Behavioral Treatment of Violent Psychiatric Patients

Wong, Stephen E.; Woolsey, James E.; Innocent, Antoine J.; Liberman, Robert Paul

doi:10.1016/s0193-953x(18)30470-2

Cited by 27 publications

(18 citation statements)

References 24 publications

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“…Behavioral interventions include (1) changing antecedent conditions that might elicit violent behavior, (2) positively reinforcing appropriate behavior, (3) reducing the positive reinforcement a patient might receive following a violent act (Corrigan, Yudofsky, & Silver, 1993;Morrison, 1993;Wong, Woolsey, Innocent, & Liberman, 1988), and (4) removing the patient to a less stimulating environment (Canatsey & Roper, 1997;Cahill, Stuart, Laraia, & Arana, 1991;Fagan-Pryor, Femea, & Haber, 1994). Most of the empirical support for behavioral methods of treatment is derived from research with chronic, low functioning mentally ill patients; highly aggressive, developmentall y delayed individuals ; children; or individuals with speci c disorders (e.g., sexual offenders) (Reiss & Roth, 1993;Rice, Harris, Varney, & Quinsey, 1989).…”

Section: Review Of the Literaturementioning

confidence: 99%

The Practices of Expert Psychiatric Nurses: Accompanying the Patient to a Calmer Personal Space

Johnson¹,

Hauser²

2001

Issues in Mental Health Nursing

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The focus of the care of potentially aggressive psychiatric patients has been on the use of seclusion and restraints. Recent concerns, however, about the potential for patient injury have made it imperative that nurses use alternative methods to calm patients who are escalating. Little is known about how expert nurses de-escalate the escalating patient. The purpose of this interpretive phenomenological study was to uncover and describe the knowledge embedded in the stories of psychiatric nurses who are skilled in the practices of de-escalating an escalating patient. Twenty registered nurses were interviewed using an unstructured format. The analysis of the data revealed that these nurses were skilled at noticing the patient, reading the situation and the patient, knowing where the patient was on the continuum, understanding the meaning of the behavior, knowing what the patient needed, connecting with the patient, and matching the intervention with the patient's needs.

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Section: Review Of the Literaturementioning

confidence: 99%

The Practices of Expert Psychiatric Nurses: Accompanying the Patient to a Calmer Personal Space

Johnson¹,

Hauser²

2001

Issues in Mental Health Nursing

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“…Disturbed behaviour is usually only noticeable at home during longer observation. However, stereotypes, restlessness, mutism, bizarre appearance, and lack of co-operation were commonly described by the clinic team who were well aware that violent behaviour in these patients can be treated by a variety of psychological and psychiatric interventions (Carlile, 1988;Wong, Woolsey, Innocent & Liberman, 1988). The present study, one of the first on this topic in South Africa, and one of the few documented in international research literature, could be replicated on greater numbers which would allow for the analysis of more data and possibly contribute to a better understanding of mutual interaction of many possible explanatory factors.…”

Section: Resultsmentioning

confidence: 99%

Cross-Cultural Indicators of Help-Seeking Behaviour in Aggressive General Hospital Patients

Schlebusch

Wessels

Rzadkowolsky

1990

South African Journal of Psychology

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In this study the authors researched cross-eultural identification of aggressive behaviour disturbances as identifying factors for patients' family members to seek professional help for the patients. Patients (N = 40), mainly Zulu-speaking were drawn from the outpatient clinic of a large academic general hospital. In all 23 (57,5%) of the patients and 25 (62,5%) of the relatives were urbanized. A comparison was made between what the patients' families considered problematic as opposed to formal professional diagnostic and aetiological considerations in the same patients. Several trends emerged from the results. It was demonstrated that the behavioural disturbances formed the most important set of identifying criteria for the family of the index patient. It held true for people in various stages of urbanization. Cognitive, mood and perceptual disturbances were of a lesser identifying value to families. Predictably, there were some differences between urban and rural families. Rural families were more attuned to the patient's problems but generally remained more tolerant of the aggressive behaviour and were less ready to seek professional help. These findings, some known from clinical observations and anecdotal communications, have seldom been objectively analysed -particularly in Africa. Implications for management, along with various related crosscultural issues, are discussed.In hierdie studie het die outeurs die kruis-kulturele identifikasie van aggressiewe gedragsverteurings nagevors as identifiserende faktore vir pasients se gesinslede om professionele hulp vir die pasianta te versoek. Pasisnta (N = 40), hoafsaaklik Zulusprekend, is geneem vanuit die buita-pasiente kliniek van 'n groat akademiese algemene hospitaal. 'n Totaal van 23 (57,5%) pasienta en 25 (62,5%) gesinslede was verstedelik. 'n Vergelyking is getref tussen wat die pasienta se gesinne as problematies beskou het teenoor formeIe professionele diagnostiese en etiologiese oorwegings in dieselfde pastente, Verskeie neigings is deur die resultate uitgelig. Dit is gedemonstreer dat die gedragsversteurings die belangrikste stel identifiseringskriteria vir die gesinne van die lndekspasiente was. Dit was die geval vir individue in verskeie stadia van verstedeliking. Kognitiewe, affektiewe en perseptuele versteurings was van minder identifikasie belang vir die gesinne. Soos voarspel kon word, was daar verskille tussen die verstedelikte en landelike gesinne. Landelike gesinne was meer ingestel op die pasienta se probleme, maar verdraagsamer teenoor die aggressiewe gedrag oar die algemeen en minder gewillig om professionele hulp te bekom. Die resultate, waarvan sommige bekend was a.g.v. kliniese observasies en anekdotiese kommunikasies, is nog seide objektief onteed veral in Afrika. Implikasies vir behandeling, sowel as verskeie kruis-kulturele aangeleenthede word bespreek.

