VIOLENCE INCLINICAL PSYCHIATRY

VIOLENCE IN CLINICAL PSYCHIATRY

Patrick Callaghan - Nico Oud - Johan Håkon Bjørngaard Henk Nijman - Tom Palmstierna - Roger Almvik - Bart Thomas

Proceedings of the 8

European Congress on

“New horizons in interdisciplinary approaches”

Patrick Callaghan - Nico Oud - Johan Håkon Bjørngaard Henk Nijman - Tom Palmstierna - Roger Almvik - Bart Thomas

VIOLENCE IN CLINICAL PSYCHIA TRY

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Prof. Patrick Callaghan Mr. Nico Oud, MNSc Prof. Johan Håkon Bjørngaard Prof. Henk Nijman Prof. Tom Palmstierna Dr. Roger Almvik Mr. Bart Thomas, MSc

ISBN 978-90-574-0112-1

9 7 8 9 0 5 7 4 0 1 1 2 1

The 8

European Congress on Violence in Clinical Psychiatry is taking place in the stimulating, idiosyncratic and authentic city of Ghent.

People from all corners of the world will deliver papers, symposia and workshops, present posters and debate how ‘new and interdisciplinary approaches’ might transform the landscape of violence research, education and practice. The concerns the congress addresses will be of interest and signifi cance to people providing, using, developing and commissioning mental health and intellectual disability services, as well as the people who shape policies.

The congress showcases scientifi c advances in violence prevention,

reduction, risk and management and their application to specifi c

populations and topics. Leading international scholars who are

at the forefront of thinking on violence in clinical psychiatry, and

beyond, spearhead what promises to be a lively three days of making

discoveries about violence in clinical psychiatry, and making these

discoveries matter to people’s health and well being.

Prof. Johan Håkon Bjørngaard Prof. Henk Nijman

Prof. Tom Palmstierna Dr. Roger Almvik Mr. Bart Thomas, MSc

Editors

Violence in Clinical Psychiatry

Proceedings of the 8

European Congress on Violence in Clinical Psychiatry

23 – 26 October 2013

Gent ICC - international convention center

Van Rysselberghedreef 2 bus 1 - Citadelpark

Ghent, Belgium

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Preface

Despite progress in the care and treatment of mental health problems, the prevalence of violent incidents – verbal or physical aggression directed at self or others – remains high in many parts of the world.

Violence towards staff is an occupational and public health issue and a serious threat to health services’ attempts to deliver quality care. Violence injures patients and staff, loses health services money as staff take time off to recover from injuries, harms the relationship between patients and staff, and damages services’ therapeutic nature. Staff are essential resources in providing quality mental health care but when they encounter violence they can suffer prolonged damage to their quality of life, and become suspicious and hostile in their work. Exposure to violence is a pre-disposing factor in the development of Post-Traumatic Stress Disorder in many people.

Patients who witness violence on the ward are likely to abscond from fear, and may then be left untreated in the community with potential consequences of harm to themselves and others.

Violence is not just a problem for clinical services in psychiatry; it has major social, political, security and judicial implications.

Preventing violence, reducing its incidence and impact, managing its consequences and understanding how and why it manifests itself requires working across different disciplinary perspectives using the most up-to-date techniques and interventions and the best available evidence. Much is already known about violence in clinical psychiatry; much remains to be discovered. It is the latter of these issues upon which the 8^th European Congress on Violence in Clinical Psychiatry will focus.

The beautiful canal city of Ghent in Belgium is host to this year’s congress which sees a gathering of international academics, clinicians, managers and others with an interest in updating and sharing knowledge on the management of violence.

As the papers in these proceedings show, this year’s congress is truly international. People from all corners of the world will deliver papers, symposia and workshops, present posters and debate how ‘new and interdisciplinary approaches’ might transform the landscape of violence research, education and practice. The concerns the congress addresses will be of interest and significance to people providing, using, developing and commissioning mental health and intellectual disability services, as well as the people who shape policies.

For the first time the congress includes an expanded range of themes showcasing advances in the neurobiological, pharmacological, social, medical, psychological, cognitive and health sciences and their application to specific populations and topics. Presentations also reflect ethical and legal issues in addition to addressing racial, gender and ethnic perspectives.

We are honoured at this year’s congress to welcome some of the leading international scholars who are at the forefront of thinking on violence in clinical psychiatry and beyond. Adrian Raine’s recently published work examining ‘The Anatomy of Violence’ sheds new light on how brain structures may underpin an individual’s propensity to commit violent acts.

His contribution to the congress will challenge notions about the role of free will and responsibility in the manifestation of violence and has far reaching implications about how societies respond to violent offenders. This is likely to be of particular interest to another of our keynote speakers Kelly McLean, a Registered Nurse who will present what is certain to be a moving account of her recovery from a violent assault while working in a psychiatric emergency room.

Risk assessment is a widely used method of seeking to predict future violence with a view to preventing and minimising the occurrence of violence and managing people whose behaviour is deemed harmful. Henrik Belfrage’s work focuses on spousal violence risk assessment. The developer of the Brief Spousal Assault Form, Professor Belfrage examines the possibilities and pitfalls in spousal violence risk assessment and raises the question of which approach might be most useful.

Restraint is a common method of managing violence in mental health settings. However, evidence shows that restraint has led to the death of patients on too many occasions. Joy Duxbury, chair elect of EVIPRG – the European Violence in Psychiatry Research Group – is one of the UK’s leading mental health nursing researchers and led a review of restraint- related deaths for the English Department of Health. Joy shares her insights gleaned from this review that will hopefully lead to practice changes that will eradicate these avoidable deaths.

The keynotes papers conclude with three speakers from Belgium, this year’s host country.

Kris Goethals discusses the role of uncontrollable sexual behaviour on violence, while Kurt Audenart examines how brain imaging studies in animals and humans help us understand the use and effect of serotonergic drugs in impulsive and aggressive patients. Christian Decoster from the Belgium Ministry of Health is a key player shaping national policy on violence in health settings. He will share his insights on the measures required to care for interned and other populations.

It seems apt that the 8^th European Congress on Violence in Clinical Psychiatry is taking place in the stimulating, idiosyncratic and authentic city of Ghent. We can think of no better setting for a lively three days of making discoveries about violence in clinical psychiatry, and making these discoveries matter to people’s health and well being.

