Advanced De-Escalation of Teens &

Young AdultsCITI 2012

Emily L. Ribnik, M. Ed, PCC-S

Emily L. Ribnik, PCC-S• Degrees in Psychology and Counseling

• Professional Clinical Counselor Licensed since 2008

• 5 years experience in emergency mental health and risk assessments – ages 6 to 90 years old

• CIT certified since 2007

• 5 years experience teaching in CIT classes and presenting at CITI conferences

• 7 years experience working with first responders, veterans (Vietnam, Desert Storm, Iraq, Afghanistan)

• Currently the mental health clinician for Kent State University at Stark – 1 of me and 4500 of them

• A.L.i.C.E. certified Instructor

Training Objectives

• Teens Today• Teens in Crisis and Types of Crises• Negotiation and De-escalation• Situation Specific Issues• Review of Priority Recommendations• Q/A

Where does de-escalation start?

Advanced de-escalation skills begin with advanced, more refined ability to identify the situation, and subject, that you are going to

de-escalate

Teens Today• 15 – 24 years old

• Age of onset for multiple severe mental health issues – Bipolar, Schizophrenia, Psychotic features

• Referred to as Generation Me, the Tech Generation, and Millennials

• Self-prioritize, zero tolerance for delay/wait, high emphasis on relationships, tech savvy, saturated by media, multi-taskers

• More likely to question, challenge and confront commands or directives that do not have an explanation – or what they feel is an explanation

• Currently make up all the students from pre-K to traditional Undergraduate and Master’s level college courses

Teens in Crisis A real, or perceived, dramatic emotional or circumstantial upheaval in one’s life…cause, or will appear to cause, multiple negative changes and, although may build, will occur suddenly and abruptly.

Same definition…. Different presentation

• Developmentally lack coping skills

• Associate external stimuli with emotional response

• Already less rational and more emotional before the crisis

• Easily escalates due to self prioritizing and zero tolerance for delay/wait– Specifically, this impacts the ability to have any future orientation….

At all

• Act out quickly, emotionally and irrationally

• Although highly emotional, may tire out much faster than an adult

With adults, you start with an advantage as a police officer or authority figure.

You will not have this advantage with a teen.

Impact on De-Escalation

o Faster, less predictable pace

o Faster reactive processing and response

o Very clear, straight forward agenda by teen

o More genuine reactions – typically have less skill in “masking” when in crisis

o Teen will struggle to grasp or respond to future orientation, and will very stubbornly emphasize the present

All of this impacts your physical set-up and approach

Types of Crises

Suicidal vs. Aggression

Either could escalate to a barricade or hostage situation

Similar cause: a need not being met

The Four “Teen Needs”1)Love and belonging2)Power and importance3)Fun and pleasure4)Freedom and choice

Suicidal BehaviorRisk factors for suicidal ideation•Mostly similar as adult risk factors•Fewer, less developed coping skills•Emphasis on relationships•Emotional reactions more closely linked to perceptions•Media saturation• Privately suicidal can become publicly suicidal very

quickly, and NOT initiated by the teen

Suicidal Behavior3 main factors in attempting/completing suicide:

1)Thwarted belonging

2)Real or perceived burdensomeness

3)Fearlessness

These factors are what you look for to find your hook

Aggressive Behavior

Why do teens become, or “turn to” being, aggressive?

oAnger is empowering

oIt may be the only (perceived) option left to use in order to meet a need

Types of Aggressive Behavior

Emotional vs. Deliberate Aggression

Emotional Aggression

•More common in teens•Loud and attention grabbing•Comes in waves•Typically does not have a plan or long-term agenda •Typically short-lived, but repetitious

Deliberate (or Planned) Aggression

•Less common, but more destructive•Has thought and agenda•“Simmering to a boil”•Specific outcome desired•Emotional Aggression can escalate to this, but typically remains impulsive

De-escalation & Negotiating with any Teen

• You will not have the advantage of automatic trust and compliance from a teen just because you are a police officer or authority figure – in fact, you may feel more challenged and questioned which will be unusual for you

• Remove the audience – specifically limit media exposure• This will include telling families and peers to not make contact

with the teen unless you are with them to supervise

Technology: Don’t fight it.. USE it!

