Violent Behavior in Institutions

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Nowadays, clinicians are at risk of becoming the victims of violent behavior, and the task of the additional education related to the issue is to teach the professionals how to deal with behavioral emergencies. To understand and analyze the aspects of the problem, it is important to refer to the associated precipitating factors, institutional culpability, staff culpability, and legal liability as well as to propose the nine-stage model of intervention to cope with the risky situations and conflicts.

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Clinicians can be affected by the clients’ violent behaviors in many ways which include the clients’ suicides, violent reactions, and developed conflicts. Thus, clinicians can experience the shock and anxiety associated with the patients’ suicides, they can become the victims of the assaults, and clinicians can react to the patients’ violent behaviors aggressively because of being unprepared for the emergencies (The Task Force on Education and Training, 2000). It is important to pay attention to such precipitating factors as the patients’ attempts to commit suicide, the patient’s severe mental illnesses, substance abuse, the focus on prejudice and discriminative behaviors, the focus on violent methods to resolve conflicts, and the patients’ uncontrolled aggression (Otto & Douglas, 2010, p. 34-35). These precipitating factors stimulate the clients to act violently in relation to clinicians, and the same factors can be discussed as preventing for clinicians to address the emergency situation appropriately.

There are many cases when the risk of violence increases as a result of institutional culpability. Clinics attract different categories of clients who have a lot of problems with substance abuse and behavior. However, the provided security system is not enough to predict the development of conflict and emergency situations. Furthermore, the risky situations are often not discussed publicly because of the necessity to protect the counselors’ reputation and practice’s aspects. One more problem is associated with the staff culpability because clinicians often overestimate their possibilities in controlling the situation in the counseling room. Moreover, it is important to state boundaries during the sessions in order to avoid unexpected behaviors. In addition, the victims of the assaults are often the counselors who have little practical experience in the field (The Task Force on Education and Training, 2000).

The issue of legal liability should also be noted. Clinicians have a lot of legal responsibilities to control the situation in the institution, and many conflicting situations can be connected with the problem of improper treatment or with the inability of the institution’s authorities to protect the staff from the clients’ violent behavior (Otto & Douglas, 2010, p. 34). To decide about the risks of working with this or that client, it is possible to refer to the collective agreement on the issue.

According to Piercy’s nine-stage model of intervention, the conflicts and risky situations can be resolved as a result of the specific plan of actions according to which clinicians should initiate the education stage to inform about the important points; and then, they try avoiding the conflict while directing the situation to the appeasement (James & Gilliland, 2012, p. 555-556). The next important stage is deflection when the aggressor can understand or not his or her faults. One more stage is the time-out followed by demonstrating the force. At this stage, the conflict cannot be resolved positively. Then, the opponents need to focus on seclusion and further restraints. These problematic stages should end with sedation, and the clinician’s task is to make the aggressor complete this stage effectively.

Thus, clinicians often become the victims of violent behaviors because of their direct contact with persons who suffer from mental and emotional problems and disorders. As a result, clinicians need additional instructions to cope with the emergencies and to preserve their emotional balance.

References

James, R., & Gilliland, B. (2012). Crisis Intervention Strategies. USA: Cengage Learning.

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Otto, R., & Douglas, K. (2010). Handbook of Violence Risk Assessment. USA: Taylor & Francis.

The Task Force on Education and Training. (2000). Report on education and training in behavioral emergencies. Web.

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