Professor Dr. Patrick Callaghan, School of Health Sciences, University of Nottingham, UK Dr Roger Almvik, Director of Research, St Olav’s Hospital, Trondheim, Norway and Chair of the European Violence in Psychiatry Research Group

Supporting Organisations

The Congress organisation committee cordially thanks the following organisations for their support:

• European Violence in Psychiatry Research Group (EViPRG)

• Altrecht Aventurijn

• CONNECTING, partnership for consult & training

• Karolinska Institute

• British Institute for Learning Disabilities (BILD)

• World Psychiatric Association (WPA) Section on Art and Psychiatry

Section on Psychiatry and Intellectual Disability Section on Stigma and Mental Illness

• Universitair Ziekenhuis Gent

• Vlaamse Vereniging voor Geestelijke Gezondheid (VVGG)

• Ghent University

• Psychiatrisch Centrum Dr. Guislain

• Universitair Forensisch Centrum (UFC)

• St. Olavs Hospital, Trondheim University Hospital

• Geestelijke Gezondheidszorg Westelijk Noord-Brabant (GGZ WNB)

• The University of Nottingham

• Vlaamse Vereniging voor Psychiatrie

• Zorgnet Vlaanderen

• The Mandt System

• The Psycho-Fysical Consultants

• Kudding & Partners B.V.

• National Institute for the Prevention of Workplace Violence, Inc

The Scientific Committee

Prof. Tom Palmstierna (Sweden) (chair) Prof. Henk Nijman (Netherlands) (chair) Dr. Hulya Bilgin (Turkey)

Prof. Tilman Steinert (Germany) Prof. Richard Whittington (UK) Prof. Dirk Richter (Switzerland) Dr. Mojca Dernovsek (Slovenia) Dr. Brodie Paterson (UK) Dr. Joy Duxbury (UK) Prof. Stål Bjørkly (Norway) Dr. Denis Ryan (Ireland) Prof. Seamus Cowman (Ireland) Prof. Sabine Hahn (Switzerland) Dr. Mary E. Johnson (USA) Prof. Patrick Callaghan (UK) Dr. Roger Almvik (Norway)

Ass. Prof. Lars Kjellin (Sweden) Prof. Kris Goethals (Belgium)

Mr. Bart Thomas (Belgium) (local chair) Prof. Sofie Verhaeghe (Belgium) Dr. Liselotte Pedersen (Denmark) Dr. Marie Trešlová (Czech Republic) Dr. Chris Bervoets (Belgium) Dr. Rok Tavcar (Slovenia)

The Organisation Committee

Mr. Nico Oud, MNSc, N.Adm, RN. (Netherlands) (Oud Consultancy – Congress Organiser) Prof. Patrick Callaghan (UK) (Main editor of the proceedings)

Prof. Johan Håkon Bjørngaard (Norway) (Abstract review manager) Prof. Kris Goethals (Belgium) (Local representative)

General scientific remark

Occasionally the congress organization receives queries – especially from academic institutions – regarding the procedure for the selection of abstracts to be presented at the congress. Each abstract is submitted for peer review to members of the International Scientific Committee. Each abstract is anonymously adjudicated by at least three members of the committee. Abstracts are evaluated according to the following criteria:

• relevance to the conference theme,

• interest to an international audience,

• scientific and/or professional merit,

• contribution to knowledge, practice, and policies, and

• clarity of the abstract

Following the evaluation of each submission, the Organization Committee assesses the merit of each individual abstract and deliberates on the acceptance, the rejection or – occasionally – on provisional acceptance pending amelioration of the abstract. On applying this procedure, the Organization Committee endeavours to do justice to all submitters and to the Congress participants, who are entitled to receive state of the art knowledge at the Congress.

In total we did receive 307 abstracts from 52 different countries worldwide, of which 50 (16%) were rejected, 32 (10%) were withdrawn mainly due to financial reasons or not getting funding in time, and 54 (18%) were not included in the program and the proceedings due to not registering after all or not paying the fees in time. Together with the pre-congress workshops, keynotes and special workshops in total 201 presentations from 28 different countries worldwide were presented.

Content

Chapter 1 – Pre-Congress Workshops. . . . 27

Chapter 2 – Keynote speeches. . . . 39

Chapter 3 – Special Workshops. . . .55

Chapter 4 – Advances in epidemiology, nature and cross-cultural aspects. . . .56

Chapter 5 – Advances in neurobiological approaches and pharmacological therapies. . . .73

Chapter 6 – Advances in psychological therapies . . . . 82

Chapter 7 – Application of new technology . . . .89

Chapter 8 – Ethical and legal perspectives . . . .99

Chapter 9 – Innovative strategies for reducing coercive measures. . . .131

Chapter 10 – New directions in the assessment of risk, prevention & protective factors . . . .161

Chapter 11 – Other related themes . . . .240

Chapter 12 – Race, gender & ethnicity perspectives. . . .285

Chapter 13 – Service users and family perspectives. . . .286

Chapter 14 – Sexual offending & aggression . . . .292

Chapter 15 – Specific populations: child & adolescent . . . .326

Chapter 16 – Specific populations: elderly . . . .346

Chapter 17 – Specific populations: forensic. . . .347

Chapter 18 – Specific populations: intellectually disabled . . . .402

Chapter 19 – Training and education of interdisciplinary staff. . . .430

Index of Names. . . .474

Index of Keywords . . . .477

Announcement. . . .479

Supporting Organisations. . . .480

Preface . . . .5

Chapter 1 – Pre-Congress Workshops

Recognition Method. . . .27 Frans Fluttert

The Netherlands

Assessment of protective factors for violence risk: The SAPROF. . . .28 Ellen van den Broek, Vivienne de Vogel & Michiel de Vries Robbé

Van der Hoeven Kliniek, Utrecht , The Netherlands

Violence in the workplace: An endemic but not an inevitable problem of 21^st

century healthcare delivery. . . .31 David Jones

United Kingdom

Improvement of risk assessment and risk management in violent youth using the SAVRY35 H.P.B. Lodewijks

The Netherlands

Chapter 2 – Keynote speeches

Department of Criminology, Mid Sweden University, Department of Medical and Health Sciences, Linköping University, Faculty of Psychology, University of Bergen, Sweden Assaulting behavior: A personal story about the violence no one should

experience at work. . . .42 Kelly R. McLean

Erie County Medical Center, Buffalo, New York, USA

Compulsive Care: Measures taken in regard to people who have been interned

and others in need of care . . . .43 Mr. Christiaan Decoster

Ministry of Health, Belgium

Neurobiology of aggressive behaviour: about wild horses and reins. . . .44 Prof. Dr. Kurt Audenaert

Universitair Ziekenhuis, Belgium

The Anatomy of Violence: The Biological Roots of Crime. . . .45 Adrian Raine

Departments of Criminology, Psychiatry and Psychology, University of Pennsylvania, USA

A review of theories of restraint-related deaths in the UK . . . .46 Professor Joy Duxbury, Fran Aiken, Dr Colin Dale

School of Health, University of Central Lancashire, Preston, Lancashire, United Kingdom

Does hypersexuality exist?. . . .51 K.R. Goethals

University Forensic Centre, Antwerp University Hospital, Belgium;

Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Belgium;

Mental Health Care Westelijk Noord-Brabant, Halsteren, The Netherlands.

