Responding to Acute Behaviour Disturbance (Crisis)

Even with the best behaviour support plans in place, there may be times when a person’s behaviour escalates. There are ways to help a person in crisis, while still maintaining personal safety as a priority.

It may be possible to prevent a crisis after a person’s behaviour has started to escalate. However, when a crisis develops, personal safety takes priority over everything else. Ensure you have a crisis management plan that includes:

• when to disengage from an escalating situation
• making sure your exits are always unobstructed
• prior removal of any items that could be used as a weapon.

As behaviour starts to escalate, continue to work at understanding the triggers and purpose of the behaviour. It may still be possible to prevent a behavioural disturbance with:

• a calm even tone of voice and reassurance
• active listening and expressing empathy
• simple, clear directions about what is required.

The tone of voice is very important. It is normal to feel adrenalin and speak at a higher pitch during a crisis situation, even if the intention is to defuse the situation. Being aware of this and deliberately speaking quietly in a normal tone can make a big difference.

Try to identify the message behind the behaviour. You might be able to avert a crisis if you can find the trigger and deal with it directly. A positive behaviour support plan should include how to respond to each possible crisis situation. Typical strategies during the escalation phase include:

• promoting coping skills
• breathing exercises
• redirection (distraction)
• stimulus change
• ‘help me’ requests
• introducing humour (this can be a difficult technique and should only be used by a familiar person)
• exiting the troubling environment.

Once the crisis is over, it can be helpful to talk about the situation with a family member or a psychologist, particularly if it is a regular occurrence. It is important for carers to look after themselves and ensure they are well-supported.