Dealing with difficult people and difficult situations - Occupational Therapy and Community Equipment services

1. Conflict Management:
Dealing with difficult people and
difficult situations
Blaine Robin PhD – June 2011

2. What is conflict management?
“Conflict management is the practice of
identifying and handling conflict in a
sensible, fair, and efficient manner.
Conflict management requires such skills
as effective communicating, problem
solving, and negotiating with a focus on
interests”.
(
http://www.cedanet.com/meta/conflict_manage
). vc

3. What are your expectations from
todays course?
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4. Our organisation
Are supportive of all employees
Real life Jobs
Staff are valued
Training days aim to provide employees with
an opportunity to learn and practice positive
coping strategies for getting through the day
and dealing with a range of demanding
situations

5. Objectives
Coping strategies
Understanding why a client/prescriber is
being abusive
Understanding where to get support from
The process from beginning to end
Learning from other colleagues
experiences
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6. Part one
In health and social care settings we will
explore some of the reasons why people can
be difficult
People we define as: Patients? Carers?
Health and Social care professionals?
Colleagues?
We will learn about how to adopt “positive
coping strategies”
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7. Ground Rules
Our learning space is a“ safe environment” for
freedom of expression
Whilst everyone is entitled to their own opinions the
course instructors reserve the right to “move the
group on” and ask for “conformity” to support the
course objectives
We appreciate how difficult this topic can be and we
respect each of your views
Confidentiality
Any specific emotional life experiences “remain in
the training room”
 We must be “open to learn” and therefore be open
to change
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8. How do we go about responding appropriately to
difficult people and difficult situations?

9. Group Discussion
Take the time to discuss a difficult experience
that you have come across and how you dealt
with this.
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10. Reflecting on the exercise
How do people see us?
(us as individuals and as a
service we provide)
How do we see ourselves?
What do others know
about us…(that we do not
know)?
Unknown to everyone
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11. Difficult People
Is the following statement True or False?
“People start out in life being difficult”
(please discuss this statement in pairs)
Life stories can tell us something about what
makes people tick. In this course we call this
assessing peoples biographical timelines or
personal histories
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12. Some people feel the need to “fight”
Is fighting always wrong?
Prescribers
Service users Elderly/Disabled)
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13. Group Exercise
Split into smaller groups
What are the characteristics of a someone
who is difficult?
How does it make you feel when you are on the
“receiving end” of someone who is not nice?
What are the characteristics of someone who
is not difficult?
How does it make you feel when someone is polite
and not difficult?

14. Some of the reasons behind peoples attitude
Personal experience
Being victimised
Poor communication skills
Disabling environment
Ignorance
(Are there any more you wish to add?)

15. Some examples – Personal experiences
Being threatened
Prescribers being rude
Swearing
Abuse over the telephone
Emotional blackmail from prescribers
Dealing with emotional people

16. What is a biographical timeline
1. What events have happened in your life and when?
2. How would these events affect and influence the
way you think?
 1. Date of Birth
 2. Name of first school
 3. Parents job
 4. First job when you left school
 5. Affected by the war?
 6. Marital status
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17. Age Event 1 Social Event Second event
1 0 Birth Iraq War
2 5 to 11
Primary
school
Picked for hockey
team
3 12 to 16
Secondary
school Experience Bullying
4 17 to 20 Met partner First child born
Moved into
hostel
5 21 to 25 Married Second child is born
Husband loses
job
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18. Case study 1 - Group work
 Mrs. X , 84 year old pensioner from Dagenham. She
is a former war time machinist who is now widowed.
 She has hearing deficits and only gets on with her
support worker from the local advocacy services.
 She does not like to talk over the telephone and has
difficulty understanding the dialects of recently
arrived immigrants from Eastern Europe who provide
home help.
 The OT Team have asked you to provide a service.
 When you initially make contact you discover she is
quite irritable and short with you.

