Dealing with aggressive behaviour A guide for staff University of Aberdeen Estates Section Presented by Risk Trainer (V+A) NHS Grampian

Format of the course Format of the course  Introduction  Understanding aggression  Risk assessment  Use of de-escalation techniques to manage conflict  Action during instances of aggression  Incident reporting  Dealing with the effects of trauma following an incident

Definition of workplace violence and aggression “Any incident in which a person is verbally abused, threatened or assaulted in circumstances relating to their work”.

Health issues substance abuse and intoxication stress Staff approaches rigid, authoritarian, and confrontational insensitive UNDERSTANDING AGGRESSION Aggression triggers

Anger is usually defined as: Anger is usually defined as: A feeling of displeasure coupled with a desire to punish Normally for what the person regards as ‘wrongdoing’ towards themselves or others It may sometimes be excessive in nature or misplaced but not necessarily criminal

Aggression is usually defined as: Aggression is usually defined as: The first attack – verbal or physical The appearance of hostility The first act of injury to others Can be directed to objects as well as other people

Violence is: Violence is: The term used when speaking about serious physical attack Can be directed at objects and people Physical force exerted for the purpose of violating, damaging or abusing

People can be aggressive when they are not angry. Two major types of aggression: - Hostile aggression - Instrumental aggression

Escalation Indicators Flushed face. Glaring/staring eyes. Twitching facial muscles. Clenched teeth and fists. Pacing and agitation Increased respirations. Shouting or verbal profanities. Change in voice tone or pitch. Rigid, tense posture. Threatening or provocative gestures. Invasion of personal space. Poking or pushing. Banging doors / punching Walls Inconsistent behaviour.

RISK ASSESSMENT Potentially hazardous areas are those where: RISK ASSESSMENT Potentially hazardous areas are those where: Employees challenge members of the public. People are required to work alone. Cash is handled. Staff have to deal with people who are under the influence of alcohol or drugs. Staff, students and members of the public are under stress.

Assessing the likelihood of violence occurring When assessing the likelihood of violence occurring you need to consider the following questions. The more often you answer ‘YES’ the greater the likelihood of violence: Does the person appear to be drunk or under the influence? Has the person verbally abused me in the past? Has the person threatened me with violence in the past? Has the person attacked me (or someone else) in the past? Does the person seem to have unrealistic expectations? Does the person perhaps perceive me as willfully unhelpful? Do I feel anxious for my safety with this person?

Assessing the severity of the consequences of a potential attack The consequences of a potential attack will be more severe if the answer is ‘YES’ to several of the following questions: Am I alone and without backup? Are colleagues unaware of my whereabouts? Am I outnumbered? Am I without any means of raising the alarm if attacked? Am I likely to be trapped if the person becomes violent? Am I inexperienced in dealing with violent situations?

USE OF DE-ESCALATION TECHNIQUES TO MANAGE CONFRONTATION There are things that we can do to reduce the risk of experiencing assault when dealing with an aggressive person. De-escalation involves the use of both verbal and non- verbal communicating skills.

Non-verbal Skills Space (give distance) Posture (open and relaxed) Eye contact (don’t stare) Stance (stay on same level) Touch (use very carefully)

Verbal Skills Use questions to try to change their train of thought Try to distract them away from their angry thoughts Negotiate with the person if a problem or conflict exists that has a solution Apologise and express regret Show empathy

Alternative verbal skills… ‘Stop (behaviour) and tell me what you want’ Use of ‘I’ instead of ‘we or us’

ACTION DURING INSTANCES OF AGGRESSION Assess the situation Call for back-up If possible de-escalate or leave Police

Always remember…….. Trust your intuition. Keep at a safe distance. Be aware of your exits. Be prepared to call for help. Don’t be afraid to leave the situation.

INCIDENT REPORTING It is vital that all instances of aggression or violence towards Estates Section staff are recorded to: Prevent similar attacks occurring in future or reduce the consequences of these. Assess whether current procedures and training are effective. Compliance under health and safety legislation.

Incident recording When and where it occurred. Who or what sparked it off. Who was involved. Injury to staff or others. Damage to property. How the incident was resolved. Do not include personal opinions

DEALING WITH THE EFFECTS OF TRAUMA AFTER AN INCIDENT Involvement in an incident can be a traumatic event. Should staff require any support in dealing with the effects of trauma they can either: Speak to their line manager who will contact Human Resources. Human Resources will then arrange an appointment with either the University Counselling Service or the Occupational Health Service. OR Self-refer themselves in confidence to either the University Counselling Service (Tel: ) or the Occupational Health Service (Tel: ).

QUESTIONS?