De-Escalation, or DE, involves the use of the Help, Prompt, and Wait strategies to help someone engaging in escalated or unsafe behaviors return to their baseline calm.

While both the Prompt and Wait strategies can be used at any point on the de-escalation staircase, the Help strategy should only be used at the bottom of the staircase. However, since there is no set sequence, it can be hard to know which strategy to start with and when to switch from one strategy to the next.

The rest of the blog will break down each of the three Safety-Care De-Escalation strategies and when we should start with, or move on from, that strategy.

In Safety-Care, the first de-escalation strategy you learn about is the Help strategy.

Help is a de-escalation strategy that focuses on having the person communicate what they need or want, or what they want to avoid or delay, instead of engaging in challenging behavior. This strategy can be done by having someone make a specific request like, “I want water.” or, they could give the person 2-3 acceptable choices and have them make a selection from the options they provided. Another way to use the Help strategy involves asking the person an open-ended question like, “How can I help you?” All three of these options have the person use some type of communication to express a need or want.

Therefore, they would use the Help strategy when they think the person is trying to get access to, or avoid, a person, place, thing, or situation. The exception to this would be if the person wants something that is unavailable. If they know the person wants something that is not available, then they would switch to the Prompt or Wait strategies instead.

Once the person has escalated to the upper part of the staircase, the Help strategy would no longer be as effective. One reason for this is that people are unable to communicate effectively when in crisis. Also, providing access to something requested; when the person is in crisis could result in reinforcement, which could lead to an increase in crisis behaviors in the future. The other reason not to use the Help strategy when the person is at the top of the staircase is that the person is unlikely to ask for things that are available.

While the Help Strategy is all about communication, the Prompt strategy is about giving the person clear instructions to engage in safer behavior.

When prompting, prompt the desired behavior, rather than telling the person what not to do. It’s better to say, “Please sit down,” rather than “Don’t wander around the room.”

Prompts should also be requests the person is likely to cooperate with, simple tasks they know how to do and can do at the given moment. Prompted behaviors should not be enjoyable tasks, in order to avoid reinforcing the challenging behavior. Sometimes they may choose to prompt a behavior that is incompatible, or difficult to do, at the same time as the challenging behavior. For example, whispering would be incompatible with screaming.

References: Safety-Care Manual v. 7