19. Task
Working in groups think about Mrs Xs life.
What do we know about her past and what
assumptions can we make to help build a
picture of what her needs might be?
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20. Why do we do the things we do?
How the experts might explain behaviour…
We all have basic needs to be fulfilled.
Theories of Motivation (e.g. Maslow’s
Hierarchy of Needs)
When those needs are not fulfilled it can lead
to …..
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21. Why do we do the things we do?
Perhaps because of traumatic experiences
that we can no longer remember…
Theories of Personality development (e.g.
Erikson and Freud)
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22. The ultimate breakdown in communication
Can result in unresolved conflict
Violence
Other forms of abuse and or aggression
Shouting
Spitting
Swearing

23. Our aim should be to prevent conflict from
escalating
Why?...For our own health and safety…
The customer is always right
The customer is not always right
Resolving or preventing conflict might be
more about know how to negotiate for an
amicable agreement

24. Case of Mr X.
Customer call centre staff receive an order to
place an emergency same day request at 3pm.
This job cannot be completed same day due to
contract obligations and has been placed by
staff for the next day.
The next day the OT called to inform staff that
the client passed away and emphasised that the
death was related to Call centres slowness to
react. What positive coping strategies can be
used in a situation such as this?

25. Examples of Positive Coping Strategies
Taking time out : go for a walk or a fag break.
Sharing concerns with line manager
This offers support and maintains self esteem
Reflecting on ones practice
Remaining “calm” and “professional”
Good communication skills
Tension affects ones ability to communicate
logically
Documenting what took place – incident form
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26. Part Two

27. Overview
In Part One what did we achieve?
People may be difficult because of….
Some of the causes of those problems might
be…
“What is missing?”
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28. Exercise – Case Study
Mr. X suffers from a Thyroid problem and moved to the area
over a year ago. He is 35 stones and arrived in the area with
his own very old over bed rail. The technician visited to
deliver an item and noticed that the old rail was splitting. He
undertook a risk assessment and concluded that the item
needed to be removed. He provided feedback to the OT
team on his decision. As a result the OT ordered a special over
bed rail (monkey pole) for Mr. X. The item could not fit
through the doorway. The OT service blamed the trade
technician and poor decision making. The technician has a
brief discussion with the call centre assessor who describes
the distressing nature of dealing with a very pedantic OT over
the telephone.
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29. Task
List all the people involved in the case
List the challenges faced by all the people
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30. Questions
What kind of support would you like to see
from your line manager on this case and why?
How helpful and professional was the trade
technician?
What would have been the implications from
the service had he/she ignored the failing rail?
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31. Dealing with Abuse
Some abuse is given by people who are angry.
Anger can be managed but is a negative
coping strategy.
We are all capable of becoming angry
Think about a time when you experienced anger and
how did you feel under the situation

32. Case Study
Have you ever responded to anger ?
Aggressive
responses
Passive
responses
Assertive
response
Victim? Agree to
disagree?
Walk away?
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33. Context for coping with anger
We all respond to anger in different ways.
Anger can be manifested when we “lose”
something valuable:
Confidence
Self esteem
Physical abilities
Become embarrassed
Loss of a loved one through death
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34. Understanding behaviour :
Loss and Bereavement
Elizabeth Kubler Ross
(1969)
Stages
1. Denial
2. Numbness
3. Shock
4. Guilt
5. Anger
6. Acceptance
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35. Exercise:
Describe a situation where a patient has
recently lost someone
How did you find out about the situation?
What stage in the grief cycle is the person?
Reflect on some of the expressions of anguish and
loss that the person may talk about
What does coming to terms with loss mean?

36. Summary
 How we deal with the problems sets us apart from others
who are unable to use positive coping strategies
 There are reasons why people behave the way they do…not
all the reasons make their behaviour right…especially if they
have a detrimental effect on us
 Some causes of behaviour is understandable
 If you are on the receiving end of unacceptable stress from
clients please liaise with your line manager who may advise
about the merits of completing an incident form

37. Thank you.
Any questions?

38. Feedback on the session
 Feedback: Please answer these questions honestly
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 Do you think this course met your needs 1-10
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 Name 2 things that you will take away from todays course?
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 Would you feel comfortable after this training course to approach your line manger regarding difficult experiences?
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 Do you believe that you now have more skills to cope with dealing with an aggressive prescriber / Service user on the phone/ face to face.
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 In what ways has the course benefited you?
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 Is there anything you would have like us to cover on the course if so please state
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 How would you improve this training course?