how do you deal with manipulation?

I hear what you're saying. After many years in psych, here are a few of the things I learned.

Assume everyone is trying to manipulate. That's not as cynical as it sounds. Everyone on a psych unit has psych issues. Some will knowingly try to play the game. Some will do it without being conscious of their behavior. To some extent, we all do a little of this. Which leads to the next thought.

Don't take it personally. It isn't. Even when it is, it isn't. If you weren't there, the behavior would be directed at the person taking your place. It's a waste of time and energy to get upset (with the patient or with yourself) over behavior that is part of the pathology.

Communicate with other staff. It's not easy to split staff members who have the same plan and who support each other. When my kids were growing up, we had a rule. If they ever tried to play one parent against the other, whatever they wanted was automatically turned down. No one ever tried it more than once.

Know your policies and procedures. Don't bend or break the rules without a darn good reason and back-up from a manager or a very compelling reason.

Build a repertoire of phrases that buy time--

Let me think about it.

I'll get back to you.

Let me talk to so-and-so.

If there is a point system, refer back to it. A patient asks for a point-related privilege. Don't say yes or no. Ask the patient if he has the points for the privilege and let him come up with the yes or no answer himself.

Reflect your concerns back to the patient when you think you're being manipulated. "Sounds like you want me to give you special treatment. What do you think the rest of the group would say about that?"

Probably the most important thing you can do is to get your thinking out of the "tug-of-war" frame of reference. The rule with a tug-of-war is "the only way to win is not to play." Period. So if someone wants to engage in a power struggle or even some good-natured cajoling, refuse to take the other end of the rope. You do that by calling them out. "Oh, I see you're trying to butter me up." Or, "I'm not going to argue with you." You do it with the use of humor. You do it with a time out of some sort. But the main thing is you do it. And you do it without anger or irritation. Easier said than done at times but, that's the most effective approach.

I'll see if I can think of some other things. Having worked other places besides psych, let me tell you, these skills transfer beautifully to other patients. They can even work on people outside the workplace.

I wish you well.

When we have a manipulative client we will allocate nurse 'X' to grant any favours.

If the client comes to you and says nurse 'X' said I could do 'Y' then you say "Then Nurse 'X' can do it for you."

I hope that make sense.

P.S. I work in a locked ward.

All talk with a patient should be considered therapeutic. Therapeutic communication skills take years to perfect. Do you want some weblinks on them? I have a few web links to powerpoint lectures from nursing programs on basic therapeutic communication skills as well as an assertiveness tutorial that I will post for you if you are interested in seeing them.

I would love for you to post these. I could use them too!

Thanks!

All talk with a patient should be considered therapeutic. Therapeutic communication skills take years to perfect. Do you want some weblinks on them? I have a few web links to powerpoint lectures from nursing programs on basic therapeutic communication skills as well as an assertiveness tutorial that I will post for you if you are interested in seeing them.

I would love for you to post these. I could really use them too!

Thanks!

Oops! Sorry Daytonite! I don't know how to post using your quote! I don't know how I put your quote in and it has my screename!

Press the "quote"button on the posters post that you want to quote.You must have pressed your own post quote to get your name on it!( Hope that made sense!)