Dealing with Difficult Patients + Film Premiere Invite
Asana Recovery Weekly Team Update May 9, 2023
Training Tools
Dealing with Difficult Patients
Before we go any further, let’s change the title of this article. Because, the truth is, conflicts with patients are rarely as single-dimensional as them being a difficult person. How about this title: Dealing with Patients During Difficult Encounters?
If you’ve worked in addiction treatment for very long, you’ve already seen situations when a patient is acting out (verbally, non-verbally, physically) due to the physical or emotional discomfort of withdrawal/sobriety, sometimes combined with mental illnesses. But, that doesn’t lead to a “difficult encounter” 100% of the time.
Components of a Difficult Encounter
What creates a full-on “difficult encounter” is usually a combination of factors, and the “difficult patient” is only one element. According to Adams and Murray in How to Manage Difficult Patient Encounters there are three “Components of a Difficult Clinical Encounter.” They are:
Situational Factors
Patient Factors
Physician (or other care provider) factors
Situational factors include things like: language and communication issues, having multiple people in the room, breaking bad news (or some other interaction that is, by its very nature, unwelcome), and environmental sources of discomfort or anxiety.
Patient factors include things like: the mental health symptoms the person is dealing with, physical discomfort, personal stress in the individual’s life. “Patient characteristics that suggest the likelihood of difficult encounters include the presence of depressive or anxiety disorders, more somatic symptoms and greater symptom severity,” reads How to Manage Difficult Patient Encounters.
Caregiver factors include: your physical and emotional state. Are you hungry, tired or burned out? Does the client’s behavior trigger you emotionally? Are you preoccupied with a stressful situation in your personal life? Any of these factors can decrease your ability to respond to a patient using your best professional skills.
Tips for Responding to Difficult Encounters
First and foremost, ensure you and your clients are safe. If not, take action to protect everyone’s safety. If you determine safety is not an issue of concern, you can consider some of the following ideas.
Keep your eyes open for potential aggravating factors. It’s rare for someone in an agitated or dysregulated state to be able to identify the source of their problems. How often has an angry client said, “I’m upset because I’m hungry, I’m stressed about my job and you (my caregiver) remind me of my dad, who always criticized me. Also, the air freshener plugin is giving me a headache.”?
But, as an “objective” observer, it’s possible that you can identify patterns and possible triggers. This is most helpful if you can use your observations to be better prepared in the future to avoid that fateful combination of contributing factors. For example, if you notice a client becoming increasingly frustrated trying to express themselves verbally, you could suggest that they use art or writing to express themselves instead. Perhaps you notice that someone who is pleasant in one-on-one interactions becomes antagonistic in a group setting? Then, you can coordinate interactions to alleviate their social pressure.
A note of caution: times of heightened emotion may not be the best time to propose solutions or deliver important information. Use de-escalation techniques to diffuse the situation, save the observations you have on contributing factors and, if it seems wise, communicate them with the client when everyone is calm.
Try not to take things personally. As you can see, you are only one side of a triangle. While there may be things you can do to improve what you are bringing to the encounter (and certainly explore that!), it’s also possible that the difficulty has nothing to do with you. If you can remind yourself of that, it can be easier to remain calm and solution-focused instead of feeling defensive.
Don’t judge clients based on one difficult encounter. While you may walk away from a difficult encounter with some hurt feelings, carrying that baggage into your next encounter only condemns you both to ongoing conflict. Give your clients (and yourself and your coworkers) the freedom to make mistakes, to have bad days and to learn and grow and change.
What is in your control? This is the most important thing for you, as an addiction treatment professional, to consider. The majority of situational factors and client personal factors are outside of your control. But you can make an attempt to make sure you are in the best possible place for responding to a client in a difficult encounter. Work on your self-care. Try to be rested, nourished and in a good mental place during your client interactions. If you’re not, is there any option for asking for help from a coworker or taking a break?
Learn from difficult situations. Instead of fuming, getting stressed, angry, embarrassed or responding in any other counterproductive way, use difficult encounters as learning experiences. If possible, debrief with other professionals or co-workers. What will you do differently next time?
Team Member Shout-Out
HR appreciates perfect attendance! Starting May 1st, any employee who has perfect attendance/no call-out for the month of May will be entered into our Surprise Speaker Giveaway!
Invitation to Film Premiere
You are cordially invited to attend the free online premiere of CLEAN SLATE, the wonderful new award-winning documentary about two friends at a drug and alcohol treatment program who take control over their recovery by shooting a low-budget indie film while they're in treatment. As if recovery wasn't challenging enough, right?
Sunday May 14th, 2023
7pm Eastern / 4pm Pacific
Trivia
Question: What was the first non-English language to win Best Picture at the Oscars?
Contact HR with your response for the chance to win a gift card!
The answer to last week’s trivia question: Asian-Pacific American Heritage Month is celebrated in May because May 7, 1843, marked the arrival of the first Japanese immigrants to the United States. Later, May 10, 1869, or Golden Spike Day, recognized the completion of the first transcontinental railroad in the U.S., which had significant contributions from Chinese workers.
Last week’s winner was: Krystal S.