Late Stage: Setting Limits
Limit-setting techniques, properly applied, can help by placing some external control on the escalating situation, defusing it and facilitating decision-making.
Example: "Mr. Jones, please control yourself and sit down, otherwise I will have to call security."
The keys to effective limit setting are 1) using a command form to express the desired behavior and 2) providing a logical and enforceable consequence for non-compliance. Continue to acknowledge the agitated person's feelings and be empathic, reminding him or her that you're there to help (Lancee, Gallop, McCay, & Toner, 1995).
Do not confuse setting limits with issuing threats which can signal to the patient that the situation is more hopeless than they had perceived, and may precipitate a violent response. Also, avoid arguing, as that may precipitate a violent resolution of crisis.
Limit Setting Versus Threats
- Threat: "If you don't stop I'm going to call security!"
- Limit Setting: "Please sit down. I don't want to involve security but I may have to if you can't control yourself."
- Threat: "If you keep pushing the call button like that I won't help you."
- Limit Setting: "Ms. Ferris, I know you need help, but please don't ring your call like that, and give me a chance to get to your room."
- Threat: "That type of behavior won't be tolerated!"
- Limit Setting: "Mr. Barron, would you please stop yelling and screaming at me … I'm trying to help you."