Key components of de-escalation techniques: a thematic synthesis

Abstract

De-escalation techniques are a highly recommended set of therapeutic interventions that are frequently used to prevent violence and aggression within mental health services. A thematic synthesis literature review identified 11 international papers. Seven themes emerged from the data synthesis. The first three related broadly to staff skills, including: characteristics of effective de-escalators, maintaining personal control, and verbal and non-verbal skills. The last four relate to the process of intervening and include: engaging with the patient, when to intervene, ensuring safe conditions for de-escalation, and strategies for de-escalation (including two sub-themes, autonomy confirming interventions, and limit-setting and authoritative interventions). De-escalation techniques are an example of a complex intervention, which has been overlooked by rigorous research, and it is often assumed that staff are able to perform these techniques in clinical practice.