Managing Resistive Behaviour - PowerPoint Presentation

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Managing Resistive Behaviour

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Occupational Health & Safety Act Revision Bill 168Slide4

Seminar Objectives:(1) To define the term “crisis.”(2) To define and articulate what constitutes “precipitating factors.”(3) To identify and articulate what constitutes “indicators of crisis.”(4) To identify and articulate the four (4) “stages of crisis.”Slide5

Seminar Objectives:(5) To articulate and perform suggested “responses to crisis.”(6) To utilize effective strategies for “questioning challenges.”Slide6

Crisis - DefinitionA circumstance or set of circumstances, perceived or real, internal or external, that causes personal change. Slide7

Components of Crisis(1) Crisis is individually based.(2) Intensity of a crisis depends upon the individual’s ability to cope and manage circumstances.(3) Effects dependant upon the individual’s life experience. (4) Lack of personal control or power.Slide8

Precipitating Factors of Crisis(1) Unwanted Change.(2) Effects of grief.(3) Effects of fear.(4) Emotional challenges.(5) Physical

challenges.Slide9

Precipitating Factors of Crisis(6) Financial challenges.(7) Relationship challenges. Slide10

Indicators of Crisis(1) Screaming.(2) Yelling.(3) Profuse Sweating.(4) Fidgeting.(5) Skin Tone Change.(6) Heart Rate Increase.(7) Pacing Back and Forth.(8) Shaking / Adrenaline Surge.Slide11

Indicators of Crisis(9) Nervousness.(10) Paranoia.(11) Kicking-Out.(12) Biting.(13) Throwing Items.(14) Punching (Self or Others). Rude Remarks. Spitting.Slide12

Indicators of Crisis(17) Threatening. (18) Weight Loss.(19) Weight Gain.(20) Sleeplessness.(21) Bullying.(22) Self-Mutilation.(23) Loss of Personal Hygiene.Slide13

Indicators of Crisis(24) Crying.(25) Remorse.(26) Nervous Laughter.(27) Inappropriate Humour.Slide14
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Indicators of Crisis The “Indicators of Crisis” may lead you to believe:(1) A person is in a crisis situation.(2) The level that the crisis situation has escalated to.Slide16

The 4 Stages of Crisis There are four (4) basic stages to CrisisThe Anxiety Stage.The Defensive Stage.The Physically Acting-Out Stage.

The Tension Reduction Stage.Slide17

The Anxiety StageAnxiety is best described as any noticeable change in an individual’s perceived normal behaviour.Slide18

The Defensive StageThe stage of crisis where an individual begins to lose their rational thought and becomes verbally or passively resistant.Slide19

The Defensive Stageindividual may become belligerent and begin to challenge you or the authority that you represent.Slide20

The Physically Acting Out StageThe stage of crisis where an individual begins to lose physical control and starts to physically act out.Slide21

The Physically Acting Out StageThis physical action may be directed toward oneself, against others, or against property.Slide22

The Tension Reduction Stage The stage of crisis where the tension of the situation begins to diffuse and the individual begins to regain control, regaining some rational and cognitive thought.Slide23

The Tension Reduction Stage The individual may show remorse and take some responsibility for their actions or behaviour.Slide24

Responses to Crisis Anxiety Stage Defensive Stage Physically Acting Out Stage Tension Reduction Stage Supportive Response

Directive Response Physical Restraint Response Restorative Interaction PhaseSlide25

Supportive Response - Steps1. When observing signs of anxiety, respond with a display of a supportive attitude.2. This includes “effective communication” that is intended to reduce the person’s anxiety level.Slide26

Supportive Response - Steps3. It is important to display empathy with the individual.4. It is important to attempt to form a professional “rapport” with the individual.Slide27

Directive Response - Steps1. One should attempt to utilize communications that gains verbal control over the situation.2. If the subject becomes argumentative, do not argue back with them.Slide28

Directive Response - Steps3. It is important to remain professional at all times and attempt to verbally manage the situation to a calmer climate.Slide29

Physical Restraint Response1. As the individual has lost control over their situation and has become physically active, it may become necessary to consider physical control options.Slide30