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“…De plus, la soudaine avalanche d'attention et d'excitation émotionnelle pourrait renforcer le comportement agressif, rendant encore plus difficile son élimination à long terme. Trente années de données empiriques suggèrent une voie alternative viable ; ces données démontrent que, lorsqu'on organise les unités de traitement autour des principes comportementaux et de l'apprentissage social, l'agressivité et la violence chez la population des patients souffrant de psychose sont réduites (Paul et Lentz, 1977 ;Beck et al, 1991 ;Glynn et Mueser, 1992 ;Corrigan et al, 1993 ;Bellus et al, 1999 ;Wong et al, 1988 ;Ayllon et Azrin, 1968 ;Kazdin, 1982).…”

Section: Le Malade Hospitaliséunclassified

“…On a obtenu des résultats indiquant aussi une baisse sensible des comportements violents lorsqu'on a implanté le SLP chez des personnes souffrant de psychose chronique, et bénéficiant de services de psychiatrie légale (Beck et al, 1991). D'autres chercheurs ont rapporté les effets bénéfiques de l'économie de jetons sur les comportements agressifs (Liberman, 1978 ;Wong et al, 1988 ;Ayllon et Azrin, 1968), et de l'introduction systématique de comportements de remplacement par l'entremise d'un entraînement aux habiletés de vie autonome (Corrigan et al, 1993 ;Liberman, 1978 ;Wong et al, 1988 ;Frey et Weller, 2000 ;Wallace et al, 1973). Presque toujours, ces interventions sont jumelées à l'utilisation d'un temps d'arrêt du renforcement comme conséquence à un comportement agressif.…”

Section: Le Malade Hospitaliséunclassified

Traitement multimodal de l’agressivité et de la violence chez des personnes souffrant de psychose

Wilkniss

Hunter²,

Silverstein

2005

smq

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Dans cet article, les auteurs décrivent les traitements non pharmacologiques qui ont fait preuve d’efficacité pour réduire l’agressivité et la violence chez les personnes souffrant de psychose. Ils présentent ensuite une approche de formulation/planification du traitement qui aborde les influences étiologiques complexes, et les facteurs multiples qui jouent sur le maintien du comportement agressif chez ces patients. Finalement, ils présentent en exemple un cas où l’on se sert de cette approche.In this article, the authors offer a description of nonpharmacological treatments which have demonstrated effectiveness in reducing aggression and violence in patient with psychosis ; present a case formulation/treatment planning approach which addresses the complex etiological influences and multiple factors affecting maintenance of aggressive behavior in PI ; finally, they provide a case example of this approach.En este artículo, los autores describen los tratamientos no farmacológicos que han demostrado ser eficaces en la reducción de la agresividad y la violencia en las personas que sufren de psicosis. Enseguida, presentan un enfoque de formulación/planificación del tratamiento que aborda las influencias etiológicas complejas y los múltiples factores que tienen un efecto en el mantenimiento del comportamiento agresivo en estos pacientes. Finalmente, presentan como ejemplo un caso en el que se sirven de este enfoque.Neste artigo, os autores descrevem os tratamentos não farmacológicos que provaram ser eficazes para reduzir a agressividade e a violência nas pessoas que sofrem de psicose. Eles apresentam em seguida uma abordagem de formulação/planificação do tratamento que aborda as influências etimológicas complexas, e os fatores múltiplos que influenciam sobre a manutenção do comportamento agressivo nestes pacientes. Finalmente, eles apresentam o exemplo de um caso onde esta abordagem foi utilizada

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Behavioral Treatment of Violent Psychiatric Patients

Cited by 27 publications

References 24 publications

The Practices of Expert Psychiatric Nurses: Accompanying the Patient to a Calmer Personal Space

The Practices of Expert Psychiatric Nurses: Accompanying the Patient to a Calmer Personal Space

Cross-Cultural Indicators of Help-Seeking Behaviour in Aggressive General Hospital Patients

Traitement multimodal de l’agressivité et de la violence chez des personnes souffrant de psychose

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