Assessing and managing voilence risk in clinical practice
The authors review the techniques for assessing and managing violence risk in clinical practice. They discuss how the concept of risk assessment has evolved and review the accuracy of mental health practitioners' predictions of violence, the relationship between violence and major mental disorders, the base rates of violence in clinical populations, and the individual/dispositional, historical, contextual, and clinical risk factors associated with increased risk of violence. The authors then give practical guidelines for how to conduct a risk assessment, including ensuring the safety of patient and clinician, choosing the best setting for the evaluation, how to examine the patient, and what questions to ask to investigate the patient's history of violence. The article concludes with a discussion of how to determine the level of intervention that is most appropriate, strategies to reduce the probability of harm, how to determine when involuntary commitment is indicated, and the necessity to continue to monitor and reassess the patient as treatment proceeds.
Borum, R; Swartz, M; Swanson, J
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