Course content – PF23-Deeskalation
The modules of this course – work through them in order.
12. Module 12 · Self-reflection, Team & Summary
Reflecting and working together
Two aspects round off de-escalation competence. The first is self-reflection. How you handle challenging behaviour depends strongly on your own reactions, ‘sore spots’ and patterns – your behaviour shapes the dynamics of escalation, and your calm is decisive (Modules 4 and 5). Helpful questions are: How do I react in tense situations – calmly or irritably? What are my sore spots, i.e. what makes me react sensitively? How well do I stay calm? Do I take aggression personally? Reflecting alone, through feedback or in training and supervision helps you to develop your own competence deliberately.
The second is the team: dealing with challenging behaviour is a team task, and nobody has to cope alone. The team supports through mutual help in critical situations (Module 9), shared standards – an agreed approach, documented triggers and helpful responses (Module 3) – debriefing and learning from one another and sharing the strain (Module 10), and an open, supportive and learning team culture.
Learning objectives of this module
- You reflect on your own approach and develop it further.
- You know your ‘sore spots’ and your calm/reaction.
- You understand the approach as a team task.
- You bring the principles of de-escalation together.
Bringing it all together
In summary, dealing with challenging behaviour rests on these building blocks: the stance – understanding behaviour as an expression of distress instead of condemning it, de-escalation instead of coercion (Module 1); understanding – behaviour as communication, causes (above all pain) and triggers, including your own behaviour (Modules 2–3); the dynamics of escalation and early warning signs (Module 4); the de-escalating basic stance – calm, not taking it personally, empathy and safety (Module 5); verbal and nonverbal de-escalation – listening, acknowledging feelings, not arguing, calm body language, giving space (Modules 6–7); prevention through meeting needs, avoiding triggers and adapting the environment (Module 8); self-protection – no duty to endure violence (Module 9); aftercare and learning without blame (Module 10); special situations such as dementia, delirium, mental crisis and addiction (Module 11); and self-reflection and teamwork (Module 12).
The overarching message: understand challenging behaviour and de-escalate it – calmly, safely and with dignity. The key is the shift from condemnation to understanding, combined with a calm, empathetic stance, de-escalation techniques, prevention, self-protection, aftercare, reflection and teamwork. This approach addresses the cause, respects the person, avoids escalation and protects everyone involved – the person concerned, the care staff and others. Coercive measures remain a last resort that the law limits tightly (BMG, 2007; DGPPN, 2026), and sedating medication needs a medical indication – neither replaces the search for the cause. De-escalation is a learnable competence for safe, dignified care. We hope this course helps you to meet challenging behaviour with understanding, calm and dignity – for the people entrusted to you, for yourself and for everyone involved.
De-escalation at a glance
| Element | Core |
|---|---|
| Understanding | Behaviour = distress/need (do not condemn); pain! |
| De-escalating | Calm, acknowledge feelings, calm body language, space |
| Preventing | Meet needs, triggers/milieu |
| Securing & aftercare | Self-protection; strain/learning |
Table: De-escalation at a glance – summary of the course. Source: own illustration, AI-assisted.
De-escalation as a learnable competence and a team task
Two encouraging insights close the course. De-escalation can be learned. Understanding behaviour, staying calm, verbal and nonverbal de-escalation, prevention and self-protection are not a fixed talent. They grow through knowledge (like this course), reflection on your own reactions, practice – e.g. role plays and de-escalation training, offered by many organisations, for example through the accident insurance institutions or external providers – and experience. Training is particularly valuable because it practises the behaviour itself – calm reactions, body language – and builds confidence. Defence and release techniques in particular must be learned systematically and practised regularly (DGUV, 2018). Employers must instruct staff on safety and health at work, adapted to the risks and repeated where necessary (section 12 ArbSchG). De-escalation is a team task. The team provides reinforcement in dangerous situations (Module 9), shared concepts and knowledge (Modules 3 and 8), exchange and follow-up (Module 10), mutual relief and an open, non-blaming culture. Nobody has to be a ‘natural’ or manage alone – investing in your own competence and in a supportive team makes the work safer, more effective and more bearable for everyone.
Competent together
A team keeps facing challenging behaviour and feels unsure and burdened. It decides to tackle this together: everyone takes part in de-escalation training, which builds knowledge, technique and confidence. The team develops shared approaches and documents triggers and helpful responses, colleagues back each other up in critical situations, and incidents are followed up without blame. Over time, everyone handles situations more confidently and calmly, escalations become rarer and the strain more bearable. The case shows how learning and teamwork improve the approach.
