Week 11: Question for Discussion

(Wk # 11: July 13 to July 19 – Main post under Assignment by Wed, July 15 at 11:59 PM EST).

Students are required to post a minimum of three times per week (1 main post answering the question 100% before Wednesday at 11:59 PM EST and 2 peer responses by Sunday at 11:59 PM EST).The three posts in each individual discussion must be on separate days (same day postings / replies will not be accepted).

Chapter 14 – Violent Behavior in Institutions

Question(s): Be prepared to discuss 2 questions

Statistics shows that 48% of no fatal injuries from occupational assaults in the United States occurred in health care and social services particularly mental health workers.

1. Mention at least 3 precipitating factors for violent behavior in institutions?

2. Discuss each of them (3 precipitating factors).

Grading Criteria:  The answer should be based on the knowledge obtained from reading the book, no just your opinion. If there are 2 questions in the discussion, you must answer both of them. Your grade will be an average of both questions. Student mentions 3 precipitating factors for violent behavior in institutions (45 points – 15 points each clue). Student discusses / explains each precipitating factor (55 points – 18.3 points each clue).

Chapter Fourteen: Violent Behavior in Institutions

Precipitating Factors

Substance Abuse


Mental Illness



Required Reporting


Institutional Culpability

Readily accessible to clientele

Easy prey for people looking for money or drugs

Minimal security system

Institutional Culpability Cont.

Universities and their Counseling Centers

Counseling offices are isolated

Seung-hui Cho (Virginia Tech)

Rehabilitation Act of 1973 and the Americans With Disabilities Act of 1990


Do not want bad publicity

Crime Awareness and Campus Security Act of 1990 (Clery Act)

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

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

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.

Violence Potential Assessment Instruments


Violence Screening Checklist–Revised (VSC-R)

Broset Violence Checklist (BVC)

Dynamic Appraisal of Situational Aggression (DASA)

Bases for Violence


Substance Abuse

Predisposing History of Violence

Psychological Disturbance

Social Stressors

Bases for Violence Cont.

Family History


Presence of Interactive Participants

Motoric Cues

Multiple Indicators

Intervention Strategies

Security Planning

Commitment and Involvement

Worksite Analysis

Hazard Prevention and Control

Threat Assessment Teams

Precautions in Dealing with the Physical Setting


Anti-Violence Intervention



Outreach Precautions

Intervention Strategies Cont.

Record Keeping and Program Evaluation

Stages of Intervention


Avoidance of Conflict




Show of Force




The Violent Geriatric Client

Mild Disorientation


Eliciting Trust

Reality Orientation


Reminiscence Therapy


The Violent Geriatric Client Cont.

Distinguishing between Illusions and Hallucinations

Sundown Syndrome

Security Blankets


Severe Disorientation

Follow-up with Staff Members


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