3 answers
Thomas
Student
Jeffersonville, Indiana
1
Question
Asked
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Are there times when your patients become physically violent?
i would like to know this so if someone becomes overly agitated i can be prepared for it.
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3 answers
Gregory Barclay, M.D., DLFAPA, FASAP
Psychiatrist
26
Answers
Wilmington, Delaware
Updated
Gregory’s Answer
Thomas, this is an excellent and thoughtful question, one that takes courage to ask!! Good for you!! I am a psychiatrist with many years of experience so I will give you as informed an answer as I can. Let me say to begin with that aggression is extremely rare in most typical therapy settings so it is not something to lose sleep over. Aggression and physical violence are more common in different settings, such as in hospitals, emergency rooms, correctional facilities, and residential programs but even in those settings isn't a frequent occurance. The reasons for this is that physical aggression is more often associated with serious mental disorders and/or drug use and in our society, individuals with these sorts of problems do things behaviorally that tend to get them into places such as hospitals, emergency rooms, correctional facilities, or residential settings. When you work in those settings, either as a therapist, psychiatrist, or staff member, everyone receives special and ongoing training in spotting potential violence and taking steps to prevent its escalation so actual injury at the hands of a patient is rare.
In any practice, even in an office or clinic where violence has been rare, it is important to have ongoing training for all staff since we live in a time when there are record numbers of people carrying weapons and episodes of violence in everyday areas (stores, schools, even therapy offices) seems to be on the increase. This sort of training for all staff should be part of an ongoing regular staff training program that includes disaster and fire drills, tornado and blizzard management, and other potential crisis situations that are rare but could happen.
Congratulations on wanting to be a therapist, Thomas! It is a wonderful gift to be able to help people as a therapist or psychiatrist. Try to focus on all the good you plan to do with your life and career and not spend too much time worrying about the rare possiblity of violence. As I said, violence can happen these days anywhere but we all cannot spend our lives in a cave avoiding the possibility. Instead, as you proceed through your training in the future, determine if you are feeling sufficiently prepared for "what if" situations and if not, take it upon yourself to seek out supervision and training in basic violence management, de-escalation techniques, and self-defense.
Best wishes to you and Good Luck!
In any practice, even in an office or clinic where violence has been rare, it is important to have ongoing training for all staff since we live in a time when there are record numbers of people carrying weapons and episodes of violence in everyday areas (stores, schools, even therapy offices) seems to be on the increase. This sort of training for all staff should be part of an ongoing regular staff training program that includes disaster and fire drills, tornado and blizzard management, and other potential crisis situations that are rare but could happen.
Congratulations on wanting to be a therapist, Thomas! It is a wonderful gift to be able to help people as a therapist or psychiatrist. Try to focus on all the good you plan to do with your life and career and not spend too much time worrying about the rare possiblity of violence. As I said, violence can happen these days anywhere but we all cannot spend our lives in a cave avoiding the possibility. Instead, as you proceed through your training in the future, determine if you are feeling sufficiently prepared for "what if" situations and if not, take it upon yourself to seek out supervision and training in basic violence management, de-escalation techniques, and self-defense.
Best wishes to you and Good Luck!
Jacob Taylor
Production Manager
521
Answers
Stafford, Virginia
Updated
Jacob’s Answer
I can offer some general information on handling situations where someone becomes physically violent or agitated. It’s essential to remember that dealing with physical aggression requires specialized training and should primarily be managed by trained healthcare or security personnel. Here are some steps you can take if you encounter such a situation:
1. Prioritize Safety: Your safety and the safety of others should always come first. If you feel threatened, remove yourself from the situation if possible.
2. Call for Help: If you witness a patient becoming physically violent, immediately call for assistance from hospital security, medical staff, or law enforcement, depending on the severity of the situation.
3. Stay Calm: It’s crucial to remain as calm as possible. Avoid escalating the situation through aggressive language or actions. Speak in a calm and reassuring tone.
