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."