Searching LIS databases shows us that the term “problem patron” is used in the LIS field. In the Library and Information Science Abstracts (LISA) database, searching for the descriptor “problem patrons” with the keyword “librar*” from the late 1990s to the present yields an average of two to four articles each year, except in 2002, when there were twenty-seven articles listed, and 2003, when seven were listed. Many of the 2002 articles were simultaneously published in the journal The Reference Librarian and in Sarkodie-Mensah’s Helping the Difficult Library Patron: New Approaches to Examining and Resolving a Long-Standing and Ongoing Problem (2002).² A search of the Library Literature database using the subject term “problem patrons” from the late 1990s onward shows a consistent presence of one to three articles on the topic for most years, with a higher number (four to twenty-one articles) for some years from 2000 onward. The phrase “problem user”‘ is not used as a descriptor or subject term in the LISA or Library Literature databases, and keyword searches using the term provides limited and mostly irrelevant results. The consistent number of articles over the last decade on the topic of the difficult patron, along with the more recent spikes in articles by more than thirty authors, suggests that dealing with challenging situations is a very real issue within libraries.

Searching health care databases shows us that nurses experience challenging interactions with their patrons as well. The Cumulative Index to Nursing and Allied Health Literature (CINAHL), an important database for nursing, uses the phrase “problem patient(s)” as a subject heading and major heading. Using the subject search terms “problem patient” and “nurses” in CINAHL finds seven to eight articles for most years between 1996 and 1999. In 2000, twelve articles appeared, with a decrease to three or four articles in the following years, until 2004, when between five and six articles per year became the average, continuing to the present. In addition to CINAHL, I searched Medline and PsycINFO using a variety of terms reflecting the concepts of “problem patient” and “nursing” with limited results. The consistent pattern of articles suggests that the topic of the problem patient is an ongoing one in the nursing literature.

While exploring the LIS literature does not provide a clear definition of the problem patron, we can see that a clear dichotomy in thinking exists. We talk about problem users and problem behaviors. Some definitions of the problem patron focus on categories of problem users in which the problem is a person or group of people with certain undesired characteristics. The literature shows us that mentally ill or homeless patrons are often categorized as problem patrons.³ Vandals, criminals, angry patrons, and unattended children are a few other categories of people identified as problem patrons.⁴ While the literature offers examples of people being categorized as problem patrons, is this the best way to view the situation?

The second common approach to viewing the issue is to focus on a specific behavior as the problem. Chelton highlights that as early as 1994 there was the recognition of a shift in thinking from “categories of ‘problem people’ to categories of ‘problem behaviors’ regardless of the people doing them.”⁵ Blessinger notes “a problem patron could be defined as someone who infringes on others’ enjoyment of the library by displaying behavior that is deemed destructive, criminal, bothersome, offensive, or otherwise inappropriate to the norms of behavior in libraries or society.”⁶ Redfern highlights a number of “problem patrons,” including those who are disruptive, difficult, mildly irate, violent, or mentally deranged, as well as those who monopolize librarians’ time, are suspected to be under the influence of drugs or alcohol, are emotionally disturbed, and are sex offenders.⁷ Looking at these definitions and lists we can see that behavior is the focus.

People are multifaceted, and perhaps public service interactions are changing in response to awareness that behavior is a more effective area to target to produce change. Labeling a problem patron as homeless does not accurately reflect the challenge that person brings to the library. Focusing instead on behavior allows the librarian to define the same expectations for all patrons. This behavioral focus gives a librarian a starting point for problem solving, or a concrete goal to work toward.

All the definitions above reflect the idea that the problem lies within the patron. As Chatoo explains, “The word ‘problem’ when used as an adjective, as it is in the phrase ‘problem patron,’ denotes the meaning of dealing with a problem of conduct or social relationship and ‘difficult to deal with.’”⁸ In looking at both the problem patron and the problem behavior approaches to challenging interactions, we could conclude that “problem” is not only the patron’s behavior but is a reflection of the librarian’s inability to deal effectively with the situation. This idea of the problem as something beyond the patron or the behavior is interesting. In this range of approaches to defining the problem patron, we can see that in most of them the librarian judges or labels the patron. The term “problem patron” appears broad in scope, and a good and socially appropriate person can still be labeled a problem patron as a reflection of their request.⁹ It is important to recognize that “problem” is an assigned label and isn’t reflective of the individual as a whole.