Chapter 3 – Special Workshops

Coercive World . . . .55 Bob Bowen

University of Rochester School of Medicine and Dentistry in Rochester, New York, USA Supporting People with Complex Behavioural Profiles: Integrating Neurosensory, Psychological, and Behavioural Methodologies to Support People, Not Just Their

Behaviours. . . .55 Bob Bowen

University of Rochester School of Medicine and Dentistry in Rochester, New York, USA

Chapter 4 – Advances in epidemiology, nature and

cross-cultural aspects

1. Biomedical Computing and Engineering Technologies (BIOCORE) Applied Research Group, Health Design Technology Institute and Faculty of Engineering & Computing, Coventry University Technology Park, Puma Way, Coventry CV1 2TT, United Kingdom.

2. Department of Epidemiology and Community Health, University of Ilorin, P.M.B 1515, Ilorin, Nigeria.

Assessment of the Risk Factors Affecting Intimate Partner Violence in Nigeria . . . .61 L. Olayanju¹, R.N.G. Naguib¹, Q.T. Nguyen¹, R.K. Bali¹ and O.O. Kayode²

1. Biomedical Computing and Engineering Technologies (BIOCORE) Applied Research Group, Health Design Technology Institute and Faculty of Engineering & Computing, Coventry University Technology Park, Puma Way, Coventry CV1 2TT, United Kingdom.

2. Department of Epidemiology and Community Health, University of Ilorin, P.M.B 1515, Ilorin, Nigeria.

Focus on India (90 minute workshop) . . . .66 Peter Lepping, BN Raveesh, Murali Krishna, Srinivas VN Lanka, Stephen ERS Stanaway &

Jim Turner

United Kingdom / India

Mental illness and violence: a comparison between formely and never violence

patients living in residential facilities . . . .68 Giovanni de Girolamo, Valentina Candini, Chiara Buizza, Maria Elena Boero, Clarissa

Ferrari, Gian Marco Giobbio, Stefania Greppo, Paolo Maggi, Anna Melegari, Giuseppe Rossi IRCCS “St. John of God” Fatebenefratelli, Brescia, Italy

Violence against schizophrenic women: a review. . . .72 Sami Richa, Ramzi Haddad

Hôtel-Dieu de France - Université Saint Joseph de Beyrouth, Beirut, Lebanon

Chapter 5 – Advances in neurobiological approaches and

pharmacological therapies

Akane Yoshikawa, Tadashi Umekage, Tsukasa Sasaki Chubu University, Kasugai City, Japan

Neuropsychological Features and Psychosocial Backgrounds among

Schizophrenia Patients with a History of Serious Violence in Japan. . . .74 Hiroko Kashiwagi, Noriomi Kuroki, Naotugu Hirabayashi, Manabu Ikeda

Ku Mamoto University, Kumamoto, Japan

Do we need guidelines in rapid tranquilisation? A survey of prescribing

preferences in Belgian psychiatrists and emergency doctors . . . .76 Chris Bervoets ^1,2, Jürgen De Fruyt ³, Hella Demunter ⁴, Barry Dekeyser ⁵, Leen

Vandenbussche ⁶, Koen Titeca ⁶, Guido Pieters ^4,5, Bernard Sabbe ^2,7, Manuel Morrens ^2,8 1. University Antwerp, CAPRI. 2. PZ OLV, Brugge. 3. AZ Sint Jan Brugge. 4. UC Kortenberg.

5. AZ Sint Elisabeth, Lier. 6. AZ Groeninge, Kortijk. 7. PZ Sint Norbertus Duffel. 8. PZ Boechout; Belgium

Chapter 6 – Advances in psychological therapies

Orygen Research Centre University of Melbourne, Psychiatry Centre for Youth Mental Health, Carlton North Victoria, Australia

Streetwise, Self-wise, Other-wise: A novel intervention to diminish victimisation in psychiatric patients with substance use disorders . . . .85 Anneke E. Goudriaan, Marleen M. de Waal, Rien Van, Tatijana Malesevic, Jan Neleman,

Martijn Kikkert, Liselotte de Mooij, Matthijs Blankers, Jack J. Dekker Academic Medical Center, University of Amsterdam, The Netherlands

Anger Treatment: Case Formulation and the Stress Inoculation Approach. . . .88 John L Taylor, Raymond W Novaco

Psychological Services, Morpeth, United Kingdom

Chapter 7 – Application of new technology

Wang Long Li¹, Elke Daemen¹

1. Philips Research, Brain, Body and Behavior Department, Eindhoven, The Netherlands. 2.

GGzE, Eindhoven, The Netherlands. 3. Professional Services, Philips Healthcare, Eindhoven, The Netherlands.

Creating a User Interface for staff to control ambient healing environments in

acute psychiatric wards . . . .93 Tess Speelpenning¹, Marjolein van der Zwaag¹, Murray Gillies¹, Erik Kuijpers², Cor Datema³

1. Philips Research, Eindhoven, The Netherlands. 2. GGzE, Mental Healthcare institute, Eindhoven, The Netherlands. 3. Professional Services, Philips Healthcare, Eindhoven, The Netherlands.

The feasibility of implementing Internet-based interventions for psychosis,

violence risk assessment, and anger management within mental health services. . . .98 Mr Ove K. Lintvedt

St Olavs Hospital, Tronsheim, Norway

Chapter 8 – Ethical and legal perspectives

“Zero Tolerance” of violence in mental health care: practice guidance in Scotland . . . .99 Donald Lyons

Mental Welfare Commission for Scotland, Edinburgh, United Kingdom

Overvaluing autonomy. . . .103 Peter Lepping & BN Raveesh

Centre for Mental Health and Society, Wrexham Academic Unit, Wrexham, United Kingdom Violence as Event: What does it mean and for whom? A review of the

anthropological literature . . . .104 Piyush Pushkar

Manchester, United Kingdom

Factors associated with the perception of Angry and Aggressive Behavior among

psychiatric nursing staff . . . .108 Hanna Tuvesson RN, PhD

School of Health Science, Blekinge Institute of Technology, Karlskrona, Sweden Reporting violence in psychiatry to the police or not; research on the

decisive factors. . . .112 J.M. Harte* & M.E. van Leeuwen**

*VU University Amsterdam, Department of Criminal Law and Criminology, The Netherlands