4. Maintain Personal Space: Keep a safe distance from the agitated individual to prevent physical harm. Avoid any physical contact unless it’s necessary for the person’s safety or medical care.
5. Engage in Verbal De-escalation: Use verbal communication to try to calm the person down. Listen actively, show empathy, and avoid confrontational language. Sometimes, simply acknowledging their feelings can help.
6. Offer Choices: When appropriate, give the individual choices or options to regain a sense of control. This can help reduce their frustration.
7. Avoid Triggers: If you’re aware of specific triggers that might lead to agitation, try to minimize or eliminate them from the environment.
8. Involve Professionals: Allow trained professionals to handle the situation whenever possible. Hospital staff, security personnel, or mental health experts are better equipped to manage violent or agitated individuals safely.
9. Document the Incident: After the situation is resolved, document what happened, including the time, place, individuals involved, and any actions taken. This documentation can be crucial for future reference and potential legal or medical purposes.
10. Self-Care: Dealing with aggressive behavior can be emotionally draining. Make sure to take care of your emotional well-being and seek support from colleagues or counselors if needed.
It’s important to recognize that managing physically aggressive individuals requires specialized training, and attempting to intervene without the proper skills can be dangerous. If you are in a situation where you might encounter violent or agitated individuals frequently, it’s advisable to seek training in de-escalation techniques and crisis intervention from your workplace or relevant authorities.
1. Prioritize Safety: Your safety and the safety of others should always come first. If you feel threatened, remove yourself from the situation if possible.
2. Call for Help: If you witness a patient becoming physically violent, immediately call for assistance from hospital security, medical staff, or law enforcement, depending on the severity of the situation.
3. Stay Calm: It’s crucial to remain as calm as possible. Avoid escalating the situation through aggressive language or actions. Speak in a calm and reassuring tone.
4. Maintain Personal Space: Keep a safe distance from the agitated individual to prevent physical harm. Avoid any physical contact unless it’s necessary for the person’s safety or medical care.
5. Engage in Verbal De-escalation: Use verbal communication to try to calm the person down. Listen actively, show empathy, and avoid confrontational language. Sometimes, simply acknowledging their feelings can help.
6. Offer Choices: When appropriate, give the individual choices or options to regain a sense of control. This can help reduce their frustration.
7. Avoid Triggers: If you’re aware of specific triggers that might lead to agitation, try to minimize or eliminate them from the environment.
8. Involve Professionals: Allow trained professionals to handle the situation whenever possible. Hospital staff, security personnel, or mental health experts are better equipped to manage violent or agitated individuals safely.
9. Document the Incident: After the situation is resolved, document what happened, including the time, place, individuals involved, and any actions taken. This documentation can be crucial for future reference and potential legal or medical purposes.
10. Self-Care: Dealing with aggressive behavior can be emotionally draining. Make sure to take care of your emotional well-being and seek support from colleagues or counselors if needed.
It’s important to recognize that managing physically aggressive individuals requires specialized training, and attempting to intervene without the proper skills can be dangerous. If you are in a situation where you might encounter violent or agitated individuals frequently, it’s advisable to seek training in de-escalation techniques and crisis intervention from your workplace or relevant authorities.
Jennifer Fischer
Product Manager
27
Answers
Dallas, Texas
Updated
Jennifer’s Answer
Hello Thomas! Have you ever considered a career in therapy? Even though I'm not a therapist myself, I believe your query is relevant to all job sectors. In my two decades of work experience, I've sadly witnessed aggressive behavior from customers and escalating conflicts among colleagues. Regardless of your profession, it's crucial to always prioritize your safety. If you're thinking about becoming a therapist, safety measures should be an integral part of your training. That way, if you ever find yourself dealing with high-risk clients, particularly in the mental health field, you'll be equipped with the knowledge to identify potential issues and defuse tense situations.