Nursing, like LIS, is a profession that involves daily interaction with members of the public. While the term “difficult patient” is used in the nursing literature, and specific behavior is connected to the concept, we can see that the nursing literature clearly shows an understanding of the problem as something arising from an interpersonal interaction. Insights have been gained by using theory including deviance and labeling, stigma, power, and grounded theory. This has led to the understanding that not only is the label subjective, but also that the act of applying a label has an impact.

From the symbolic interactionist-based research, insight into how labels occur within the context of a relationship emerges, as well as the recognition that a deviant label is subjective. Using Goffman’s concept of stigma, including the idea that deviant status is not static, but exists on a continuum, Macdonald characterizes the difficult patient as “a person who does not assume the patient role expected by the health care professional, who may have beliefs and values or other personal characteristics that differ from those of the caregiver and who causes the caregiver to have self doubt.”¹⁰ Using deviance and labeling theory, Trexler notes that labeling patients involves three components: a behavior or act committed by the patient, the judgement of that behavior by the nurse, and the response of the patient to being judged.¹¹ These definitions incorporate not only patient behavior, but also perceptions and expectations of the nurse. This reinforces the subjective nature of the label, which those who use it should keep in mind. This caveat is important as the nursing literature also notes that the label is transmitted between staff.¹² A subjective interpretation of a patient’s behavior by one nurse could influence how others view a patient they have never met.

Influences at the interpersonal, organizational, and societal level also play a role in labeling. At the interpersonal level, aside from behavioral expectations, the nurse herself plays a role. Breeze and Repper’s study of nurses explores the theory of power, and they conclude “threats to the nurses’ competence and control were important components when defining patients as difficult.”¹³ Trexler made a similar conclusion: “Nurses’ self esteem, belief systems, clinical experience and tolerance levels may also affect the probability of labeling.”¹⁴

Organizational and societal influences also play a role in labeling. Breeze and Repper found that “nurses were more likely to feel ‘challenged’ when they were ‘short staffed’ than when resources were perceived to be adequate.”¹⁵ Macdonald, using a grounded theory approach, explores the construction of the difficulty in the encounter and identifies influences such as the patient’s family members, resources, colleagues, and the physical work environment as part of the context potentially influencing the encounter.¹⁶ Juliana et al. note that the health care reform movements of the 1990s resulted in fewer nursing staff and quicker patient discharges, which left nurses feeling that taking time with patients was a luxury they no longer had.¹⁷ Browne, Dickson, and Van der Wal identify the influence of health care philosophy—such as patient- and family-centered care—which can result in patients thinking they have the right to make demands. This “results in a threat to the autonomy of health care providers as they may now have to provide what they feel is inappropriate treatment or say ‘no.’”¹⁸ Beyond the patient and the nurse, it is evident that the larger organizational and societal context plays a role in the “problem patient” label through its influence on the interaction.

In addition to being subjective, labels may have unintended impacts. Labeling theory explores the power that people have imposing a label on another person and the reaction of others to the labeled individual.¹⁹ The nursing literature highlights that both patients and nurses respond to the “difficult” label. Trexler notes that nurses respond to difficult patients by either trying to get the patient to conform or by physical or psychosocial avoidance.²⁰ Nurses may not respond as quickly to difficult patients or may try to avoid them by having them assigned to a different nurse.²¹ Patients also have a response to being labeled. Macdonald notes Goffman’s consequences of being stigmatized as “self-derogation, self-hate, suspiciousness, depression, hostility, anxiety, defensiveness and bewilderment.”²² Patients might respond to a label by stopping the behavior, by increasing the behavior, or they might feel that their identity is now connected to the behavior and respond by acting accordingly.²³ In short, nurses who label patients as difficult could be unintentionally fostering difficult behavior.

It is evident in the nursing literature that the individuals in the interaction, as well as the larger society and organization, all play a role in “difficult” interactions. Macdonald notes that by exploring the “difficult patient” term the knowledge may “add to the discipline by raising consciousness regarding the effects of the widespread use of this stigmatizing term.”²⁴ Understanding the subjective nature and impact of the label may enable professionals to re-evaluate its use.