**Inforsa, Hospital for Intensive and Forensic Psychiatry, part of Arkin Amsterdam, The Netherlands

Mental Health Nurses’ Experiences of Patient Assaults. . . .116 Maria Baby

Department of Psychological Medicine, University of Otago, New Zealand Southern District Health Board, Dunedin, New Zealand

Mental Health Nurses’ Experiences of Patient Assaults. . . .121 Maria Baby

University of Otago, Psychological Medicine, Christchurch, New Zealand

Strengthening the Pavement of Good Intentions: Ethical and Legal Implications

of Restraint and Seclusion Strategies . . . .122 Bob Bowen, Adjunct Assistant Professor of Psychiatry, University of Rochester Medical

Center, NY, USA

Pat Risser, Mental Health Consultant and Advocate, USA

The Place of Ethics in Mental Health Nurses’ Clinical Judgment in the

Use of Seclusion . . . .126 Isabelle Jarrin, Marie Edwards, Elaine Mordoch

Health Sciences Centre, Winnipeg, Canada

The Place of Ethics in Mental Health Nurses’ Clinical Judgment in the

Use of Seclusion . . . .127 Isabelle Jarrin, Marie Edwards, Elaine Mordoch

Health Sciences Centre, Winnipeg, Canada

Impact of prosecution for violence in hospital on the continuing rate of violence

and on staff safety . . . .128 Dr Kevin Murray, Clinical Director, Broadmoor Hospital, England

Mr Matthew Wilding, Security Liaison Nurse Manager, Broadmoor Hospital, England Detective Constable Jayne Payne, Thames Valley Police, Hospital Liaison Officer, Broadmoor Hospital, England

Chapter 9 – Innovative strategies for reducing coercive

measures

for Safety’ . . . .131 Natalie Hammond, Amanda Pithouse

South London and Maudsley NHS Foundation Trust, London, United Kingdom

The effect of physical space on aggression in psychiatry . . . .133 Thijs Beckers & André Merks

RiaagZuid, Schinveld, The Netherlands

Successful Seclusion & Restraint Reduction in a Large Civil & Forensic Mental

Health System 2000-2010 . . . .136 Gregory M. Smith, Alexandria A. Windcaller

Response Training Programs LLC, Shutesbury, Massachusetts, USA

Psychiatric Use of Unscheduled Medications in the Pennsylvania State Hospital

System: Effects of Discontinuing the Use of P.R.N Orders . . . .137 Gregory M. Smith, Robert H. Davis, Aidan Altenor, Dung P. Tran, Karen L. Wolfe, John A.

Deegan, Jessica Bradley, Pennsylvania State Hospital System, Pennsylvania Department of Public Welfare, Pennsylvania, USA

The Psychiatric Emergency Response Team Process: A Non-Violent Approach to

Supporting People in Crisis . . . .138 Gregory M. Smith, Alexandria A. Windcaller

Response Training Programs LLC, Shutesbury, Massachusetts, USA

The Safewards Model and Cluster RCT. . . .139 Duncan Stewart, Len Bowers

Institute of Psychiatry, Health Service and Population Reserach, London, United Kingdom

National guideline for physical restraint in the Netherlands. . . .140 Hamp Harmsen

GGZ Nederlands, Amersfoort, Netherlands

A new managed care model in emergency psychiatry: The Crisis Response

Center of Tucson, Arizona, U.S.A. . . .141 Virgil Hancock MD, MPH

Tucson, Arizona, USA

No more solitary confinement! One to one guidance to restore connection with

the patient during coercion and confinement. . . .145 Minco Ruiter

KIB/LIZ Inforsa, Arkin, Amsterdam, The Netherlands

Specialists in de-escalation: the de-escalation supporter. . . .146 Minco Ruiter

KIB/LIZ Inforsa, Arkin, Amsterdam, The Netherlands

Leading the Way: How an Organization’s Leadership Promotes Least

Restraint in a Canadian Psychiatric Hospital . . . .149 Isabelle Jarrin, Debbie Frechette, Patrick Griffith

Health Sciences Centre, Winnipeg, Canada

Leading the Way: How an Organization’s Leadership Promotes Least

Restraint in a Canadian Psychiatric Hospital . . . .150 Isabelle Jarrin, Debbie Frechette, Patrick Griffith

Health Sciences Centre, Winnipeg, Canada

Reducing the time patients spend in seclusion at a Medium Secure Unit (MSU) In the North West of England; Utilizing a ‘Human Factors’, approach to inform

decision making . . . .151 Anthony Crumpton, Carl Edwards, Anne-Marie Begg, Louise Owen, Ian Wyatt, Mark Birch

Prescot, Merseyside, United Kingdom

Conflict Management Program: Fidelity Scale in Psychiatric Care . . . .152 Elizabeth Wiese-Batista Pinto, Simone Vlek, Thom Piethaan, Chantal de Koning,

Marnou van den Berg, Carina Bruin, Laurens van Gestel, Irma Janssen, Wendy van Vlerken, Daida Voorneman, Josephine Zelleke & Ernest Franken.

University College Roosevelt, Honors College of Utrecht University, The Netherlands International seclusion figures, literature and conditions for international

comparisons. . . .156 Wim Janssen

Altrecht Aventurijn, Den Dolder, The Netherlands

The use of a swaddle as an alternative in reducing the number of fixations

at seclusions. . . .157 Erik Van Tilburg

PC Sint Amedeus, Mortsel, Belgium

Does a Patient-Directed Admission Process Reduce Violence?. . . .158 Michael Polacek, MSN, BSed, RN, Lori Kessler, BSRN, RNC

Salem Health, Psychiatric Medicine Center, Salem, USA

Nurses’ intuition as an explanatory variable for the length of restraint . . . .159 Eila Sailas, Nina Lindberg, Raija Kontio, Hanna Putkonen, Päivi Soininen, Toshie Noda,

Grigori Joffe

Kellokoski Hospital, Kellokoski, Finland

'You don’t Know What You’re Doing'. The governance of training in the prevention and management of violence and aggression as an approach to

reduce coercive strategies in forensic settings. . . .160 Colin Dale & Christopher Stirling

Lancashire, United Kingdom

Chapter 10 – New directions in the assessment of risk,

prevention & protective factors

Modena, Italy

Dark Knights: Donning the Archetype. . . .163 Brian Van Brunt, Ed.D.

The NCHERM Group, Malvern, Pennsylvania, USA

The Structured Interview for Violence Risk Assessment (SIVRA-35). . . .167 Brian Van Brunt, Ed.D.

