Education / News

Regarding De-escalation - Applying UCLA's CICARE to Law Enforcement

Dr. Mark Goulston is a #1 best selling author of seven books, former hostage negotiation trainer, speaker, trainer, coach and renowned psychiatrist. He is regarded as an internationally renowned expert in the field of empathy and listening. As a result of his rich and diverse background and... Read More

Like most transformational consultants and advisors, I believe that you can’t solve a problem that requires a paradigm shift from within its paradigm. However, you sometimes can solve it, if you think and reach outside your box.

What follows is an “outside the box” approach to de-escalation between law enforcement and civilians.

Law enforcement is very focused on improving de-escalation training in their officers.

Having been trained as a psychiatrist at UCLA and having stayed in touch with the leadership of UCLA Hospital over the past few decades, it recently occurred to me that their method for “de-escalating” the anxiety in patients regarding their illness, might also work with law enforcement and civilians. In other words, their paradigm might have some utility with regard to law enforcement.

Here is information about the CICARE program and process taken directly from the UCLA Health website:

CICARE is an evidence-based acronym that creates a standard process for interactions with patients, families, and colleagues. All UCLA Health employees are expected to make the connection by practicing each of the six steps of CICARE with everyone on every encounter.

CICARE Behaviors

With everyone on every encounter, we commit to:

·       Connect with Compassion by addressing the patients as Mr./Ms. or by the name that they prefer.

·       Introduce yourself with Integrity by stating your name and your role.

·       Communicate with Teamwork what you are going to do, how long it is going to take, and how it will impact the patient.

·       Ask with Discovery by anticipating the patient needs, questions, or concerns.

·       Respond with Respect to patient questions or requests with immediacy.

·       Exit with Excellence by ensuring all of the patient's needs are met.

Our Mission is to deliver leading-edge patient care, research, and education.

Our Vision is to heal humankind, one patient at a time, by improving health, alleviating suffering, and delivering acts of kindness.

Our Values ensure Compassion, Respect, Excellence, Discovery, Integrity and Teamwork in the work we do daily.

Our Service Promise is to create a welcoming, healing, caring, safe, and professional environment for our patients, their families, visitors and each other.

To these ends, our staff, with leadership support, developed CICARE, a set of six communication behaviors to guide the best possible interactions with everyone on every encounter. Since then, it has evolved into an organizational symbol of UCLA Health's patient-centered vision, values and behaviors.

Let’s deconstruct CICARE:

·       Connect with Compassion by addressing the patients as Mr./Ms. or by the name that they prefer. This means having a mindset that the patient is in a state of distress and being so, needs to feel compassion (i.e. caring along with technical care) to comfort them.  Also a person deserves the respect of addressing them properly and even formally until you have earned the right from familiarity to call them by their first name.  To do so prematurely is talking down to them if you are in a position of authority, just as their addressing you by your first name would also be a sign of disrespect towards you.

·       Introduce yourself with Integrity by stating your name and your role. By declaring what your name and role is, you are making a statement of who you are and what they can expect. This is a way of taking charge without being controlling.

·       Communicate with Teamwork what you are going to do, how long it is going to take, and how it will impact the patient. This addresses the uncertainty they feel regarding their situation, what’s going to happen and why it’s going to happen.

·       Ask with Discovery by anticipating the patient needs, questions, or concerns. This addresses what the Doctor knows is generally on the minds of most patients in this situation. It addresses things of concern to the patient that he or she didn’t even know they were concerned about.

·       Respond with Respect to patient questions or requests with immediacy. Patients often become calm enough to ask questions that they wouldn’t be able to ask if the Doctor had not gone through the prior steps.

·       Exit with Excellence by ensuring all of the patient's needs are met. Leave with a commitment to action in addressing any and all of the patient’s needs.

How law enforcement can learn from and apply CICARE to de-escalation:

·       Connect with Respect – For example, “Excuse me, sir, m’am, young man, young lady, I need to speak to you, what’s your name and how would you prefer I address you?”

·       Introduce yourself with Integrity by stating your name and your role. -  For example, “I am (or this is – if over a loudspeaker), Officer (officer’s last name). I pulled you over because I noticed x or I pulled you over because I received a report to check and investigate a (explain briefly what you heard).”

·       Communicate with Teamwork what you are going to do, how long it is going to take, and how it will impact the patient. For example, “I/we are now going to (explain what you are going to do, and we don’t know how long that will take, and these are your rights).”

·       Ask with Discovery by anticipating the patient needs, questions, or concerns. For example, “Most people in your situation have these worries and concerns which we can answer if you’d like us to.”

·       Respond with Respect to patient questions or requests with immediacy. For example, “Do you have questions from your end that you’d like to ask, including us explaining to you what your rights are?”

·       Exit with Excellence by ensuring all of the patient's needs are met. For example, take person into custody or leave having informed them of everything they now need to know and again telling them what their rights are and suggesting what they should do on their end to bring this to the best possible conclusion.

Our Mission is to establish and maintain peace and safety in the communities we serve by administering the laws established by our city, county, state and federal government.

Our Vision is to bring peace, safety and justice to the communities we serve, one civilian at a time by assuring that out civilians abide by the laws that cover all of us.

Our Values ensure Compassion, Respect, Excellence, Discovery, Integrity and Teamwork in the work we do daily.

Our Service Promise is to create peaceful, safe and law-abiding communities that we serve.

This is a work in progress and hopefully a catalyst for law enforcement communities to learn better methods for de-escalating potential confrontations between them and the communities they serve