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March 2024: The Behavior Issue
The Art of De-Escalation, Part 2
In Part 2 of this 2-part article, we’ll explore strategies for calming down dealing with clients whose stress levels are high, who are showing behavior that ranges from anger to outright hostility.
Defusing Even More Tense Client Situations
In Part 1 of this two-part article, we looked at strategies for calming down annoyed clients whose stress levels are mild to moderate, and what can set people off in these situations. In Part 2, we will go over the more extreme cases of client anger, when stress levels are escalated and through the roof.
Again, with a little curiosity and a fair amount of empathy, you can successfully navigate most of these interactions. But, especially with really irate clients, you have to know when to get out of the situation in order to protect your wellbeing and safety.
Client Stress Triggers: Review
Last time, we broke down the deeper issues at play that may send a client into “fight or flight” mode when they are in your practice. These are the four main triggers, and the strategies you can use to help defuse them. (For more details see Part 1 of this article in the January 2024 issue of Trends.)
Trigger: The client feels that their goals are being blocked.
Example: They are in a hurry to refill their meds but you usually need 24 hours.
Strategy: Uncover their goals and brainstorm ways to help them meet their goals.
Trigger: The client feels powerless.
Example: Their pet needs care but it is difficult for them to afford it.
Strategy: Help them see they still have power by providing options.
Trigger: The client feels they are being treated unfairly.
Example: A patient’s wound is not healing and needs more surgery.
Strategy: Provide reassurance that you will help them.
Trigger: Making a mistake and feeling guilty.
Example: The client removed the pet’s Elizabethan collar, and the pet chewed on its sutures.
Strategy: Use empathy and compassion to let them know you understand and it will be OK.
Assessing Anger Levels
When dealing with angry clients, it is important to assess their level of anger as each requires a different strategy.
In Part 1 we talked about the Level 1 Angry Client, the client that is on the verge of becoming upset. The goal with this client is to uncover what they are feeling and thinking so you can help resolve the situation before they escalate.
Ask them “Is everything okay?” or “Is that what you were expecting?” Asking how they are feeling opens up the door for them to tell you what is on their mind.
Now, let’s look at the next two levels and how to handle them.
Level 2: The Angry Client
This is the client that is mildly to moderately upset. They likely have a mid-level grievance that is bothering them that they want to talk about. They may have a raised voice and be emotional but they aren’t acting threatening or calling you names. They likely have a real problem that they are very stressed about and are trying to hold it together.
In situations where the client’s stress is not a result of your or your team’s error, your primary goal is to assure them that you’re there to help.
Our goal with the Level 2 upset client is resolution. We want to de-escalate them so that we can collaborate and find a solution for their situation as quickly as possible. In general, they are a good person but aren’t bringing their best version of themselves to the practice because they are scared.
Defusing a Level 2 Angry Client
In situations where the client’s stress is not a result of your or your team’s error, your primary goal is to assure them that you’re there to help. Establish trust and empathy through the following steps:
- Reassure the client you are there to help. Make it clear that you’re committed to helping them and their pets. Let them know you’re on their side, no matter what. Use language that conveys your unwavering support, such as “I’m here for you and your pet. Let’s figure this out.”
- Put yourself in their shoes. This allows you to understand their perspective and emotions. It might be hard but try to imagine how you would feel if you were in their exact situation. This empathy can help you connect with them on a deeper level. Most people will start to feel better just knowing you care.
- Relocate to a quiet place. Try not to have this conversation in front of an audience in the lobby for everyone to hear. Also, it is hard to focus on the client if you feel you are on stage yourself. If at any point you feel threatened, open the exam room door. Try this phrase to move them out of the lobby. “Let’s go to the exam room so I can give you my undivided attention.”
- Think Outside the Voice Box. Use nonverbal body language to help calm the client down. Sit down if possible. Palms up, hands to side or in lap. Position yourself 45 degrees from the other person. Do not stand face to face and have your arms crossed. Another tip is to blink slowly. One study showed that blinking slowly at a cat can help improve positive communication. Personally, I haven’t had success with this yet but I do notice that blinking slowly when someone is displaying anger gives me something to focus on and helps improve facial expressions. It’s quite hard to have an ugly face while blinking slowly (try it out!).
- Become Curious George. Encourage the client to express their concerns and feelings. Ask open-ended questions to understand the situation better. Remember that complex pet issues require a thorough exploration. It is critical that you do not interrupt the client or try to explain your point of view at this moment. This is the actual defusing step and by letting the client explain all of their feelings, you are alllowing them to let the steam off the pressure cooker. You want to get as much steam off as possible before you respond. Ask questions to get them to tell you more. “I’m very curious about that part. Can you tell me more?”
- Paraphrase back to them. Show that you’re actively listening by summarizing what the client has told you. This demonstrates that you grasp the issue and care about their perspective. “What I am hearing you say is . . .”
- Ask for more. Give the client ample opportunity to share their thoughts. Sometimes, there may be underlying pet-related issues they haven’t mentioned initially. When they finish their monologue and take a deep breath, wait for five seconds then ask, “Is there anything more you didn’t feel went right?”
- Respond with your side of the story. When providing solutions, try to shoot for a compromise that meets both the client’s pet care needs and your veterinary practice’s goals. It is unlikely there is a straightforward answer to their problem but giving options to people makes them feel more in control, which lowers their stress level. Try this phrase: “I have a good understanding now. I’d like to share my perspective. Is that okay with you?”