Everyone on their own. The same team, but nothing changes. Each colleague deals with challenging behaviour in their own way: one argues, another avoids the resident, a third threatens consequences. There is no training and no shared approach; triggers and helpful responses are not passed on at handover. Incidents are only discussed briefly in the corridor. The residents experience contradictory reactions, escalations become more frequent, and one colleague goes on sick leave because of the strain.
How to classify it: Without a shared approach, the people concerned meet different reactions every day, which makes them more insecure and makes escalation more likely. Without training and follow-up, nobody learns from incidents. Employers must assess the risks of violence and psychological strain and instruct staff (sections 5 and 12 ArbSchG); the team can contribute by agreeing on a common approach and supporting each other.
| Aspect | Case study: competent together | Version B: everyone on their own |
|---|---|---|
| Learning | de-escalation training for everyone | no training |
| Approach | shared, triggers documented | everyone does it differently |
| Critical situations | colleagues back each other up | each person alone |
| Incidents | followed up without blame | only corridor talk |
| Outcome | more confidence, fewer escalations | more escalations, sick leave |
Table: Comparison of the two versions of the case. Source: own illustration, AI-assisted.
Exercise: Look back on the course. How do you react in tense situations, and what are your sore spots? How would you like to develop your de-escalation competence – through training, reflection or practice? How do you use and strengthen support in your team? What would you like to do differently from now on?
Show suggested approach
Write down three short notes – only for yourself: 1. One strength you already bring to tense situations (e.g. a calm voice, patience, knowing the residents well). 2. One thing you want to develop (e.g. not taking insults personally, spotting early warning signs, stepping back in time). 3. One step for your team (e.g. suggesting a short debriefing after incidents, documenting triggers, asking for de-escalation training).
Choose a concrete situation in the next weeks in which you will try your step, and look back afterwards: what helped, what was difficult? There is no right or wrong – the aim is your own development.
- Self-reflection on your own reactions and sore spots is the basis for developing de-escalation competence.
- Challenging behaviour is a team task: mutual help, shared standards, debriefing and relief.
- The course in one sentence: understand the behaviour and de-escalate it – calmly, safely and with dignity.
- De-escalation can be learned through knowledge, reflection, practice and experience – nobody has to be a ‘natural’.
Self-reflection (voluntary)
Voluntary · not assessed – your thoughts are not saved or evaluated. Think about each question first, then open the prompt.
1. Which situation from the last weeks would you handle differently after this course?
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2. What are your ‘sore spots’ – and how do you notice that you are reaching them?
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3. What do you need from your team – and what can you offer your team?
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4. Which idea from the course do you want to keep in mind most?
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References for this module
Arbeitsschutzgesetz (ArbSchG) [Occupational Safety and Health Act], section 5 Beurteilung der Arbeitsbedingungen [assessment of working conditions], as in force in October 2026. https://www.gesetze-im-internet.de/arbschg/__5.html
Arbeitsschutzgesetz (ArbSchG) [Occupational Safety and Health Act], section 12 Unterweisung [instruction of employees], as in force in October 2026. https://www.gesetze-im-internet.de/arbschg/__12.html
Bundesministerium für Gesundheit [Federal Ministry of Health] (Ed.). (2007). Rahmenempfehlungen zum Umgang mit herausforderndem Verhalten bei Menschen mit Demenz in der stationären Altenhilfe [Framework recommendations on dealing with challenging behaviour in people with dementia in residential care]. https://www.bundesgesundheitsministerium.de/fileadmin/Dateien/5_Publikationen/Pflege/Berichte/Bericht_Rahmenempfehlungen_zum_Umgang_mit_herausforderndem_Verhalten_bei_Menschen_mit_Demenz_in_der_stationaeren_Altenhilfe.pdf
Deutsche Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde (DGPPN). (2026). S3-Leitlinie Verhinderung von Zwang: Prävention und Therapie aggressiven Verhaltens bei Erwachsenen [S3 guideline: Avoiding coercion – prevention and treatment of aggressive behaviour in adults] (Version 3.0, AWMF register no. 038-022). https://register.awmf.org/de/leitlinien/detail/038-022
Deutsche Gesetzliche Unfallversicherung (DGUV). (2018). Prävention von Gewalt und Aggression gegen Beschäftigte im Gesundheitsdienst und in der Wohlfahrtspflege: Eine Handlungshilfe für Arbeitgeber und Arbeitgeberinnen [Preventing violence and aggression against employees in health and social care: A guide for employers] (DGUV Information 207-025). https://publikationen.dguv.de/widgets/pdf/download/article/3429