Enhancing verbal de-escalation skills in nurses: a video-based workshop intervention for admitted patients

Purpose This study aims to develop and evaluate a culturally tailored, video-based workshop designed to enhance verbal de-escalation skills among nursing staff in inpatient psychiatric settings. Design/methodology/approach The study used a quasi-experimental design and was conducted in 2024–2025 at Iran Mental Health Hospital with 52 nursing staff. The training was developed based on Kern’s Six-Step Approach and included locally produced video scenarios drawn from common aggression management situations in the hospital. Participants attended a four-hour session and completed a scenario-based assessment at baseline, immediately after the session, and three months later. Statistical analyses included the Wilcoxon signed-rank test and independent-sample t-tests. Findings Verbal de-escalation scores increased significantly after the training (p < 0.001), with mean scores rising from 4.32 (SD = 2.54) at baseline to 6.55 (SD = 2.75) post-intervention. At three-month follow-up (mean = 6.38, SD = 2.45), improvements were largely maintained, with no significant decline (p = 0.753). Participant feedback indicated that the video scenarios were relevant to daily clinical practice and supported practical skill development. Research limitations/implications This study relied on self-reported data and a relatively short follow-up period of three months, which may not fully capture long-term retention or behavioral changes in clinical practice. Additionally, the absence of direct observational measures or patient perspectives limits the generalizability of findings. Future research should include longer-term evaluations, comparisons with alternative educational modalities (e.g. simulation, team-based learning), and assessments across diverse psychiatric care settings. Broader studies may further clarify the scalability and sustainability of video-based training as a complementary tool in psychiatric nursing education and staff development. Practical implications The findings suggest that video-based de-escalation workshops offer a scalable and low-cost method for enhancing psychiatric nurses’ confidence and skills in managing patient aggression. By integrating realistic, culturally tailored scenarios, the program provides a psychologically safe environment for practicing complex communication techniques. This approach can be incorporated into psychiatric nursing curricula and staff development initiatives, especially in resource-limited settings, to reduce reliance on coercive practices and improve patient–staff interactions. It also highlights the value of multimedia educational tools for addressing hard-to-teach competencies, supporting sustainable improvements in psychiatric care delivery. Social implications By promoting non-coercive strategies in psychiatric care, video-based de-escalation training can reduce the use of restraint and seclusion, thereby enhancing patient dignity, safety, and trust. Improved staff competence in managing aggression fosters healthier therapeutic relationships and contributes to a more humane ward culture. On a broader level, this approach supports mental health systems in addressing stigma, workplace violence, and ethical concerns, while advancing global efforts to shift from coercive practices toward patient-centered, rights-based care models. Ultimately, such training may help create safer, more compassionate, and socially responsive psychiatric environments. Originality/value This study describes a culturally contextualized video-based de-escalation training program developed using Kern’s Six-Step Approach. By combining structured educational planning with realistic clinical scenarios, the program provides a practical approach to supporting non-coercive aggression management training in psychiatric care settings.

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Publication Details

Journal
The Journal of Mental Health Training Education and Practice
Published
2026-04-03
DOI
https://doi.org/10.1108/jmhtep-10-2025-0107
Primary Topic
Workplace Violence and Bullying
Type
article
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article

Enhancing verbal de-escalation skills in nurses: a video-based workshop intervention for admitted patients

Tara Rezvankhah, Fatemeh Shirzad, Mohammad Ghadirivasfi, Seyed Vahid Shariat et al.
The Journal of Mental Health Training Education and Practice
Workplace Violence and Bullying
article

Enhancing verbal de-escalation skills in nurses: a video-based workshop intervention for admitted patients

Tara Rezvankhah, Fatemeh Shirzad, Mohammad Ghadirivasfi, Seyed Vahid Shariat, Kaveh Alavi, Amir-Abbas Keshavarz-Akhlaghi, Seyedeh Faezeh Jazayeri Sureshjani
article en

Abstract

Purpose This study aims to develop and evaluate a culturally tailored, video-based workshop designed to enhance verbal de-escalation skills among nursing staff in inpatient psychiatric settings. Design/methodology/approach The study used a quasi-experimental design and was conducted in 2024–2025 at Iran Mental Health Hospital with 52 nursing staff. The training was developed based on Kern’s Six-Step Approach and included locally produced video scenarios drawn from common aggression management situations in the hospital. Participants attended a four-hour session and completed a scenario-based assessment at baseline, immediately after the session, and three months later. Statistical analyses included the Wilcoxon signed-rank test and independent-sample t-tests. Findings Verbal de-escalation scores increased significantly after the training (p < 0.001), with mean scores rising from 4.32 (SD = 2.54) at baseline to 6.55 (SD = 2.75) post-intervention. At three-month follow-up (mean = 6.38, SD = 2.45), improvements were largely maintained, with no significant decline (p = 0.753). Participant feedback indicated that the video scenarios were relevant to daily clinical practice and supported practical skill development. Research limitations/implications This study relied on self-reported data and a relatively short follow-up period of three months, which may not fully capture long-term retention or behavioral changes in clinical practice. Additionally, the absence of direct observational measures or patient perspectives limits the generalizability of findings. Future research should include longer-term evaluations, comparisons with alternative educational modalities (e.g. simulation, team-based learning), and assessments across diverse psychiatric care settings. Broader studies may further clarify the scalability and sustainability of video-based training as a complementary tool in psychiatric nursing education and staff development. Practical implications The findings suggest that video-based de-escalation workshops offer a scalable and low-cost method for enhancing psychiatric nurses’ confidence and skills in managing patient aggression. By integrating realistic, culturally tailored scenarios, the program provides a psychologically safe environment for practicing complex communication techniques. This approach can be incorporated into psychiatric nursing curricula and staff development initiatives, especially in resource-limited settings, to reduce reliance on coercive practices and improve patient–staff interactions. It also highlights the value of multimedia educational tools for addressing hard-to-teach competencies, supporting sustainable improvements in psychiatric care delivery. Social implications By promoting non-coercive strategies in psychiatric care, video-based de-escalation training can reduce the use of restraint and seclusion, thereby enhancing patient dignity, safety, and trust. Improved staff competence in managing aggression fosters healthier therapeutic relationships and contributes to a more humane ward culture. On a broader level, this approach supports mental health systems in addressing stigma, workplace violence, and ethical concerns, while advancing global efforts to shift from coercive practices toward patient-centered, rights-based care models. Ultimately, such training may help create safer, more compassionate, and socially responsive psychiatric environments. Originality/value This study describes a culturally contextualized video-based de-escalation training program developed using Kern’s Six-Step Approach. By combining structured educational planning with realistic clinical scenarios, the program provides a practical approach to supporting non-coercive aggression management training in psychiatric care settings.

The Journal of Mental Health Training Education and PracticeVol. 21(3)
Iran University of Medical Sciences (IR), Tehran University of Medical Sciences (IR)
Quality Education
Openalex Percentile: Top 36%
Workplace Violence and Bullying
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