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Tips for De-escalating Instead of Re-escalating a Crisis Situation

By Kris Kilpatrick

Helping run a treatment program for adolescent girls, I’ve had many opportunities to intervene therapeutically in crisis situations. Crises often come at unexpected times and can be overwhelming for all involved – even parents and seasoned professionals. When we, as caregivers, are thrown off and overwhelmed, it’s easy to react in ways that escalate the crisis. While our intention as a parent or professional is to be helpful and ensure a safe and productive resolution, it is easy to inadvertently add intensity to the situation through our actions, words, and even mannerisms.

Learning by Experience

As is generally true for those of us in the treatment profession, my schooling and training isn’t really where I developed skill managing crises. Instead I learned about crisis management rather abruptly and through direct experience. During one of my first group sessions, a young woman I’ll call Sarah was confronted by another student. Her advice was well intentioned and delivered appropriately, but Sarah was not ready to hear it. In fact, Sarah got up from her seat, walked right across the therapy circle, and – before anyone could respond – punched her would-be advisor in the face. Fortunately, Sarah wasn’t an accomplished boxer and the other girl was shocked but not hurt. Sarah then sprinted out of the building to take the rest of her anger out on the furniture in her bedroom. I was partnered with more experienced colleagues, one of whom stayed with the group and the other of whom I followed to Sarah’s room, where she had already pulled drawers out of dressers, turned over mattresses, thrown vases, and broken picture frames. As soon as we opened the door, she looked up at us and fell to her knees with her hands over her face, sobbing.

Following my colleague’s lead, I gave Sarah her space by remaining quiet and keeping as much physical distance as the room would allow. Sarah had already cycled out of the peak of her crisis and was now in the “cooling down” or reflective phase. After a period of silence and stillness, my colleague slowly approached Sarah in a round-about way to avoid the appearance of a confrontation. My friend made sure to respect Sarah’s personal space by keeping about 3-4 feet of distance between them. She sat next to Sarah. By getting down on the floor with Sarah, she effectively made herself seem physically smaller and put herself at the same level as the crying girl. This simple action effectively conveyed a spirit of compassion and removed the appearance of authority and confrontation. Next, the therapist gently moved Sarah’s hands from her face and placed them on her lap so that communication could begin to take place.

My co-worker did a number of simple but critical things to prevent the crisis from escalating to self-harm or the need for physical intervention. She demonstrated a combination of inward awareness and restraint, and outward strategy which, together, kept Sarah from re-escalating. Because this event was so early in my professional experience, I have referred back to it often as a reference point for the basic principles of de-escalation. Following are seven of those principles.

1) Manage Triggers

We all have what are commonly called emotional triggers, which are any sensory stimuli that elicit strong and sudden emotional reactions. A trigger might take the form of a name someone was called during a highly vulnerable time in their youth; being called this name again years later might elicit sudden rage, shame, or other unresolved emotion. A song playing in the background during a rape or the smell of the perpetrator’s cologne can also serve as triggers. Any word or phrase that reminds one of a past trauma or emotional crisis can set off, or trigger, a new crisis. Triggers can launch someone who is otherwise on an emotional even keel almost instantly into a very agitated, out of control, irrational state.

We can intentionally or unintentionally say and do things that pull these triggers and escalate others. Sometimes the trigger is pulled not by another person, but simply by environmental factors, such the radio, a breeze carrying a familiar scent, etcetera. If, in a crisis, we’re able to identify the trigger, we need to remove that trigger from person in crisis or remove the person in crisis from that trigger – whichever represents the quicker, easier task. If a song on the radio is causing the escalation, we can simply turn the radio off. If another person is making provocative statements, we can ask that person to stop speaking or to leave. Sometimes it’s easier to just remove the individual in crisis from the charged situation.

As with so many things, the best solution to crisis is prevention. By staying alert and quickly removing triggers from the individual or vice versa before emotion escalates to crisis, we can frequently prevent a crisis from happening in the first place. This requires vigilance, sensitivity, and a strong relationship with the young people in your care.

2) Remain Cool, Calm, Collected

If I, as the adult caregiver, am not cool, calm, and collected, I risk escalating the young person in or approaching crisis. It sounds trite, but don’t forget to breathe during a crisis! Anxiety can create a physical tightness that affects our breathing, our voice, our expressions, and our physical movements. Paying attention to your breathing and taking slow, deep breaths can do wonders for relaxing the body and the mind, allowing us to remaining cool, calm, and collected regardless of the circumstances. If we allow our voice to escalate in pitch, intensity or volume, or if we come across as agitated, we can very easily escalate or re-escalate someone into crisis.

