As in any other environment, individuals at work are at risk of physical attack, but employees may also be subjected to threats, bullying, harassment and other psychological harms. Whilst workplace violence is now being recognised as a serious issue, it remains an ambiguous term and an under researched problem. This report provides an overview of fatal and non fatal violence in Australian workplaces and identifies research and policy options for its prevention and control.

Violence in the workplace

The mathematical representation of E. Brunswik’s (1952) lens model has been used extensively to study human judgment and provides a unique opportunity to conduct a meta-analysis of studies that covers roughly 5 decades. Specifically, the authors analyzed statistics of the “lens model equation” (L. R. Tucker, 1964) associated with 249 different task environments obtained from 86 articles. On average, fairly high levels of judgmental achievement were found, and people were seen to be capable of achieving similar levels of cognitive performance in noisy and predictable environments. Further, the effects of task characteristics that influence judgment (numbers and types of cues, inter-cue redundancy, function forms and cue weights in the ecology, laboratory versus field studies, and experience with the task) were identified and estimated. A detailed analysis of learning studies revealed that the most effective form of feedback was information about the task. The authors also analyzed empirically under what conditions the application of bootstrapping— or replacing judges by their linear models—is advantageous. Finally, the authors note shortcomings of the kinds of studies conducted to date, limitations in the lens model methodology, and possibilities for future research.

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Determinants of linear judgment: A meta-analysis of lens model studies

Despite recent declines in the reported rate of juvenile violence, there appears to be increasing public and professional concern about violent behavior among children and adolescents. Media accounts of school shootings and juvenile homicides have prompted a need to develop approaches for systematically assessing violence risk. This article describes the task of assessing general violence risk among youth, and argues that a somewhat different approach is required to assess cases where an identified or identifiable young person may pose a risk to a specifically identified or identifiable target (also referred to as "targeted violence"). Key risk factors for violent behavior among children and adolescents are identified, fundamental principles for conducting an assessment of violence potential in clinical and juvenile justice contexts are outlined, and an approach to assessment when an identified person engages in some communication or behavior of concern that brings him or her to official attention is briefly described.

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Assessing violence risk among youth.

We identify two distinct components of parent participation in intensive family preservation services: collaboration in treatment planning and compliance with program expectations. Using hierarchical linear models, we explore influences on collaboration and compliance at the case, worker, and program levels. Effects of cross‐level interactions are also examined. Parental substance abuse, mental health problems, minority status, and lack of extended family support predict lower levels of participation. Workers' perceptions of their clients and of their own working conditions appear to influence client participation. Program factors matter as well, although some operate in tandem with case characteristics and worker perceptions.

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A Multilevel Model of Client Participation in Intensive Family Preservation Services

Re-visioning risk assessment for human service decision making

Social workers have long reacted negatively to the idea of limiting client freedoms, seeing such activity as directly contrary to such central social work values as autonomy and self-determination. Nevertheless, practitioners often find themselves required to actively intervene in a protective manner when clients are unable to fend for themselves. Such interventions are increasingly a part of everyday practice as social workers respond to new mandates to provide services to disabled and vulnerable individuals. Because of these changing circumstances, the concept of beneficence and the process of protective treatment are currently being re-examined, especially in mental health. This article develops a conceptual model of protective intervention that can be used by clinical decision makers in a variety of situations. Case examples drawn from work with chronically mentally ill patients are used to illustrate the discussion.

