Skip to main content Accessibility help
×
Hostname: page-component-848d4c4894-2pzkn Total loading time: 0 Render date: 2024-05-17T06:24:07.985Z Has data issue: false hasContentIssue false

Chapter 14 - De-escalation

Published online by Cambridge University Press:  15 March 2024

Roland Dix
Affiliation:
Gloucestershire Health and Care NHS Foundation Trust, Gloucester
Stephen Dye
Affiliation:
Norfolk and Suffolk Foundation Trust, Ipswich
Stephen M. Pereira
Affiliation:
Keats House, London
Get access

Summary

De-escalation is a term that is often used by psychiatric professionals yet if they asked for a definition of it, there would be differing responses. This chapter outlines not only a definition but the essential elements within its practice and how de-escalation fits into the spectrum of management of challenging and disturbed behaviour.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2024

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bensley, L, Nelson, N, Kaufman, J, Silverstein, B and Shield, J (1995) Patient and Staff Views of Factors Influencing Assaults on Psychiatric Hospital Employees. Issues in Mental Health Nursing 16 (5) 433–46.CrossRefGoogle ScholarPubMed
Berne, E (1964) Games People Play: The Psychology of Human Relationships. Harmondsworth: Penguin.Google Scholar
Betempts, E, Somoza, E and Buncher, C (1993) Hospital Characteristics, Diagnoses, and Staff Reasons Associated with the Use of Seclusion and Restraint. Hospital and Community Psychiatry 44 (4) 367–71.Google Scholar
Blair, D (1991) Assaultive Behaviour: Does Provocation Begin in the Front Office?. Journal of Psychosocial Nursing and Mental Health Services 29 (5) 21–6.CrossRefGoogle ScholarPubMed
Boettcher, E (1983) Preventing Violent Behaviour: An Integrated Theoretical Model for Nursing. Perspectives in Psychiatric Care 21 (2) 54–8.Google ScholarPubMed
Cheung, P, Schweitzer, I, Tuckwell, V and Crowley, K (1997) A Prospective Study of Assaults on Staff by Psychiatric In-Patients. Medicine, Science and the Law 37 (1) 4652.CrossRefGoogle ScholarPubMed
Davis, S (1991) Violence by Psychiatric In-Patients: A Review. Hospital and Community Psychiatry 42 (6) 585–9.Google Scholar
Davis, W (1989) The Prevention of Assault on Professional Helpers. In Howells, K and Hollin, C (eds.), Clinical Approaches to Violence. Chichester: Wiley. pp. 311–28.Google Scholar
Department of Health (2015) The Mental Health Act 1983. London: Department of Health. www.gov.uk/government/publications/code-of-practice-mental-health-act–1983.Google Scholar
Farrell, G and Gray, C (1992) Aggression: A Nurse’s Guide to Therapeutic Management. London: Scutari Press.Google Scholar
Frude, N (1989) The Physical Abuse of Children. In Howells, K and Hollin, C (eds.), Clinical Approaches to Violence. Chichester: Wiley. pp. 155–81.Google Scholar
Johnston, I, Price, O, McPherson, P, Armitage, CJ, Brooks, H, Bee, P, et al. (2022) De-escalation of Conflict in Forensic Mental Health Inpatient Settings: A Theoretical Domains Framework-Informed Qualitative Investigation of Staff and Patient Perspectives. BMC Psychology 10 (1) 30.CrossRefGoogle ScholarPubMed
Kaplan, S and Wheeler, E (1983) Survival Skills for Working With Potentially Violent Clients. Social Casework 64 (6) 339–46.CrossRefGoogle ScholarPubMed
Karpman, SB (2011) Fairy Tales and Script Drama Analysis. Group Facilitation (11) 4952.Google Scholar