The LIS and nursing literatures share common elements: evidence of a “problem” label covering a multitude of expectations and undesired behaviors, awareness that labeling the person is not effective, and indications of a search for alternative ways to approach the “problem.” Additional insights may be drawn from the nursing literature, including awareness of the “difficult” label’s subjectivity, insight into the staff person’s contribution to difficult interactions, and understanding of the contextual factors that influence the application of the label. It is important to note that it is the theory’s application, specifically symbolic interactionist theory, which has provided the opportunity for nursing to gain many of these insights.

Blumer notes there are three underlying premises of symbolic interactionism: first, humans apply meaning to things and act toward them on the basis of these meanings; second, meaning is interpreted or evolves through social interaction with others; and third, meanings are constantly modified or evolving as people interact and interpret their situations.²⁵ Macdonald chose to use Goffman’s stigma framework and notes his focus on social interaction from a symbolic interactionist perspective.²⁶ The concepts of deviance and labeling theory also fall under the umbrella of symbolic interactionism.²⁷ In choosing these theoretical approaches, the focus and questions asked will naturally relate to the interaction. Symbolic interactionism is effective for gaining insight into everyday interactions, and therefore of value in exploring challenging encounters.²⁸ The nursing literature also highlights that there are factors beyond the interaction that can influence it. De Laine notes that symbolic interactionism of the late 1960s and early 70s has been criticized for not seeing the larger social structure, or issues beyond the interactions at the level of individuals, but that more recent approaches in the 1990s have incorporated concepts of larger social structure.²⁹ While symbolic interactionism is only one paradigm that could be used to explore the issue of the problem patron, it has proven to be an effective paradigm used by nursing to gain insight.

In the LIS and nursing literature, behavior is a key element in the “problem.” It might be easy to conclude that through focusing on behavior we can find a solution. As Ross and Dewdney note, different kinds of behaviors require different responses at the individual level and from the library organization as a whole. They also explain that “much of the LIS literature fails to distinguish between the kinds of behavior that pose problems.”³⁰ Looking at behavior from a labeling and symbolic interactionist perspective provides us with the opportunity to see different aspects of the “problem.”

Recognizing the use of the label is a good starting point for reflection, not to look at the behavior alone, but to understand who is applying the label. A “deviant” label might be applied to the patron at the individual interaction level as well as the organizational and community levels (see table 1). Using this multilevel approach to explore patron behavior labeling, we can see that different factors contribute to the label at each level. Understanding how the label is generated at each level might help library staff determine whether there is some subjectivity in applying the label and might provide some insights for finding a solution at that level.

Many factors can influence the application of the “deviant” label at each level, including norms, laws, policies and procedures, expectations, values, and beliefs (see table 1). We must realize that people are part of different communities and that different groups’ norms may conflict within a library. For instance, a homeless patron likely operates under a different set of norms than a mother who comes to the library with her child for a children’s program. As LIS professionals, we are likely able to relate more to the patron who shares similar norms and expectations. This is important to recognize when we look at behaviors defined as deviant at the community level; we might need to look beyond our own norms and expectations to understand our patrons and find solutions.

Norms might be connected to laws or reflect values within the community. Values in an interaction or societal context are defined as “the principles or moral standards of a person or social group; the generally accepted or personally held judgment of what is valuable or important in life.”³¹ Hale highlights that systems of values or ideologies can be used to justify actions.³² Laws reflect the shared values and justified action society has determined is the appropriate response to the “deviant” behavior. At the organizational or library level, norms or shared values around how the library should be used are often reflected in the library policies or procedures. These guide actions to be taken when a patron contradicts the “norms” or “values.”

Beliefs, in the same way, can be either individual or shared. Beliefs can be seen as “a firm opinion or conviction.”³³ These might be connected to values. If there is a shared value that the library should be a place for study, then a connected belief could be that people shouldn’t talk loudly in the library. Shared values do not always lead to the same beliefs. Someone who values the library as a place to study could have the firm opinion that study includes collaboration and that the library should encourage dialogue and discourse as part of learning.

