1. Threat Assessment Developed by DATA of Rhode Island through a grant from the RI Department of Human Services

2. Definition Threat (risk) Assessment refers to the establishment of a judgment of risk in the very near future, based on the weighing of information that is available. In general in assessing risk or threat, it is always better to err on the side of caution Threat assessment has a number of elements similar to suicide risk assessment

3. Threat Assessment GOALS Participants to increase knowledge of threat risk factors associated with hostile/violent actsParticipants to increase knowledge of threat risk factors associated with hostile/violent acts To understand which factors should be most of concernTo understand which factors should be most of concern To understand when the worker should intervene?To understand when the worker should intervene?

4. Understanding aggression All persons have capacity for aggressions, though most never have need to act on it. Aggression is broadly defined in two categories: 1.Instrumental 2.Endogenous/hostile

5. Instrumental aggression Instrumental aggression is defined as the use of aggression as part of a problem solving process and the act is first motivated by a goal (having and instrumental purpose) Examples include: protecting from threat, robbery, retaliation

6. Hostile Aggression Hostile aggression is primarily emotion driven usually with some sort of “perceived” provocation. Sometimes the provocation is clearly observable to a third party. Other times provocation is more internally driven with only minimal cues from the environment.

7. Assessing client risk Three major domains effect assessing client risk. These are: Previous history, current psychosocial or environmental stressors and client behavioral/emotional status

8. Historic Factors Historic factors are unchanging and help to establish a baseline of risk Historic factors include: Previous history of violence History of maltreatment as a child History of relationship instability Personality disorder Substance abuse Unemployment Access to weapons Relationships Note: The presence of Axis1 mental illness is not a predictive factor.

9. Emotional/behavioral Considerations Impulsivity Active substance abuse particularly alcohol Poor communication Skills Highly negative attitude Cognitive impairment Mood instability Affect regulation Degree of arousal…Agitation to fury Intentionality Tunnel Vision/Reversibility Lack of interpersonal support

10. Current Stressors Interpersonal conflict Relationship Break up Loss Recent arrest Public embarrassment/humiliation

11. Screening Process Screening process for threat is similar to process for suicidal risk

12. COMPONENTS OF THREAT ASSESSMENT Survey and identify client risk factors Elicit direct client communication from client (if possible) Direct observation Previous History Level of Provocation Relationship between involved parties

13. Areas of greatest concern Client under the influence Client has identified a “target” person who is object of his aggression Client demonstrates a high level of agitation Client has history of aggressive actions Client has difficulty with redirection No supports or toxic supports

14. Response to threat First Rule: If ever you have concern for your safety do not conduct client interview alone. Rule Two: If threat seems imminent toward yourself or others, seek safety, call for help and recognize your duty to warn. Rule Three: Document your actions Rule Four: With an interpersonal conflict there are always two sides, try your best to remain neutral. Rule Five: Even if the threat level appears to be relatively low, the worker should always provide some kind of response and follow up.

15. Questions and Wrap up