number on it... hang on to it because, I'm going to do all I can to correct his situation...and I don't what I can do, but I will do all I can, and if you have to follow up with me you'll have my number."

The staff person establishes control over the situation and frames his role as an ally. He gives the angry person his card within an acceptable context. In a brief introduction he establishes reciprocity.



Wednesday, August 24, 2011

De-eescalation and Social Influence-- Social Proof

How do we know what to do? We often determine what is correct by finding out what other people think is correct. This is especially true when there is uncertainty. We are particularly prone to follow the lead of people we perceive as similar to us.

Uncertainty is often a component of escalating aggression. The aggressive person is at a loss of what to do next. It is the uncertainty, and accompanying frustration, that leads to greater agitation. 

Application

We can "normalize" the emotional response of the agitated person. If we communnicate to the agitated person that his or her emotional response is understandable given the circumstances, that they are expected--in other words, that they are normal--we can begin the defuse the situation. We can also define the normal behavioral response to the circumstance.

"Of course you're upset with all that's going on...this doesn't happen very often, but when it does, of course people get upset...and we're always able to come to a better situation when we take some time to talk about  how it is I can help you."

Tuesday, August 16, 2011

Ethic Concerns for De-escalation Training

If an organization requires employees to respond to violent situations, but provides inadequate training to respond safely that is negligence.

All hospitals (that except insurance) are required to have plan for responding to potentially violent situations. The plan must include, among many other things,  who is trained, what is the content of the training and the response when a situation of violence or potential violence occurs. The typically there will be an overhead announcement, such as "Code Gray" or "Dr. Strong" summoning people to the scene.

Those responding place themselves in harm's way if they do not have the skills to adequately respond to physical aggression. A staff member can easily be injured because he or she is not prepared to exercise personal safety techniques. The aggressive person is placed in harm's way if staff members do not have the skills to respond appropriately. An aggressive person can easily be injured because improperly trained staff members are more likely to use excessive force.

What is the role of the trainer who recognizes the inadequacy of training that certifies people to respond? The trainer trains staff in the organizations approved curriculum, knowing that the methods taught (or omitted from training) are not enough for the safety of staff or clientele.  The organization has defined a certain course as meeting the requirements for safe response. The trainer knows the course is inadequate, and places people in danger. What is the proper ethical response?

Of course the question can be much broader. You know your training is inadequate (constraints of time and $), but it is deemed as sufficient by the larger organization, and that the inadequacy of training places people in harm's way? Is better than nothing okay? What is a little knowledge is more dangerous than none at all?

Tuesday, June 7, 2011

De-escalation and Social Influence- Scarcity

De-escalating conflict relies on the ability of an individual to define the frame of an interaction. The principle of scarcity states that people value more highly that which is scarce, and that generally speaking people are more motivated to avoid a lost than to achieve a gain. There are a number of ways to frame an interaction to make use of this principle.

Once communication with an agitated person is established, that connection with some one has value to the agitated person. One reason to state clearly early in the interaction your intention of helping the person, is to create and enhance this value.Establish early on that you are there to help the situation. If the person escalates in verbal aggression, let him know that continued escalation can result in ending your alliance with him.

"I am here to help you with this situation, and I need to let you know that if you continue to yell I won't be able to help you."

In a long term treatment facility, one strategy is to reminded the agitated person of the progress made (consistency principle), and continued escalation of aggression will result in loss of progress and effort made. Be careful with mentioning loss of privileges, as this will emphasize unequal power status and can escalate conflict. The emphasis is not on rewards granted, rather on goals achieved.

Along the same lines, avoid mentions of rewards for cooperation in terms of benefits granted him. Again frame it in terms of benefits achieved through his efforts.

For example, not: "If you cooperate we'll let you have extra time for visiting," rather, "You've worked hard for that extra visiting time, and you're so close."

Sometimes, letting the agitated person know that the time to act cooperative is limiting is beneficial. This is not done in terms of an ultimatum, rather in terms of options closing.

"Right now we have a number of options for dealing with this situation if we work together, we're not going to have as many options if we delay."

People are motivated to act by scarcity. Scarcity is a useful frame for de-escalating conflict, because it can be used to help the agitated person realize that communication and cooperation is the best option.

Friday, June 3, 2011

De-escalation and Social Influence: Authority

Through genetics and social conditioning people have a tendency to comply with authority. Children are trained to listen to teachers at school, respect men in uniform, and obey their parents. Where ever animals form social groups hierarchies arise.

"As humans, people want to defer to a legitimate authority," says Cialdini, Arizona State University professor of Psychology who identified the six universal social influencers, "I don't know about you, but when I'm sitting in a doctor's waiting room, I'm looking at the diplomas and certifications on the wall. We need that shortcut to feel trust. It does make a difference."
 "The lesson of authority for the influence process is that any communicator who wishes to move people in his or her direction would be well-advised, before actually trying to influence those people, to first reveal or uncover the credentials that he or she has," explains Cialdini.

