Confrontational Avoidance Techniques (C.A.T)

Confrontational avoidance techniques help maintain relationships, reduce stress, preserve productivity, promote communication, and facilitate conflict de-escalation. 

Confrontation Avoidance Techniques (C.A.T.)

Confrontation Avoidance Techniques are some common sense techniques used to calm down an agitated person. Avoiding confrontation is your responsibility as a Direct Support Professional. If the people you are providing services to could avoid such confrontations, they would not be living in a specialized residential setting. As the “trained” DSP, you are responsible for knowing how to calm a person down when they become upset or agitated about something. The better relationship you have with the person the better chance these techniques will work for you. Think of a time in the past where you were upset or agitated. If you needed someone to calm you down which would you choose? A complete stranger or someone you know well and feel comfortable with?

ALWAYS:

• Reward “good” behavior a much as possible. When you see it...reward it!!!

• Show care and concern daily; not just when a person becomes upset.

• Actively listen. Stop what you are doing and pay close attention to the person.

• Be fair, sometimes firm, and be consistent. It is important for all DSP’s to work together as a team to provide consistent treatment. This is the “key” to successfully teaching people appropriate social skills.

• Get to know each person you provide services to. Learn their earliest signs of agitation so you can intervene at the beginning of the problem.

• Look out for and avoid events or situations that may upset the person. Remember it is your responsibility to avoid confrontations. People who display challenging behavior on a regular basis may be living in this home to learn some appropriate ways to deal with their emotions. This will be an important part of your job.

• Stay in control of yourself. Be aware of your voice tone and body language. If you show signs of anxiety, this may increase the person’s agitation.

Crisis

What is a crisis or emergency situation?

A crisis or emergency situation is defined as: A situation in which an individual has a serious mental illness or a developmental disability and one of the following apply:

• The individual can reasonably be expected within the near future to physically injure himself, herself, or another individual, either intentionally or unintentionally.

• The individual is unable to provide himself or herself food, clothing, or shelter, or attend to basic physical activities such as eating, using the toilet, bathing, grooming, dressing, or walking, and this inability may lead in the near future to harm to the individual or to another individual. Remember this is not a typical behavior for the individual!

What to do in an emergency/crisis situation:

In a crisis/emergency the DSP has multiple responsibilities and must act quickly to de-escalate the situation, assist the individual to calm down, and ensure the safety of the individual and others who may be present. The DSP who has the best relationship with the individual will have a better chance of finding out what is wrong and helping the person calm down. Emphasis should be placed on using verbal and non-verbal communication including body language as the DSP approaches the individual. Attempt to find out what is wrong, listen carefully and non-judgmentally. This is the perfect time to use the Confrontation Avoidance Techniques (C.A.T.) and the Proactive Options which were covered earlier in this unit. Your approach and ability to listen respectfully will send a message of support, care, and concern. Individuals may become upset, anxious, or agitated for a variety of reasons. It could be a symptom of a mental illness; it could be as a result of a traumatic event that the individual experienced or a reaction to a medication. Investigating the cause or trigger for the agitation will occur after the DSP has successfully helped the person to calm down.

Debriefing

Debriefing occurs when the DSP staffs discuss what happened during an incident. Because everyone sees things from a different angle and we want to avoid another incident, this is an important follow-up to the crisis. Debriefing can also help staff decompress by sorting out thoughts and feelings about the incident. Other DSP staff can help you get a more complete and clear picture of what really happened. Discuss what happened before, during, and after the confrontation occurred.

Answer these questions during the debriefing:

• How did I feel before, during, and after the confrontation?

• What was the person doing before, during, and after the confrontation?

• What signs of agitation did I or others observe before the confrontation?

• What confrontation avoidance techniques & proactive options were used?

• What happened as a result?

• Did other staff assist? If "no" why?

• If "yes" was communication clear between staff? Were actions coordinated?

• Were other people present? Were they removed from the area/made safe?

• If the incident happened again, what would I do?

• How will this affect interactions with this individual in the future?

Debrief with the person involved in the confrontation, if appropriate, after he or she has calmed down and re-established self-control. All physical injuries, unusual behavior, and all actions by DSP staff to calm the individual must be documented on an Incident Report. 

Documentation of agitated and aggressive behavior provides important information. Remember the DSP must be descriptive not evaluative when documenting. Write down what you see, not what you think those actions mean. Remember we all become angry sometimes and we almost always have a reason for our anger. Sometimes there is a real and legitimate reason and other times it is a matter of perception: what we thought the person was doing or saying to us. Our perceptions impact how we interpret others behavior and actions. Most of us have learned how to control our anger. 

Many of the individuals we work with did not have the same opportunity to learn how to control their anger. The individual may be reacting to trauma they may have experienced or something in the environment or “fill in the blank”, whatever the trigger and there are many it makes sense to respond in a calm and compassionate manner. 

Remember the individual is NOT attacking you although sometimes it may feel that way. The DSP has got to be careful to be professional and separate personal feelings and reactions, becoming angry, yelling or having threatening body language will not help. These types of reactions from a DSP could escalate a situation into a “Me against You” confrontation which won’t teach the individual anything and will damage the relationship between the DSP and the individual involved. 

Are you familiar with the old saying “You catch more flies with honey than with vinegar?” Meaning be nice and you're more likely to get what you want, if the DSP treats people with respect and is a good role model then you will have very few problems and many great opportunities to assist people in positive ways.

Now that you have completed the Confrontation Avoidance Technique (C.A.T.) module, please proceed to take the test. To successfully complete the course, you must achieve a passing score of 80% or higher.