How to deal with confrontation and difficult situations

Confrontation is something that you may experience as a health and social care worker, especially if you work with individuals that display behaviour that challenges, so it is important you a familiar with your employer’s agreed ways of working and each individual’s care plan so that you know how to handle these situations correctly.

Causes of confrontation

There are several causes of confrontation, which are usually the result of some sort of distress, a need not being met or expectations not being fulfilled.

Broadly speaking, they can be divided into these four groups:

1. Biological – e.g. pain or discomfort
2. Psychological – e.g. loneliness, bullying, depression
3. Social – e.g. not understanding others or being understood, lack of social contact
4. Environmental – e.g. too hot, too cold, poor lighting, loud noises

When an individual is not comfortable, there is an increased likelihood of a difficult situation or confrontation happening.

Using communication to reduce the likelihood or impact of confrontation

Communication is a great tool both for preventing confrontations and reducing their impact.

A sensible approach is to keep an open dialogue with individuals and encourage them to speak to a member of the staff team if they have any issues. If you have experience working with an individual then you may be able to pick up on signs or triggers that they are upset and initiate a conversation to try and resolve it before it escalates.

When communicating with an individual about things that are upsetting to them, you should treat them with respect and dignity, be non-judgmental and show compassion and empathy. It is better to have these discussions when an individual are at a baseline level before any potential confrontation has occurred because they are more likely to listen, think things through logically and not be blinded by emotion.

Despite the best planning and proactive approaches, confrontations are still possible. When they happen, you should remain calm, speak slowly and demonstrate neutral body language. If you are too defensive or too aggressive, the confrontation could escalate further. If possible, move to a quiet and private area to talk with them. Listen to what they say and take their issues seriously. Negotiate to find some common ground on which to build a solution.

If you feel that an individual is too emotionally charged to think clearly or you believe that the situation may escalate further, leave them alone to calm down in their own time and reopen discussions when they are more responsive.

Risk assessment in confrontational situations

Confrontational situations often call for us to make ‘on-the-spot’ risk assessments to reduce risks.

These are quick risk assessments where we scan the environment and the situation for any potential risks and do what we reasonably can to remove them. For example, if an individual is becoming aggravated and you notice a pair of scissors on the table, you may decide it is best to put them away. Or if an individual is being verbally abusive towards you, you may decide the best action is to remove the target of their anger (yourself) from the situation and go to another room.

If an individual regularly displays behaviour that challenges, they should have documented risk assessments as part of their care plan, which will advise staff about how to manage and reduce the risks both proactively and reactively.

Getting support

If you feel you are unable to manage a confrontational situation, you should seek advice and guidance from your manager who will recommend the best course of action. You may also obtain support from your co-workers, especially those that are experienced in working with that particular individual.

Reporting confrontations

Your employer will have agreed ways of working (policies and procedures) for reporting confrontations.

It usually means filling in a form. Your employer may have a generic form that is used for incidents, accidents and confrontations or may have a dedicated form for confrontations. ABC forms may also be used – these record what happened before the confrontation (Antecedent), what happened during the confrontation (Behaviour) and what happened after the confrontation (Consequence).

No matter which format you use, you should try to include as much detail as possible in the record, ensure it is accurate, legible, up-to-date and complete and factual (e.g. states only facts and not your own feelings or opinions). You will need to specify where the confrontation happened, who was involved and if there were any witnesses. You should also ensure it is signed and dated.