Course Title:

Advanced Strategies in De-escalation: A Masterclass for Challenging Situations

Course Aim:

To equip staff working in acute, intensive care, and emergency department environments with advanced knowledge, understanding, and practical skills to effectively manage challenging situations involving people with acute mental health difficulties, using trauma-informed approaches that preserve dignity while ensuring safety.

Course Duration: 2 days

Target Audience: Healthcare professionals working in PICU, acute, and emergency department settings who may encounter people with acute mental health difficulties, including nurses, support workers, security personnel, and clinical staff.

Learning Outcomes:

By the end of this course, participants will:

Know:

• The Seven Phases of Crisis (Kaplan Wheeler) and how they manifest in acute mental health situations.
• Legal frameworks including duty of care, necessity, and proportionality in healthcare settings.
• Risk factors and warning signs specific to escalating behaviours in people with acute mental health difficulties.
• Gateway behaviours that indicate potential escalation.
• Trauma-informed approaches and their evidence base.
• The relevant aspects of the Human Rights Act as they apply to healthcare interventions.
• The SCARF Model and its application in managing distressed individuals.
• The proper response protocols when called to disturbances in healthcare settings.

Understand:

• The principles of trauma-informed care and person-centred approaches for patients with acute mental health difficulties.
• The importance of staff wellbeing and emotional equilibrium when managing challenging situations.
• The difference between conflict and crisis behaviours in patients with mental health difficulties.
• The ethical considerations in avoiding coercion and blanket restrictions in acute care environments.
• How trauma affects a person’s behaviour and responses during crisis situations.
• The difference between emergency and planned interventions in mental health care settings.
• How to recognise when team members may need assistance to remain professional.
• Decision-making processes under pressure in high-stakes healthcare encounters.

Be able to:

• Identify early warning signs and gateway behaviours to prevent escalation.
• Apply advanced de-escalation and non-escalation techniques in complex situations.
• Use trauma-informed and person-centred approaches to defuse risk and preserve dignity.
• Communicate and coordinate effectively as a team during incidents.
• Reflect on incidents using structured tools for personal and organisational growth.
• Maintain emotional equilibrium and support wellbeing for both staff and patients.
• Take appropriate action when verbal methods fail, knowing legal and safety boundaries.
• Approach and engage persons with cognitive difficulties using the five-step crisis intervention pathway.
• Implement the “First Responder Philosophy” for proper incident management.
• Intervene ethically when professionally difficult situations arise within the team.

Learning Methodologies

The course utilises a variety of teaching methods including classroom instruction, practical role-play, realistic scenario-based practice, and hands-on skills development. Participants will engage with lived experience experts and practise in contexts specifically designed to reflect the unique challenges of acute, intensive care, and emergency department environments. The SCENA approach (Scenario, Coaching, Engagement, Non-linear learning, and Assessment) ensures transfer of skills to real-world operations through progressively complex scenario practice.

Tailoring and Relevance

This training is specifically designed and tailored to the unique roles, tasks, and problems faced by healthcare staff working in high-pressure environments with patients experiencing acute mental health difficulties. Scenarios and examples are drawn from PICU, acute care, and emergency department settings, including situations involving bereavement, delirium, psychosis, and trauma. The course addresses specific challenges such as managing patients who may be highly distressed, paranoid, or experiencing psychotic episodes.

Legal and Medical Review

All content is tactically effective, legally correct, and medically safe, with specific attention to the particular risks and considerations present when working with people experiencing acute mental health difficulties in healthcare environments. Training includes awareness of risks of sudden death proximal to restraint and emphasises the importance of maintaining safety while respecting human rights.

Trainer Qualifications and Credibility

The course is delivered by expert facilitators from Dynamis and Vistelar with decades of experience in conflict management, trauma-informed practice, and advanced de-escalation, trusted by NHS Trusts and other leading healthcare organisations. Our trainers have demonstrated expertise in brain injury, empathic communication, and the physiology of threat response.

Resources Provided

Participants receive comprehensive course materials, reference guides for post-training implementation, and access to ongoing support resources to reinforce learning after the course. Takeaway tools include pocket reference cards, access to short reinforcement videos, and brief team-based exercises that can be implemented in the workplace.

Monitoring and Evaluation Plan

The effectiveness of the training is measured through participant satisfaction surveys, pre and post-course knowledge assessments, and follow-up evaluation of incident rates and staff confidence levels in the workplace. Success will be measured by improved patient experience, reduced incidents, decreased staff injuries, and enhanced staff confidence and morale.

Reinforcement and Ongoing Learning

Learning is reinforced through structured debriefing tools, team reflection practices, and ongoing support resources that help maintain skills and prevent complacency over time. A programme of sustainment ensures both short-term impact and ongoing sustained improvement in your healthcare environments, with champions identified to help embed the learning within teams.