Beyond ‘Challenging Behaviour’: Empathy and De-escalation in Healthcare

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Mariam interviews Andy Baker, Managing Director of Able Training Support Ltd, as they explore the psychology of workplace violence and aggression within healthcare settings. Drawing from his personal journey, from being mugged at knifepoint to becoming a leading expert in conflict management, Andy challenges the traditional ‘punishment and reward’ models of behaviourism. He also introduces his TARGET framework, a six-stage model that shifts the focus from judging ‘challenging behaviour’ to understanding the unmet needs and stressors behind it. 

KEY TAKEAWAYS

De-escalation is most effective when you first establish a human connection. Addressing a patient's emotional state before enforcing rules (like ‘you can't leave’) prevents escalation.

Shifting from the term ‘challenging behaviour’ to ‘behaviours that challenge’ shifts the focus from labelling the person to acknowledging how the observer perceives the action based on their own boundaries and stress levels.

All behaviour serves a function, often acting as a strategy to meet an unmet need or cope with stress. Understanding the why (the unmet need) is more productive than punishing the ‘what’.

Healthcare workers cannot effectively care for others if they are depleted. Organisations must move beyond ‘tick-box’ trauma training to fostering a culture that prioritises staff well-being and emotional regulation.

Approaching conflict with curiosity rather than judgment allows staff to move from an emotional survival mode to a rational problem-solving mode, leading to better outcomes for both staff and patients.

BEST MOMENTS

"I can never teach you anything that's going to force you to change somebody else's behaviour. Whose behaviour can you change? Your own. And by changing your own, you force other people to interact differently with you."

"We're all in our own boat, but we're all in the same storm or in the same sea, and it's how we then turn our sails or manage our oars to cope in that situation."

"If a person doesn't know how to read, we teach. If they don't know how to write, we teach. But when they don't know how to behave, our instinct is to punish rather than teach."

"You don't need to accept bad behaviour, but we should always accept thoughts and feelings."

"Happy people don't kick off. So something must be wrong for them to be acting that way."

HOST BIO

Mariam is a GP trainee in Wales passionate about improving our healthcare colleagues' wellbeing. She has experience on the Schwartz Round Steering group and as a facilitator for her health board, and she created and led the Balint Group Programme for Foundation Doctors in her hospital. These are regular spaces for healthcare professionals to speak about real issues that affect their well-being amongst colleagues to improve mutual support and camaraderie in the workplace. She also holds qualifications in Life Coaching and healthcare leadership and management. Whatever your reason for joining us on this podcast, we are glad you have taken the time. 

If you are having stressful days at work, leaving you feeling demotivated, and depleted, I'm hoping I can help here.

This Podcast has been brought to you by Disruptive Media. https://disruptivemedia.co.uk/