• Will find names or even cited events• Look up information in recent posts, blog entries and photographs• May help you find a supportive person in their life

• However, remember anything you say can and will be looked up by the teen

• Limit media exposure

• Be in contact with your secondary via texts and images – you want to avoid looking like you are multi-tasking

• Technology confiscation – ie. Cell phone

Visuals and Visibility

• Any hint at posturing can damage the rapport you are building

• Be aware of jaw clenching, hiding your hands, and rigid walking

• Slow down hand movements

• Try to limit how many people are visible to the teen – it is another stimuli that you can reduce

Voice• Aim for an even, real tone – a very low tone may be

perceived as anger or frustration

• Explain, Explain, Explain and Explain some more – it will feel excessive to you

• Be careful of association statements and arguing• corrections (“I didn’t say…), because regardless – that is what they

heard• “I know how you feel” because you don’t – instead try to put out

stories and information that aligns with teen’s experience

Voice• Say names and avoid pronouns

• Stay in the present – you could get stuck in the past, and teens struggle with future orientation

• Ask their opinion and work towards them making decisions and finding solutions

• Remember – de-escalation is about joining with the person

Specific Situations

Some situations call for some additional advanced skills, suggestions and recommendations.

•Suicidal •Aggression•Psychosis

Suicidal Behavior• Rapport – needs to be doctor/patient, not friend

• Can give the impression that you are doing things for the teen you don’t usually do

• Remember – this generation expects and wants to be treated like they are “special”

• Can build rapport without becoming a friend

• The idea is to partner with the teen and allow them to feel they are leading and that they are regaining some level of power/control that they feel they have lost

• Identifying rank if it has benefits– This is completely your call

– Remember, they can look it up anyway

– Can support the idea that you are in a position to help them

Suicidal Behavior

Suicidal Behavior• Set up multiple observers that can communicate with

each other– Watch agitation level – reactive and escalating aggression

can happen if the teen feels forced, minimized, or has lost face/control (or perceives any of this)

– Talk vs. behavior “dissonance” – if the teen talks calmly on the phone, BUT is behaviorally aggressive/agitated when not in contact, this could indicate • the possibility of a vindictive suicide or suicide-by-cop• The stronger possibility of an agenda

Suicidal Behavior• Avoid trading/bargaining – offer choices instead or ask for

suggestions

• Instill hope

• Empathize and try to find a personal connection – even if tenuous– Do NOT state “I know how you feel”, this WILL sever everything

you have built because you have taken the feeling away from them

Aggressive Behavior

• First, determine which aggression you are dealing with

• If you don’t know, or don’t have enough information, start with the skills for emotional aggression – they will quickly show you if it is deliberate aggression

Emotional Aggression

• Remember – a staple of this aggression is that it will come in “waves”, so be prepared to adjust and “go with the flow”

• May take hostages – however, this will typically be a reactive impulse

– The danger is that once they have a hostage, they will panic because they didn’t want or plan to

Emotional Aggression• Do not force a contact/conversation – it can escalate

the aggression

• Instead, consistently provide reassurance that you are there and available when (not if) they want to talk– Announce out loud (megaphone or building speaker) when

you are going to call – it allows them to decide whether they want to talk to you at that time

– Allow silences

Emotional Aggression• Literal Reflective Listening– Allows venting, checking accuracy, being a “sound

board”

– Gives teen ability to hear what they said and think about it

– Repeating exactly what was said sounds strange, which can interrupt an behavior cycle

Emotional Aggression• Literal Reflective Listening

– Long pauses or the teen asking why you are repeating what they are saying is a signal of openness for conversation

– Always use an explanation• “I was repeating it to make sure I was hearing what you were

saying”• “I wanted to repeat it to make sure I was understanding you”

Emotional Aggression• Offer suggestions

– Only for the immediate situation – remember, they will struggle to connect with future orientation

– Only after prompting the teen to provide acceptable options

– If the teen’s answer is “I don’t know”, that is typically a sign that they are open to other suggestions and is your signal to provide some• “I don’t know” is often genuine – look at how they are acting

Emotional Aggression• Agenda?

