Psychosocial approaches to violence and aggression: contextually anchored and trauma-informed interventions

被引:4
|
作者
Horowitz, Deborah [1 ]
Guyer, Margaret [2 ,3 ,4 ]
Sanders, Kathy [5 ,6 ]
机构
[1] Massachusetts Dept Mental Hlth, Off Training & Dev, Westborough, MA USA
[2] Massachusetts Dept Mental Hlth, Cent Off Res Review Comm, Boston, MA 02114 USA
[3] Massachusetts Mental Hlth Ctr, Div Publ Psychiat, Boston, MA 02115 USA
[4] Harvard Univ, Beth Israel Deaconess Med Ctr, Sch Med, Boston, MA 02215 USA
[5] Massachusetts Dept Mental Hlth, Clin & Profess Serv, Boston, MA 02114 USA
[6] Harvard Univ, Massachusetts Gen Hosp, Sch Med, Boston, MA USA
关键词
Aggression; prevention; psychosocial; trauma informed; violence; violence assessment; RISK; CHILDHOOD; OFFENDERS; BEHAVIOR;
D O I
10.1017/S1092852915000280
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Psychosocial interventions are part of the complex understanding and treatment of violent behavior in our state mental health hospitals. A comprehensive assessment of violence and aggression includes attention to all 3 domains of prevention and assessment (primary-institutional, secondary-structural, and tertiary-direct). Trauma experiences and their consequences may include behavioral violence and aggression. The authors' premise is that trauma is a universal component in the individual assessment of violent behavior. Therapeutic interventions must include a trauma-informed formulation to be effective. Organizational commitment to trauma-informed, person-centered, recovery-oriented (TPR) care is crucial to the efficacy of any of the interventions discussed. Thus, the dynamic nature of the individual, interpersonal, environmental, and cultural factors associated with the daily operations of the inpatient unit need to be assessed through the lens of primary and secondary violence prevention, building on the recognition that the majority of persons served and staff have significant trauma histories. Once a compassionate, respectful, empathic, and empowering approach is embraced by leadership and staff, the work with individuals can proceed more effectively. Interventions used include a variety of cognitive-behavioral, interpersonal, and somatosensory therapies. These interventions, when effectively applied, result in more self-esteem, self-mastery, self-control for the person served, and diminished behavioral violence.
引用
收藏
页码:190 / 199
页数:10
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