Managing a client who is angry or aggressive

Dos and don'ts of managing a client who is angry or aggressive

Problems relating to anger and aggression are not uncommon in alcohol and other drug services and should be managed appropriately. For example, one study of presentations to an Australian emergency department (ED) in 2016 found that behavioural disturbance (i.e. agitation or aggression) was present in 78% of cases (Isoardi et al. 2018). The clear majority (94%) of ED presentations examined involved crystal methamphetamine ('ice') as opposed to less forms of methamphetamine such as speed.

In general, episodes of aggression are usually triggered by a particular event, which may involve circumstances that have led the client to feel threatened or frustrated.

The following signs may indicate that a client could potentially become aggressive or violent:

• Appearance: bloodstained, carrying anything that could be used as a weapon.
• Physical activity: restless or agitated, pacing, standing up frequently, clenching of jaw or fists, hostile facial expressions with sustained eye contact, entering ‘off limit’ areas uninvited.
• Mood: angry, irritable, anxious, tense, distressed, difficulty controlling emotions.
• Speech: loud, swearing or threatening, slurred.
• Worker’s reaction: fear, unease, frustration, anger.

If a client becomes aggressive, threatening or potentially violent, it is important for service providers to respond in accordance with the policies and procedures specific to their service. It is also important for service providers to have knowledge of how to respond to challenging behaviour, including physical threats or actual violence. Below are some general strategies for managing aggression.