People prefer to work with experts. An angry or agitated person in losing control; he wants to know that someone is in control. The bottom line is, they're more likely to listen to people they believe to be experts, that is someone in control, than other people -- even when those experts are asking them to do something they otherwise wouldn't otherwise do.

Application:  In order to make use of this tendency use the symbols of authority that already exist. Many of these clues are nonverbal such as how one dresses, how one talks, and how one carries ones self. When approaching a person in behavior crisis state your name and your title, and what your purpose is (eg. "to help deal with this situation"). If you dress smartly, and talk like you are in charge your authority will be assumed. Speaking confidently to a person in behavior crisis gives reassurance that someone is in control.



There two down sides to the power of authority. One is that for many people authority will trigger reactance, a natural reaction to having one's options limited. Being told to that one must do something or can not do something by someone in authority (or policy) strips a person of control. This creates a reaction that seeks to gain back control, which can create a stubborn fight-back against authority. Individual will have this response if they consider the use of authority to be unfair or uninterested in their needs. You must convey your intention to address the concerns of the agitated person.

A second downside of the power of authority is how far will people go in obedience to authority. How far they will go was revealed by the famous Milgram experiment performed in the 1960s. One of the best presentations of the experiment is TV Mentalist Derren Brown’s genuine recreation of them, that can be viewed here.  If you are unfamiliar with the experiment I will leave it for you to  watch the video.

Saturday, May 28, 2011

Social Influence and De-escalation: Liking

It's no surprise; people are more likely to cooperative with people they like, and who like them. People prefer to say yes to individuals they know and like.  Liking can create influence and when responding to an angry or agitated person you may emphasize certain factors and/or attributes to increase your overall attractiveness and subsequent effectiveness.

Several factors can be used:.

Physical attractiveness often may help to create some influence. Physical attractiveness seems to engender a "halo" effect that extends to favorable impressions of other traits such as talent, kindness, and intelligence. As a result, attractive people are more persuasive in terms of getting what they request and in changing others' attitudes.While physical characteristics are only marginally changeable, how one dresses and grooms is under one's control. Smiling enhances physical attractiveness.

Similarity influences both Liking and cooperation.  We like people who are like us and are more willing to say yes to their requests, often without much critical consideration.

Praise produces Liking. Insincere flattery, however, can backfire when it is crudely transparent.   Generally compliments most often enhance liking and can be used as a means to gain cooperation.

Familiarity through repeated contact with a person or thing is yet another factor that normally facilitates Liking. This holds true principally when that contact takes place under positive rather than negative circumstances. One positive circumstance that may works well is mutual and successful cooperation.

Association is a final factor linked to Liking. By associating with positive things or ideas those who seek influence frequently share in a halo effect by association. 

Applications/examples:

When approaching, smile, at least initially, and introduce self, ask the person his or her name if you don't know it. Use the person's name. These are all signs of friendliness.

Pay attention person's verbal patterns and match these. If the person is angry you don't want to match anger in the voice, but you do want to match the importance and urgency in the voice. Match the rate and rhythm of his of her speech. Match expressions. For example if he says he is "pissed off" use the term "pissed off"; if he uses the phrase "mad as a hornet", use the" phrase "mad as a hornet." Match verbal patterns evokes similarity, which enhances liking. Be cautious, however, that this matching is only used initially, as you want to eventually lead the angry person towards more a cooperative frame.

Express appreciation for any cooperation received.

All these applications are to engender the feeling that you like the person you are talking to. Unless you genuinely do like people, they will all seem fake and can escalation anger. The most important application, therefore, is to genuine like people.

Wednesday, May 25, 2011

Flight-Fight-or-?

In the face of danger all vertebrates (many, but not all invertebrates as well) respond with a heightened state of physiological arousal that prepares them for either fight of flight--or more correctly in order of preference, flight or fight. Many people point to a third response, "freeze". Freezing, however is a variation of flight, many animals become virtually invisible to their primary predators when they remain motionless. So freezing is not itself the third path.

The third path I am referring to is another stress response that anthropologist have recognized in primates. Primates when confronting danger will sometimes follow a third path, that of increasing pro-social behaviors. In other words, primates, humans included, will respond to stress by increasing social bonding. This has been called the "friend", "connect" or "cuddle" response by various anthropologists.


Not surprisingly, there are gender differences. Females more than males exhibit this response, although male chimps and apes display increased social behavior when confronting danger as well.

The implications of this third path when dealing with stress are profound. It is clearly a more highly evolved characteristic (strictly speaking, the notion of any trait being "more highly evolved" is an anthropocentric value judgment--but I am an anthropoid after all). The fight or flight response we share with most animals. The connect response we share only with primates.  There is, I believe a purely human response, as well.

When other primates display the connect response they do so only within family groups. Humans have the capability to connect outside family groups. Just as humans are the only animal that trades with others of its species outside its own family clan, we are able to extend pro-social behaviors to other humans, to strangers.

The third path is this path of connection with others. It's not fight-flight-or-freeze, but flight-fight-or-friend. De-escalation/conflict resolution/assertiveness is the third path.