Beneficence Re-examined: Protective Intervention in Mental Health

Social workers and other helping professionals have increasingly become the targets of violence and attack by clients (Guy, Brown, & Polestra, 1990; Star, 1984). It is estimated that all direct-service practitioners, including social workers, are in danger of being assaulted during their careers (Wagner, 1990). It is clear that social work, along with such fields as teaching, nursing, and psychiatry, has become a profession in which the constant risk of assault is "part of reality" ("Risk of Assault," 1989, p. 3). Thus, there is a growing need to increase the abilities of practitioners to predict and control dangerous behavior by clients (Newhill, 1992). This article examines the potentially assaultive or preassaultive client and suggests some ways to minimize the risk of assault by such clients. The data used in this article are derived from the author's 10-year experience in providing social work services on an acute psychiatric ward in a large public medical center. Although the data are limited to one setting, recent studies indicate they may be generalizable to other settings as well (Newhill, 1992). POTENTIALLY ASSAULTIVE CLIENT CONDITIONS Several authors have developed categories to describe clients who may become assaultive or events that may lead to assault (Kaplan & Wheeler, 1983; Madden, 1983). For the purposes of this article, the most serviceable set of categories is that provided by Kronberg (1983), and we have adapted her analysis for use in this discussion. In general, the potentially assaultive client's condition and behavioral cues determine which treatment approaches and therapeutic goals are used. Table 1 outlines some of the most important factors associated with five commonly observed preassaultive conditions, the cues associated with each condition, and the approaches and goals that have been found to be helpful in the management of these conditions (Kronberg, 1983). It should be stressed that these conditions do not represent diagnostic categories but instead signify commonsense definitions of behavioral events frequently encountered in psychiatric settings. Panic Clients can sometimes become so overwhelmed by fear that they lash out in panic at all who attempt to influence their choices or constrain their behavior. Victims of attack can include helping professionals as well as friends or immediate family (Kneisl, 1988). These behaviors are illustrated in the following vignette: A 39-year-old male psychiatric patient became distraught while speaking with the ward social worker about making arrangements to see his estranged wife. His distress grew as the social worker attempted to explore and analyze his feelings until he finally became threatening toward the TABULAR DATA OMITTED worker, claiming he feared that his wife was leaving the state with his infant son and that staff were keeping him from seeing her. The worker quickly exited her office and sought assistance from ward staff. Such clients generally show signs of severe anxiety, such as pressured speech, obsessional thinking, and fears of catastrophe or abandonment. They may exhibit clinging behavior toward staff, in which they claim helplessness and the need to rely on staff for even minimal assistance. Apparent unconcern by staff or even attempts to objectify the client's feelings are often interpreted by the client as indifference and can trigger desperate explosive reactions. The task of calming a severely frightened individual places constraints on the reactions of the helping professional. Because such clients feel as if they are under attack, it is important for the practitioner to avoid any appearance of threatening behavior. Responses to the client should be calm and reassuring, deliberate without haste, with purposeful avoidance of eye contact unless this is sought by the client, because eye contact is often interpreted as a threat. Practitioners should avoid physical closeness unless desired by the client. …

