Expecting the Unexpected: Responding to Unpredictable Behavior

Hospital, school and university staff dealing with individuals who are addicted to drugs or alcohol must maintain their professionalism, as well as keep their messages to the agitated person short and non-judgmental.

Unpredictable actions can be behavioral adaptations related to a previous psychological trauma. Individuals with a trauma history will often turn to alcohol or drugs as a means to self-medicate their emotional pain. When the individual stops using a substance to self-medicate, he or she will often look for other behavioral adaptations to fill the gap.

Trauma can change the way that person sees the world, and often what seems like an unpredictable behavior starts to make sense when we look past the behavior itself and look more at what function the behavior is serving. Nearly all behavior has some meaning, and it is up to us to make sense of it. When we know more about the function of the inappropriate behavior, we can begin to look for more suitable coping strategies. 

It is easy and not uncommon for loved ones or professionals t
o assume negative behaviors exhibited by an individual in recovery are indicative of relapse. While it certainly is a possibility, there are many other considerations. Be sure to rule out any potential medical conditions, comorbidities or drug interactions. Remember, behavior is communication, and unpredictable behavior has a root that may help us to predict its path, intervene earlier and prevent crisis in the future.

6 Intervention Strategies

Here are some strategies that can be used when intervening with an intoxicated person who exhibits anger, hostility or other unpredictable behavior. These strategies should be explored and practiced through training:

  1. Separate the escalating person from others. Removing the audience eliminates the need to prove or save face. An audience can
    also instigate and stir up other emotions.
  2. Don’t assume that you are safe because you know the person. Irrational thought processes give way to unpredictable behavior.
  3. When intervening with an unpredictable client, make sure you leave any potential escape routes open. This is where balancing responsibilities of care with responsibilities for personal safety is paramount. 
  4. Use a team approach. Having a team available to intervene increases safety and helps us maintain our professionalism.
  5. Avoid physical intervention if possible. Physical restraint presents risks to both the client and staff. Continue verbal interventions and create safe distances to minimize risks. Physical intervention should be viewed as an emergency response and last resort to be used only if the risk of allowing the individual’s behavior to continue outweighs the potential risk of restraint.
  6. Follow organizational procedures to contact law enforcement or security when a person becomes dangerous to self or others.

Judith Schubert is president of CPI. For further information, visit crisisprevention.com.

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