Physical Restraint Response2. This involves the use of techniques that manage the physical actions of a subject and provide an element of safety for all involved persons.Slide31

Restorative Interaction Response1. In order to bring about tension reduction, begin “Restorative Interaction” as soon as you arrive at the situation.Slide32

Restorative Interaction Response2. One should use words (communications) that is designed and intended to de-escalate the tension of the situation and maintain safety for all persons involved.Slide33

Interaction with the “Defensive Stage”1. The “defensive stage” is challenging to manage.2. You should realize that verbalization is not personally directed towards you.Slide34

Interaction with the “Defensive Stage”3. The “defensive stage” is verbal in nature and displays four (4) stages of verbal escalation.Slide35

Interaction with the “Defensive Stage”Stage #1: QuestioningStage #2: RefusalStage #3: VentingStage #4: ThreateningSlide36

Interaction with the “Defensive Stage”4. The categories are escalating but do not have a divisible line between each.5.You may experience one or a combination of the stages.Slide37

Interaction with the “Defensive Stage”6. You must remain aware and always maintain or obtain appropriate distance.Slide38

Stages of Verbal EscalationQuestioning PhaseDuring the Questioning Phase, there are two types of questions.Information Type Questions.Challenging Type Questions.Slide39

Stages of Verbal EscalationInformation Type Questions1. Subjects often ask open or closed information type questions.2. The subject requires information to enable the decision making process to kick in.Slide40

Stages of Verbal EscalationInformation Type Questions3. If the subject requires information they will ask questions of you.4. If you know the answer to the question, you should always be honest and truthful with your response.Slide41

Stages of Verbal EscalationChallenging Type Questions1. Challenging type questioning may be used by a subject to put you on the defensive.2. This may alter your intended goal or strategy.Slide42

Stages of Verbal EscalationChallenging Type QuestionsThere are essentially two types of Challenging Questions.1. Illegitimate.2. Legitimate.Slide43

Stages of Verbal EscalationGoals - Effective Communications1. To Instill Professionalism.2. To Obtain Management of the Incident.3. To De-escalate the Incident.4. To Create Positive Witnesses

.5. To Create Subject Accountability.6. To Allow for Justification of Your Actions.Slide44

Responses to Illegitimate ChallengesTo Deflect the Challenge.To Sidestep the Challenge.Slide45

Deflect the Challenge The theory behind the use of deflection is to allow the subject their dignity. The right to think, have an opinion and to voice that opinion is important to us all.Slide46

Deflect the ChallengeExamples- I can appreciate why you say that, but… - That may be so, but....- I’m sorry you feel that but...Slide47

Deflecting the ChallengeThese phrases display “empathy” for subject’s position.Permit you to “direct the conversation” back to the issues at hand.Slide48

Sidestep the Challenge The Sidestep is very similar to the Deflection process except that you do not acknowledge the original comments of the subject and go on about your task.Slide49

Sidestep the ChallengeYou require to be directive and put forward the reason for your interaction.Explain why you are here and make good use of effective communications. Slide50

Sidestep the ChallengeYou are being professional.You are being sensitive and are creating positive witnesses.You are creating a position of safety for all persons present.Slide51

Refusal Phase1) The next phase of the Defensive Stage of Crisis is the subject’s refusal. 2) This may be a very frustrating stage in the Crisis. Many expect that the subject should or will obey our commands.Slide52

Refusal Phase3) When a subject refuses to comply, the management of the situation changes momentarily.4) What occurs with change and loss of power? A Crisis.Slide53

Refusal Phase(5) When the power or authority changes sides during an interaction, who enters a Crisis?You or the participant? YouSlide54

Refusal PhaseThis stage of the crisis can be brief, unless you don’t have a coping or directive mechanism ready to use.7) What techniques will work in this situation to ensure you regain control, de-escalate the situation and make the subject responsible for their actions? Slide55

Refusal Phase8) For the subject who is displaying passive resistance and refusing to obey requests, try to utilize the technique of “Setting Limits”.Slide56

Managing Resistive Behaviour

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