If you work in the human services industry, de-escalating potentially dangerous situations is probably part of your job description. While restraint is something we try to prevent at all costs, it sometimes occurs; the big question before, during and after the incident is: was that restraint necessary? Can we do/could we have done something to prevent that restraint?
There are a lot of reasons to avoid restraint, all of them extremely convincing (risk of harm, potential for abuse, psychological trauma, etc). So why do restraints sometimes happen when they don’t need to happen? One big reason might be that staff don’t know what to do instead! This might seem obvious, but it’s often overlooked: it’s important to give your staff a full bag of tools that they will be able to use to de-escalate a situation before a crisis escalates.
So, what can we do to prevent restraint? Think ahead: create a supportive, safe environment that is free from potentially dangerous items, or that can be cleared quickly in the event of escalation. We can provide functional communication training to teach the individual how to appropriately ask for what it is he/she needs or wants. For example, if I want a glass of water, but I don’t know how to ask for it, I might throw some things around or reach out and grab someone to try to get my point across. Teaching replacement behavior may prevent the individual’s need to express him/herself in less appropriate ways in the future.
Once you’ve trained your staff on crisis de-escalation strategies, make a plan to follow up with practice and review sessions! Role-play relevant situations until staff feel confident in how they will respond when an individual exhibits challenging behavior.