Therapist's Guide to Clinical Intervention - Sigmund Freud

N. Positive reinforcement for efforts and accomplishments
O. Maintain keen awareness for your own reaction to the person
P. End the interview if there are signs of increasing agitation. Inform the person that
you sense the difficulty that they are experiencing in maintaining self-control
2. Inpatient setting
If the person is hospitalized the appropriate intervention selection will be based
on the person's level of agitation and their ability to self-monitor and to
respond appropriately. The basic goal is to provide a safe environment.
A. Give supportive feedback, and encourage appropriate ventilation and expression of
feelings
B. Maintain personal safety behaviors at all times (don't turn your back on the person,
position yourself close to the door, leave the door open, maintain adequate distance)
C. Set clear and consistent limits. Educate the person about what is expected of them
and how they will benefit by cooperation and collaboration
D. Provide them with appropriate structure to discharge body tension
E. Set physical limits on violent behaviors when verbal limits are not sufficient. Call for
help immediately if there are signs of escalation with impending violent behavior. As
attending you must assume a role of leadership to assure the staff and the person
that you are prepared to take charge and direct the necessary step to insure safety of
the person, unit peers, and staff. If possible, offer the person choices of self-restraint
for regaining control. If necessary seclude the person, and if warranted use
restraints. At the very least the person should spend some time in the quiet room
which is free of objects and easy to monitor, until they have time to regain
composure and take responsibility for their behavior and be able to offer plausible
alternatives for dealing with feelings of agitation or hostility. Consult with the
treatment team psychiatrist regarding medication if person is unable to calm down
and remains in an agitated state
F. Provide education on assertive communication
G. Provide education on anger management
H. Provide education regarding the relationship between behavior and consequences
I. Encourage the person to take responsibility for their behaviors
J. Positive reinforcement for efforts and accomplishments
Dangerousness 123