Psychology: Resolving Difficult Patient Behaviors

Many frontline practitioners often describe feeling like they are “held hostage” by their chronic pain patients. A lot can be learned from reviewing hostage negotiation techniques used in real-life crisis situations. These negotiation strategies typically yield a 95% success rate, which is a remarkable statistic for any form of intervention strategy. Hostage negotiation is all about psychology. These skills are critical for any “negotiator” faced with high-tension conflicts that occur during shared medical decision making. The goal of such negotiations is to work with people in crisis towards a peaceful resolution that previously seemed impossible. It entails influencing a behavioral change in someone in order to gain voluntary compliance. The unifying factor in crisis situations is that the person’s actions are being dictated by their emotions to the detriment of rational thinking. Therefore, an effective crisis negotiator seeks to reduce the negative emotions and bring back a more rational thinking process by employing a set of skills. Using the Behavioral Change Stairway Model developed by the FBI’s international hostage negotiation unit, 5 steps—including active-listening techniques, maintaining an open-minded approach, and building rapport—can be utilized to influence one’s counterpart. (Recorded at PAINWeek 2018)