Communicate respect and promote dignity. These positive interaction strategies are the foundations of Safety-Care® and encourage therapeutic rapport. We all know, in the field of human services, rapport is everything. Having rapport with fellow staff and individuals can be the difference between having a pleasant day at work and walking into an awkward nightmare. Rapport supports staff resilience, encourages a healthy working environment, complies with regulatory requirements, and helps organizations meet their obligations to the individuals served. With some individuals, rapport may be difficult to earn or difficult to maintain. Sometimes, the individuals we provide services to, may make the most “Zen” staff feel insulted, irritated, or intimidated. The danger here is when staff are frustrated or provoked, they may respond by engaging in a power struggle.
What is a power struggle?
A power struggle is an attempt to use threats or force (i.e., coercion) in response to challenging behavior. This can happen when you are beginning to place demands on an individual, when an individual is starting to escalate, even when an individual is in crisis! If you have ever heard a staff yell loudly, “STOP THAT NOW!” or “You better do what I say, or else!” those are power struggles. When a staff engages in power struggle behavior, that can trigger dangerous behavior which puts everyone at risk and chips away at precious rapport.
Engaging in a power struggle does not promote dignity.
Examples of power struggles: (Note: these may be subtle to an onlooker, but may seem clearly aggressive and provocative to an individual)
Physical intimidation – Bullying, posturing, angry or upset facial expressions, getting uncomfortably close, or moving too quickly.
Negative tone – Loud, angry, and/or sarcastic.
Humiliating statements – Retaliation, making fun of the person.
Threatening statements – Threatening excessive, inappropriate, aggressive consequences.
Escalating criteria of success – Increasing triggering demands upon challenging behavior, nagging.
Using force – Inflicting pain, using the most restrictive strategies (e.g., using physical management without meeting criteria) before less restrictive ones, abuse, mistreatment, neglect.
Why does it happen?
We may all experience frustration in our work and private lives, that may be difficult to leave at the door before entering work, but we cannot let that impede our therapeutic relationship with the individuals we serve. An organization should work hard to create a culture of support for all levels of staff. Such a culture teaches staff how to successfully identify a power struggle and engage in alternative behavior. Additionally, a multi-tiered culture of support values management teams that encourage helpful staff resilience solutions.
What are the alternatives to power struggles?
There are many alternatives to power struggles that promote dignity. Remember, the job is to support, not control.
Alternatives to power struggles:
Q-TIP: Quit Taking It Personally, in other words, managing your own emotional reaction. An individual may be directing hurtful statements, racial/gender-based slurs towards you but it’s not about you, it’s about the circumstances that surround the individual. Awareness of our own triggers, understanding behavior, and being mindful of physical presentation can help promote dignity.
Provide Choices: Providing 2-3 acceptable choices are powerful in helping the individual de-escalate by showing them what their options are.
Pick your battles: “Pick the battles big enough to matter, not small enough to win” (Shout out to Safety-Care trainer, Karen Manuel, of Gain Learning Center for this quote). Be aware of what you are asking the individual to do and why. Is this helping them meet programmatic goals? If not, why are you asking them to do it?
Change the request you are making: Look at how you request something from an individual, is your tone polite? Age-appropriate? Is your request respectful?
Give the person more time: A lot of the individual we work with have limitations in communication. Additionally, when anyone starts to escalate, language processing becomes more difficult. Give an individual enough time to process and even a little bit more time to decide what they want to do next.Be patient.
Be helpful: There will always be difficulties everyone’s life. Can we be helpful, supportive, the wind beneath their wings?
Change staff: Maybe the current situation is too triggering, maybe the individual is mad at you specifically, maybe you haven’t established the rapport you need to make a certain request, consider changing staff. This could be a quick step in or taking a break from working with the individual. Sometimes we may have challenging days, multi-tiered cultures of support honor reasonable staff breaks.
Safety-Care Differential Reinforcement procedures: This strategy is taught as a competency in Safety-Care trainings. This is a procedure to help replace challenging behavior with more desirable behavior by reinforcing desirable behavior and withholding reinforcement from challenging behavior.
Safety-Care De-Escalation Strategies: Highly effective, fluid strategies taught as a competency in Safety-Care. These strategies replace escalation and crisis behaviors with either functional communication, calming behaviors, or creating safe, trigger-free environment for the individual to calm themselves in.
The Safety-Care curriculum goes into great detail about power struggles and how to identify and engage in the alternatives. Staff should try to avoid power struggles by using these alternative strategies. However, just reading these strategies is not enough to promote their use. That is why we teach these alternatives using competency-based training. Additionally, some of these strategies requires the support of the organization. For example, changing staff is a strategy that requires a multi-tiered culture of support within an organization, where supervisors honor staff requests to switch out or take breaks. Adopting such a culture helps organizations provide high quality care for individuals. Safety-Care training helps establish a multi-tiered culture of support within an organization by successfully teaching skills that promotes dignity.
Are you interested in promoting dignity in times of crisis? Consider signing up for Safety-Care Trainer Training today!
References: Safety-Care Manual V.6
Keywords: Avoiding power struggles, Safety-Care Training, Competency-based training, Promote dignity, communicate respect, De-Escalation, Staff behavior
