Solutions to the epidemic levels of violence in healthcare settings are in dire need. De-escalation training has promise for its potential to prevent violent incidents and defuse incidents as they occur, limiting the need for last-resort techniques like restraint and seclusion. However, the field of de-escalation lacks widespread testing, validation, and improvement of clear de-escalation frameworks. The non-profit research institute RAND Europe conducted a review of 19 studies on de-escalation training, for which they found consistent reports of gained knowledge and self-efficacy following training interventions. Yet the group was unable to find any measure showing that de-escalation training actually reduces violent incidents. De-escalation training deserves, by RAND’s recommendation, “well-designed studies to confirm preliminary results.” This criticism of de-escalation in the literature was echoed by Hallett (2017), Beech (2006), and Anderson (2010), who went so far as to describe de-escalation recommendations in the literature as “weak or dubious” given the lack of validating studies. As this body of work continues to grow, however, violence in healthcare settings will likely be mitigated. Growth, though, can only be achieved through concerted efforts by researchers, healthcare staff, and hospital administrators to investigate, report, and publish data regarding the efficacy of de-escalation training.
Abigail Shulman received a B.A. from Rice University in Cognitive Sciences and Religion, specializing in the impact of policy, religion, and culture on health outcomes. She is currently pursuing a Masters in Public Health at the University of Texas School of Public Health, with a major in Epidemiology and particular experience studying sexual health and HIV. With her continued interest in the political and societal bearing on health behaviors, Abigail hopes to contribute to a culturally invested intervention programs aimed at improving community health.