A trauma informed approach to de-escalation: Working with patients to create safe environments

A trauma-informed approach to de-escalation: working with patients to create safe environments
 
Keywords
 
Background
 
Coping with and understanding violent and threatening behaviour in mental health care settings is a challenging, but integral part of a caregiver’s job. If not managed well, such situations can result in staff and patient injuries, and they can lead to the use of harmful restrictive practices and coercive measures. Moreover, facing violence is a traumatic experience for all parties and can cause secondary traumatic stress in staff.
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This workshop is based on the presenters’ research about trauma informed de-escalation approaches undertaken in the UK and Denmark in collaboration between service-users, staff and researchers. The research is related to how patients and staff members understands violent and threatening situations and how they ascribe meaning to the stream of actions in successful de-escalation situations, literature searches, surveys and de-escalation training.
 
Trauma-informed de-escalation is founded in the public health perspective  and involves patients in creating a safe physical and emotional environment. Taking this approach changes focus from reacting to violence, to focusing on changing the social, behavioral, and environmental factors that cause violence.
 
A trauma-informed approach can foster shared problem solving and offers a turning point in violence management: instead of blaming the patient, members of staff will help the patient to gain control by understanding what brought the patient to this specific situation. Trauma-informed de-escalation approaches every patient with the assumption that at some point in their lives they may have experienced trauma. Based on that knowledge they ask sensitive questions and motivate patients to advocate for themselves by explaining to staff about their concerns. This lifts de-escalation to a professional level and avoids confrontations and power struggles.
 
The aim of the workshop is to discuss and reflect upon how de-escalation practices can be trauma-informed and how a personalised de-escalation approach can reduce violence and the use of coercive measures.
 
The workshop contains:
An introduction to the trauma informed de-escalation approach and the underlying research including presentation of a de-escalation training program
A discussion about what constitutes trauma informed de-escalation approaches
Participants will be divided into groups. Each group will discuss the trauma informed de-escalation approach and transferability to their own clinical setting.
 
Educational Goals
To reflect on de-escalation as a social and changeable process
To discuss the evidence behind de-escalation
To explore essential de-escalation skills