Patrick Frato, Ed.S., NCSP, SP597
Lecturer in School Psychology
School Psychology Program
Cleveland State University
Michael Shockey, M.A.
School Psychology Intern
Cleveland State University
Rocky River City Schools
School psychologists are often asked to help calm out of control students (McNamara, York, Kubick, McMahon, & Clark, 2013). Administrators and teachers frequently assume that school psychologists are highly trained and skilled at implementing de-escalation strategies. After a short time with a school psychologist, unmanageable students are expected to be compliant and ready to return to the classroom, or await the arrival of a parent or guardian.
While most school psychologists receive some general training in counseling, few have studied and practiced the specific skills required for de-escalation. Ironically, for many school psychologists, this is the only type of counseling in which they ever engage (McNamara, et al., 2013). In the absence of knowledge about and training in de-escalation, school psychologists are left with only instinct and a basic toolkit of counseling skills to deal with crises that require competent and effective intervention. The following article seeks to explain, explore, and provide effective interventions for de-escalation.
De-escalation must be understood as a set of specific counseling interventions relevant only to an equally specific set of scenarios– intensely angry, upset, or otherwise unmanageable children (Price & Baker, 2012). General counseling techniques - rapport building cognitive behavioral therapy, etc. - are often effective in treating already deescalated children, but are rarely effective de-escalators in and of themselves. Further, functional behavioral analyses and behavior intervention plans may be able to prevent or decrease the severity of episodes requiring de-escalation, but these steps require time, frequent adjustment, and do not altogether eliminate the need for in-the-moment de-escalation. Consequently, school psychologists must possess a toolkit of strategies specifically designed for de-escalation. While there is an alarming lack of direct research on de-escalation in schools, other professions – law enforcement and nursing – can provide insight into this topic. Police officers and nurses in mental health facilities regularly engage in de-escalation and research from these fields may inform effective school-based interventions. However, not all de-escalation techniques from other professions are relevant to or appropriate for school-aged children, or the school environment. School psychologists must therefore use professional discretion in utilizing interventions from other fields. Nevertheless, in the absence of school-based research, intervention recommendations from other fields may very well result in more effective de-escalation outcomes.
Research
A theme among de-escalation research from other professions is that there is no one-size-fits-all technique for de-escala tion (Richmond et al., 2011). Professionals must evaluate individual situations and skillfully choose appropriate interventions. This requires that school psychologists possess a range of de-escalation strategies, so that if one technique is not effective, an alternative can be efficiently deployed.
One technique that has shown to be less effective than originally believed is the use of restraint/seclusion (Price & Baker, 2012). An assessment weighing the impact of these programs found that while training results in an increase in staff knowledge, little improvement is evidenced in actual de-escalation outcomes (Price & Baker, 2012). What’s more, while there is no accurate data on deaths and injuries resulting from physical restraints in schools, the Child Welfare League of America (2002) estimated that there were between eight and ten deaths annually due to unsuitable physical restraint actions (Ryan, Robbins, Peterson, & Rozalski, 2009). Therefore, restraint interventions should be used as a last resort option and replaced, if possible, by lower risk techniques.
Available literature suggests that more research is necessary to identify and better understand effective de-escalation strategies (Richmond et al., 2011). What is known, however, is that no single deescalation technique has shown to be most effective; this further highlights the need for school psychologists to possess, and practice, multiple techniques. As Price and Baker (2012) asserted: “Deciding on a strategy for de-escalation is an instinctive, intuitive process, requiring flexibility and creativity and is based on the individual needs and characteristics of each patient displaying aggression.”
De-escalation often requires school psychologists to engage with highly volatile students in seemingly out of control scenarios. Increasing one’s knowledge and understanding of these techniques and strategies may help a bad situation from becoming worse. Further, effective de-escalation can assist in returning children to classrooms, increasing academic learning time, and improving academic outcomes.
Strategies for Success: De-escalation Ideally, behavior intervention plans limit, or even eliminate, the need for intensive deescalation (Klehr, 2009). In reality, despite best efforts at implementing plans, many school psychologists are still regularly called upon to deescalate students. The following strategies can be implemented to assist in de-escalation.
Calm demeanor. Remain calm and use a steady, confident (but not arrogant) voice, regardless of what the student says or does. It may be possible to project outward calm, even if you are experiencing significant internal stress (Duperouzel, 2008).
Direct, Simple Language. Use short sentences with simple vocabulary. Students in heightened emotional states may not be able to process complex language. Allow students time to respond after asking questions (Wright, 2013). Active Listening. Utilize active listening skills such as summarizing, repeating, rephrasing, and labeling of emotions to ensure that students feel understood (Carlsson, Dahlberg, & Drew, 2000).
