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How to use the FBI’s Behavioral Change Stairway Model to influence like a pro

This five-step crisis communication process can improve interactions with both partners and patients

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It can take a good deal of practice and a long time to get these steps right.

Photo/Vermont Department of Health

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Motor vehicle collision, cardiac arrest or cut finger, the one thing they all have in common is that the EMS provider will always have to manage the scene. To accomplish this, you’ll often need the help, or at least the cooperation, of other people to do so and sometimes those people may not be eager to assist. In some cases, the very people that you need to help you most may be downright hostile.

The FBI Hostage Negotiation Team developed a method to aid in communicating to manage an incident quickly and effectively. This five-step method can be easily adapted by EMS providers for everything from crisis communications, to scene management, to everyday patient care.

When using this method, known as the Behavioral Change Stairway Model, each step must be followed carefully, and in order, as each step builds upon the previous steps to help de-escalate crisis situations and help get the other person to see your point of view.

1. Employ active listening

The first step is to listen to what the other person (or people) has to say and let them know that you’re doing so. While this seems simple, it can be difficult to truly listen to someone else, rather than just stay quiet while you wait for your turn to talk. No one listens until they first know that they are being heard. This is especially true if you’re in conflict with the other person and are trying to bring them around to what you want them to do.

When you want or need someone to do something, it can be a challenge to listen to what they want instead of telling them what you want. Simple cues to let the other person know you’re listening include:

  • Don’t interrupt, disagree or make your request while they are talking.
  • Acknowledging what they are saying with simple phrases like “I see” and “uh-huh.”
  • Repeat back the gist of what they’ve told you to show that you understand their point of view.

This will not only help them realize that you are listening to them, making them more likely to listen back, it will also help you follow through with the next steps.

2. Display empathy

Once you have heard what they have to say, the next step is for you to truly try to understand where they are coming from. Empathy does not mean that you agree with the other person or condone their actions.

It does mean that you understand their perspective, where they are coming from and where they are trying to go.

3. Build a rapport

With an understanding of the other person’s state of mind and objectives, you can speak to them in ways that they will respond to. People, especially people in crisis, will respond most effectively to others who are “speaking their language.”

4. Exert your influence

Don’t think of this as finally getting to tell the other person what to do. Influence means that you help them achieve or at least move forward toward their objective, in the way that their mindset understands.

Empathizing with their position, and speaking their language, look at realistic solutions to the situation including, if appropriate, the negative possibilities of what they are suggesting or trying to do.

5. Initiate behavioral change

If you’ve done well with your prior steps, the conclusion of behavioral change is a matter of proposing a solution that makes sense to the other person and is acceptable to you.

By first listening to what they are trying to say, empathizing with their position and establishing a rapport with your first words, you are influencing them towards realistic solutions so that you can achieve the desired behavioral change.

It can take a good deal of practice and a long time to get these steps right, but when negotiating crisis communications, better a long road to success than a quick turn to a bad end.

Rom Duckworth is a dedicated emergency responder, author and educator with more than 30 years of experience working in career and volunteer fire departments, hospital healthcare systems, and private EMS. He is a career fire captain and paramedic EMS coordinator for the Ridgefield (Connecticut) Fire Department and the founder of the New England Center for Rescue and Emergency Medicine. Duckworth is recipient of the American Red Cross Hero Award, Sepsis Alliance Sepsis Hero Award, and the EMS 10 Innovators Award in addition to numerous awards and citations for excellence in education and dedication to service. Duckworth is a member of numerous national education, advisory and editorial boards, as well as a contributing author to more than a dozen EMS, fire and rescue books, including the IFSTA Pumping Apparatus Driver/Operator textbook as well as over 100 published articles in fire and EMS journals, magazines and websites. Duckworth has a bachelor’s degree in public safety administration from Charter Oak State College in Connecticut. Connect with Duckworth via or or on LinkedIn.