Phase 2 is the escalation phase. It is important to recognise and address signs of distress or conflict and use appropriate techniques to try and de-escalate the situation. Common signs of escalation include pacing, voice quivering, quick breathing, flushed face, twitching, dilated pupils, tense appearance, abusive, intimidating and derogatory remarks, and clenched fists.
The LASSIE model is a useful tool for communication and de-escalation of the situation in this phase:
L Listen actively: allow the client to run out of steam before you talk.
A Acknowledge the problem/situation: validate the client’s feelings, empathise.
S Separate from others: to ensure the safety of others if escalation occurs.
S Sit down: symbolises readiness to negotiate.
I Indicate possible options: give alternatives to alleviate the situation.
E Encourage the client to try these options: assist the client to follow through.
The following strategies may also be useful in managing escalating aggression:
- Provide a safe environment for the client, yourself and others.
- The presence of a familiar person may help to calm and reassure the client.
- Do not assume aggressive behaviour is necessarily associated with mental illness.
- Know your own limits and refer/seek help if necessary.
- Be warm, friendly and non-judgemental; reassure the client.
- Stay focused on the current situation but anticipate problems.
- Carefully monitor the physical and psychological condition of the client.
- If the client’s behaviour escalates, withdraw and seek assistance immediately.
- Try to maintain a quiet, non-stimulating environment for the client (excessive noise or people may contribute to aggression).