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The Agitated Client Back to Course Index

The staff member does not intervene with a supportive approach, the individual refuses to accept the staff’s support, or the staff member arrives too late during the crisis development, there may be the possibility of the individual escalating to the second level, the defensive stage.

The Agitated signifies the beginning stages of loss of rationality. At this point, the person begins to give you cues, verbally and nonverbally, indicating he is beginning to lose control. The Agitated Level is a highly volatile state and usually includes verbal belligerence and hostility. You will find the individual challenging you, your institution, and your authority. The defensive person begins to respond or cue on different modes of communication. Often, at the peak of his defensiveness, he no longer responds to the rational context of your words. Instead, he may be more in tune with other types of communication such as your tone of voice, your proximity to him, or your body posture.

Here is where we see power struggles and “button pushing” begin. Abusive language alluding to your race, weight, sex, and other sensitive areas is spouted.The person is testing you, and testing your limits. He may even solicit help with his verbal barrage from onlookers. Many times the verbal “acting out” strays far from the original issue that upset him, and staff may find themselves defending a completely different topic than originally precipitated the crisis.

This is an extremely critical time during the crisis development. At this stage, the staff can make or break the intervention. If the individual’s irrationality and “button pushing” affects the staff member to the point where he loses his professionalism and becomes irrational, he has little chance of defusing the situation. Irrationality breeds irrationality. If the person senses you are not in control of your behavior, it will serve as further fuel for the fire.

The perfect example happens many times in larger institutions. A crisis alarm or signal that alerts security to report to a particular area is sounded. When security arrives on the scene, they see two people in a heated shouting match, one more agitated than the other. Being a large institution, security’s first task turns out to be determining who is the staff and who is the client. The point here is that during the Defensive Level, it is very easy for the staff member to slip into his own crisis development. If this occurs, no one is in control and the situation is almost sure to escalate.