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Crisis Model of Institutional Violence Prevention


Human service professionals help people live their lives effectively. However, these professionals are at a high risk of being subjected to violent behavior from clients. This problem has become so pervasive that the American Psychological Association formed a task force to report on education and training in dealing with behavioral emergencies.

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The precipitating factors include legal liability, institutional and staff culpability. This paper will discuss these factors and the nine-stage model of a crisis intervention developed by Piercy in 1984 as a means of preventing violent behavior of clients.

Institutional Culpability

Institutional culpability has led to vulnerability of the staff members to violent human behavior. The accessibility and unrestricted movements in the institutions by clients of all calibers without proper security check poses a big threat to the personnel. Long waits can also agitate and distraught the clientele.

The availability of money and drugs also makes them a likely target of a robbery. The administrators of these institutions are trained to only deal with logistical, personnel and financial functions and fail to consider security as a priority. To address institutional culpability, these institutions should be obliged to carry out an assessment of potential violent behavior of all their clients.

Staff Culpability

The nature of these professions makes them culpable of violent behavior of the clients. They are caring, but not always attentive, thus the recipients of their services tend to be hostile and violent towards them. Moreover, when the treatment demands seclusion, restraints, use of force and locked units, the staff members are likely to suffer violence from the clients (Rabinowitz, 2002). The attitude and experience of the staff also determine if there will be an assault, for instance, trainees, interns, and students are more vulnerable to assaults.

After being assaulted, the staff are held legally liable for their actions irrespective of their well intentions. Many lawsuits against caregivers have been successful and mainly for the reason of lack of proper diagnosis, treatment and control of violent clients and failure to prevent an assault. Failure of health workers to relay information on a client having a history of violence has contributed to the lawsuits.

Piercy nine stage model for crisis intervention suggests educating, avoiding of conflict, appeasement, deflection, time-out, show of force, seclusion, restraints, and sedation techniques. In the first stage of education, the client is taken through the process methodically, slowly and patiently. The terms of explanations given should be non-technical and simple to help the clients understand the situation.

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The second stage is avoiding conflict whenever possible. The human service professional should avoid at all cost any confrontation with the clients. The staff should reflect on the client’s feelings in an honorable way (Fauteux, 2011). However, if the client continues to be aggressive, the staff should try to calmly move the client away to avoid aggravating the situation. If the client is still hesitant, it is better to take them in their room though this incidence may be potentially volatile.

Nonetheless, the staff should be calm and invite the client to have a controlled dialog. The client is made to understand that their violent behavior has dire consequences. This is appropriate and mostly applicable in cases when a staff do not know the client they are dealing with and the demands are reasonable and simple.

In the fourth stage, the staff attempts to shift the client’s anger to other topics. For example, a staff member can offer to go to the backyard and have a soda as they talk with the client. This sets a calm atmosphere for non-violent dialog with the client (Aguilera, 1998).

In the fifth stage, the staff proposes to the client to take some time out and think. Ideally, this is done in a less-stimulus environment. The sixth stage involves show of force whereby if the client proves to be non-compliant and violent. At this stage, the disorganized client regains control of themselves as they feel threatened and perceive non-tolerance of their violent behavior. It is important that the staff should involve other parties as it is hard to deal with the client alone.

Seclusion is the seventh stage which is involuntary and the client is placed in an environment that is safe and secure in order to reorganize their feelings, thinking and ultimately their behavior. It is essential to observe the state or federal guidelines when secluding a client (Fauteux, 2011). This stage is applicable in situations whereby the client becomes a threat to self and others. In this case the client is normally agitated, verbally threatening, hyperactive or has a tendency of damaging property (James & Gilliland, 2012).

It is also applied if the client is prone to be harmed by others. This stage is mainly beneficial to the client who becomes overstimulated. The next stage is that of restraint, which applies normally in a psychiatric setup. It is facilitated by the nurses and approved by a doctor. Due to the controversial nature of restraints, they are legally and ethically regulated.

Finally, the last stage of the Piercy model is sedation that applies normally when every other effort has failed, and the doctors decide that the client needs chemical restraining. In this case, the problem is medical and little or no human service is helpful.

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Aguilera, D. (1998). Crisis intervention. St. Louis, Mo.: Mosby.

Fauteux, K. (2011). Defusing angry people. Far Hills, NJ: New Horizon Press.

James, R., & Gilliland, B. (2012). Crisis Intervention Strategies (7th ed). London: Cengage Learning.

Rabinowitz, R. (2002). Occupational safety and health law. Washington, D.C.: Bureau of National Affairs.

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