Verbal De-Escalation Mindset and Techniques

As helping professionals, we rarely think of ourselves as exerting control over our clients. At the core of our work is a desire to help, to understand, and to join with our clients toward a goal of their choosing. 

We speak of the value of person-centered care. We see our clients as the experts of their own experiences. 

We may guide our clients, or provide an interpretation of what they share; and we certainly do not seek to take away their choices. 

However, when crises occur, it is most often a misuse—or a misunderstanding of the nature of choice and control—that makes us ineffective. 

When verbal de-escalation fails, it is not because we said the wrong thing, but rather that we took the wrong approach. 

In this article, I’ll explain how  providing choice in intentional ways is one of the most universally powerful approaches in verbal de-escalation.  

Even more compelling is how easy it is to practice verbal de-escalation—it’s  as simple as making a few adjustments in how we present options and make requests of our clients.

Understanding escalation from the client’s perspective

We commonly think of individuals in an escalated state as having “lost control” of themselves. 

When we experience an escalated state, our thinking becomes clouded, our interactions are hampered, and our general ability to self-regulate is diminished. 

As clinicians, our goal should be to help escalated clients regain  self-control. 

In pursuit of this goal, we may mistakenly scramble to exert our own control over the client. 

We focus on altering the person’s behavior— telling them to sit down or lower their voice. We enact unique “crisis precautions” by sending them to a different room to speak with a supervisor, or abandoning  our normal therapeutic techniques, in the interest of “resolving a crisis.” 

These are not inherently incorrect practices and may be necessary to maintain safety, or properly assist our clients; however, it is important to understand that they are butting up against the individual’s natural need for control, as self-regulation.

For example, imagine a client comes into a community mental health clinic, appearing upset. He says he needs help immediately and asks if anyone would be willing to speak with him. He’s given a series of questionnaires, then sent to a chair with a clipboard, a pen that doesn’t write well, and a vague statement like “Someone will be with you shortly.” 

Within a matter of seconds, the client becomes escalated, yelling that they are not receiving the help they need. They won’t provide the information requested and stand at the front desk, refusing to leave until they can see someone who will help.

We may say this person is being uncooperative, or needlessly confrontational, but let me offer another explanation—this person feels untethered and unable to manage a situation on their own. They feel “out of control” and, instead of receiving assistance, their experience seems to indicate  they are in even less control than they feared. 

They’re already in distress upon arrival, and have been immediately ordered to sit and produce answers to questions they don’t understand the value of, with a pen that doesn’t work, and told to wait for an undisclosed amount of time. They have no information on why, when, how, or where they will receive help. 

What little bit of choice and control they felt they had, when exercising agency to find and get help, has been stripped away. The health care professionals have demonstrated, in no uncertain terms, that they will decide when the client’s control can be restored in this situation. 

And so, what do we, as humans, do when we lose something precious? We try to get it back however we can, and in the quickest way possible. 

We may blame this client for the power struggle that has been created, but it is our communication that created the power differential to begin with.

How to verbally de-escalate 

Professionals may point out that policies exist for a reason and we cannot abandon these in the interest of verbal de-escalation. Although they are correct, there is a time and place for policies and procedures. Assessing potential perception and timing are key in communicating effectively with an escalated client.  Verbal de-escalation is about how we deliver the message as opposed to the message being delivered. 

Instead of uniformly following protocols, verbal de-escalation requires the professional to consider the client’s perspective, then ask: 

“How can I communicate with my client so they feel like collaboration with me will increase their control over the situation and themselves?”

1. Create opportunities for choice 

Fundamentally, control is the ability to make choices and see that those choices are respected. The simplest way to provide that experience is to create choice with manageable options.

In our example, if I were working at the clinic, I might tell the client that we have paperwork to be filled out prior to the meeting to set expectations. Then, I’d listen to the client and offer to further explain the forms, our intake process, and our facilities.

These choices can be offered by asking questions or presenting options such as: 

• Is there anything you’d like to tell us prior to your appointment?
• Do you have any questions about the forms or our intake process? Feel free to ask any questions as you fill them out.
• This floor has three waiting areas and you’re welcome to sit in any of them. We will call you up as soon as possible, but there is a wait, so please sit wherever you feel most comfortable. 
• To fill out the forms, you can pick any of the pens in our stationary bin. 

These may seem like meaningless choices, but they are far from it. They are choices that empower a client to make decisions you can honor and respect, which helps build rapport and avert escalation.

If we understand that our client feels a lack of control and will inevitably seek it, then we understand that our option is to create the space for these types of choices. 

If not, we will have to face the consequences of the choices he creates, which were to not complete the paperwork and not sit down to allow other clients to be seen. These are choices that we cannot manage without altering our process, or engaging in a power struggle, resulting in a loss of  credibility, rapport, and agency.

2. Offer help first 

During verbal de-escalation, it may be helpful to visualize the interaction as a staircase—with escalation at the top, and productive conversation at the bottom. Our goal is to climb down the metaphorical staircase, reaching productive conversation. Each directive is a step up the staircase, while each perceived act of assistance is a step down toward de-escalation. 

Therefore, I recommend that you listen intently to your client’s needs for the first few minutes of the interaction. This way, you can empathize with your client’s perspective, accurately reflect your understanding of their needs, and explain how you intend to help. 

I call this front-loading your attention. Although this requires intentional investment upfront, it saves us time in the long run—often getting us to a productive conversation much more quickly and without initial confrontation.

3. Provide directives last 

If a client  comes in feeling escalated, we want to do our best not to further agitate them. In our example,  the client is told to do  paperwork with a dysfunctional pen, lower his voice, and stay seated until a professional is ready to speak with him in the first few interactions. That is quite a leap up the stairs, so to speak. 

Instead, if we say that we will be happy to help, provide plenty of choice, and give space for him to explain his needs, we have now been objectively helpful. Taking these three steps down the escalation stairs facilitates a smooth transition into our directives to complete paperwork and wait a few minutes, by mitigating immediate negative impact.

Working through an escalated situation with your client can be daunting; however, the biggest mistake comes in thinking that the feelings and behavior of an escalated client are inherently different from normal human reactions to a lack of choice. 

We all want to feel competent and effective. We all want control over our reality, and for our choices to be valued. Respect that reality, provide choice, and listen with the intention to understand and assist. 

If you approach escalated interactions with a focus on choice and a willingness to relinquish your control of the outcome, you will be amazed by how effective you can be, and the therapeutic value you can immediately deliver to clients.

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