Working with potentially assaultive clients

An understanding of heuristic reasoning has long been seen as important by researchers in human decision making (Newall & Simon, 1972). Recently, attention to this phenomenon has also arisen in social work (Heineman Pieper, 1989; Tyson, 1992). The decision strategies incorporated in heuristic reasoning have been viewed as both essential (Braunstein, 1976) and dangerously misleading (Kahneman, Slovic, & Iversky, 1982). However, despite possible drawbacks, this form of reasoning continues to generate interest because decision makers are often forced to rely on such informal methods to render decisions in pressured work environments (Cohen & March, 1986). Until recently, discussions of heuristic reasoning in social work have been confined to issues of research methodology. Lately, this theme has begun to emerge in discussions of clinical practice (Goldstein, 1990; Imre, 1991; Nurius & Gibson, 1990). What is Heuristic Reasoning? Heuristics are basically rules for decision -- or what Wildavsky (1974) termed "aids to calculation." Both formal and informal clinical decision rules have been identified (Arocha, Vimla, & Vimla, 1993; Holtgrave, Lawler, & Schweibert, 1993); informal heuristics are discussed in this article. Such heuristics can be defined as rough rules of thumb used to solve problems (Haugeland, 1989). These rules have been identified as integral components in clinical judgment (Schon, 1983). Such heuristics do not always give the correct answer but are generally adequate or "good enough" for everyday behavior. The following are some common examples of informal heuristic rules: * Red sky in the morning, sailors take warning. * First come, first served. * The shortest waiting line is the fastest. * If it ain't broke, don't fix it. To better understand the use of such informal rules, the following description by Wiest (1975) is helpful: We all use heuristics in our daily living, drawing them from our knowledge and experience.... We devise simple rules of thumb that free us from the task of solving the same or similar problems over and over again. For example, consider the rule, "when the day is cloudy, take an umbrella to work." The problem at hand is how to defend oneself against the potential discomforts of the weather.... For many problems of this kind, we lack the time or inclination to employ more thorough problem-solving procedures. A simple ... rule serves us best. (p. 382) Informal Heuristics as Decision Strategies The idea that heuristic reasoning in practice situations is made up of various decision strategies has generated various attempts to identify the strategies most often used by decision makers. Werner, Rose, and Yesavage (1983), for example, studied the informal decision strategies used by hospitals in making predictions about the imminent dangerousness of psychiatric inpatients. Other research has included studies of screening decisions in psychiatric emergency rooms (Segal, Watson, & Nelson, 1985), decision making in psychiatric emergencies (Murdach, 1987), social workers' decision making about violent clients (Werner, Rose, Murdach, & Yesavage, 1989), strategies for involving volunteer clients in treatment (Rooney, 1988), and decision making in the "welfare bureaucracy" (Schmidt, 1990). Of particular interest are the investigations of clinical decision making conducted by Rennels, Shortliffe, and Miller (1987). Drawing on research done on multiattribute decision making and other work in artificial intelligence, Rennels et al. proposed four decision strategies for management of patient care: 1. lexicographic ordering -- Solutions are ranked according to acceptability and the most preferred is selected. 2. …

Clinical Practice and Heuristic Reasoning

Social workers often help clients make decisions that they experience as "difficult" because of the stressful and challenging circumstances involved (Gibelman, 2005). However, despite extensive clinical exploration of the helping process by social work authors, the process of assisting clients with difficult decisions is not currently much explored in the literature. Because this area of practice is of significant interest to the profession, it is clearly a topic that needs further exploration. This article examines some of the current literature on the topic of difficult decision making, drawing on research in clinical medicine, psychiatry, nursing, psychology, and social work. WHAT ARE DIFFICULT DECISIONS? Difficult decisions can be defined as decisions spurred by situations characterized by high levels of uncertainty, risk, and fear. Although it has been observed that many of the decisions social work clients are required to make are routine, a large number of the decisions that clients are confronted with also involve major elements of threat and uncertainty and, thus, can be defined as difficult decisions (Murdach, 1995). The following are some examples of situations that are rife with these types of decisions: * A mother is told that her unborn child will be born with severe mental retardation. * A husband is notified that his wife was in a car accident and is now on life support at a local hospital. * A middle-aged couple returns to find that their home and possessions have been destroyed by fire. * A 45-year-old married man with an infant daughter receives a diagnosis of incurable brain cancer. * A young wife with two small children is threatened with a severe beating by her abusive husband. Although the list could be expanded indefinitely by adding less dramatic but still challenging situations, the foregoing examples serve to highlight the confusion and dread encountered by individuals and families attempting to make clear choices in difficult circumstances. It should also be noted that some clients face not just one difficult situation but multiple stressful situations requiring numerous challenging decisions. In the past few years, a number of authors in the helping professions have sought to improve our understanding of decision making in such situations and to develop ways in which clients can be helped to better cope with the challenges to dealing constructively with the stress encountered at such times. In what follows, I draw upon this research in social work and related fields to better understand this significant aspect of clinical care. DIFFICULT DECISION MAKING IN THE LITERATURE The field of social work was once in the forefront in the development of ways to assist clients with decision making in difficult situations (Perlman, 1979; Rapoport, 1965). Lately, however, this honor has been more closely associated with other fields, such as medicine (Buckman, 1992), psychiatry (Margulies, 1989), nursing (Andrews & Boyle, 1995; Purtilo, 1984), and psychology (Pollin & Koocher, 1998). This is not to imply that social work is now absent from this area of study, but only to suggest that other priorities have currently directed the field away from continuing to give sustained attention to this topic (Witkin, 2000). This shift in social work over the past several decades can be illustrated by comparing two classic social work texts, Upham's (1949) A Dynamic Approach to Illness and Germain's (1984) Social Work Practice in Health Care. Upham simply and movingly details how social workers assist clients with decision making in a number of medically oriented difficult situations. Germain says many of the same things, but in her book, the analysis of such situations occurs in the context of such a large mass of theoretical, administrative, and technical detail that the central importance of the helping relationship in assisting clients with decision-making challenges is significantly deemphasized. …

