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Chapter Fourteen: Violent Behavior in Institutions.

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Presentation on theme: "Chapter Fourteen: Violent Behavior in Institutions."— Presentation transcript:

1 Chapter Fourteen: Violent Behavior in Institutions

2 Precipitating Factors Putting workers at risk:  Substance Abuse  Deinstitutionalization (lack of facilities)  Mental Illness  Gender  Gangs  Required Reporting  Elderly (no longer passive)

3 Institutional Culpability  Readily accessible to clientele  Easy prey for people looking for money or drugs  Minimal security system

4 Institutional Culpability Cont.  Universities and their Counseling Centers  Counseling offices are isolated  Denial  Do not want bad publicity  Crime Awareness and Campus Security Act of 1990 (Clery Act)

5 Staff Culpability  Believe they are immune from the threat because they are supportive and caring  Client may act aggressively if they feel they have little control over their treatment  Staff also need to set limits in a positive, firm, fair, and empathic manner

6 Staff Culpability Cont.  Staff members who are burned out are more likely to be assaulted than those who are not  46% of all assaults involved students or trainees and the incidence of assaults decreased as the workers gained experience

7 Legal Liability  Health-care providers may be the victims of assaults but they may also become legally liable for their actions  Liability extends to the institutions and directors of those institutions  Failure to properly diagnose, treat, and control violent clients or protect third parties from assaultive behavior  One of the better predictors of who will be at risk to become violent is the collective judgment of clinical workers.

8 Violence Potential Assessment Instruments  HCR-20  Violence Screening Checklist–Revised (VSC-R)  Broset Violence Checklist (BVC)  Dynamic Appraisal of Situational Aggression (DASA)

9 Bases for Violence -pridictors  Age (males 15-30, elderly)  Substance Abuse  Predisposing History of Violence  Psychological Disturbance  Social Stressors (loss of job, relationship, abuse, financial stress)

10 Bases for Violence Cont.  Family History of violence  Work History  Time (admission and tenure before help)  Presence of Interactive Participants (those brining the person to treatment)  Motoric Cues (physical cues, verbal cues, threats)  Multiple Indicators

11 Intervention Strategies  Security Planning  Commitment and Involvement  Worksite Analysis  Hazard Prevention and Control  Threat Assessment Teams  Precautions in Dealing with the Physical Setting  Training (pages )  Anti-Violence Intervention  Assumptions  Precautions  Outreach Precautions

12 Intervention Strategies Cont.  Record Keeping and Program Evaluation (recording of incidents)  Stages of Intervention  Education (through reasoning and reassurance)  Avoidance of Conflict  Appeasement (but not be a doormat)  Deflection (shifting to less threatening topics)  Time-out  Show of Force (open to others that can help)  Seclusion (severe limit setting)  Restraints, for safety not punishment  Sedation

13 Follow-up with Staff Members

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