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A safer place to work preventing and managing violent behaviour in the Health workplace

Module 2 AMT002 Aggression minimisation in high-risk environments Facilitator manual

NSW Health is a zero tolerance zone

NSW DEPARTMENT OF HEALTH 73 Miller Street NORTH SYDNEY NSW 2060 Tel. Fax. (02) 9391 9000 (02) 9391 9101

TTY. (02) 9391 9900 www.health.nsw.gov.au

This work is copyright. It may be reproduced in whole or in part for study training purposes subject to the inclusion of an acknowledgement of the source. It may not be reproduced for commercial usage or sale. Reproduction for purposes other than those indicated above, requires written permission from the NSW Department of Health. NSW Department of Health 2003 SHPN (CMH) 030136 ISBN 0 7347 3557 X July 2003 updated August 2004

MODULE 2 Aggression minimisation in high-risk environments

ContentsAcknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Overview of the manual . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Modular structure of the aggression minimisation program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . How the manual is set out. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Facilitator preparation before training . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Sequence and timing of the modules . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Recognition of prior learning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Other resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 3 4 6 6 7 8

Introduction to Module 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 How Module 2 fits into the whole program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Assessment to Module 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NSW Health preventing and managing aggression in the Health workplace Assessment conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Assessment questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Self assessment checklist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Peer assessment checklist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Scenarios . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Session plan for Module 2 . . . . . . . . Materials. . . . . . . . . . . . . . . . . . . . . . . Equipment required. . . . . . . . . . . . . . . Participant requirement . . . . . . . . . . . . Beginning the training session . . . . . . . 1. Welcome participants to the module 2. Housekeeping. . . . . . . . . . . . . . . . . 3. Outline principles of adult learning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .................. .................. .................. .................. .................. .................. .................. . . . . . . . . . . . . . . . . . . . . . . 11 11 12 12 13 14 15 19 19 19 19 21 21 21 21

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Background information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23 Part 1 Working in high-risk environments. . . . . . . . . . . . . . . . . . . What are high-risk environments? . . . . . . . . . . . . . . . . . . . . . . . . . . . Why are they high-risk? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Zero tolerance approach to aggression . . . . . . . . . . . . . . . . . . . . . . . Some legal and ethical issues and scenarios in high-risk environments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 . . . . . . . . . . . . . . . . . 26 . . . . . . . . . . . . . . . . . 27 . . . . . . . . . . . . . . . . . 28 . . . . . . . . . . . . . . . . . 30

Part 2 Prevention in high-risk environments. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 Keeping your area secure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44 Some principles for recognising and dealing with unauthorised visitors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46 Working in the community and outreach environments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 Working in isolated areas. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53 How to maintain safety when approaching a person with the potential for aggression. . . . . . . . . . . . . . . . . . . . . . . . 54 Ensuring the safety of self and others when interviewing patients or others . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55 Part 3 Understanding aggression in high-risk environments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Triggers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Cycles of aggression . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Some possible responses at each stage of the aggression cycle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Self-control plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Part 4 Managing aggression in high-risk environments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Core values and skills . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Options when a person has been identified as being high-risk . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Short-term options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Long-term options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Strategies during hostage or armed hold-up situations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57 58 61 62 63

. . . . . 67 . . . . . 67 . . . . . 69 . . . . . 70 . . . . . 75 . . . . . 84

Related NSW Health policies and guidelines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89NSW HealthA safer place to work preventing and managing violent behaviour in the Health workplace Module 2 AMT002 Aggression minimisation in high-risk environments (Version 1) July 2003 updated August 2004

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MODULE 2 Aggression minimisation in high risk environments

AcknowledgmentsThis NSW Health violence prevention training program was developed by Brin FS Grenyer, Olga Ilkiw-Lavalle and Philip Biro from the Illawarra Institute for Mental Health. Mark Coleman provided assistance with the facilitator manuals and pilot workshops. The project was coordinated from the Violence Taskforce, Centre for Mental Health by Frances Waters. The members of the project contract steering committee who provided extensive guidance during the development of this project were Frances Waters (Violence Taskforce, Centre for Mental Health), Kathy Baker (Community & Extended Care Services and Nursing Services, Northern Sydney), Trish Butrej (Occupational Health and Safety, NSW Nurses Association), Maggie Christensen (Learning and Development, Central Coast), Nicole Ducat (Occupational Health and Safety, South E