Norms, values, laws, and beliefs involve expectations around behavior. Using them to define appropriate behavior includes an element of subjectivity as variation can occur at the individual, group, and societal level. Consequently, a “problem” label might occur simultaneously at different levels and require different solutions at each level. If the behavior is defined as a problem at a higher level, such as the larger community, then it is likely to be a problem or require some level of response at the lower levels. A criminal act, labeled at the societal level, is likely to be viewed as a problem at all levels. A homeless patron sleeping in the library might be defined as a problem at the individual staff or library level. There can also be variation in the application of the label at the individual level. One staff member may see a student who continually approaches the reference desk with questions as a “problem patron” because that student uses too much staff time without trying things on his or her own. Another staff member may see the same interaction as an opportunity for teaching or as just another reference question.

Differences in values, norms, or perceptions possibly also cause a behavior to be defined as “normal” or “expected” at one level, but as a “problem” at another. In a large university with multiple libraries, a “no food in the library” policy at one library while other libraries on campus permit food reflects a discrepancy between the norms of the larger community and the individual library. At the individual library level, the patron bringing in food could be labeled as a “problem patron,” yet in the larger community that same behavior is permitted. Knowing where the problem is labeled is one of the key steps in finding the best strategy to deal with it.

Different factors influence the creation of the label at each level, so the questions and the solutions are different at each level (see table 2). It is important to target the response to the level at which the behavior is labeled as “deviant” or “problematic.” At the community or societal level, asking questions about laws or norms should be the foundation for thinking about the solution. For problems identified at the library level, understanding the role of policies and procedures or the expectations and norms of staff and patrons might offer insights toward finding solutions. At the staff–patron interaction level, the personal beliefs, values, and knowledge of the staff person can be an important focus for addressing problems. In the example of different library policies around food, targeting change at the community level, such as trying to get the other libraries to change their policy, may not be as effective as focusing at the individual library level on patron education or even evaluating the need or philosophy behind the policy. Using this multilevel framework, we can explore the approaches to “problem patrons” offered in the LIS literature to address the “problem” at the most effective level to find a solution.

In the LIS literature on “problem patrons” we can see that the reality for librarians involves dealing with behaviors defined by the larger community as problems. At the community level, the questions for thought reflect the following ideas: processes exist in the larger community to address deviant behavior defined by laws, community partnerships are essential for finding solutions, and knowing the larger issues in the community provides a foundation for proactively addressing issues (see table 2). At this level, it is important to look to the community for resources and solutions.

With criminal behaviors, there are clearly defined systems and processes in place in the larger community to label and respond to it. The response of the library to these “problem behaviors” should be to look to these systems for partnership and guidance. Shuman notes that crime in libraries is generally against property or against people and that society and libraries respond differently to each.³⁴ Braaksma describes the sometimes faulty perception that the library is a safe place, even by the police, which has resulted in calls for assistance not being taken seriously. As a result, it was important to establish partnerships and work with the police to respond to issues within the library.³⁵ Examples in LIS literature highlight other external partnership resources, including other libraries or workplaces,³⁶ lawyers,³⁷ and campus police.³⁸ Seeking support, advice and resources from those who have experience in dealing with illegal behavior or who understand the laws that affect the library is essential for those who experience illegal behavior in their library.

Partnerships also help with “problems” that are reflective of larger community issues. Braaksma noted an increase in unpleasant encounters in the library and suggests these were partially influenced by “the closure of beds at a local psychiatric facility, and rising unemployment.”³⁹ Community-level changes, such as a new high school being built close to the library or a factory closing down, can cause a change in the “typical” patron, resulting in new patron groups who operate under a different set of norms or expectations. This could result in conflicts or “problems” at the library level. Maintaining good community partnerships and knowing community issues, values, and norms can provide insight and focus for solutions to related “problems” arising at the library or staff level and can also enable the library to be proactive in policy development or staff education.

Proactively preparing to address problems labeled at this level is essential. Shuman outlines a number of case scenarios and promotes thinking about options and responses in advance to enable staff to be better prepared to respond to a crisis.⁴⁰ Ross and Dewdney offer a number of tips for dealing with illegal or dangerous behavior and note that it is library staff that often have to respond to these situations, so clear policies and procedures need to be in place to address them.⁴¹ Advance planning for problems through policy development and dissemination is a key element of dealing with community-level problems in the library.

