This course addresses interventions to prevent or de-escalate aggressive behavior and to reduce use of seclusion and restraint for aggressive behaviors. It focuses on studies in acute health care settings, particularly focusing on (1) the effectiveness of different available alternative strategies to prevent aggressive behavior and (2) the effectiveness of alternative strategies compared with each other or with seclusion and restraints to de-escalate aggressive behaviors or improve health outcomes for those who are acutely aggressive. De-escalation is conceptualized in terms of both preventing aggressive behaviors and reducing use of seclusion and restraints. Three key questions are addressed:
(1) What are the comparative benefits of strategies to prevent aggressive behavior, de-escalate aggressive behavior, and reduce the use of seclusion and restraints?
(2) What are the comparative harms of strategies to prevent aggressive behavior, de-escalate aggressive behavior, and reduce the use of seclusion and restraints?
(3) What characteristics of patients, intervention components, or acute care settings modify the benefits or harms of interventions for psychiatric patients at risk of, or presenting with, active aggression?
This course is based upon material published by the Effective Health Care Program of the US Agency for Healthcare Research and Quality, as a Comparative Effectiveness Review and is available as an open access article.
This course on preventing and de-escalating aggressive behaviors in psychiatric patients is designed for social workers, professional counselors, psychologists, nurses, and substance abuse counselors, who do clinical work. This course is appropriate for beginning, intermediate and advanced level practitioners who wish to develop their understanding of interventions to prevent and de-escalate aggressive behaviors with reduced reliance on restraints and seclusion. The course material includes a literature review of available interventions, as well as their potential benefits and harms. It may also be useful for licensed clinicians who require clinical continuing education courses for license renewal.
The course is based on a journal article which includes research. It contains statistical analysis and data that some clinicians enjoy reading and others do not. A major benefit of reading research based articles for continuing education is they provide practitioners with the latest findings in their field.
Authors: Gaynes, BN, Brown C, et al
Learning Objectives: This course will provide the practitioner with detailed information regarding the reduction and de-escalation of aggressive behaviors in psychiatric patients. Specifically, a professional will:
- Describe the comparative benefits of strategies to prevent aggressive behavior
- Identify the comparative benefits of strategies to de-escalate aggressive behavior
- Participants can identify the comparative harms of strategies to de-escalate aggressive behavior.
Citation: Gaynes BN, Brown C, Lux LJ, Brownley K, Van Dorn R, Edlund M, Coker-Schwimmer E, Zarzar T, Sheitman B, Palmieri Weber R, Viswanathan M, Lohr KN. (2016). Strategies To De-escalate Aggressive Behavior in Psychiatric Patients. Comparative Effectiveness Review No. 180. (Prepared by the RTI-UNC Evidence-based Practice Center under Contract No. 290-2015-00011-I) AHRQ Publication No. 16-EHC032-EF. Rockville, MD: Executive Summary excerpted by: Agency for Healthcare Research and Quality. July 2016. www.effectivehealthcare. ahrq.gov/reports/final.cfm.