As a Social Worker new to the State Hospital, my goal was to get to know the individuals I serve so I can best support and help them in their recovery. The time I invested in this effort brought me the opportunity to help a particular individual, JD, overcome disappointing news without becoming angry or aggressive.
I witnessed this JD become aggressive after being told that his category and privileges were being decreased due to his behaviors. When he received the information, he became physically and verbally aggressive, endangering himself and others. This situation was resolved and over time he gained back his privileges.
A couple of months passed and new rules were put in place. JD had not been checking in on time and was considered AWOL multiple times. Due to this behavior, he again was going to be decreased in his privileges. Remembering and understanding the results of his last decrease in privileges and focusing on my belief in my abilities and growing relationship with him, I choose to be the person to tell him that his privileges would be decreased. The psychiatric emergency response team members, were available just in case he became aggressive.
I took the individual into a separate room with 3 staff members and began telling JD that I have been concerned lately, because he hadn’t been checking in on time. I asked if he was having trouble adjusting to the new check in time rules and if I could assist in getting him a watch to help him realize when he needed to come back inside. He said no and reported that he was getting confused by the new rule. I provided him with different ways the team could support him and explained that he was going to have his privileges decreased due to him not checking in. I could see him slightly tense up and because of my relationship with him, I knew he would be most concerned with how it would affect his smoking. Therefore, I quickly added that he would still be able to go outside and smoke, but it would be a shorter time frame. I again explained to him that I want to help support him in checking in on time and increasing his privileges and reminded him of the options I gave him as to how we could help. To my surprise, he reached out his hand and I shook it. I thanked him for talking with me and told him that I would check in with him every day to see how it was going and I did. After a week, he was back to full privileges.
I’ve thought about both instances and analyzed them over and over to try and figure out why JD didn’t show a negative behavior when I explained his privilege decrease. There are certain things I have come up with. I treated him with dignity and respect prior to this problem, during our conversation and after it. I didn’t blame him for his actions or say things to make him defensive. Instead, I used I-statements and expressed my concerns. I demonstrated empathy and genuineness. I spoke in the same calm tone I have used with him time and time again and my non-verbal communication was consistent with what I was saying. My RADAR was on and I was able to respond to his nonverbal cues appropriately based on my knowledge from developing a relationship with him.
MANDT reinforced in me that I have the ability to escalate or de-escalate situations based on my response to situations. It is my job as a professional to treat everyone with dignity and respect, to support them, and to build them up. This hospital is a place for recovery and enhancing ones well-being and it is my job to create an environment where they can honestly say “In this place, and with these people, I feel safe.” I believe that with this situation, he trusted me and felt safe.
Kim Jabolonski, Mandt Certified Instructor
