# Considerations for Developing Robot-Assisted Crisis De-Escalation Practices
## 3 Basic Requirements for Social Robots and Working Model for De-Escalation
### Working Model of De-Escalation  
Grounded in the findings of the qualitative studies, the working group consensus statement, and the literature reviewed above, we created a working model for de-escalation (Figure 1). We opted to develop our own model rather than draw upon one in the literature because the requirements for instructing humans on de-escalation practices differs from those for robots. By developing our own model, we obtain the level of detail and type of stepwise organization required for considering the translation of de-escalation practices into human-robot interactions.  
The model begins with principles for verbal and non-verbal communication as well as other general principles that are typically applicable throughout the de-escalation process. For robots, these can be conceived as a checklist of relatively fixed conditions that should be met at most, and in some cases all, timepoints of the interaction. In addition to these general principles, the model includes a stepwise illustration of de-escalation. [PERSON] et al. [10] described de-escalation as follows:  
\"De-escalation frequently takes the form of a verbal loop in which the clinician listens to the patient, finds a way to respond that agrees with or validates the patient's position, and then states what he wants the patient to do (e.g., accept medication, sit down, etc.). The loop repeats as the clinician listens again to the patient's response. The clinician may have to repeat his message a dozen or more times before it is heard by the patient.\" [10] (p. 19)  
Informed by this description, we conceptualized de-escalation as a flexible, creative, and iterative process, in which crisis responders (i.e., people engaging in de-escalation with agitated individuals) move fluidly through the stages, drawing upon a large set of possible skills and approaches to move towards the goal of decreasing agitation and helping individuals regain their own internal locus of control. From a psychological perspective, humans engaged in de-escalation are operating with complex schemas and heuristics (or mental models), drawing upon their training, past experiences, intuition, and rationale about the current situation. Throughout, crisis responders engage in continual, ongoing assessment of the agitated individual to gauge the risk for violence and aggression, whether selected de-escalation strategies are working, and the anticipated trajectory of the situation. There are few fixed rules about which skills and approaches should be included within each de-escalation scenario; however, generally, the interaction should begin with (1) establishing verbal contact (e.g., stating name and role, providing orientation to time and place, etc.) and developing rapport, and (2) gathering information about agitated individuals and identifying their concerns or reasons for agitation and escalation. The latter is important forinforming the selection of subsequent de-escalation strategies and identifying conditions that may facilitate de-escalation. Next, crisis responders have multiple options by which to proceed, though their choice should ideally be grounded in their assessment of the individual and the situation. The consensus of experts in emergency medicine is that de-escalation can frequently be successful in less than five minutes [10]. After successful de-escalation, a best practice is to debrief with fellow crisis responders or staff and with the agitated individual whenever possible.