I nside the addiction clinic, it's not always roses and rainbows. There are points when patients can become irate and aggressive. Sometimes you see it coming, sometimes you don't. It doesn't always happen because of something you deliberately say or do. Even the most mindful and considerate counselors can be caught by surprise when an innocuous word or phrase triggers a patient to anger. Once an escalation happens, how do we de-escalate? Let's discuss. Note: this article discusses de-escalation with patients who are not experiencing a mental health issue or crisis. The patient is angry and yelling. What do I do? The one thing you don't do, ever , is get angry and yell back at the patient. Never raise your voice. Never match their intensity. A sure sign of an unprofessional counselor is one who is unable to de-center themselves during live conflict. A professional counselor should always remember that unless you've said something deliberately disrespectful to th...