"I'm not going to do it" is usually followed by "and I'd like to see you make me." This phrase is heard daily in direct care. Whether you are a nurse, teacher, mental health worker or correctional officer, you are bound to encounter the passive/aggressive or noncompliant individual in your daily interactions. What can you do? How do you get a person to leave an unauthorized area? What if a patient refuses medication? How do you talk an adolescent into doing daily chores which are a part of the group home routine? How can you make someone do something they are stubbornly refusing to do?
You can't. When all is said and done, you cannot make anyone do anything. Here is where we all fall into a trap from time to time. Sometimes we feel if we can't get a person to do what we are directing them to do we lose our credibility. This is not true. Often this attitude on our part only escalates a situation. As the verbal interaction progresses: "Do it now;" "No, I don't have to;" "Yes, you do;" "No I don't;" "I said so;" "Who cares what you say - make me;" several things happen -
You get frustrated and lose your professionalism. This leads to a loss of your own rationality and decreases your chance that compliance will be the end result.
The individual who is noncompliant feels more powerful. He or she begins to feel in control of the verbal interaction and in fact, is manipulating your reactions.
What is the best response when dealing with the noncompliant person? First, you must remember that you as the staff member, cannot make the person do anything. Unless you are going to physically force compliance, your task is not to make a person comply. Instead, your job is to explain and enforce the consequences of the person's choice of compliance or noncompliance.
Here are some key verbal intervention tips when dealing with noncompliant behavior:
1. Maintain your rationality. If you lose your cool you will get into a power struggle which is a no win situation. The more frustrated and irrational you become, the more the noncompliant person's "button pushing" game is succeeding.
2. Place responsibility where it belongs. Take the burden of responsibility off of your shoulders. Toss it back to the noncompliant individual. For example: When confronted by the statement, "I'd like to see you make me do it," let the individual know that you can't make him do anything. Rather, explain to him that he makes the choice. You are there only to issue the directive and outline and enforce the consequences.
3. Explain the directive. Often we assume the individual knows why a directive is issued. At times, this is not the case. Give the person the benefit of the doubt and clarify why you are issuing the directive.
4. Set reasonable limits. Noncompliance is a limit testing game. The individual is testing how far they can go. If unreasonable limits or consequences are issued, the person will know you cannot enforce them. Take a minute to think before giving consequences.
5. Be prepared to enforce your limits. If you impose limits, be prepared to enforce them. For example: If a noncompliant individual is in an unauthorized area and you give him the choice of walking out of the area with you or being removed from the room, you should be prepared to follow through. If the person sees that you are not going to enforce your limits, your chances for compliance are greatly diminished. You will also have a great deal of difficulty setting limits with the person during future interactions.
6. Don't stress the negative. Limit setting does not have to take the form of a "you better or else" ultimatum. Every coin has two sides. Similarly, the individual's compliance has a positive consequence. There is no need for you to pass judgment. Be as objective as possible when explaining the choices.
Here's an example of the six steps outlined above being utilized in a verbal interaction with a noncompliant person:
Staff: "Jim, it's 9:00 and you know you have to leave the day room and get ready for bed."
Jim: "Why do I have to go so early?"
Staff: "You have to get up early for school tomorrow. You have been here for six weeks and you know all residents have to leave the day room at nine."
Jim: "I'm tired of rules. I'm not going and I'd like to see you make me."
Staff: "I can't make you do anything. You have to make your own choice."
Staff: "Look Jim, you have a couple of choices. You can walk out with me, or I may have to call some other staff and we will have to physically escort you out of the day room. You decide what you want to do."
Jim: "You guys are always physically abusing me! You're going to need more than a couple of staff to get me out of here. What gives you the right to tell me what to do? You're not a psychologist."
Staff: "O.K. Jim. I've explained your choices to you. I'll give you a minute or two to decide. If you choose not to come with me, then I'll be back with some other staff. Let me know what you decide when I come back." (Staff leaves the day room.)
In our example the staff member avoided a verbal power struggle, explained why Jim had to leave the day room, made it clear it was his choice to leave or stay, and gave clear, non-judgmental consequences for the behavior. The only step left if the noncompliance continued would be to follow through and enforce the limits imposed.
Will following these steps guarantee compliance? Of course not. However, by following these tips you can maximize the chances of a person complying. By maintaining a calm, professional attitude you also minimize the chance that the situation will escalate to a much more difficult and dangerous behavior level. In addition, making an individual realize he or she is responsible for the consequences of his or her actions facilitates behavioral change, and that is an essential part of any effective behavior management program.
Gene T. Wyka
National Report -- Fall 1986 -- Volume 6, Number 2