3) Employ Empathy and Compassion

The last thing any of us wants to hear when we’re suffering is that we are wrong or shouldn’t be feeling a certain way. Our feelings are our own and can’t always be controlled – in fact, fighting feelings can actually give them more power and increase one’s reactivity to those feelings. Empathy and compassion can go a long way toward reducing reactivity during a crisis. Validating comments can be an effective way to communicate our empathy and compassion; such comments might include: “that makes sense,” or, “it’s okay for you to be hurt or frustrated,” or, “wow, that must be very difficult.” Staying connected and compassionate, and verbalizing that compassion, can help the person in crisis realize that you are on their side and that you understand them and their emotions. This can have a profoundly calming effect.

4) Manage Non-Verbal Messages

It’s true that our actions speak at least as loud as our words. The way we physically position ourselves in crisis situations can also reduce the appearance of threat. I always find a way to make myself smaller and less threatening than the young person in crisis. If a student is standing, I will sit in a chair. If they are sitting in a chair, I will sit on the floor. I remain aware of my surroundings and what is going on so that I can provide safety for the young person, others, and myself if she acts out physically, but I always want to avoid the appearance that I am intimidating or a threat.

Awareness of posture, eye contact, expressions, sighs, etcetera, is also critical for managing a crisis situation. In the situation described earlier, my colleague masterfully used non-verbal communication to avoid re-escalating Sarah. She gave Sarah physical, and therefore emotional, space; she allowed Sarah time to gather her thoughts and cool down; she slowly and carefully approached Sarah. Had she gone quickly and directly toward the Sarah, she might have triggered her right back into crisis.

They key to managing these external behaviors, of course, is managing their source – your own emotions. Being mindful of your own feelings in the crisis is important. Without self-awareness, and a relatively cool, calm, collected interior space, it’s tough to project the kind of outward calm that will soothe a young person in crisis.

5) Know What you Don’t Know

During crisis situations we often come in late and have little or no idea of the circumstances. An automatic reaction is to jump in as the adult and try to resolve things authoritatively and instantly without the appropriate curiosity. Once any immediate physical danger has been managed, we want to get the person in crisis talking. Be curious and ask questions. Talking can help the young person pull herself out of an impending crisis, especially when we balance their talking with tender validation. Providing a context for talking quickly demonstrates that we are an ally, which is reassuring and calming.

6) Tune In

Only by staying tuned in to the emotional source of the crisis can we take the proper course of action. We want to be present and tuned-in enough to discern environmental triggers so that we can separate them from the person in crisis or vice versa. If they will take a walk with you, that is great. Get them away from the trigger if you know what that trigger is.

7) Honor the Crisis Cycle

At the peak of a crisis, it’s helpful to resist the urge to intervene immediately – either verbally or physically (unless there is an immediate risk of harm to self or others). A crisis, as a general rule, doesn’t last long. If the young person isn’t hurting herself or others, or if there isn’t a high risk of this happening, the best course is to let her cycle out of the escalated emotions on her own. There is no need to talk, because they are not in a place to listen – they are in a place of emotion, not logic. If they are being unsafe to themselves or are hurting another person, then of course it’s critical to ensure safety, either by calling the police, an ambulance, or – as professionals – using your training to physically hold the person in such a way as to prevent injury.

Cooling down comes after the person has passed through the crisis cycle. Their breathing slows down and they are able to speak and take direction and feedback. This is the appropriate time to talk them through the crisis experience. This can be an emotionally vulnerable and open period; if we use our words correctly we can build an even stronger relationship during this time immediately following crisis. We can also use these experiences to establish new boundaries by telling them what was and was not appropriate in their behavior during the crisis, and helping them construct a self-management plan for future crises.

Nutshell

Crises are scary and elicit all kinds of reactions from those involved. A crisis can seemingly come out of nowhere, catch us off guard, and evoke responses from us as caregivers that escalate instead of de-escalate the situation. By being vigilant for environmental triggers, remaining calm, and understanding crisis as cyclical and therefore temporary, we are more likely make the crisis cycle both shorter and safer. These approaches are critical for turning what could be a destructive event into a constructive opportunity for increased trust and personal growth.

Kris Kilpatrick is the program director at New Haven Residential Treatment Center, part of the InnerChange family of therapeutic programs.

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