Responding to Escalating Behaviors on a Child Inpatient Unit: Five Elements Often Missing in De-escalation Dialogs

Unit leadership should find opportunities to cultivate knowledge and skills related to teamwork, a shared understanding of a youth's behavior, the dynamics underlying aggression, and building engagement. These dimensions of practice are nuanced and often involve implicit aspects of teamwork and unit culture. Yet they are critical to keeping units safe and supporting de-escalation. These elements and how they support de-escalation should be articulated and cultivated with novice staff and new team hires.