Use the RREMSS Approach When Working with Adults with Behavioral Issues

client laying on sofa with therapist helping her

The RREMSS approach supports a client who is experiencing a behavioral issue. The approach empowers the client and diffuses conflict. RREMSS involves the important element of choice making so both verbal or non-verbal clients respond to this collaborative approach.


Put forth to the client that behaving a certain way is best to meet a particular end result that is preferred by the client. Create a picture of the preferred scenario so they can imagine themselves there. “It seems to me that you really want to go in the van. Putting on your shoes is a great way to make that happen”.


Help the client remember that, in the past, they have been able to move through a behavior incident to an end, with preferences being met as a result. Remind the client of the bridge it takes to get there. “Do you remember how you took 3 breathes this morning and you felt better? Let’s do that again.”


Provide enthusiastic support to continue doing the recommended activity, or to transition to doing it. “You got this!” “I know you can make good choices. We have seen you do it lots of times!”


Stimulate the client’s interest and enthusiasm for doing something. Be clear and straightforward with the motivating statement. “It is going to be so great when we finish brushing all of your teeth because then it’s video game time!”


Give the client a choice related to the desired behavior making them feel you are not overly invested in the outcome. Connect the dots in a neutral manner to gain traction toward the next step.  “Do you want to sit on the couch or the chair? On the couch you could have a blanket. On the chair you could have a cup of ice. Your choice.”


Provide assistance as needed. Observe if the client may need help to move towards the action you are proposing. Example: Maybe they are feeling a bit unbalanced and need help carrying their backpack, so you offer to carry it for them in order to complete the transition.

A client who does not have the skills to get on track needs a professional to not only be the witness to that challenge, but be the conductor of the fastest solution.  The RREMSS approach acknowledges “what it is” to be triggered and want a solution. RREMSS decreases the power of the behavior over the long term because it engages rather than commands. The RREMSS approach humanizes the client who is fragmented and deeply connects the person providing the steps to the solution, to that solution.

What are your techniques for dealing with challenging client behavior in adults? We would love to hear from you! Please share your thoughts by commenting below.

1 thought on “Use the RREMSS Approach When Working with Adults with Behavioral Issues

  1. Dr. Lisa Keliher Reply

    We received this email question from Steve T:
    Is there any evidence that RREMSS is better than the competing approaches like PR0-ACT, CPI?

    We have had this question before and thought we would post our response here:
    Organizations use RREMSS for those moments when staff and client/student are engaged in a power struggle. In scenarios in which preventions have not worked. In scenarios in which response strategies prescribed are not adequate to meet the opportunity of a “learning moment”.  
    RREMSS supports staff mindset to be grounded throughout the behavior incident away from trying to manage, handle and deal with a behavior but rather find the middle ground in each minute of the escalation and each minute of the de-escalation.  
    Being on the floor of hundreds of crisis situations, the empowerment staff and I have when RREMSS is used, though not evidenced based, allows us to lean into the client’s experience without hands-on.  
    I would keep with Pro-ACT, CPI, Mandt System, etc… as these trainings create dialogue.  
    RREMSS is there for staff groups who feel that they need more interaction tools for clients who are unique in their response to traditional methods of stabilization/de-escalation.

    Steve T ~ appreciate your question.

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