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Aggressive behavior and violence is a serious issue for psychiatric and alcohol and other drug treatment facilities. In most cases it is potentially predictable because of warning signs exhibited by patients. Often times, it is also evident that staff plays a very large part in the escalation or preferably the de-escalation of a crisis situation. It has been discovered that a relative lack of response by staff members to the violent acts of patients is of concern.   It is very important for staff to be trained to identify warning signs and act accordingly to avoid an intensification of negative behavior.

Aggression is more likely in persons with one or more of the following attributes:images-3

  • Greater degrees of intellectual disability;
  • Organic brain damage;
  • Sensory disabilities;
  • Difficulties in language;
  • Poor coping skills;
  • Poor problem-solving skills;
  • Limited social skills;
  • Weak or non-existing social support system;
  • Psychiatric disorders

With psychiatric and alcohol and other drug treatment populations you frequently have:

  • Limited social skills
  • Multiple legal and social problems and
  • A history of substance abuse

Each of these can exacerbate a tendency toward aggressive behavior.  None of these preclude the ability to diffuse the frustration and anger that is beginning.

Potential Triggers for Violent or Aggressive Behavior:

  • Recent relapse
  • Severe stress
  • Violent history
  • Social isolation
  • Significant loss or frustration (e.g. losing parental rights)
  • Receive a warning about their behavior
  • Believe they have been treated unfairly or disrespectfully
  • Failure to receive a privilege they expected or counted on
  • Have a hostile relationship with another client
  • Receive negative news (from courts or DCF)
  • Feel they have nothing to lose (total emersion into the present situation; nothing else matters)


Signs include:

  • Poor relationship with peers
  • Poor personal hygiene
  • Drastic changes in personality traits
  • Making threats of violence, getting back at someone, etc.
  • Intimidating others (bullying)
  • Getting very angry easily or often; loss of control
  • Using abusive language
  • Believing others are out to get him or her
  • Blaming others for their problems (playing the blame game)
  • Being rigid and inflexible (generally introverted)


Staff should avoid:

  • Letting threats go (Staff from the old school would often let the situation continue with a statement like they will outgrow this behavior pattern. History has proven this to be an incorrect approach as most individuals need professional help to change their attitude and behavior.
  • Ignoring aggressive behavior or warnings signs of aggressive behavior
  • Failure to report abnormal client behavior to other staff members
  • Failure to follow established rules and procedures
  • Treating clients deferentially (playing favorites)
  • Treating clients disrespectfully
  • Speaking in very loud or aggressive tones of voice
  • Expressing their own frustration to a client inappropriately
  • Ignoring client requests, frustrations or angry feelings
  • Staff awareness of client behaviors and coping styles; this information is key to identifying situations that could lead to aggressive behaviors.