Making Difficult Decisions

Beginning in the 1890s, major social and economic changes steadily began to affect every aspect of life in the United States Social workers, social reformers, community activists, and social planners were caught up in waves of speculation and activity as they sought to determine the best ways to develop, restructure, and guide social programs and even society itself (Trattner, 1999) One offshoot of this tremendous burst of concern and energy was the attempt on the part of a small number of social workers and social thinkers to develop both a "scientific" as well as a "social" approach to social work direct practice Foremost in this effort were Jane Addams, Mary Richmond, Ada Sheffield, Eduard Lindeman, and Mary Parker Follett Either working together or under each other's influence, they pioneered efforts to forge a new "situational" approach to social work practice, a method that used evidence derived from practice experience combined with the latest findings of the social sciences to craft interventions designed to improve the lives of those needing assistance THE GROWTH OF SITUATIONAL THINKING Development of the situational approach in social work was initially driven by the emergence in the late 19th century of various concepts of social reconstruction inspired by developments in the physical sciences, biology, and sociology (Franklin, 1986) One of the offshoots of these new ideas was the philosophy of pragmatism, which emphasized process and experimentation instead of fixed qualities and mechanistic explanations (Franklin; James, 1967; Thayer, 1973) A key idea in the pragmatic approach is that human situations, or "contexts in which human intelligence, purposes, and action affect what is experienced" (Thayer, p 113), are both the starting point and basis for all human learning and development Such ideas especially appealed to social workers, who found all their work heavily influenced by the environmental and social contexts in which their clients were engaged The concepts of "situation" and "situational practice" were widely used in the social work literature until the end of the 1920s, when they fell into temporary abeyance following attacks by the increasingly influential psychiatric wing of the social work profession (Siporin, 1972) Proponents of a more psychiatrically oriented approach dismissed the sociological perspective in social work direct practice as "futile" (Robinson, 1930) because they felt it failed to get "beneath the purely situational aspects of an individual's problem" (Robinson, p 52) To achieve this they recommended instead the "accepting [of] the psychiatric point of view as the basis of all social case work" Robinson, pp 54-55, compare Field, 1980) Beginning in the 1960s, interest in situational thinking in social work revived, largely because of theorists and researchers such as Siporin (1972, 1975, 1978), Meyer (1976), and Germain (1984) Central to this renewed interest in situational approaches is the concept of transactional relationships--social interactions characterized by negotiation and exchange (Safran & Muran, 2000), a basic perspective also well known to the pioneers discussed here To better understand the emergence of the situational approach, I re-examine its beginnings and its subsequent development in social work practice I begin by considering the work of Jane Addams JANE ADDAMS Jane Addams (1860-1935) remains, by all accounts, the most famous and influential social worker this country has produced Born in rural Illinois of well-to-do and politically prominent parents (her father was a state senator), Addams was educated privately both in this country and in Europe After witnessing grinding poverty in Europe, she returned to this country to found Hull House, a settlement house in Chicago Through her intense involvement in settlement work and as a champion of a wide variety of public and political causes, she became first nationally and then internationally known …

Allison D. Murdach

Papers

Beneficence Re-examined: Protective Intervention in Mental Health

Working with potentially assaultive clients

Clinical Practice and Heuristic Reasoning

Making Difficult Decisions

Situational Approaches to Direct Practice: Origin, Decline, and Re-emergence