1. BEST PRACTICES FOR THREAT ASSESSMENT Presented by: BRETT A. SOKOLOW, ESQ. www.ncherm.org

2. Threat Assessment The NCHERM model utilizes a multi-disciplinary rubric to assess threat on three scales: 1: Mental Health-related risk Potential harm to self 2: Generalized risk Operational, reputational, facilities, financial 3: Aggression Measures Potential harm to others

3. We need all three Combining the resources of these three disciplines gives behavioral intervention teams the tools they need to accurately assess the source, nature and severity of any threat posed to the community. 3

4. Measures of Mental Health-Related Risk The “D” Scale Distress Disturbance Dysregulation/Medical Disability 4

5. Distress Failure to cope with situational stressors and traumatic events results in disruptive and/or concerning behavior Emotionally troubled (e.g., depressed, manic, labile) Potentially psychiatrically symptomatic 5

6. Disturbance Behaviorally disruptive, unusual, and/or bizarrely acting Destructive, apparently harmful or threatening to others May misuse and/or abuse substances 6

7. Dysregulation Suicidal (thoughts, feelings, expressed intentions and ideations) Parasuicidal (self-injurious, eating disordered to a life-threatening level) Engaging in risk-taking (e.g., substance abusing) Hostile, aggressive, relationally abusive Deficient in skills that regulate emotion, cognition, self, behavior, and relationships 7

8. Medical Disability (parallel risk to dysregulation) Profoundly disturbed, detached view of reality Unable to self-care (prolonged starvation, poor self care/protection) At risk of grievous injury or death without an intent to self-harm Often seen in psychotic breaks 8

9. Measures of Generalized Risk The NCHERM 5-level Risk Rubric is applicable to potentially violent and injurious acts and those that threaten reputation, facilities, operations, and financial risk Apply these as default measures when there are no overt mental health-related risks or signs of aggression. 9

10. CLASSIFYING THE RISK THE NCHERM CUBIT MODEL RUBRIC FOR GENERALIZED RISK: MILD MODERATE ELEVATED SEVERE EXTREME

11. 1. Mild risk Disruptive or concerning behavior. Student may or may not show signs of distress. No threat made or present. 11

12. 2. Moderate risk More involved or repeated disruption. Behavior more concerning. Likely distressed or low-level disturbance. Possible threat made or present Threat is vague and indirect Information about threat or threat itself is inconsistent, implausible or lacks detail Threat lacks realism Content of threat suggests threatener is unlikely to carry it out. 12

13. 3. Elevated risk Seriously disruptive incident(s) Exhibiting clear distress, more likely disturbance Threat made or present Threat is vague and indirect, but may be repeated or shared with multiple reporters Information about threat or threat itself is inconsistent, implausible or lacks detail Threat lacks realism, or is repeated with variations Content of threat suggests threatener is unlikely to carry it out. 13

14. 4. Severe risk Disturbed or advancing to dysregulation Threat made or present Threat is vague, but direct, or specific but indirect (type of threat v. object of threat) Likely to be repeated or shared with multiple reporters Information about threat or threat itself is consistent, plausible or includes increasing detail of a plan (time, place, etc) Threat likely to be repeated with consistency (may try to convince listener they are serious) Content of threat suggests threatener may carry it out. 14

15. 5. Extreme risk Student is dysregulated (way off their baseline) or medically disabled Threat made or present Threat is concrete (specific and direct) Likely to be repeated or shared with multiple reporters Information about threat or threat itself is consistent, plausible or includes specific detail of a plan, often with steps already taken Threat may be repeated with consistency Content of threat suggests threatener will carry it out (reference to weapons, means, target) Threatener may appear detached 15

16. 9 Measures of Aggression Provides BITs the ability to assess potential for harm to others in an objective way Integrates the NCHERM model with the Center for Aggression Management’s Aggression Continua Enables BITs to prevent injury and violence via trained Aggression Managers. Crisis Management, Threat Assessment & Conflict Resolution Aggressive versus assertive 16

17. Primal & Cognitive Aggression 17

18. Three-phase construct Trigger Phase Escalation Phase Crisis Phase 18

19. Level 1—Hardening Cognitive Aggressor: Becomes more distant and argumentative Demonstrates a lack of understanding and empathy Conceals motives and intent through deception Example: averted eye contact in class, rationale does not make sense 19

20. Level 2—Harmful Debate Cognitive Aggressor: Becomes fixated on his or her own view May exhibit cutthroat-competition, distrust, proleptic and obstructionist behavior Has no interest in others’ perspectives or finding common ground May manifest in frequent arguments as resident advisors confront code violations or as faculty find students arguing in class just for the sake of argument 20

21. Level 3 Communicate with Actions vs. Words Cognitive Aggressor: Leaves argument behind Takes action without consulting others Appears detached and is self-absorbed Perceives the intent of his/her intended victim(s) as not in his/her best interest RAs and other staff may notice this behavior as students withdraw from contact with others and developing concerning behaviors like punching bathroom doors. 21

22. Level 4 Image Destruction: This aggressor plants seeds of distrust with their intended victim’s community − those individuals the victim likes and respects and by whom they want to be liked and respected in return Examples: potentially stealing ideas or credit, provoking anonymous, false accusations, or other subtle undermining Issues become bipolar, attacks intended victim’s core identity. 22

23. Level 5 Forced Loss of Face This aggressor unmasks his or her victim as an enemy of their own community. You’re not who you pretend to be. 23

24. Level 6 The final level of the Escalation Phase reveals Threat Strategies, where the aggressor becomes more overt toward their victim or victims. Often this level of aggression is about controlling or manipulating a victim or victims, positioning them so that they feel the full impact of the aggressor’s threat. This aggressor presents an ultimatum to his or her victim or victims, aggressively responds to perceived threats, possibly on the verge of panic. 24

25. Level 7 Limited Destructive Blows: This aggressor is the Complicit Tactician, the individual who is complicit with the eighth and ninth-levels of the aggression continuum but does not intend to murder or die for their cause. This aggressor will inspire others to do so or aid the others in the committing of their violence. In the generic sense this individual is an “accomplice.” 25

26. Level 8 Win/lose Attack: This aggressor may be prepared to give up their life for this cause but intends to survive. Generically, this is the murderer (or in a military or homeland security context, a combatant). 26

27. Level 9 “Plunging Together into the Abyss” Murder/Suicide, the ultimate lose/lose attack This Cognitive Aggressor: Does not intend to survive Has a profound disconnection from his/her own well-being Will often take his own life to avoid capture or incarceration 27

28. Using the Chart Primary framework—the 5-level generalized risk (mild to extreme) scale: Will indicate to the team the overall risk level and appropriate resources, support and intervention techniques to deploy. Scale applies to every case Mental health and aggression measures only apply as overlays when mental health issues and/or signs of aggression are indicated Using all of the information reported to the team it will then assimilate the information and assign a risk level. 28

29. MORE ON THE CHART If mental health-related issues are present Classify the student on the “D” scale first. Then, identify the corresponding level of generalized risk, and any indicators of aggression. If there is no evidence of mental health-related risk Directly classify the risk according to the 5-level scale If generalized risk is unclear, and because measures of aggression are more objective, you can Work the chart from right to left, assigning a correct level of aggression From that, assign the corresponding level of generalized risk There may or may not be a corresponding level of mental health-related risk 29

30. FINALLY Use the right-hand side of the NCHERM Risk Rubric Table. This will give you the corresponding tools in the toolbox for your team to deploy depending upon the level of risk you have perceived.

33. THE CUBIT RESOURCE PAGE www.ncherm.org/CUBIT.html www.ncherm.org/CUBIT.html