Personal Safety

1. Personal Safety Chapter 6 Horejsi Workbook

2. Background Information • The potential sources of harm to a social worker include the following: • Clients who are angry and feel mistreated by the agency and its staff. • Persons who are not clients, but who are acquainted with or related to clients and are aware that the clients feel mistreated by the agency and its staff. • Clients who present a special threat because of alcohol or drug use, a pattern of violent behavior, antiauthority attitudes, or unstable mental condition.

3. Background Information • Potential sources of harm (continue): • Person with criminal intent and inclination who are to be found in neighborhoods near the agency or in areas where the social worker travels and works. These individuals are not clients, nor do they have a relationship with the worker’s clients. • Biohazardous and toxic materials that may be encountered in hospitals and other health care facilities and during visits to clients in their home.

4. Background Information • Certain practice settings present more risk to social workers than others. • Individuals with mental illnesses are not inherently more dangerous than persons who do not suffer from such impairments. • Certain social work practice and interventions have a greater likelihood of placing the worker at risk.

5. Background Information • In their work with clients who are potentially dangerous, social workers face the difficult challenge of remaining humane, open, and accepting of clients while also being alert to the possibility of attack. • It is important not to expect every client to be a threat, but to recognize a client who might be.

6. Guidance and Direction • Most dangerous interpersonal situations are the result of tensions that have grown and intensified over time. • It is vital to understand the phases of escalation, the person’s needs and feelings during each phase, and what actions or interventions by the social worker might reduce the tension and level of risk.

7. Guidance and Direction • It is preferable to intervene as early as possible in order to prevent escalation and eventual loss of control by the angry person. • Four stages of crisis management: • Initial tension and frustration • Verbal attack • Loss of control • Recovery after outburst.

8. Crisis Management • Stage 1: Initial Tension and Frustration • The individual is anxious and experiencing high levels of emotions but are still rational and in control of their behavior. • They will respond best to an approach that helps them vent emotions, reflect on the situation, and devise a solution on their own. • The use of active listening will help these individuals express and examine their own feelings and to reduce the level of tension.

9. Crisis Management • Stage 2: Verbal Attack • The individuals are feeling threatened and vulnerable. They become defensive and go on the offensive with verbal attacks. • Irrational thoughts and strong feelings begin to override their self-control. • Effective displays of calm body language, using a non-threatening tone of voice, reflecting client’s feelings and behaviors are useful approaches. • Set limits on what behavior is allowable.

10. Crisis Management • Stage 3: Loss of Control • Workers need to immediately assess the level of danger and their ability to provide control; they should be preparing to escape, if necessary. • Workers are more likely to gain control of the situation if they can empathize with the client’s fear about doing something they will later regret. • Workers must remain calm and continue to build rapport, while shifting focus to the threatening behavior. The out of control person must be controlled, either by the worker or police.

11. Crisis Management • Stage 4: Recovery after the Outburst • Individuals struggle to regain their composure and, having fallen apart, need help in putting themselves back together. • Workers should allow them to further vent their anger, explain their feelings, and come to some closure regarding the incident. • Allowing people to stabilize themselves decreases the risk of re-escalation. • People may gain insight, allow mutual problem solving with the worker and prevention of future outburst.

12. Dealing with the Potentially Violent Client • Past behavior is the best predictor of future behavior. • Be very cautious when dealing with a person who is under the influence of alcohol or drugs. • Be cautious when around people who may be involved in illegal activities. • Remove all potential weapons from your office when dealing with a potentially dangerous client including scissors, staplers, paperweights, etc.

13. Dealing with the Potentially Violent Client • Leave your office door partly open during an interview with a potentially dangerous client. • Notify others if you are planning to meet a potentially dangerous client in your office and arrange for a way to signal for help. • Avoid meeting with clients when you are alone in the office.

14. Dealing with the Potentially Violent Client • Remember that worker attitudes play a role in either controlling or provoking threatening behavior. Maintain a positive, non-judgmental attitude toward clients. • Recognize that both increased structure and decreased stimuli may help clients to remain calm and gain self control. • Utilize skills that facilitate communication and help clients to express themselves in words.

15. Dealing with the Potentially Violent Client • Do not argue with or criticize an angry person. • Trust your instincts. If you feel afraid, assume that you are in danger. • Remember that an attack by a client is almost always the reaction of someone who is afraid and feeling threatened. Speak and act in ways that lessen the client’s need to be afraid of you.

16. Dealing with the Potentially Violent Client • Avoid standing above others. Standing is more authoritarian and threatening than sitting. • Attacks by clients are most likely when they feel trapped or controlled, either psychologically or physically. Give clients options or choices. • Be alert to signs of an imminent attack such as rapid breathing, teeth grinding, dilated pupils, flaring nostrils, choppy speech, clenched fists, and bobbing and dipping movements of the body.

17. Dealing with the Potentially Violent Client • Allow angry persons to vent their feelings. Most people will begin to calm down after two or three minutes of venting or name calling. • Do not touch an angry person, especially if they may be under the influence of a drug. • An angry or dangerous person is more likely to attack someone who appears weak, insecure, and unsure. Present yourself as calm, composed and self-confident.

18. Handling the Dangers of a Home Visit • Do not enter a situation that could be dangerous without first consulting with others and formulating a plan to reduce risk. • Keep your agency informed of your plans and itinerary and check in by phone on a pre-arranged schedule. • Assign two staff members for potentially dangerous home visits.

19. Handling the Dangers of a Home Visit • Do not enter a home or apartment building until you have taken a few minutes to determine its level of danger. • Be aware that guns are most often kept in the bedroom and that a kitchen contains knives and other potential weapons. • Do not sit in an overstuffed chair or couch from which you cannot quickly get to your feet.

20. Handling the Dangers of a Home Visit • Keep your vehicle in good running order and full of gasoline so that you will not find yourself stranded in a dangerous or isolated area. • If you are being followed, go immediately to a police or fire station or to a public place. • Wear shoes and clothing that permit running.

21. Handling an Intense Argument between Two or More People • Begin by gaining their attention. Anything short of physical force may be used. • Ask those in conflict to sit down. If they will not sit down, remain standing also. • Separate the disputants as necessary. Bring them back together when self-control has been demonstrated. • Always intervene in a crisis situation with a partner.

22. Agency Procedure and the Dangerous Client • The agency’s record-keeping system should use color codes that identify individuals or households that have a history of violence. • The agency should maintain a log of all threats of violence so staff can identify those individuals and situations that present a special risk.

23. Agency Procedure and the Dangerous Client • The agency should institute security measures within the agency (use of word codes). • The agency should develop policy and procedures on how to respond to dangerous situations. • The agency should develop a protocol on when and how to use police assistance.

24. Agency Procedure and the Dangerous Client • The agency should file criminal charges against those who harm or threaten physical injury to either the worker or the worker’s family. • When a worker is harmed, the agency should respond with appropriate counseling and emotional support to lessen the effects on the worker.

25. Agency Procedure and the Dangerous Client • The agency should keep waiting rooms and offices clean and strive to create a pleasant and inviting physical environment. • The agency should post in waiting rooms a statement explaining that alcohol, drugs and weapons are not allowed in the building, and that threats and violence or the possession of a weapon will prompt an immediate call to the police.