The NCHERM Group, Malvern, Pennsylvania, USA

Institutional Risk Processes for Violence: Institutions Viewed through the PRISM . . . .172 David Cooke

Glasgow, United Kingdom

The incremental validity of a bio-psycho-social approach for violence

risk assessment . . . .173 John Olav Roaldset, Aalesund Hospital, More and Romsdal Health Trust. Centre for Research

and Education in Forensic Psychiatry, Oslo University Hospital. The Norwegian University of Science and Technology, Norway

Stål Bjørkly, Centre for Research and Education in Forensic Psychiatry, Oslo University Hospital. Molde University College, Norway

Nurses’ contribution to prevent seclusion in acute mental health care – a

prognostic study protocol . . . .177 Paul Doedens, RN^a

Jolanda Maaskant, RN MSc^b

a. Department of Psychiatry, Academic Medical Centre, The Netherlands

b. Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Medical Faculty, Academic Medical Centre and University of Amsterdam, The Netherlands

‘The conversation room’ experience with reducing coercive measures . . . .181 Bjarne Dahl, Thor Egil Holtskog

Regional Sikkerhetsavdeling RSA, Oslo University Hospital, Asker, Norway Facial Emotion Recognition and Crime Trends in Patients with Bipolar

Affective Disorder . . . .182 Husrev Demirel, Dilek Yesilbas, Erhan Yuksek, Ismail Ozver, Suheyla Aliustaoglu, Murat Emul

Istanbul, Turkey

Translation of risk assessment to risk management:challenges and solutions. . . .184 Ellen van den Broek, Michiel de Vries Robbé, Vivienne de Vogel

Van der Hoeven Kliniek, Utrecht, The Netherlands

Violence on the ward: Characteristics of mental health professionals who

have an increased risk of becoming victims of inpatient violence. . . .185 M.E. van Leeuwen, Inforsa, Hospital for Intensive and Forensic Psychiatry, part of Arkin

Amsterdam

J.M. Harte, VU University Amsterdam, Department of Criminal Law and Criminology, The Netherlands

Violence risk assessment in women: Results from a Dutch multicentre study . . . .190 Vivienne de Vogel, Jeantine Stam, Eva de Spa, & Michiel de Vries Robbé

Van der Hoeven Kliniek, Utrecht, The Netherlands

Using the SOAS-R scale in the Psychiatric Department of the Lausanne University

Hospital (DP-CHUV): lessons and limits after five years . . . .193 Didier Camus, Mehdi Gholam-Rezaee, Nicolas Kühne, Jean-Philippe Duflon, Jean-Michel

Kaision, Valérie Moulin.

CHUV, Psychiatric Department, Vevey, Switzerland

The importance of analysing aggression incidents for preventing violence: using

a pack of cards based on PRISM . . . .198 Katrien de Ponti MSc

Dutch Association for Mental Health and Addiction Care (GGZ Nederland ), Amersfoort, The Netherlands

Relationship between the incidence of violence in emergency medical services

and type of assistance provided . . . .202 Maria Dolores Piqueras Acevedo, Juan J. Gascón Cánovas, José Mª Salcedo-López, Carles

Iniesta-Navalón, Gustavo Granados-Paucar, Pascual Piñera-Salmerón, Nico Oud, Antonia Gallardo-Robles, María J. Sánchez-Carrasco

Universidad de Murcia, Murcia, Spain

Kennedy Axis V: clinimetric properties assessed by mental health nurses. . . .203 Margo D.M. Faay, MSc, RN., Roland van de Sande MSc, RN., Floor Gooskens, MSc, RN.,

Thóra B. Hafsteinsdóttir PhD, RN.

Division of neurosciences, Department of Psychiatry, UMC Utrecht, The Netherlands Dynamics in risk assessment: change in risk and protective factors

during treatment. . . .205 Michiel de Vries Robbé, Vivienne de Vogel, & Ellen van den Broek

Van der Hoeven Kliniek, Utrecht, The Netherlands

Development of Combined Assessment of Psychiatric Environments

(CAPE) Profiles – Psychiatric Inpatient Version . . . .207 Mary E. Johnson, PhD, RN, PMHCNS-BC, FAAN, Kathleen R Delaney, PhD, RN,

PMHNP-BC, FAAN Evanston, IL, USA

Prevention of violence in psychiatric inpatient care – aspects of ethics and safety

in encounters with patients. . . .209 Lars Kjellin, Veikko Pelto-Piri

Psychiatric Research Centre, Örebro, Sweden

Prediction and prevention of violent recidivism through risk assessment with

the Short Term Assessment of Risk and Treatability (START). . . .211 N.A.C. Troquete¹*, R.H.S. van den Brink¹, H. Beintema², T. Mulder³, T.W.D.P. van Os⁴, R.A.

Schoevers¹ & D. Wiersma¹

1. University Center for Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. 2. Mental Health Organisation Lentis and Forensic Psychiatric Clinic dr S. van Mesdag, Groningen, The Netherlands. 3. Mental Health Organisation Drenthe, Assen, The Netherlands. 4. Mental Health Organisation Friesland, Leeuwarden, The Netherlands

An exploration of the broader and applied concept of clinical aggression across a spectrum of healthcare and related settings: translating measurement,

prevention and management evidence into practice. . . .213 Joy Duxbury, Sabine Hahn, Bridget Hamilton, Sanaz Riahi, Marie Gerdzt

England

Prevalence and precipitants of aggression among psychiatric inpatients in

Alexandria: An exploratory Study. . . .215 Dalia Nagui Moheieldin, Hoda Salama, Ossama El Kholy, Heba Essam Abo Elwafa

Alexandria University, Faculty of Medicine, Alexandria, Egypt

‘Development of a Training DVD for analysis of incidents of violence

and aggression’ . . . .216 Joanne Skellern; Andrew Lovell

University of Chester, Faculty of Health and Social Care, Chester, United Kingdom

Psychiatric patients need a more active role in managing their own aggression. . . .219 Marja de Schutter, Hein Lodewijkx

Curamus, Medical and Paramedical Services, Hulst, The Netherlands

Prospective Validity of the Structured Assessment of Protective Factors (SAPROF)

Instrument for Violence . . . .224 Alina Haines, Richard Whittington, Andrew Brown, Stephen Noblett, Taj Nathan

University of Liverpool, Liverpool, England

Using the checklist ‘V-RISK-10’ to identify future risk of violence in both

psychiatric and dependency disorders emergency units. . . .225 Charlotte Pollak, Christina Holmén, Tom Palmstierna

Karolinska Institutet, Klinisk Neurovetenskap, Stockholm, Sweden

Assessing aggression risks in patients of the ambulatory mental health

crisis team . . . .227 E. Penterman, H. Nijman.

