This document discusses anger and violence management. It provides objectives around safety awareness and considering alternative responses to potentially dangerous situations. It examines reasons for violence including perceived control roles and societal factors. Causes of aggression are explored such as whether it is innate, learned, or driven by frustration. Predictive individual factors for violence like history of abuse or mental illness are outlined. The document provides tips for de-escalating situations through communication techniques, being aware of environmental and internal signals, setting limits, and allowing retreat.

1. Anger/Rage Management Part
1

2. Objectives
• To encourage you to be more alert to and
mindful of safety issues
• Provide information about how to detect the
potential for physical violence
• To consider alternative responses in potentially
dangerous situations
• To help understand the application of
communication skills in some situations of
potential danger
• To introduce safety awareness in the facility and
treatment process

3. Resons for violence
• Perceived role of “Control” for case
managers
• Negative preconceptions of counselors
• Increasing violence in society

5. • http://www.ksat.com/video/18428265/index
.html

6. Causes of Aggression/Violence
• Is violence inevitable to human beings?
• Is it a part of Human Nature?
• Is it learned?
• Is it an outcome of life’s frustrations?
• Is it driven by society?

7. Causes of Violence
• Aggressive impulses are innate and build
up if blocked
• Disequilibrium in power can trigger
violence
• Aggressiveness is socially learned and
rewarded
• Frustration leads to aggression

8. • Aggression can be initiated by human
need
• A single intervention won’t work
• “flexibly” consider varied ways of
responding
• Learning safety needs to be ongoing

9. Predictive individual factors
• History of violence
• Mental illness
– Substance abuse/dependence
– History of child abuse
– Various demographics
• Between 15 and 40
• Male
• Criminal history
• Military training
• Social isolation

10. • Isolated area of treatment center
• Patient history of violence
• Presence of many potential weapons
• Unknown patient
• Etc…

11. Predictive individual factors
• Clinicians who:
– Introspective < violence
• More safety conscious and non-blaming attitudes
– Authoritarian approach > violence
• Exacerbates feelings of powerlessness
– Gender
• Not shown to be a factor

17. Pushing Buttons
• Imagine there are no buttons to push – it’s
easy if you try
• The million dollar question 

18. Environmental signals
• Are there other patients who could get hurt
near by?
• Is there anyone who would serve as an
inciting audience?
• Are there any other staff members
available to assist you?
• Are there any obvious weapons?

19. Internal signals
• What are your own inner reactions?
• Do they give you any indication of
potential danger?

20. Person-in-Environment
• Association with Peers that may influence
me
• Peers as a source of “normalization” of
negative feelings

21. De-escalating verbal
communication
• Facilitate expressing feelings and thoughts
• Respond succinctly
• Encourage problem solving
• Redirect (changing the subject)

22. Other De-escalating techniques
• Be conscious of physical approach
• Mirror (opposite) Body Language
• Set Limits appropriately
• Equalize Relationship
• Personalize (self-disclosure)
• Stay calm and THINK
• Retreat
• Allow patient to retreat

23. Discuss
• When have you felt unsafe?
• What changes can La Hacienda make to
improve safety?