Lanza, M (1988) Factors Relevant to Patient Assault. Issues in Mental Health Nursing 9 (3) 259–70.CrossRefGoogle ScholarPubMed
Lanza, M and Campbell, R (1991) Patient Assault: A Comparison of Reporting Measures. Quality Assurance 5 (4) 60–8.Google Scholar
Lazan, M (2016) Changing Mindset to Improve Results. Industrial and Commercial Training 48 (5) 231–3.CrossRefGoogle Scholar
Le Poole, S (1987) Never Take No for an Answer: A Guide to Successful Negotiation. London: Kogan Page.Google Scholar
Maier, G (1996) Managing Threatening Behaviour. The Role of Talk Down and Talk Up. Journal of Psychosocial Nursing 34 (6) 2530.Google ScholarPubMed
McHugh, I and West, M (1995) Handle With Care. Nursing Times 91 (6) 62–3.Google ScholarPubMed
Nyberg-Coles, M (2005) Promoting Safer and Therapeutic Services. Mental Health Practice 8 (7) 1617.CrossRefGoogle Scholar
Patel, MX, Sethi, FN, Barnes, TRE, Dix, R, Dractu, L, Fox, B, et al. (2018) Joint BAP NAPICU Evidence-Based Consensus Guidelines for the Clinical Management of Acute Disturbance: De-escalation and Rapid Tranquillisation. Journal of Psychopharmacology 32 (6) 601–40.CrossRefGoogle ScholarPubMed
Pelto-Piri, V, Warg, LE and Kjellin, L (2020) Violence and Aggression in Psychiatric In-Patient Care in Sweden: A Critical Incident Technique Analysis of Staff Descriptions. BMC Health Services Research 20 (1) 362.CrossRefGoogle Scholar
Poyner, B and Warne, C (1986) Violence to Staff: A Basis for Assessment and Intervention. London: HMSO.Google Scholar
Price, O, Baker, J, Bee, P and Lovell, K (2018) The Support-Control Continuum: An Investigation of Staff Perspectives on Factors Influencing the Success or Failure of De-escalation Techniques for the Management of Violence and Aggression in Mental Health Settings. International Journal of Nursing Studies 77: 197206.CrossRefGoogle ScholarPubMed
Stevenson, S (1991) Heading Off Violence with Verbal De-escalation. Journal of Psychosocial Nursing and Mental Health Services 29 (9) 610.CrossRefGoogle ScholarPubMed
Substance Abuse and Mental Health Services Administration (SAMHSA) (2014) SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach. https://ncsacw.acf.hhs.gov/userfiles/files/SAMHSA_Trauma.pdf.Google Scholar
Turnbull, J Aiken, I, Black, L and Patterson, B (1990) Turn it Around Short-Term Management for Aggression and Anger. Journal of Psychosocial Nursing 28 (6) 710.Google ScholarPubMed
Ward-Stockham, K, Kapp, S, Jarden, R, Gerdtz, M and Daniel, C (2022) Effect of Safewards on Reducing Conflict and Containment and the Experiences of Staff and Consumers: A Mixed-Methods Systematic Review. International Journal of Mental Health Nursing 31 (1) 199221.CrossRefGoogle ScholarPubMed
Webster, CD, Douglas, KS, Eaves, D and Hart, SD (1997) HCR-20 Assessing Risk of Violence, Version 2. Burnaby: Simon Fraser University and Forensic Psychiatric Services Commission of British Columbia.Google Scholar
Whittington, R and Patterson, P (1996) Verbal and Non-Verbal Behaviour Immediately Prior to Aggression by Mentally Disordered People: Enhancing Assessment of Risk. Journal of Psychiatric and Mental Health Nursing 3 (1) 4754.CrossRefGoogle ScholarPubMed
Wilson, A, Hurley, J, Hutchinson, M and Lakeman, R (2021) ‘Can Mental Health Nurses Working in Acute Mental Health Units Really Be Trauma-Informed ?’ An Integrative Review of the Literature. Journal of Psychiatric and Mental Health Nursing 28 (5) 900–23.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×