TY - JOUR
T1 - De-escalation: The evidence, policy and practice
AU - Inglis, Pamela
AU - Clifton, Andrew
PY - 2013
Y1 - 2013
N2 - Purpose: The management of violence and aggression is an important aspect of any service in the NHS and has been rightly tackled as a whole organisational approach. De-escalation is one such aspect of the organisation approach relating foremost to the safety of people and as such is a central part of relational security, personal safety and the therapeutic relationship.
Design/methodology/approach: The paper explores the evidence and policies around de-escalation.
Findings: The paper recommends that a randomised-controlled trial be designed, comparing different de-escalation techniques to establish an evidence base for this routine practice.
Research limitations/implications: The paper is limited to discussing de-escalation as an approach and the policy that directs it, and does not consider individual theories on aggression and management. It makes recommendations for policy, research and practice.
Practical implications: There is a lack of high-quality evidence around de-escalation policy and principles which staff may believe is evidence-based practice because training is often mandatory. This obviously impacts upon the patient experience and aspects of safety. The paper is valuable to practitioners working in secure environments, or with offenders that may require management of violence and aggression.
Originality/value: There are many policies and guidelines from the government and from professional bodies that seems to have tailored off since 2005 (Muralidharan and Fenton, 2006; UKCC, 2002). Forensic staff are constrained by such guidance which is further complicated by debates concerning care/coercion and forensic environments, some of which is alluded to here.
AB - Purpose: The management of violence and aggression is an important aspect of any service in the NHS and has been rightly tackled as a whole organisational approach. De-escalation is one such aspect of the organisation approach relating foremost to the safety of people and as such is a central part of relational security, personal safety and the therapeutic relationship.
Design/methodology/approach: The paper explores the evidence and policies around de-escalation.
Findings: The paper recommends that a randomised-controlled trial be designed, comparing different de-escalation techniques to establish an evidence base for this routine practice.
Research limitations/implications: The paper is limited to discussing de-escalation as an approach and the policy that directs it, and does not consider individual theories on aggression and management. It makes recommendations for policy, research and practice.
Practical implications: There is a lack of high-quality evidence around de-escalation policy and principles which staff may believe is evidence-based practice because training is often mandatory. This obviously impacts upon the patient experience and aspects of safety. The paper is valuable to practitioners working in secure environments, or with offenders that may require management of violence and aggression.
Originality/value: There are many policies and guidelines from the government and from professional bodies that seems to have tailored off since 2005 (Muralidharan and Fenton, 2006; UKCC, 2002). Forensic staff are constrained by such guidance which is further complicated by debates concerning care/coercion and forensic environments, some of which is alluded to here.
KW - De-escalation
KW - forensic
KW - learning disability
KW - policy
U2 - 10.1108/JIDOB-01-2013-0001
DO - 10.1108/JIDOB-01-2013-0001
M3 - Article
VL - 4
SP - 100
EP - 108
JO - Journal of Intellectual Disabilities and Offending Behaviour
JF - Journal of Intellectual Disabilities and Offending Behaviour
SN - 2050-8824
IS - 3
ER -