Behavioral expectations defined at the library level are often evident in policy or dialogue between staff and patrons. In looking for solutions to “problem” labels applied at the library level, the ideas of developing effective policy, recognizing environmental influences, understanding patron needs, and identifying staff training needs are themes for the questions you might ask as you seek solutions (see table 2).

Effective policy is a repeated theme we find in the LIS literature, arising especially around the issue of problem patrons in the library. Waller and Bangs state that “the most valuable tool we attempt to give our staff is the ability to determine when a problem is really a problem.”⁴² Policy is one clear way of letting staff know what is acceptable and when to take action. Morrissett notes that policy is often created in reaction to a situation, but policy should be created proactively.⁴³ Policies and procedures are valuable tools that staff can use to deal with problems as they arise.

For those looking to develop a new policy or reevaluate current policy, reviewing the literature or connecting with another library are good places to find guidance. Holt and Holt’s article, “Setting and Applying Appropriate Rules Governing Patron Behavior,” outlines the development of the policy in collaboration with external partners and staff, shares an example, and highlights specific staff responses to different types of “problems.”⁴⁴ Willis’s Dealing with Difficult People in the Library includes appendixes that cover a wide range of policies, language suggestions, and procedures.⁴⁵ Wright provides an example of policy that connects the rules and expectations with the mission of the library.⁴⁶ The establishment of a meaningful vision or mission for the library can be the foundation for gaining both staff and patron commitment to behavior policies.

Policies are important but meaningless without staff support and effective dissemination to both staff and patrons. Blessinger notes that libraries need clear guidelines in print, and staff need to be consistent with problem behaviors.⁴⁷ Holt and Holt suggest an ongoing dialogue should happen with staff throughout the policy development process to allow staff to understand what they can, cannot, or should do and that the completed policy should outline appropriate actions for individual situations including an indication of degrees of severity of staff response based on a legal framework.⁴⁸ If all staff do not agree with a policy or proposed action and respond inconsistently, patrons will get mixed messages about what is okay in the library: “Any policy not backed by both staff and management needs to be reconsidered.”⁴⁹ A policy clearly outlining what is expected of patrons and how staff are to respond to a situation is an effective proactive tool for managing patron behavior.

In addition to staff training on policy, enhancing staff knowledge related to specific patron groups is important for dealing with problems that are labeled at the library level. Many resources can be found in the LIS literature that aim to increase understanding and identify strategies to work toward effective interactions with patron groups, such as the mentally ill and youth or with specific challenging behaviors such as anger.⁵⁰ Connecting with external experts to provide training is valuable. Ford highlights an effective example of bringing in a speaker from a local mental health association to dispel myths around mental illness, as well as help staff to understand some signs and symptoms to be aware of and to develop a comfort level in boundary setting.⁵¹ Understanding patron needs can be an important part of creating a positive interaction.

A problem might be a sign that services, spaces, or policies need to be looked at in response to a changing patron population or assumptions about the library and its patrons. Chelton highlights the fact that unexamined assumptions, such as learning as a solitary activity in the library, might be in direct conflict with the need of adolescent patrons to develop social competence skills.⁵² Library staff need to balance their norms with those of their patrons. Chelton suggests that public libraries include “enjoyment of working with youth” and “ability to relate to youth” as job requirements.⁵³ If you have a group of patrons that offers a challenge to your library, understanding their needs and proactively trying to meet them or providing staff with the skills to work with them might help avoid problems. Brown notes how one staff person who advocated on behalf of and had a passion for working with youth was a driving force in changes and new programs within that organization.⁵⁴

As part of avoiding problem behavior, there is value in seeing the connection between behavior and the library environment. Braaksma illustrates some steps taken to deter problem behavior, such as installing security cameras and convex mirrors, rearranging furniture and shelving to provide better sightlines, and replacing upholstered furniture with study tables.⁵⁵ In addition to deterring behavior, the environment can promote different kinds of behavior. Brown notes that providing a room for teenagers to use was a great solution to the “problem” of noisy teenagers in the library.⁵⁶ Finding creative solutions to problems can allow staff to feel good about meeting patron needs.

