Safety Strategies

Strategies for Safety

It is important to consider your safety when working with any client population, but in particular with forensic clients. This client group can present as agitated, unpredictable, substance affected, volatile, chaotic, guarded, manipulative and defensive, which can lead to displays of aggressive behavior including verbal aggression with the possibility of physical violence. Whilst incidents of physical violence are extremely uncommon, verbal aggression and generally “unpleasant presentations” occur from time to time and it is important to consider how you would manage these types of clients/situations and most importantly how to keep yourself safe when working with this population.

Factors contributing to client’s aggressive behaviour:

• Feeling powerless or helpless
• Feeling angry, frustrated or hostile
• Feeling hurt or rejected
• Feeling intimidated or threatened
• Blaming self or others
• Struggling or feeling overwhelmed
• Not wanting to engage in treatment (wanting a way out)
• Attempting to regain control: Conscious or unconscious attempts to manipulate
• Being overly sensitive or insensitive
• Being under the influence of drugs, medication or alcohol

Managing aggressive clients:

• If a client is agitated or aggressive during the session remain calm and adopt a neutral facial expression and keep your voice and tone calm and controlled.
• Allow space for the client – (both space to speak and physical space)
• Ensure others are out of harm’s way – you may need to take the client to another space away from others
• If the client is agitated/aggressive and says they are going to leave the session, allow them to leave, do not try to make them stay.
• If the client stands up, do not also stand up as this could escalate their behaviour.
• Never confront a client verbally or physically.
• Always inform your supervisor or a senior staff member if you encounter an aggressive client as the situation will need to be managed and you should access debriefing.
• You may also need to complete a “Critical Incident report”, ask your supervisor (or senior staff member) for guidance around this.
• If the session is being delivered towards the end of the day or after hours, make sure you leave the office with another staff member. Allow at least 20 minutes after session closure to leave the building – you can use this time to pack up, debrief and prepare for the next session.

DR LASSO technique

DR LASSO is a de-escalation technique with seven core principles. The technique can be useful in several settings, such as when interacting with aggressive clients.

Danger                        Assess risk and safety
Relocate                     Consider moving to another safe space

Listen                          Active listening, show empathy, be genuine
Ask                              Determine what the problem is, and what they need
Summarise                 Demonstrate your understanding, and validate their feelings

Set Out Scope             Explain what you can do and what they can do
Offer Options              Describe some options and the rationale for them

Staff and Client Safety

The following approaches are recommended for agencies to consider when delivering programs to forensic clients, to maximise safety:

Visible Staff Presence

In addition to the AOD worker, it is important that participants are aware that there are other people in the building. Ensure that there is at least one other staff member present for the duration of the session, such as a receptionist or another clinician, and that they are seen by clients upon arrival. This person is also then able to respond should an incident occur, such as notifying other staff or police if necessary. You may also consider starting after-hours programs at 4:30pm when there are more people around.

Building Security

Consideration should be given to controlling building access when programs are running, especially for after-hours programs. The entrance door may be kept locked if a staff member is available to let people in when they arrive (including police). However, it will also be important that an agitated client is able to leave the building quickly if necessary. Implementing access control equipment may be considered, allowing secure entry without impeding people from exiting the building.  Some agencies may consider installing CCTV cameras in public spaces such as carparks, building entrances, reception areas and corridors where clients have access.

Duress Alarms

The installation of duress alarms in reception, counselling rooms and group program spaces will ensure a timely response if a situation escalates, and provide a sense of safety to staff delivering programs.

Maintain Visibility

Whilst counselling sessions are running, ensure that the counselling space remains visible to people outside, by keeping windows free from obstructions and blinds etc, so that any incident can be observed by other staff.

Keep Others Informed

If you are aware that a client has a history of aggressive or challenging behaviour, advise reception in advance so they can be ready to respond. Also let other staff know of your whereabouts when the session is being delivered.

Minimise Exposure to Others

Keep the door closed (or locked) between the counselling areas and the general staffing area, to maximise the safety of other staff and to avoid exposing them to incidents. If an incident is occurring, ensure that any other clients who are in the waiting room are moved to a safe space away from risk and exposure to the incident.

Communicate with Local Police

It is valuable when working with forensic clients to build a relationship with the local police. Let them know that you are working with this cohort and the times you will be delivering programs, particularly after-hours. Police should be advised of the lay-out and access points to your building. This can help ensure a timely and appropriate response should an incident occur.

Ensure staff are familiar with risk-management processes

Making sure that all staff are familiar with your agency’s risk-management policies and procedures is crucial to ensuring an appropriate and consistent approach to incidents should they occur. Having a safe space where staff can retreat in case of an emergency and developing an evacuation drill will help should an incident occur.

Restrict client access to personal information

Protecting your personal details (such as home address or phone number) – E.g. through registering as a silent voter and by using an alias on social media. Social media websites often change their privacy settings and even if private, you can be found through friends of friends and sent a direct message without permission. You can block specific people on social media where they aren’t able to contact you at all- this is something you might consider doing (find your client and block them).

Remove potential weapons.

Don’t have anything that could be turned into a weapon in the room (e.g., stationery, scarves, lanyards etc.). Install chairs that cannot be easily thrown or used as a weapon.