GGZ Oost Brabant, Veghel, The Netherlands

All things being equal? Predictive validity of the HCR-20 among heterogeneous

groups of secure psychiatric inpatients. . . .230 Prof Geoffrey Dickens ^1,2, Laura O’Shea ¹, Dr Fiona Mason ¹, Dr Marco Picchioni ¹

1. St Andrew’s Academic Centre, King’s College London Institute of Psychiatry, Northampton, United Kingdom. 2. School of Health, University of Northampton, Northampton, United Kingdom.

Assessment and treatment of aggressive behavior in an emergency context requires an interdisciplinary approach: Emergency doctors and psychiatrists in

acute agitation; birds of a feather?. . . .231 Hella Demunter, Chris Bervoets, Jürgen De Fruyt, Andy Dewitte, Koen Titeca, Joris

Vandenberghe

UPC KU Leuven, Kortenberg, Belgium

Dynamic relationship between multiple START assessments and violent incidents

over time. . . .232 Richard Whittington, Johan Håkon Bjørngaard, Andrew Brown, Rajan Nathan & Stephen

Noblett

University of Liverpool, Institute of Psychology, Health & Society, Health Services Research, Liverpool, United Kingdom

Using research findings to develop and implement caring modalities for nursing

staff following violent episodes . . . .234 Staci Curran, Lee Bransky, Christopher Coleman, Mary Ann Zeserman

Belmont Behavioral Health, Philadelphia, USA

Violence Prevention in a Psychiatric Unit . . . .236 Ramzi Haddad, Sami Richa, Michelangelo Aoun, Elyssar Chbeir, Wadih Naja

Hôtel-Dieu de France - Université Saint Joseph de Beyrouth, Beirut, Lebanon Structured short term risk assessment and caring for patients in crisis – An overview of empirical research and risk management practice development in

acute psychiatric wards in the Netherlands . . . .237 Mr Roland van de Sande, Henk Nijman, Eric Noorthoorn, Andre Wierdsma, Edwin

Hellendoorn, Cees van der Staak, Niels CL Mulder

Hogeschool Utrecht, University of Applied Science, The Netherlands

Chapter 11 – Other related themes

group therapy. . . .240 Nellie Visantiadou

Hellenic Center for Psychodrama, Psychotherapy Deparment, Thessaloniki, Greece

250 Years of psychiatric diagnoses and violent behavior. . . .242 Virgil Hancock MD, MPH

Tucson, Arizona, USA

Potential Lethality of Restraint In Seated Positions: Case Examples And

Experimental Measurement Of Lung Function. . . .246 John Parkes, Coventry University, United Kingdom

Co-authors of laboratory research: Doug Thake, Mike Price, Coventry University, United Kingdom

Project for the reduction of staff injuries caused by patient aggression. . . .248 Valerie Isaak, PhD, Hava Kostisky, MA, RN, Dor Bar-Noy, MA, RN, Shmuel Hirschmann, MD,

MPA, LLB, Alexander Grinshpoon, MD, PhD, MHA, Israel

Psychiatric nurses’experiences with anger and social support in Japan. . . .254 Naoko Shibuya, Risa Takahashi

Chubu University, Kasugai City, Japan

The Causes of Violence Applied to Health Personnel Working at Family Health

Centers as reported by Patients/ Families. . . .256 Havva Öztürk, Elif Babacan

Trabzon, Turkey

The Causes of Violence directed at Health Personnel Working at Community

and Family Health Centers . . . .258 Havva Öztürk, Elif Babacan

Trabzon, Turkey

Does a Patient-Directed Admission Process Reduce Violence?. . . .260 Michael J Polacek, MSn, RN and Lori Kessler, BSRN, RNC

250 years in the psychiatric mangement of violent behavior. . . .264 Virgil Hancock MD, MPH

Tucson, Arizona, USA

The Mental Machine – Perspectives on High Security Asylums in the 20^th Century . . . .269 Øyvind Thomassen, Hilde Dahl, Eivind Myhre

Broset Centre for Research and Education in Forensic Psychiatry, Trondheim, Norway Routine recording of inpatient aggression: challenges, solutions and experiences

from a large treatment facility after 6 years of recording aggressive incidents. . . .270 Klaus Drieschner

Boschoord, The Netherlands

From Building to Body; predicting aggression on different levels. . . .271 Prof. dr. Henk Nijman, Drs. Floor van Dijk, Dr. Eric Noorthoorn, Altrecht Aventurijn, Den

Dolder, The Netherlands, Drs. E. Kuijpers, The Netherlands, Drs. A. Bousardt, GGNet, The Netherlands

Clear communication and procedures at admission or transfer: procedural

differences between countries and what we may learn from another over countries? . . . .274 E.O. Noorthoorn, C. Bervoets, L. Goderis, J. Duxbury

The Causes Of Violence Applied To Health Personnel Working At Hospitals

By Patients/Their Families According To Health Personnel . . . .275 Elif Babacan, Havva Öztürk

Trabzon, Türkiye

Physical restraint in psychiatric inpatient care . . . .277 Ana Ivaniš, Štefica Bagariæ, Petrana Breèiæ

Zagreb, Croatia

The reliability of the diagnosis set by the Checklist Risks Crisis service . . . .278 Anda Sabelis, Sanne Rasing, Berry Penterman

Herlaarhof, Child and adolescent Psychiatry, Vught, The Netherlands Integrating advanced research training into higher professional

development for senior psychiatrists: the Liverpool SAPROF Experience. . . .279 Alina Haines, Khurram Sadiq, Fahad Javaid, Oladipupo Omodunbi, Fayyaz Khan,

Rhiannah McCabe & Wahid Zaman Liverpool, United Kingdom

Report of a Behavioral Crisis Response Team lead by Psychiatry. . . .281 Cheryl A. Kennedy, MD (presenter), Nancy Rodrigues, BA, MPH and Ritesh Amin, MD

Rutgers New Jersey Medical School, Rutgers School of Public Health, Newark, USA Universal Behavioral Precautions: A Workshop for Development of a Hospital Crisis Response Team lead by Psychiatry • Safer Team, Safer hospital for All

• Using Universal Behavioral Precautions as a Consultation Liaison Psychiatrist. . . .282 Cheryl A. Kennedy, MD, DFAPA

Rutgers New Jersey Medical School, Rutgers School of Public Health, Newark, USA Prevalence of Violence prior to admission to an Acute Psychiatric Unit

in Victoria, Australia . . . .283 Melvin Pinto, Mahendra Perera, Eunice Dai

Casey Hospital, Berwick, Victoria, Australia

The prevalence of state anger and trait anger within psychiatric outpatients . . . .284 D.M. Lievaart, E.G. Geraerts, I.H.A. Franken & J.E. Hovens