The LIS literature shows us a multitude of strategies that can address problems defined at the library level. Policy, partnerships, staff education, and understanding patron needs can all play a role in the solution. Asking the right questions to identify and understand the “problem” at this level allows you to decide where to best focus your energy and time to find a solution.

There are times when the “problem” is not a crime, or even a violation of library rules, but is a “problem” for the individual librarian in the moment. At the interpersonal level in table 2, we can see that asking questions about individual perceptions, beliefs or values, and skill sets can help lead to a solution to the problem. There is an abundance of LIS literature that promotes developing interpersonal communication skills and enhancing professional competencies as strategies for dealing with challenging interactions.

The LIS literature places importance on interpersonal level self-awareness when negotiating challenging situations. Currie encourages librarians to reflect on whether they label patrons as difficult because patrons don’t use the library resources in the way librarians think they should or because librarians don’t make the effort to understand patrons’ needs.⁵⁷ Willis outlines strategies, such as understanding the issues you are sensitive about and avoiding personalizing the situation, as strategies for maintaining self-control.⁵⁸ Knowing yourself and controlling your responses can allow you to avoid making a challenging situation worse.

So, can one person make a challenging situation better? The literature highlights interpersonal skills as a key element of working through difficult interactions. We may think that we know how to listen and understand what patrons want. However, reading the literature provides interesting insight into skills we can improve. When interacting with an upset patron, staff might effectively de-escalate the situation through the use of skills such as listening, awareness of nonverbal cues, seeing the issue from the patron’s perspective, displaying empathy, and focusing on the library-specific issues.⁵⁹ Ross and Dewdney’s Communicating Professionally explores both verbal and nonverbal communication and breaks each down into manageable components for reflection and skill practice.⁶⁰ Other LIS resources include sections highlighting active listening as a skill to resolve patron problems.⁶¹ If problems arise at an interpersonal level and reflect a need for further skills, there are many resources in the LIS literature to use as a starting point to explore skill development.

There is also a clear connection identified in the literature between “problems” and professional competency. Osa highlights the feelings of inadequacy and incompetence that staff can feel when confronted with what they label as a difficult patron.⁶² She suggests that in improving competence through training staff to provide better reference service, both staff and patrons will be more satisfied with the interaction.⁶³ Currie also notes this idea of a connection between skill set and ability to deal with problem patrons, suggesting that building staff computer, analytical, and database-searching skills can be helpful for managing difficult interactions.⁶⁴ Staff, empowered through knowledge and a sense of competence, should be less likely to personalize patron problems and will probably be able to more effectively focus on finding a solution.

It is clear that empathetic, knowledgeable, and competent staff are invaluable when problems arise with patrons. With problems labeled at all levels, it is the staff in the moment who have to respond. Building staff skills and teaching people how to effectively identify the issue is the starting point for finding a solution. However, to build the necessary skill set and create and implement the most effective policies, librarians need to begin with a clear understanding of the problem.

LIS promotes reflective practice, and asking questions about how we approach our work is an essential part of solving “problems” in the library. This framework attempts to offer an opportunity for librarians and library managers to step back to gain a sense of the “big picture,” offering some questions for reflection, taking the focus off the patron, and encouraging us to reflect on how library policy, staff, or the larger community each contribute to the “problem.” Under the symbolic interactionist paradigm, each player in the situation can play a role. It is important that librarians fully understand the role they play in both the problem and the solution.

Knowing which questions to ask to help understand how to address the issue at the appropriate level is a key element of this framework, and a good start to approaching challenging interactions. However, ongoing work is needed to fully implement the suggested solutions highlighted here. The questions identified here for reflection arise from theory-based research, yet additional work is required to identify reflective questions about the solutions we choose to implement. At the same time, while many of the solutions found in the LIS literature are examples of actions taken in libraries to deal with problems, perhaps using more theory to frame our research and work will provide the foundation for not only effectively identifying the problem, but also for gaining insight and developing models for effective solutions. Reflection and asking questions about practice should be an ongoing process not only to understand how to define a problem but also to determine the best solutions and how to implement them.