Behavioral Health Techniques for Hostage Negotiation

1. Behavioral Health Techniques for Hostage Negotiation By: Susie Kroll, MA, MHP, LMHC King County Sheriff’s Office MHP and Negotiator

2. What are we going to cover? • What is behavioral health? • Universal techniques • Techniques for groupings of behaviors (diagnoses) • Utilizing your Coach and Team This Photo by Unknown Author is licensed under CC BY

3. Who am I? • alphabet and Student loans • The police and who? • CJTC • CNT • The system from many eyes

4. Standard Techniques • Active Listening-paraphrasing • minimal encouragers • summary • open-ended questions • mirroring • emotional labeling • effective pausing • Progressive risk assessments This Photo by Unknown Author is licensed under CC BY-SA-NC

5. Why? We are seeking resolution to the crisis: • By introductions • Using our ALS • Conveying empathy • Empathy creates rapport • Rapport will help us with ability to influence the individual • Influence hopefully allows for agreement and behavioral change This Photo by Unknown Author is licensed under CC BY-NC-ND

6. The Groupings • Diagnoses are not the point • Characteristics and behaviors inform techniques Typically people in crisis fall into two categories Mood Disorders Personality Disorders Psychotic Disorders This Photo by Unknown Author is licensed under CC BY-SA

7. Mood Disorders • Bipolar-mood vacillations, confusion, disorientation, impulsivity, high energy, sleep disruption, when in depressive state feelings of worthlessness or inadequacy • Often substance abuse or other mental illness are co-occurring These behaviors and symptoms can be present with anxiety and depression

8. Negotiation techniques • Try to save face and not argue with delusional thinking • ALS – may be difficult but continue the efforts • Be aware of threats of suicide • Avoid sarcasm jokes • Assurances • Keep subject occupied and part of decision-making • Empathize and so compassion for their dilemma This Photo by Unknown Author is licensed under CC BY-NC

9. Depressive disorders • Sadness, worthlessness, emptiness • Difficulty making decisions or concentrating • Sleep disturbances and difficulty feeling pleasure • Feelings of isolation and withdrawal from others • Possible suicidal ideation (long standing) or intention This Photo by Unknown Author is licensed under CC BY-NC-ND

10. Negotiation techniques • ALS and rapport • Slow things down and allow time to run on • Be aware that responses will be slow and lethargic • Stay present • Avoid talking about a miserable future-even if the subject continues to focus on it • Try to offer hope without disregarding the suffering

11. Personality disorders • Anti-social: psychopath/sociopath, lack of remorse or conscience, disregard for others young, self-centric view of world, charming, charismatic, manipulative, irresponsible, need for instant gratification, everything done is because of someone else, little fear and anger is more prevalent, reasonably intelligent and socially skilled This Photo by Unknown Author is licensed under CC BY-NC-ND

12. Negotiation techniques • Do not lie about criminal justice or police tactics • Guilt-based strategies are not effective due to lack of remorse • Rationalization do not work unless the rationalization is part of the subject’s world view • What the subject can gain from talking or complying is best practice • Be direct without being adversarial or confrontational (watch for quick rapport) • Try to engage the subject in decision-making • Lower risk of suicide but it may be a tool for manipulation

13. Personality disorders • Borderline Personality: desperate effort to avoid real or perceived abandonment • Pattern of unstable or emotional relationships • Will use deception or lie to protect self/relationship • Will have poor boundaries, especially with someone they could be attracted to (or that is perceived as a savior/hero) • Dramatic (usually to gain favor), impulsive, chronic feelings of emptiness, mood swings

14. Negotiation techniques • Focus on relieving alienation/abandonment • ALS, build up ego/self esteem, and not be judgmental about behaviors • Maintain frequent contact and avoid taking outbursts personally • Keep good boundaries “just doing my job” use “we” not “I” • Reduce stress since there is a low tolerance for it • Use a soft and reassuring tone • Watch for suicidality (not usually wanting to commit it but “accidently” can)

15. Personality disorders • Paranoid: can look like schizophrenia but no hallucinations • Very suspicious of others and distrustful • Perceives threats or danger in harmless statements or situations • Very sensitive to personal attacks real or perceived • Quick to counter or have angry reactions to things • Reluctant to trust, confess, or align with others This Photo by Unknown Author is licensed under CC BY-SA

16. Negotiation techniques • Keep calm and continue to use ASL even if subject does not believe you • Do not argue with delusions and/or criticize subject • Show respect and do not disregard the subject’s feelings and provide simple clear explanations • View time for subject to off-gas feelings and fatigue and offer reassurance • Be aware of suicidal or violence threats This Photo by Unknown Author is licensed under CC BY-NC-ND

17. Psychotic disorders • Schizophrenia: disorganized thinking, erratic behaviors, misinterpretation of one or more senses, incoherent speech, delusions and hallucinations, impaired emotional experiences and expressions, sense of being manipulated, mocked, mistreated, typically not violent • Can have co-occurring substance abuse, strong attachment to animals or possessions • Conversations are “stream of consciousness” and often tangential

18. Negotiation techniques • Reduce stimuli-radio traffic, lights, sirens, voices, etc. • ALS, Patience, calm voice, allow the subject to explain-this will likely take time • Anxiety reduction techniques help with escalations, empathy for distress • Do not endorse delusions but listen and acknowledge the emotions behind them • Ask if the subject hears voices and what they are saying (command hallucinations) • Try not to demean the subject or speak to them as if there is a cognitive or process delay

19. The Value of a Mental health professional • These are broad summaries of disorders • The nuances of behaviors and diagnostic criteria are often patient-specific • Knowing mental health history from doctor or counselor is helpful • Having a mental health professional on the team is best practice (shameless plug)  This Photo by Unknown Author is licensed under CC BY

20. Utilizing your Team • Primary-techniques help the conversation • Coach-filters techniques to primary • Intel-MHP and Intel work hand-in-hand • Recorder-makes note of risk assessments with MHP input • Team Leader-conveys bigger picture to tactical/SWAT • Mental Health Professional-monitors the subject and team stress This Photo by Unknown Author is licensed under CC BY-NC-ND

21. Questions & Contact information • Susie Kroll, MA, MHP, LMHC • 206/963-3145 susie.kroll@kingcounty.gov • 425/589-4507 skroll@redmond.gov