- Search for a compromise. In general there are always at least three solutions to every problem. Do your best to identify three possible options for your client. If you are fortunate enough to have a problem that doesn’t require an immediate answer, take advantage of that. If possible, allowing 24 hours between the client venting and your response will increase your chance of success because the client will have cooled down quite a bit more by then. Try this phrase: “I have a few options that I think might work for you. Let’s discuss those and see if any work for you.”
- Thank them for sharing. The client just unloaded on you and probably the last thing you feel like doing is thanking them. However, if you can bring yourself to do this, you will end up having the final upper hand in the situation and show that you are a class act. Everyone on the planet wants to be seen and heard. When you are able to display that to your client, they will know how much you care regardless of the outcome. Say something like this: “I appreciate you sharing how you feel. I know that wasn’t easy but I’m glad we were able to find a compromise.” Or, if the outcome was less than ideal, try this: “I appreciate you sharing how you feel. I know that wasn’t easy. I’m sorry we couldn’t find a resolution for your problem.”
Level 3: The Hostile Client
This is the client that is extremely mad. Their behavior doesn’t seem to match the situation, and they are likely trying to bully their way to a solution with threats and aggression. They generally have a puffed up body position, moving into your personal space, using a commanding loud voice, hurling insults. They are likely swearing and making immediate demands for their problem. They may also be displaying a clenched jaw and fists.
Our goal with a Level 3 hostile client is to listen to their concerns and get them to calm down, and then ease them out of the practice, never to be seen again. Their behavior is unacceptable. They have anger management problems that are red flags for future visits.
Defusing a Level 3 Hostile Client
Dealing with a Level 3 hostile client is no fun and hopefully something you don’t have to deal with very often. First, you must recognize the situation, then remain calm and collected as you implement your de-escalation plan. This is very similar to when you encounter a bear in the forest. It is important to not provoke the client further.
Here are a few things that you should NOT do:
- Tell them to calm down
- Interrupt them
- Yell back
- Turn your back to them
- Move in on their personal space
Dealing with a Level 3 hostile client is no fun and hopefully something you don’t have to deal with very often.
Here is what you SHOULD do:
Maintain a nonthreatening body stance
The first step in de-escalating an angry client is to convey openness and nonaggression through your body language. Adopt a nonthreatening body stance, with your hands by your sides and palms open, facing slightly away from the client. Position your body at a 45-degree angle to them. This posture communicates that you are not a threat and are willing to listen.
Keep your emotions in check
Remaining calm and composed is essential when facing a hostile client. It’s easy to become defensive or frustrated, but doing so can escalate the situation further. Take deep breaths, remind yourself to stay calm, and focus on the client’s concerns rather than getting caught up in the emotional intensity. Think of it as a game of chess.
Have a colleague present
Whenever possible, have another coworker accompany you when dealing with a hostile client. This provides both emotional support for you and an additional witness to the interaction. Their presence can help maintain a sense of security and accountability, potentially calming the client as well. Their role is to be a silent bystander, not give additional commentary unless the situation is escalating and they need to step in.
Allow the client to vent
Hostile clients often need to express their frustration and anger. Let them vent and express their concerns. Do not interrupt or argue with them during this phase. Sometimes, simply allowing them to voice their feelings can help to de-escalate the situation naturally as their energy becomes depleted.
Position a physical barrier
If your workspace allows for it, position a physical barrier, such as an exam table or counter, between you and the angry client. This barrier can act as a psychological buffer, creating a sense of physical separation and safety for both parties. It can also discourage aggressive behavior.
Choose your phrases carefully
After the client has finished expressing their anger, it’s time to respond. Use phrases that acknowledge their concerns while also establishing boundaries. For example, you can say, “I understand that you’re upset, and I want to help, but I can’t assist you if you continue to raise your voice or act aggressively.” For a list of more helpful phrases, see Toolbox on the opposite page.
Request them to leave peacefully
If the situation continues to escalate or the client’s behavior becomes threatening, politely and firmly request that they leave your premises. You can say, “I’m sorry, but I can’t help you in this situation. I must ask you to leave.” Stay firm but avoid confrontation.
Call for assistance
In extreme cases where the client’s behavior becomes dangerous or violent, it’s important to prioritize the safety of everyone involved. If necessary, call the police or your security team to handle the situation and ensure the safety of all parties.
It is important to recognize that, with the exception of hostile clients, every interaction is an opportunity to strengthen the bond with the client. Whether diffusing annoyance, addressing anger, or managing hostility, the veterinary team’s dedication to providing compassionate care remains paramount. The art of defusing a client outburst ultimately lies in creating a space where both clients and staff feel heard, respected, and supported, fostering a harmonious partnership in the pursuit of optimal pet health and wellbeing.
Navigating the intricacies of defusing a client’s anger is undoubtedly an art, demanding an understanding of human emotions and the ability to adapt strategies based on the intensity of the situation. It is crucial to emphasize the significance of empathy, active listening, and thoughtful responses. The veterinary team’s role in de-escalating conflicts involves a genuine commitment to understanding the client’s perspective, even when faced with the most challenging circumstances.
Stacee Santi, DVM, is a 1996 DVM graduate from Colorado State University and the founder of Vet2Pet, a technology client engagement platform for veterinary practices. |
Photo credits: LightFieldStudios/iStock via Getty Images Plus, skynesher/E+ via Getty Images