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Behavioral Escalations — Navigating Difficult Conversations with Families — Clinical Pathway: Outpatient Specialty Care and Primary Care

Behavioral Escalations Clinical Pathway — Outpatient Specialty Care and Primary Care

Navigating Difficult Conversations with Families

During behavioral escalations, maintaining clear communication can help to improve cooperation and reach our goal of staff and visitor safety.

Quick Tips for Navigating Difficult Conversations

Dos

  • Prioritize safety. Set clear expectations with emphasis on patient health and safety.
  • One Voice. Consider one person communicating next steps to reduce confusion, and to avoid overstimulation.
  • Acknowledge feelings. Use supportive language to address patient feelings around the presenting situation.
  • Offer choice. Where possible (e.g., “I can contact 911 with you in the room, or I can call from the hallway”).
  • Be mindful of environment and personal space.

Don’ts

  • Avoid promise statements (e.g., “everything will be okay”).
  • Avoid confusing phrases, such as, “Calm down” and “Its Okay.” These statements may lead to increased escalations.
  • Avoid minimizing patient feelings.
  • Do not feel pressure to break silence. When possible, allow escalated person time to think, to make decisions and to process the situation.
  • Avoid mirroring escalated person’s behavior. Keep awareness of body postures and non-verbal cues that could be perceived as aggressive (e.g., crossed arms, hand gestures or clenched fists).

Additional De-escalation Strategies or Considerations

 

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