De-escalation and Social Influence- Consistency

Cialdini:  "Consistency is a principle that asserts that people want to be and to be seen as consistent with their existing commitments. Those commitments can be things they've either said or done in the past, especially in public, that give them a position or a stand on some issue."

No one wants to be known as a liar or as wishy-washy or erratic. People much prefer to be considered honest and trustworthy. When they make public commitments or promises, they will tend to want to back up those words with action. 

When de-escalating an angry person consistency can be a powerful tool. When confronting an angry person you need to find ways to shift from an adversarial to a collaborative frame. It's no small challenge. But it's one that can be tackled, by asking for small concessions of favors. 

Examples of use:

An angry individual is yelling at you. Your response: "I can tell how angry this is making you, and I will do what I can to resolve it, and for that I would really appreciate you bringing down your voice..." When person lowers voice, whether it's immediate or after more venting,  express appreciation, "Thank you for being willing to work with me on this."

Patients involvement in treatment planning promotes collaboration and compliance, as their acceptance of a treatment plan is a prior commitment .

Example of misuse: "I know you don't want to, but you said..."  (Holding people accountable for their words is appropriate. To do so when one is angry is wrong timing.)

As with all verbal tools they need to be applied skillfully and at the right time.








Tuesday, May 24, 2011

Six Universal Influences part 1

Dr. Robert Cialdini is recognized as one of the world’s leading experts on social influence. He describes six universal social influences. De-escalation is a social interaction. A skilled de-escalater can apply each of these six influences. The six influences are:

Consistency--  Each time we comply with a request, even a trivial request we will tend to act more consistently with that initial act of cooperation.

Liking-- People prefer to say yes to the requests of people they know and like. Increasing the degree to which you are liked by someone will increase the probability that they will cooperate with you. 

Authority-- Once someone has accepted you as an authority, they will more likely follow your instructions.

Scarcity--People are more motivated to avoid a loss than gain a benefit.

Social Proof--People determine what is correct, especially in the presence of uncertainty, by finding out what other people think is correct 

Reciprocity--When people receive things from others, they are naturally inclined to repay the favor.

I'll explore each of these in following posts.

Monday, February 7, 2011

Understanding Violent Behavior

This blog uses the terms “violence” and “coercion” to describe behavior that is non-nurturing or doesn’t maintain the dignity and safety of those involved. This is in contrast to behavior (especially communication) that is non-violent or therapeutic.

People behave in ways that get what they want or need, or to get away from something, someone or some place they do not want.  People do not engage in problem behaviors because they have mental illness, conduct disorders, developmental disabilities or other cognitive disabilities.  They engage in behaviors that have worked for them. 

People do not "have" behaviors; rather, they use behavior for specific reasons.  

One goal of the professional is to create environments and relationships that support therapeutic alternatives to problem behaviors.

A professional will conduct a range of assessments to determine the message of a person’s behavior.  The professional then will support the person to find new ways to achieve his/her goals in ways that are more appropriate, or that in the least do not cause harm or injury to themselves and/or others. 

Wednesday, February 2, 2011

Situational Awareness, a definition


Simply put, situational awareness is knowing what is happening and what is likely to happen next. While this sounds simple, it does not merely mean good observation skill. It requires one to have a knowledge base that includes, the nature of aggression, and  environmental, individual, staff, and situational factors that contribute to or reduce agitation and aggression.  

At the lowest levels, this skill requires that all responding to a person in behavioral crisis, know how to identify escalating agitaion and call for a support when needed. 

When interacting with a hostile person it means keeping actively aware of the effects of your efforts to deescalate. Is your approach effective? Is it decreasing the anger?

If responding to a call for support, minimally those responding need to know how to identify the lead person  and environmental hazards, and be ready to take direction from the lead person.

Tuesday, February 1, 2011

The 6 skills sets of de-escalation

De-escalation is a set of interaction and communication skills used to decrease agitation or aggression and prevent a person from acting violently.

There are numerous de-escalation skills and numerous ways to classify them. I classify them into these key 6 skills sets:
  • Situational awareness
  • Managing space
  • Non-verbal communication
  • Empathic communication
  • Communication for influence
  • Self-management
These are important skill setss for any one interacting with the public. When responding to a person in  behavioral crisis they are critical for the safety of all involved.These are the classification used in subsequent posts.

De-escalation and the Care and Connect Response

A simple definition of de-escalation:  De-escalation is a set of interaction and communication skills used to decrease agitation or aggression and prevent a person from acting violently. It is a subset of a larger set of skills, that can be referred to as social or emotional intelligence.


I use the term "the third path" to describe de-escalation because in addition to fight or flight, there is a third natural response to threat, the "tend and befriend" or "care and connect" response. (Some people include "freeze" as a response, but it be more properly understood as a form a form of flight). It the face of threat a third choice is to tend to the needs of and affiliate with others. This is the intent of verbal de-escalation. to connect with the aggressive person, and to relieve his or her distress (anger) in a peaceful manner.


As a set of skills it can be learned, but with the intent to address the need of the person in distress, not amount of learning techniques will enable a person to successful face the challenge of de-escalating the anger of a person in crisis.