|Aggressive||If a patient is becoming aggressive, it is important to make sure they are safe. You would not want to move closer to the patient or try to take on a more assertive and directive role because that will create further aggression and decrease safety for the OT and the patient. It’s best to keep the patient in a safe position and acknowledge that they are upset and try to help them calm down. If the behaviors escalate you can push the call light, so someone else can help assist.|
– Movement disorder that makes it difficult to sit still.
|Allow the patient to move around as needed. Select gross motor activities whenever possible (over fine motor/sedentary).|
|Delusions||Do not attempt to deny the delusion. Redirect the patient to reality-based thinking/actions. Avoid discussions that reinforce the delusions.|
|Dementia||Create a routine of enjoyable activities. Make sure the patient is safe at all times. Make eye-contact. Adopt a positive/friendly expression.|
|Escalating Behavior||Avoid challenging the patient’s behavior, maintain a distance, actively listen to the patient. Avoid making the patient feel trapped. Use a calm tone, do not use a patronizing tone. If the patient’s behavior continues to escalate, remove the other patients from the room and call for help.|
|Hallucinations||Provide a distraction free environment. Activity must be highly structured. Redirect patient if experiencing hallucination.|
|Lack of initiation/participation||Identify reasons for lack of participation and offer choices a sa means to motivate the patient.|
|Manic/ Monopolizing||Use highly structured activities. Thank the patient for their input and move on to another patient – re-direct your attention.|
|Offensive behavior (physical or verbal)||Set limits and immediately address the behavior. Be clear – clearly present the reasons why the behaviors are not acceptable in a nonjudgmental way and clearly communicate the consequences of such behavior. Keep the needs of the entire group of patient’s in mind, and protect them from being harmed.|
|Poor self esteem||If a patient is afraid of doing an activity it is helpful for the OT to provide constant reassurance that the activity is going well. It will also allow the patient to know what is coming next.|
Conflict within a group
When there are conflicts within a group, the leader and the members sometimes want to avoid the conflict rather than spending the time and effort necessary to work through them. However, conflict is inevitable in all relationships, including groups. It is the avoidance of conflict that makes it problematic.
Strategies for addressing group conflict include:
1. Lower your voice. When group members yell at one another, you can model calmness by lowering your voice. Group members often will take heed and lower their voices as well.
2. Eliminate threatening behavior. If group members are yelling at one another, the group leader can ask them to lower their voices. If they stand, you can ask them to sit down. If they point at one another, you can ask them to stop pointing. You can make a statement such as, “When group members yell at each other and point fingers at each other, these can be perceived as threats, and in order to communicate with each other effectively, it’s important for group members not to feel threatened.”
3. Repeat back. When two group members are arguing with each other, they’re often not listening to each other. Asking group members to repeat what the other has said to that person’s satisfaction can decrease conflict, as the original speaker feels heard.
4. Remove the tension. When group members are in conflict and they find it impossible to talk directly to one another without exploding, you can remove the tension by asking them to talk directly to you about the source of their anger. Their fellow group members, with whom they are angry, will hear their comments and may be less defensive because they’re talking to you.