Institute for Psychology, Erasmus University, Rotterdam, The Netherlands

Chapter 12 – Race, gender & ethnicity perspectives

factors of female forensic patients . . . .285 Vivienne de Vogel, Jeantine Stam, Stéphanie Klein Tuente, Michiel de Vries Robbé

Van der Hoeven Kliniek, Utrecht, The Netherlands

Chapter 13 – Service users and family perspectives

from domestic violence by their husbands: With action research for supporters . . . .286 Yuko Yasuda, Kyoto, Japan

Describing The Positive Patient Care Experience within a Forensic HDU

Rehabilitation Ward by using an Electronic Patient Feedback System. . . .288 Michael Shortt, Gillian Kelly, Samuel Parker

West London Mental Health Trust, Forensic Psychiatry, London, United Kingdom Systemic and family psychotherapeutic contributions in a forensic psychiatric

ward for rehabilitation . . . .289 Virginie Vanbinst, Louis De Page, Pierre Titeca

Centre Hospitalier Jean Titeca, Brussels, Belgium

Accumulated coercive events (ACEs) and quality of life after admission to

psychiatric hospital. . . .290 Stephen Shannon, Eric Roche, Kevin Madigan, Patrick Devitt, Larkin Feeney, Kieran Murphy,

Brian O’Donoghue, Dublin, Ireland

Chapter 14 – Sexual offending & aggression

Ann W. Burgess, William F. Connell School of Nursing, Boston College, Chestnut Hill, MA, USA Rosanna F. DeMarco, William F. Connell School of Nursing Chestnut Hill, MA, USA

The Influence of Perpetrator Type on Psychological Health Outcomes in

Victims of Rape . . . .302 Carrie M. Carretta, The State University of New Jersey, Newark, New Jersey, USA

Sheila H. Ridner, Vanderbilt University School of Nursing, Nashville, TN, USA

Childhood Narratives of Perpetrators Who Sexually Abuse Children . . . .311 Sandra P. Thomas, Kenneth Phillips, Mary Gunther

University of Tennessee College of Nursing, Knoxville, TN, USA

Childhood Sibling and Peer Relationships of Perpetrators Who Sexually

Abuse Children. . . .315 Mary Gunther, Sandra P. Thomas, Kenneth Phillips

University of Tennessee College of Nursing, Knoxville, TN, USA

The Relationship of Adverse Childhood Experiences with Quality of Life in

Adults Who Themselves Have Committed a Sex Offense Against a Child . . . .319 Kenneth Phillips, Sandra Thomas, Mary Gunther, Abbas Tavakoli, Elizabeth Shieh, Jill

Lancaster

University of Tennessee, College of Nursing, Knoxville, TN, USA

Male Sex Offenders’ Capabilities to Meet Their Goals: An Explanatory Model

of Male Sexual Offending. . . .321 Sara Jones

University of Arkansas for Medical Sciences, College of Nursing, Little Rock, AR, USA

A Research-Based Model of the Meanings of Violence to Perpetrators. . . .325 Jane Gilgun

University of Minnesota, Twin Cities Social Work, St. Paul, USA

Chapter 15 – Specific populations: child & adolescent

community USA/MEXICO . . . .326 Marie Leiner Ph.D.^{1, 2}, Cecilia de Vargas MD³, Maria Theresa Villanos MD¹, Cathy Gaytan

LCSW, MA⁴, Carmen Avila MS²

1. Texas Tech University Health Sciences Center – El Paso, TX. USA– Department of Pediatrics 2. El Colegio de Chihuahua – Ciudad Juarez, Chih. Mexico.

3. Texas Tech University Health Sciences Center – El Paso, TX. USA– Department of Psychiatry 4. El Paso, Child Guidance Center – El Paso, TX, USA

Contextual Factors and Disclosures of Child Sexual Abuse During

Forensic Interviews. . . .335 Jane Gilgun, Gwendolyn Anderson

University of Minnesota, Minnesota, USA

Short- term psychopathological effects on children and adolescents

who suffered different forms of abuse . . . .337 Stefano Vicari, MD, Paola De Rose, Flavia Cirillo, Francesco Demaria, Fortunata

Salvaguardia, Paola Bergonzini, Maria Pia Casini, Deny Menghini

Child Neuropsychiatry Unit, Neuroscience Department, “Children’s Hospital Bambino Gesù”, Rome, Italy

Coercion in adolescent psychiatric care: Can it be diminished? . . . .342 Anja Hottinen, Raija Kontio, Grigori Joffe, Eila Sailas, Nina Lindberg

Hospital District of Helsinki and Uusimaa Psychiatry, Hus, Finland

Risk assessments in clinical practice: Can training in structured assessment

methods improve social service evaluations of delinquent youths?. . . .343 Therese Åström

Clinical Neuroscience, CPF, Danderyd, Sweden

Inappropriate treatment of children and adolescents with psychiatric

disorders in Slovenia. . . .344 Leonida Zalokar, Kristina Tina Šelb

Residential Institution Treatment Planina, Planina, Slovenia

Reduction of Aggression in adolescents with autism – a critical factor for a

successful treatment?. . . .345 G.I. van Driel-Kruizenga (MSc), Dr. J.J. Stolker (MD, PhD), H. Nijman (PhD), A. Bal (MSc)

Stichting Dr. Leo Kannerhuis, Nijmegen, The Netherlands

Chapter 16 – Specific populations: elderly

Psychiatric Hospital Hronovce during the years 2004-2012. . . .346 Marek Zelman, Silvia Godinova, Alexandra Priscakova, Zholob Mykola

Psychiatricka Nemocnica, Hronovce, Slovakia

Chapter 17 – Specific populations: forensic

functioning and developing a new self-report measure . . . .347 Michael Lewis^1,2, Jane L. Ireland^1,2, Janice Abbott¹, & Caroline Mulligan²

1. School of Psychology, University of Central Lancashire, Preston, Lancashire, United Kingdom 2. Ashworth Research Centre (ARC), Ashworth High Secure Hospital, Mersey Care NHS Trust, Liverpool, Merseyside, United Kingdom

Neuropsychological executive functions as predictors for response to

treatment in violent offenders . . . .352 Vicente Vazquez-Vera & Juan Jose Sanchez-Sosa

National University of Mexico, Mexico City, Mexico

The enduring myth of the violent client’, living group climate and aggression

in a forensic psychiatric setting. . . .358 Petra Schaftenaar & Peer van der Helm

The Netherlands

Ethical issues regarding psychiatric inpatients necessitating prolonged seclusions. . . .360 Dor Bar-Noy Dor R.N., M.A.. Valerie Isaak, PhD., Alexander Grinshpoon M.D., Ph.D., M.H.A.

