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Coping with violence: a guide for the human services
Journal of Clinical Forensic Medicine (1997) 4, 105 106 © APS/Pearson Professional Ltd 1997
B O O K REVIEWS
prevention and diffusion of violence and post trauma support of assaulted workers'. This is indeed a broad aim and Bowie delivers. It is a thorough look at the topic and is well researched. It is marketed as part of a training package and ideally I would like to see it utilized in this way as many of the chapters need to be discussed in training forums and certainly physical intervention skills need demonstration and a full understanding of the situation before they are used. The initial chapters describe types of workplace violence and the wide variety of workers at risk. 'Health service workers are 26 times more likely to be assaulted and seriously injured than members of the general public'. The definition of workplace violence is discussed and the types of violence in and out of the workplace. The difficulties in estimating the prevalence due to under-reporting of events is described. The cost of violence to employers is discussed, both financial and 'intangible costs such as loss of morale, problems with recruitment and retention, effects of violence on treatment and the therapeutic environment and negative public relations...'. The problem in predicting violence and possible causes as well as the theoretical basis for violence is discussed. The types and phases of violent behaviour and the assault cycle are outlined as a model. Different types of communication are discussed, the use of verbal persuasion techniques and an awareness of non verbal means of communication. The distinction between content and context of the communication is useful and would be usefully illustrated by examples. Checklists for home visits and community visits are common sense and ought to be included in most workplaces as policy. The principles of physical intervention and the fact that people should be psychologically, perceptually and physically prepared are illustrated. Danger zones and the use of movements to block blows or escape from a situation are illustrated. I would like to see these techniques used only by those with adequate training and would advocate that a training programme occur in the workplace. Reading a book is not a substitute for tuition by an expert and could lead to false bravado and potentially damaging situations. I was pleased to see that restraint techniques were not detailed but left to a practical workshop for training. The approach to aggression management emphasizes the importance of objectivity and details a variety of intervention options including negotiation. The principles utilized in negotiation are described and when to and when not to negotiate. The effect of violence on workers, the risk of post-traumatic stress disorder and the risk and types of depression and burn-out in the health service worker are all discussed. Treatment strategies are briefly outlined. The use of critical
R i s k assessment - a practitioner's guide to predicting harmful behaviour. By B r y o n y M o o r e , 1996. W h i t i n g a n d Birch L t d : L o n d o n . 156pp. £12.99. I S B N 1871177847 This is a dense, small book with a wide aim of teaching risk assessment to staff in a variety of disciplines including probation officers, social workers, residential care workers and health/nursing staff. There is a useful list of key questions at the end of each chapter. This is helpful as it is sometimes difficult to quickly see the main points in the text. It is divided into four sections. Section One sets the assessment in context and describes some statistical difficulties in making assessments and the hazards of predictions. The examples are useful and clear. Section Two looks at factors in individual risk. Again, theoretical issues are illustrated by case examples. These tend to be quite specific and deal mainly with sexual and criminal offences. Past behaviour as a predictor of future behaviour is debated as is the use of punishment of behaviour. Motivational issues are discussed as well as ways in which motivation is controlled and disinhibited. The question of insight is dealt with and the distinction between influence and responsibility. The cost of the behaviour in terms of probable victims and the cost to those victims, to the perpetrator and to the professionals involved is discussed. Section Three tries to identify the influence of external factors on the potential of an individual to act in a certain way. The role of victims, the influence of victims' behaviour and the availability of victims is discussed. Section Four is an overview of the book with a useful risk assessment framework with headings which the individual carrying out the assessment would address. The text is specialized and describes a lot of theoretical issues. I suspect that most people picking up a book of this nature would want additional help in terms of workshops to share difficulties in the practical aspects of these assessments with real cases, Its market would mainly be limited to those working in forensic settings. D R VIVIENNE S C H N I E D E N Randwick, NSW, Australia Coping with violence: a guide for the human services. By Vaughan Bowie, 1996. Whiting and Birch Ltd: London. 187pp. £14.95. ISBN 1871177464 This compact book certainly packs a punch. It is presented as teaching 'practical, commonsense principles for the 105
106
Journal of Clinical Forensic Medicine
incidence stress debriefing is described and the debate about its efficacy mentioned. Long-term interventions and support mechanisms are discussed along with the use of 'defusing' after an assault. The final chapter talks about training programmes and the type of training appropriate for different staff.
