This study aims to develop and evaluate a culturally tailored, video-based workshop designed to enhance verbal de-escalation skills among nursing staff in inpatient psychiatric settings.
The study used a quasi-experimental design and was conducted in 2024–2025 at Iran Mental Health Hospital with 52 nursing staff. The training was developed based on Kern’s Six-Step Approach and included locally produced video scenarios drawn from common aggression management situations in the hospital. Participants attended a four-hour session and completed a scenario-based assessment at baseline, immediately after the session, and three months later. Statistical analyses included the Wilcoxon signed-rank test and independent-sample t-tests.
Verbal de-escalation scores increased significantly after the training (p < 0.001), with mean scores rising from 4.32 (SD = 2.54) at baseline to 6.55 (SD = 2.75) post-intervention. At three-month follow-up (mean = 6.38, SD = 2.45), improvements were largely maintained, with no significant decline (p = 0.753). Participant feedback indicated that the video scenarios were relevant to daily clinical practice and supported practical skill development.
This study relied on self-reported data and a relatively short follow-up period of three months, which may not fully capture long-term retention or behavioral changes in clinical practice. Additionally, the absence of direct observational measures or patient perspectives limits the generalizability of findings. Future research should include longer-term evaluations, comparisons with alternative educational modalities (e.g. simulation, team-based learning), and assessments across diverse psychiatric care settings. Broader studies may further clarify the scalability and sustainability of video-based training as a complementary tool in psychiatric nursing education and staff development.
The findings suggest that video-based de-escalation workshops offer a scalable and low-cost method for enhancing psychiatric nurses’ confidence and skills in managing patient aggression. By integrating realistic, culturally tailored scenarios, the program provides a psychologically safe environment for practicing complex communication techniques. This approach can be incorporated into psychiatric nursing curricula and staff development initiatives, especially in resource-limited settings, to reduce reliance on coercive practices and improve patient–staff interactions. It also highlights the value of multimedia educational tools for addressing hard-to-teach competencies, supporting sustainable improvements in psychiatric care delivery.
By promoting non-coercive strategies in psychiatric care, video-based de-escalation training can reduce the use of restraint and seclusion, thereby enhancing patient dignity, safety, and trust. Improved staff competence in managing aggression fosters healthier therapeutic relationships and contributes to a more humane ward culture. On a broader level, this approach supports mental health systems in addressing stigma, workplace violence, and ethical concerns, while advancing global efforts to shift from coercive practices toward patient-centered, rights-based care models. Ultimately, such training may help create safer, more compassionate, and socially responsive psychiatric environments.
This study describes a culturally contextualized video-based de-escalation training program developed using Kern’s Six-Step Approach. By combining structured educational planning with realistic clinical scenarios, the program provides a practical approach to supporting non-coercive aggression management training in psychiatric care settings.
