When dealing with someone who is becoming aggressive in a Youth AOD service setting, it is important to understand the underlying reasons for the person feeling anger and potentially becoming violent.
People become angry for a multitude of reasons that are often interrelated. Anger can arise for young people and potentially be expressed as aggressive behaviour when they are:
- Exposed to a physical threat
- Something valued is lost or destroyed (relationships and possessions)
- Self esteem and identity is threatened
- Injustice is experienced (young people are very sensitive to inconsistent application of boundaries and rules)
- Frustrated and confused
- Experiencing uncomfortable physical states (eg: tiredness, hunger, headaches, withdrawal)
Young people and families can become frustrated when their expectations of a service are not being met. This can occur when clients are not adequately informed or in some cases have prejudice based on previous interactions with other services. It can also stem from a real or perceived:
- Lack of attention and/or a slow response from a service
- Inefficient and inconsistent service responses
A young person’s behavioural repertoire, including how they deal with anger, is shaped by their life experiences and influenced by social learning. The following is a list of factors that can also underlie anger and influence the way it is expressed:
- AOD related issues (eg: Unable to obtain / intoxication / hang over - coming down / withdrawal)
- Level of irritability associated with tiredness, hunger and other physical states like headache
- Health issues or medical conditions (eg: Chronic pain, diabetes, hypoglycaemia, acquired brain injury-ABI, etc)
- Mental health conditions (eg: Psychosis, Post traumatic stress disorder)
- Level of psychological and emotional distress including anxiety, fear and grief
- Degree to which a person has learned emotional regulation skills (particularly anger management skills)
- Personal temperament, cognitive ability and problem solving skills
- Systems of belief (core self beliefs and world view)
- Language difficulties that lead to misunderstanding and frustration
- Confusion stemming from difficulty understanding how the service and service system operates (particularly for people from different cultural backgrounds and young people and families with limited or no previous experience with AOD and related services)
- Health (and mental health) literacy- Degree to which a person understands what is going on for them and how to negotiate for assistance
Adapted from: Centre for Social Health (1997) Managing Violent & Potentially Violent Situations
People might also have learned to use aggression and violence to manipulate or control a situation through intimidation and threats.
Prevention and early intervention are the most effective strategies to help stop a situation escalating ‘out of control’ and into a crisis situation when a physical attack is most likely. Understanding the reasons and recognising the signs why a person is becoming aggressive are important features in early intervention.
Physical signs that a person may becoming aggressive and potentially violent include:
- Huffing and puffing
- Pacing up and down - rapid movements
- Facial indicators: staring - frowning - rubbing forehead - reddened complexion
- Raised voice
- Aggressive body language/actions - pointing - clenched fists hitting things – throwing magazines, pens and other objects down in frustration
- Words expressing threats - including swearing
- Argumentative and belligerent - won’t follow advice
The following acronym ‘S.T.A.M.P.’ can be used to best describe the behaviours exhibited by a person who is becoming agitated and potentially aggressive and violent:
S- STARING -prolonged glaring at staff
T- TONE -sharp, sarcastic, loud, argumentative
A- ANXIETY -flushed face, heavy breathing, rapid speech, reaction to pain
M- MUTTERING -talking under breath, criticising staff to self or others, mimicking staff
P- PACING -walking around in confined space, walking into areas that are off limits
