Wednesday, November 11, 2009

Dealing with Challenging Clients: de-escalation during hard times

calm > anxiety > anger > hostility > aggression > violence > (impulsive action)

During hard times and high demand for career counseling, sometimes patience runs thin and front line people take the brunt of frustration turned outward. Learning some tips to deal with challenging clients can be helpful for those you serve and for your own sanity. What follows are some tips to use when working with challenging clients.

Trust– developing trust can have a positive impact on a clients willingness to comply with organizational requests, disclosure of information, adjust to changes and help them feel motivated instead of vulnerable.

Proper Boundaries—avoid intrusions in personal space or into their personal affairs. Any breach in boundaries can cause anxiety and stress; at worst it can generate fear and emotional escalation. Professional boundaries should include limits to allow for staff to remain helpful, but detached.

Attitude—people forgive mistakes, but attitude is unforgivable. Attitude is contagious. Reflecting a good attitude increases the likelihood of a student responding in kind. Modeling what you want to see in who ever you’re working with (regardless of their attitude) will bring positive results.

Respect– common courtesies such as, “please” and “thank you” will help establish trust and reflects respect to whoever you are working with. Sometimes when we are rushed and under the gun, we forget the most common rules of respect.

Cultural Differences– diversity can affect the way we perceive a situation. A client’s non-compliance may be due to value differences. Most clients appreciate it when we learn something about their culture and maybe even a greeting in another language.

Negative Language vs. Positive Language– confrontational language triggers anxiety, defensiveness and possible emotional escalation. Be careful about word usage and tone– avoid using words like “can’t” or “won’t”. Instead use language that demonstrates cooperation and collaboration. Show a willingness to recognize the person’s point of view and allows the person to “save face”.

Rational Detachment- don’t take acting out behavior personally, nor mirror it. While we can’t control precipitating factors, we can manage our own outward response.

Conditions Often Associated with Potential for Aggressive Behavior– mood disorders, personality disorders, anxiety disorders. The number one predictor for someone who may became aggressive or verbally abusive is impulsivity. Impulsivity is defined as “ action without thought”, intolerance for routine and rules, restlessness, impatience, and incautioness”. (Eysenck & Eysenck, 1978). Impulsives are more likely to go from anger to aggression than non-impulsive.)

Recognizing Potential for Escalation– Verbal: morose silence; short clipped responses, illogical flow, easily frustrated by “no” ;loud voice, demanding or derogatory remarks. Non-Verbal: tense jaw, clinched fist, pacing, shift from relaxed to ‘squared off’ body position.

De-escalation Skills: Greeting them– show that their needs are important to you. Use their name if you know or ask, and smile. Manage space: when people are angry they often need more physical space. Stand if they stand, sit if they sit. Personal Space issues can create anxiety and escalate aggression.

Paraverbal Communication: tone, volume and cadence. Avoid impatience or inattention (tone). Keep volume appropriate even if the person is raising their voice; sometimes just by lowering your volume, you can trigger their volume control to go lower also. Speak in a even rate and rhythm (cadence).

Show Empathy: “ I understand that you are concerned or upset”. Gestures go a long way: if in an office setting– offer a chair or a beverage if possible– tissue if warranted. Empathetic listening requires undivided attention, allowing silence, using restatement to clarify what is being said. Showing non– verbal cues that you are listening is important also. Ask questions– it shows interest; helps you discover more about the individual’s particular dilemma and what they know, how they feel and what they think the problem is.

Setting Limits: give info in a clear and concise manner. Answer questions, clarify misconceptions, give the reason or context for specific rules and guidelines. Remember– empathy with or without options has been shown to be effective in setting limits without escalating an angry situation.

Disengagement: brief breaks to gather additional information can help to give more time to diffuse and resolve an angry situation. It needs to be done with courtesy and in a timely manner. Do not leave a person if you think they are beyond the anger stage of escalation; if you think they may become impulsive or physically aggressive.

Direct a Person’s Anger towards problem solving efforts: having the person go from angry about their issue to solving it can empower them. You may easily transition from the ‘enemy’ to an “ally’.

Identify Other Options or Choices: you may identify immediate steps or future ones. Acknowledge their suggestions and incorporate them in resolving the issue whenever possible.


LAST WORDS:

DO’s: remain calm, enforce limits, listen, be consistent, show empathy, be aware of non-verbal messages.

DON’T’s : over react, get into a power struggle, make false promises, fake attention, or use jargon.