The best staff response during the Agitated level is to begin Setting Limits, which entails setting behavioral limits for the individual. It is quite clear that a supportive, empathic approach is not very productive when a person becomes irrational and is testing limits. In many cases, support merely feeds into the irrational person’s defensiveness. The individual needs, and at times is actually seeking, structural limits to regain rational control.

There are several critical keys in setting limits. First, make sure that your limits are clear to the person. Don’t assume that she understands why the directive is being issued. Second, be sure that your limits are simple. Don’t make them overly complex. When a person is losing rationality, she does not need five or six options to process. The key is to ensure that any limits you impose are enforceable. For example, if you tell someone she must calm down or you will have to remove her from the area, think about whether or not this is something you are prepared-or authorized-to do. You can almost guarantee that any limits you impose will be tested.

Limit setting should be done as objectively as possible and should not be delivered in a threatening manner. Your goal is to make the person realize that the consequences of her behavior are up to her. The limits you impose on the individual should not merely be enforceable either; they have to be reasonable. Avoid getting yourself into a knowing situation by issuing limits which cannot be enforced.

Behavioral limits do not have to be issued negatively. The “do it this way or else” ultimatum can be the spark which ignites the dynamite in a volatile situation. Inform the individual of the positive consequences resulting from her compliance. Let her make the choice.

For example, if the person is getting too loud, the first step is to let her know why her behavior has to cease. A simple explanation of the fact that the noise is disturbing others can often be enough to calm her down. If it is not, there is no need to threaten the person into compliance. Instead, point out the fact that she can remain in the area if she quiets down. Also inform her that she will have to be escorted out of the area if she continues the behavior. Make the individual feel as though she has a choice; Le., the consequences of her behavior are determined by her decision. This approach will avoid getting you into a no-win power struggle. You must keep in mind that you are there to enforce the consequences of the individual’s choice and not to make the person choose one option or the other.

Limit setting is a skill which requires practice and a calm, professional approach. Verbal abuse by anyone can be frightening, not to mention insulting. It is critical, however, that you maintain your professionalism. A verbal loss of control at this moment may be the reaction that escalates a person into a total loss of control.