The book incorporates a lot of information and will be of use to workers dealing with violence and as an adjunct to a training package on dealing with violence. D R VIVIENNE S C H N I E D E N Randwick, NSW, Australia
B O O K REVIEWS
prevention and diffusion of violence and post trauma support of assaulted workers'. This is indeed a broad aim and Bowie delivers. It is a thorough look at the topic and is well researched. It is marketed as part of a training package and ideally I would like to see it utilized in this way as many of the chapters need to be discussed in training forums and certainly physical intervention skills need demonstration and a full understanding of the situation before they are used. The initial chapters describe types of workplace violence and the wide variety of workers at risk. 'Health service workers are 26 times more likely to be assaulted and seriously injured than members of the general public'. The definition of workplace violence is discussed and the types of violence in and out of the workplace. The difficulties in estimating the prevalence due to under-reporting of events is described. The cost of violence to employers is discussed, both financial and 'intangible costs such as loss of morale, problems with recruitment and retention, effects of violence on treatment and the therapeutic environment and negative public relations...'. The problem in predicting violence and possible causes as well as the theoretical basis for violence is discussed. The types and phases of violent behaviour and the assault cycle are outlined as a model. Different types of communication are discussed, the use of verbal persuasion techniques and an awareness of non verbal means of communication. The distinction between content and context of the communication is useful and would be usefully illustrated by examples. Checklists for home visits and community visits are common sense and ought to be included in most workplaces as policy. The principles of physical intervention and the fact that people should be psychologically, perceptually and physically prepared are illustrated. Danger zones and the use of movements to block blows or escape from a situation are illustrated. I would like to see these techniques used only by those with adequate training and would advocate that a training programme occur in the workplace. Reading a book is not a substitute for tuition by an expert and could lead to false bravado and potentially damaging situations. I was pleased to see that restraint techniques were not detailed but left to a practical workshop for training. The approach to aggression management emphasizes the importance of objectivity and details a variety of intervention options including negotiation. The principles utilized in negotiation are described and when to and when not to negotiate. The effect of violence on workers, the risk of post-traumatic stress disorder and the risk and types of depression and burn-out in the health service worker are all discussed. Treatment strategies are briefly outlined. The use of critical
R i s k assessment - a practitioner's guide to predicting harmful behaviour. By B r y o n y M o o r e , 1996. W h i t i n g a n d Birch L t d : L o n d o n . 156pp. £12.99. I S B N 1871177847 This is a dense, small book with a wide aim of teaching risk assessment to staff in a variety of disciplines including probation officers, social workers, residential care workers and health/nursing staff. There is a useful list of key questions at the end of each chapter. This is helpful as it is sometimes difficult to quickly see the main points in the text. It is divided into four sections. Section One sets the assessment in context and describes some statistical difficulties in making assessments and the hazards of predictions. The examples are useful and clear. Section Two looks at factors in individual risk. Again, theoretical issues are illustrated by case examples. These tend to be quite specific and deal mainly with sexual and criminal offences. Past behaviour as a predictor of future behaviour is debated as is the use of punishment of behaviour. Motivational issues are discussed as well as ways in which motivation is controlled and disinhibited. The question of insight is dealt with and the distinction between influence and responsibility. The cost of the behaviour in terms of probable victims and the cost to those victims, to the perpetrator and to the professionals involved is discussed. Section Three tries to identify the influence of external factors on the potential of an individual to act in a certain way. The role of victims, the influence of victims' behaviour and the availability of victims is discussed. Section Four is an overview of the book with a useful risk assessment framework with headings which the individual carrying out the assessment would address. The text is specialized and describes a lot of theoretical issues. I suspect that most people picking up a book of this nature would want additional help in terms of workshops to share difficulties in the practical aspects of these assessments with real cases, Its market would mainly be limited to those working in forensic settings. D R VIVIENNE S C H N I E D E N Randwick, NSW, Australia Coping with violence: a guide for the human services. By Vaughan Bowie, 1996. Whiting and Birch Ltd: London. 187pp. £14.95. ISBN 1871177464 This compact book certainly packs a punch. It is presented as teaching 'practical, commonsense principles for the 105
106
Journal of Clinical Forensic Medicine
incidence stress debriefing is described and the debate about its efficacy mentioned. Long-term interventions and support mechanisms are discussed along with the use of 'defusing' after an assault. The final chapter talks about training programmes and the type of training appropriate for different staff.
The book incorporates a lot of information and will be of use to workers dealing with violence and as an adjunct to a training package on dealing with violence. D R VIVIENNE S C H N I E D E N Randwick, NSW, Australia