How to De-escalate Agitated Episodes

Agitated episodes can be traumatic for both caretakers and the person having the agitated episode. In the past, resolve for aggressive agitation was primarily through physical restraint or calling authorities. However, what if that person is your adolescent child? There may be larger issues to work through if your teen frequently experiences scary, agitated episodes.

What Is an Agitated Episode?

According to the Western Journal of Emergency Medicine, “agitation is an acute behavioral emergency requiring immediate intervention.” Often, an agitated person will yell, scream, harm themselves, harm others, harm property, or make threats. This behavior creates a dire and critical need to eliminate the agitation. As mentioned before, agitated episodes were, until recent years, often handled with physical restraint and even medication, but it does not have to go that far.

Agitated episodes can start small with repetitive movement, hairpin triggers, obsessive thoughts, or misunderstandings about communicating thoughts effectively. Before extreme agitation, a person may rock back and forth, pace, speak to themselves about the thought, warn those around them, or perform repetitive movements in an attempt to self-regulate. If this doesn’t work and the trigger isn’t going away, the agitated episode could escalate to violence or acute trauma. It’s important that caretakers actively try to de-escalate before reaching this stage.

In children and teens, it may be easy to see the signs of agitation ramping up. Small children will scream and throw tantrums, and teens can be the same. Teens, however, are bigger and stronger than small children and require more effort to help them self-regulate if they’re prone to agitation. Watching out for the early signs and practicing and modeling how to calm down effectively can help ease the intensity of an agitated episode.

New Methods of De-escalating Agitated Episodes

Today, medical knowledge moves people toward a non-coercive approach that doesn’t take the free will from the person having an agitated episode. Instead, according to the Western Journal of Emergency Medicine, medical staff advise a three-step approach to attempt de-escalation of an agitated episode.

The three steps include:

#1 Verbally Engage the Child

The person who de-escalates the situation needs to keep talking to the child using calm, even tones. Validate the child’s feelings but not their actions. Don’t try to speak over them. Let them talk, as being interrupted can cause further agitation. Use calming words, calm body language, and resist encroaching on personal space. Remain non-judgemental as you speak with the child, and avoid making any demands. Instead, kindly and calmly ask them to try a few different calming techniques, and let them answer you. Giving them choices may also help them realize they have options and aren’t stuck.

#2 Establish a Collaborative Relationship 

Establishing a collaborative relationship means that both the agitated child and the adult responding are communicating effectively. For example, the adult may be validating their feelings, and the child responds with calmer behavior. Further, the adult may do what the child asks, like move away from a door or adjust body language. The child may also do what the adult asks or make a better choice than their initial reaction. The adult should listen, respond, and not argue with the child in an agitated state. Finding a solution should happen through working together. The main benchmark here is that the child and adult are responding to each other constructively.

#3 Verbally De-escalate the Child Out of This State

Verbal de-escalation means that the collaboration worked, the child and the adult were able to find a resolution. Therefore the child was given the space and autonomy to calm down on their own and communicate effectively.

Things to Think About When De-escalating an Agitated Episode

There are several things an adult should keep in mind when attempting to de-escalate a child verbally.

  • Physical space needs to be a safe space. There shouldn’t be harmful things around that the child can access.
  • Whoever is helping to de-escalate the child should be appropriate for the job. For example, it’s not another child’s job to de-escalate and should be someone the child feels comfortable and safe around.
  • Do not be provocative or try to agitate the child further.
  • Set clear limits, but do not boss. Offer optimism and the autonomy to make the right choice instead.
  • Verbal de-escalation is great but may not be enough to work. In extreme cases, you may still need to physically restrain an agitated child or call law enforcement for help, especially if there is any danger of harm to the child or others.


man in gray dress shirt standing beside white wall

When an agitated child needs support, verbal de-escalation is the best way to keep a child from becoming more agitated or harming themselves. In general, episodes of agitation are scary and can be very traumatic for those involved. Talking to a doctor or therapist may be necessary to help understand your child’s agitated episodes.

Sometimes, agitation and the trauma associated with it can be too much for families and their teens. In that case, it may be time to call Havenwood Academy for help. Here at Havenwood Academy, we offer an environment for teen girls with issues ranging from mental health problems to trauma. Our professional staff can help your teen through therapy, support, and education about their options and choices before they get too agitated.

Helping your child heal from their trauma is what we do best, and we can help them learn to de-escalate too. Call (435) 586-2500 today for more information. 


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