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Violent Behavior in Institutions

Human service professionals are at an increased risk of becoming victims of violent behavior. The problem has become so persistent that some psychologists have reported incidents of assaults by their patients. Social workers are becoming increasingly concerned about dealing with the most emotionally, economically, and socially disintegrated persons (Kelen & Catlett, 2010). The paper examines the precipitating factors for violence, institutional culpability, staff culpability and legal liability in regards to violence. These factors shall be examined in light of the 9-stage model designed by Piercy (1984).

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In the human service business, the major precipitating factors to violence are the elderly, gangs, gender, mental illness, deinstitutionalization, and substance abuse (Gilliland & James, 2013). Substance abuse has been considered one of the major causes of violence. Moreover, past research have indicated that people with such mental illnesses as delusions, hallucinations and violent fantasies tend to have violent behaviors (James, 2008). Gender stereotypes may have contributed to acts of violence in the human service business, as most males, for example, are violent on account of their aggressive nature. Most elderly people are more likely to engage in acts of violence compared to the youth as a result of psychological changes.

Deinstitutionalization of mentally ill persons, lack of follow-up care, staff shortage and, inadequate facilities promote acts of violence among clients because they tend to regress to their past pathological states (Gilliland & James, 2013). Peer pressure among groups promotes violence as the members try hard to gang up and participate in violence.

Increased levels of violence in institutions are promoted by institutional culpability, staff culpability and, legal liability. Under institutional culpability, most of universities and their counseling centers lack choke points, pervasive mental illness, and separate offices for violent people. Therefore, security is underestimated making the staff prone to violent acts (Gilliland & James, 2013). Most of the institutions are caught up in denial as they hate to admit that acts of violence take place for fear of negative publicity. Staff members are culpable to violence since “human service workers are caring, well-intentioned people, recipients of their services will act in reciprocal way” (Gilliland & James, 2013, p. 545). This assumption is misplaced as patients may become aggressive if they feel that they have lost control over care or treatment provided. Healthcare providers are legally liable if they fail to properly diagnose, control and treat violent clients. Therefore, legal liability is extended to healthcare institutions.

While undertaking the management of potentially violent happenings, it is always advisable to proceed sequentially based on the 9-stage model designed by Piercy (1984). The intervention stages are “(1) education, (2) avoidance of conflict, (3) appeasement, (4) deflection, (5) time out, (6) show of force, (7) seclusion, (8) restraints, (9) sedation” (Piercy, 1984). Personal responsibility is required in preventing violence through the aforementioned 2 stages. Stages 1 to 5 relies heavily on communication rather than acting out, which is a primary goal of violent intervention. It is always advisable to talk to violent persons in the hope of stopping violent acts. At he first stage, it is advisable to reason with and reassure the violent person that the situation will be under control.

At the second stage, confrontation and conflict are avoided as much as possible with the objective being to reduce any further violence. At the third stage, the elements of humility are shown to appease the violent party. It is advisable to reflect, acknowledge, and affirm the feelings of the client so as to shift to less threatening talks or topics at the deflection stage (Piercy, 1984). This is followed by time out with strong and clear statements of reason to the client. “Show of force” stage is used to ensure that no act of violence is tolerated. This is aimed at enabling clients to regain their self-control. It is always advisable for workers to call further assistance as the act of violence is normally high at this stage (Piercy, 1984). The client is later secluded and restrained to reduce the threat. Finally, he is sedated to put him to sleep.

References

Gilliland, B. E., & James, R. K. (2013). Crisis intervention strategies. Belmont, CA: Brooks/Cole, Cengage Learning.

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James, R. K. (2008). Crisis intervention strategies. Belmont, CA: Thomson Brooks/Cole.

Kelen, G. D., & Catlett, C. L. (2010). Violence in the health care setting. JAMA, 304(22), 2530-2531. Web.

Piercy, D. (1984). Violence: The dry and alcohol patient. In J. T. Turner (Ed.), Violence in the medical care setting: A survival guide. (pp. 123–152). Rockville, MD: Aspen Systems.

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