De-escalation in the Management of Aggression and Violence: Towards Evidence-based Practice

Paterson, Brodie; Leadbetter, David

doi:10.1007/978-1-349-13577-6_6

Cited by 23 publications

(32 citation statements)

References 14 publications

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“…Practice is now guided by theory, and discrete skill modules such as de‐escalation have replaced intuitive judgement about handling volatile situations (Paterson et al . ). The language of ‘control and restraint’ has been explicitly rejected in favour of ‘calming and restraint’ or other formulations that do not evoke the language of correctional services (Paterson ).…”

Section: Introductionmentioning

confidence: 97%

Optimizing arousal to manage aggression: A pilot study of sensory modulation

Sutton

Wilson

Kessel

et al. 2013

Int J Mental Health Nurs

146

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The dominant model that informs clinical training for preventing violence and managing aggression posits arousal as mediated downwards from higher cortical structures. This view results in an often-misplaced reliance on verbal and cognitive techniques for de-escalation. The emergence of sensory modulation, via the Six Core Strategies, is an alternative or complementary approach that is associated with reduced rates of seclusion and restraint. Sensory-based interventions are thought to promote adaptive regulation of arousal and emotion, but this connection has had limited theoretical and empirical development. This paper presents results of a pilot trial of sensory-based interventions in four inpatient mental health units in New Zealand. Narrative analysis of interview and focus group data suggest that modifications to the environment and the use of soothing stimuli moderate or optimize arousal and promote an ability to adaptively regulate emotion. Findings are discussed in light of recent advances in the neurophysiology of emotional regulation and the General Aggression Model that posits arousal and maladaptive emotional regulation as precursors to aggression.

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Section: Introductionmentioning

confidence: 97%

Optimizing arousal to manage aggression: A pilot study of sensory modulation

Sutton

Wilson

Kessel

et al. 2013

Int J Mental Health Nurs

146

View full text Add to dashboard Cite

show abstract

“…Perhaps in situations where the risk of violence is greater, attempts to engage and de‐escalate the patient may be taken more cautiously. Taken together, these findings may reflect a lack of confidence in de‐escalation techniques by staff (Inglis & Clifton ), which is particularly evident when the perceived risk is greater (Whittington & Wykes , Paterson & Leadbetter ).…”

Section: Discussionmentioning

confidence: 99%

Predictors of effective de‐escalation in acute inpatient psychiatric settings

Lavelle

Stewart

James

et al. 2016

Journal of Clinical Nursing

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“…For example, research has reported that more experienced police officers are less likely to arrest or use force on people experiencing mental illness; similarly, more experienced nurses tend to utilise less restrictive strategies (Lowe et al 2003, Mcelvain andKposowa 2008). In terms of mental health, Lowe and colleagues (2003) suggest that more experienced nurses may have greater confidence what might enable them to perceive the patients' behaviour as not so alarming, or they may have a more established therapeutic relationship with them, and therefore still effectively use de-escalation and communication methods (Paterson et al 1997).…”

Section: Accumulated Years Of Experience and 'Exposure' To Mental Illmentioning

confidence: 95%

Police management of mental health crisis situations in the community: status quo, current gaps and future directions

Tribolet-Hardy

Kesic

Thomas

2014

Policing and Society

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This paper considers the application of principles widely used to conceptualise and address violent and aggressive behaviour in psychiatric settings and examines if and to what extent they may be applicable to the police resolution of community-based mental health crisis encounters. It suggests that police should distill the significant accumulated practical wisdom available within its ranks to inform the beginnings of an evidence-based approach regarding effective resolution of such incidents. These can then be further validated within the frameworks of interpersonal theory and enhanced therapeutic communication style recommended in psychiatric settings to help better equip police with a suite of evidence-based tools when encountering such situations.

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De-escalation in the Management of Aggression and Violence: Towards Evidence-based Practice

Cited by 23 publications

References 14 publications

Optimizing arousal to manage aggression: A pilot study of sensory modulation

Optimizing arousal to manage aggression: A pilot study of sensory modulation

Predictors of effective de‐escalation in acute inpatient psychiatric settings

Police management of mental health crisis situations in the community: status quo, current gaps and future directions

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