– Typically, one will not exist due to impulsivity of the aggression – which you can work to your advantage

• Can be used to help with releasing hostages because “that wasn’t planned – we don’t have to keep going in that direction”

– “Unknown agenda”• This is the idea that although they do not have a conscious

agenda, they need to express or release the emotions• Once this expression or release has completed – remember the

waves – the aggressive behavior is also completed

Deliberate Aggression• Remember – there is a reason and agenda behind the aggression

– Seen more in shooters and hostage takers

– Meeting their real or perceived “unmet need” is the agenda/goal

– Genuine agenda – work WITH it, not against it if possible

– The agenda = your hook

– Clearest indicator that it is Deliberate Aggression

Deliberate Aggression• Techniques are progressively more direct

– Remind – subtle, verbal hint that the behavior is not acceptable

– Warn – State consequences if there is not compliance

– Confront – Clearly, firmly state the situation/behavior and an instruction

Active Shooter

What’s their agenda?• Power and importance• Mass media attention, historical significant, get in to

Wikipedia

• Hurt or kill a specific person• High body count• “Beat Columbine”

Active ShooterResponse

– Minimize loss of life and availability of targets– A.L.i.C.E.

– Most law enforcement follow “first response” or “solo engagement”• An individual officer/responder will enter and attempt to engage/eliminate the threat (shooter). They

will not wait for backup, SWAT, approval, or medical response preparedness

– Law enforcement response will focus on the shooter, not aiding others present

– Do not expect negotiations or de-escalation

Psychosis• Reduce stimuli as much as possible – including your

own movements and gesticulations

• Emphasize participation, choice and decision-making

• Expect non-linear communication

• Hallucinations– Possible visual signs – shaking head a lot, hitting head, eye

darting, sudden looking around, excessive jumpiness, talking to self (could also be stress)

Psychosis• Delusions– May initially appear to be assumptions or

generalizations

– Find “work-around”

– Monitor for incorporation

Priority Recommendations• Social Media– Have a non-personal log in for common sites

(Facebook, Twitter, MySpace)– Ask family and peers if there is another site that

teen uses (ie. My Yearbook)– Specifically tell family and peers to NOT message

teen during the negotiation– Consider options for cutting off access if possible –

turning off power, turning off wi-fi

Priority Recommendations• Significant reduction of ALL stimuli– This could include social media to cut out

“audience” factor– Look at privacy options– Stimuli includes lights, sirens, number of people,

etc.– If possible, keep media the farthest back– Rope off as large an area as possible

Priority Recommendations• Use technology - Utilize text and image messages on

your phones so it does not overtly appear you are multi-tasking

• Use names – try to avoid pronouns

• Use explanations – it will feel excessive, but this is a primary thing in de-escalating teens

• Remain in the here and now – teens will struggle to connect with future orientation

Priority Recommendations• Remember – Anger is empowering and

aggression may be the last (perceived) option

– Identify the type of aggression– One of their needs is not being met– Identifying which need will give you your hook for

negotiation and de-escalation

Readings & InformationWhy People Die by Suicide – Dr. Thomas Joiner, specifically Ch 2 about acquiring fearlessness

De-Escalating Juvenile Aggression – Jeffrey S. Golden, J.D. (www.policechiefmagazine.com – May 2004 Archives)

Classroom De-Escalation – An Unnatural Act! – www.keepschoolssafe.org

A.L.i.C.E. Trainings – www.responseoptions.com

Active Shooter: How to Respond – U.S. Department of Homeland Security 2008, www.dhs.gov

Guide for Preventing and Responding to School Violence – Bureau of Justice Assistance and International Association of Chiefs of Police, www.theiacp.org

Why Teens Kill: Warning Signs, Causes, Triggers and Prevention – Phil Chalmers, www.philchalmers.com

Emily L. Ribnik, M. Ed, PCC-Seribnik@kent.edu

Office: 330-244-5048Cell: 330-990-6963

6000 Frank Avenue NWNorth Canton, OH 44720