Body Language & Proximity. Ensure that nonverbal cues – posture, eye contact, proximity, facial gestures - convey genuine concern for the student (Virkki, 2008). Educators should stand two arms lengths away, at an angle to students with empty and open hands held to their sides (Larson, 2005). Avoid blocking exit routes; this may make students feel trapped (Wright, 2013).
Sincerity. Attempt to convey genuine concern, empathy, and a permissive (non-authoritarian) attitude (Carlsson et al., 2000).
Isolation. De-escalate in a safe, secluded environment away from peer and adult spectators. Students may engage in facesaving behavior in the presence of an audience (Larson, 2005).
Choices. Offer alternatives to aggressive behavior and negotiate a mutually agreed upon plan. Providing choices allows students to maintain dignity in the course of de-escalation. This may limit negative behaviors resulting from embarrassment caused by the episode (Duperouzel, 2008).
Distraction. Distract by engaging in a simple game or activity. It’s often difficult for students to regulate emotions when they are focused on a stressful and traumatic event. Distraction can divert attention, lower stress and anxiety, and prepare students for a rational conversation.
Humor. Employ gentle humor to distract and disarm the student and assist in transitioning to a healthier and less volatile emotional state. Humor must be used with caution; students may feel that it is being directed towards them (Duperouzel, 2008).
Case-by-Case Basis. Connect needs of individual students and circumstances to appropriate interventions. Different students may require different de-escalation strategies. An understanding of specific antecedents can empower educators to remove a child from a triggering situation. Further, modifying consequences may ensure decreased frequency and duration of episodes. It should also be noted that, while most students respond best to compassion, some may respond better to explicitly stated limits and boundaries (Delaney & Johnson, 2006).
Threats. Avoid threats, ultimatums, and power struggles. These are often escalating, as opposed to de-escalating (Johnson & Hauser, 2001).
Follow-Up. Develop and implement a plan. Students that engage in a consistent pattern of aggressive and violent behavior require functional behavioral analysis, a behavior intervention plan based on the FBA, and, for most, regular counseling to increase emotional regulation skills.
References
Cowin, L., Davies, R., Estall, G., Berlin, T., Fitzgerald, M., & Hoot, S. (2003). Deescalating aggression and violence in the mental health setting. International Journal of Mental Health Nursing, 12, 64-73.
Carlsson, G., Dahlberg, K., & Drew, N. (2000). Encountering violence and aggression in mental health nursing: A phenomenological study of tacit caring knowledge. Issues in Mental Health Nursing, 21, 533–545.
Delaney, K. R., & Johnson, M. E. (2006). Keeping the unit safe: Mapping psychiatric nursing skills. Journal of the American Psychiatric Nurses Association, 12 (4), 1–10.
Duperouzel, H. (2008). ‘It’s OK for people to feel angry’: The exemplary management of imminent aggression. Journal of Intellectual Disabilities, 12, 295–307.
Johnson, M. E., & Hauser, P. M. (2001). The practice of expert nurses: Accompanying the patient to a calmer space. Issues in Mental Health Nursing, 22, 651–668.
Klehr, D.G. (2009). Addressing the unintended consequences of no child left behind and Zero tolerance: Better strategies for safe schools and successful students. Georgetown Journal on Poverty Law & Policy, 16, 585-610.
Larson, J. (2005). Think first: Addressing aggressive behavior in secondary schools. New York: Guilford Press.
Larson, J. (2008). Angry and aggressive students: Knowing how to prevent and respond to student anger and aggression is important to maintaining order in school. National Association of Secondary School Principals, 1, 13-15.
McNamara, K., York, J., Kubick, R., McMahon, C., & Clark, P. (2013). OSPA omnibus survey. Columbus, OH: OSPA.
Price, O., & Baker, J. (2012). Key components of de-escalation techniques: A thematic synthesis. International Journal of Mental Health Nursing, 21, 310-319.
Richmond, J., Berlin, J., Fishkind, A., Holloman, G., Zeller, S., Wilson, M., Rifai, M., & Ng, A. (2011). Verbal de-escalation of the agitated patient: Consensus statement of the American Association for Emergency Psychiatry project BETA de-escalation workgroup. Western Journal of Emergency Medicine: Integrating Emergency Care with Popular Health, 13, 1.
Ryan, J., Robbins, K., Peterson, R., & Rozalski, M. (2009). Review of state policies concerning the use of physical restraint procedures in schools. Education and Treatment of Children, 32(3), 487-504.
Virkki, T. (2008). The art of pacifying an aggressive client: ‘Feminine’ skills and preventing violence in caring work. Gender, Work and Organization, 15, 72–87.
Wright, J. (2013). How to: Calm the agitated student: Tools for effective behavior management. Retrieved from http://www.interventioncentral.org.