Sha’ar Menashe Mental Health Center, Hadera, Israel

Applying clinical formulation to reduce violence and support recovery in an Adult Forensic Psychiatric Service: The specific needs of patients with

neurocognitive deficits . . . .365 Andrea Livesey, Geraint Lewis

Edenfield Centre Prestwich Hospital, Manchester, England

Lack of Insight: No Longer a Bar to Forensic Rehabilitation. . . .366 Katie E Bailey, Michael W. Jennings

Partnerships in Care, Kemple View Psychiatric Service, Blackburn, Lancashire, United Kingdom

Aggressive Behaviour Management training in a High Secure Mental

Health Facility. . . .370 Ian Tracey

The Park Centre for Mental Health, Aggressive Behaviour Management, Prenzlau Queensland, Australia

A study into the attitudes towards violence and aggression a high

security hospital . . . .373 K.M. Wright; J.A. Duxbury; A.M. Baker & A. Crompton

School of Health, University of Central Lancashire, Preston, United Kingdom

Involuntary hospitalization for offenders with mental disorders in Japan. . . .377 Akihiro Shiina ¹, Masaomi Iyo ¹, Akira Yoshizumi ², Naotsugu Hirabayashi ³

1. Chiba University Hospital, Chiba, Japan

2. National Hospital Organization Sakakibara Hospital, Mie, Japan 3. National Center of Neurology and Psychiatry, Tokyo, Japan

A Survey of Staff and Patient Attitudes towards Aggression in a United

Kingdom High Secure Hospital . . . .381 David Pulsford, Anthony Crumpton, Alison Baker, Tracy Wilkins, Karen Wright, Joy Duxbury

School of Health, University of Central Lancashire, Preston, United Kingdom Frequency of relapse in challenging behaviour in forensic patients.

Special care unit vs. traditional care unit . . . .385 Christian Delcomyn Steffensen, RN, Nurse specialist, Steen Madsen, RN, Nurse specialist

Psykiatrisk Center Sankt Hans Forensic, Frederiksberg, Denmark

Patient involvement in planning for the prevention and management of

aggression and violence: an audit study. . . .386 Nutmeg Hallett, Jörg W Huber and Geoff Dickens

St Andrew’s Healthcare, Northampton, United Kingdom

What are we doing to de-escalate? Inpatient staff views on de-escalation . . . .390 Nutmeg Hallett

St Andrew’s Healthcare, Northampton, United Kingdom

Disciplinary infractions in three Flemish forensic institutions: prevalence and

judicial reaction. . . .391 Inge Jeandarme¹, Ciska Wittouck², Freya Vander Laenen², Jan De Varé³, Yves Grouwels⁴,

Michèle Ampe⁴, T.I. Oei⁵

1. Knowledge Center Forensic Psychiatric Care (KeFor), Rekem, Belgium. 2. University of Ghent, Belgium. 3. St Jan Baptist Zelzate, Belgium. 4. I-BioStat – University of Hasselt, Belgium. 5. Tilburg University, the Netherlands

Working in forensic mental health . . . 395 Dr Derith Harris

University of Tasmania, Launceston, Tasmania, Australia

Strengthening of mental health services in Egypt, but did we learn something? . . . .399 Osmo Vuorio, Aila Vokkolainen

Niuvanniemi Hospital, Kuopio, Finland, Vanha Vaasa Hospital, Vaasa, Finland Handling relations towards legal instances in forensic psychiatric ward

regarding intramural violence. . . .400 Louis De Page. Virginie Vanbinst, Pierre Titeca

Centre Hospitalier Jean Titeca, Schaerbeek, Belgium

No Show for treatment in forensic outpatients with ADHD. . . .401 Drs. Kasja Woicik, Dr. Rosalind van der Lem, Prof. Dr. Stefan Bogaerts

Het Dok, Rotterdam, The Netherlands

Chapter 18 – Specific populations: intellectually disabled

psychiatric problems . . . .402 Diana Polhuis, Hans Kruikemeier, Wendy Kamp & Ben Lijten

GGZ NHN De Rotonde, Expertisecentrum VG GGZ, Heerhugowaard, The Netherlands The relation between staff attitude towards aggression of clients with

intellectual disabilities and the applied interventions in different working contexts. . . .405 M.H. Knotter^1./2., I.B. Wissink ^2., X.M.H. Moonen ^2., G.J.J.M. Stams 2., & G.J. Jansen ^3.

1. De Twentse ZorgCentra, Den Alerdinck 2, 7608 CM Almelo, The Netherlands 2. University of Amsterdam, Nieuwe Prinsengracht 130, 1018 VZ Amsterdam, The Netherlands. 3.Hanze Hogeschool Groningen, Zernikeplein 7, 9747 AS / 9700 RM Groningen, The Netherlands.

Institutional aggression in intellectually disabled (ID) offenders – An analysis of

5 specialized forensic ID projects . . . .408 Claudia Pouls & Inge Jeandarme

Knowledge Center Forensic Psychiatric Care (KeFor),OPZC Rekem, Rekem, Belgium A community groups approach to managing interpersonal violence in an

intellectual disabilities service . . . .412 Dr Simon Crowther, Dr Paul Withers, Paula Capewell, Vicky Chatburn and Diane Sharples

Psychological Treatment Services, Calderstones Partnership NHS Foundation Trust, Whalley, Clitheroe, Lancashire, United Kingdom

Risk factors for inpatient aggression by adults with intellectual disabilities and

severe challenging behaviour: a long-term prospective study. . . .414 Klaus H. Drieschner

Groningen, The Netherlands

Personality Assessment in Offenders with Intellectual Disabilities: Associations

with Personality Disorder, Clinical Engagement and Aggression. . . .419 John L. Taylor

Psychological Services, Northagte Hospital, Morpeth, United Kingdom

Intellectual Disability, Alcohol Misuse and Risk for Violence . . . .420 Bruce Gillmer

Psychological Services, Northgate Hospital, Morpeth, United Kingdom

Anger Treatment Gains and Violence Reductions. . . .421 Raymond Novaco, John Taylor

University of California Irvine, Irvine, CA, USA

Bridging the gap between assessment and treatment of people with learning

disabilities who offend. . . .422 Marita Sandvik, Siv Anita Tsakem, Pål Birger Olsen

St. Olav Hospital, National Unit of Mandatory Care, Trondheim, Norway

The effectiveness of risk assessment tools for adults with intellectual disabilities:

A systematic review. . . .423 Juliet Hockenhull, Richard Whittington

University of Liverpool, Liverpool, United Kingdom

Mandatory care for people with a mental retardation . . . .424 Thor Anders Aase & Tom Nergård

Trondheim, Norway

Evaluation of Electrical Aversion Therapy (EAT) for aggressive and sexual inappropriate behaviour after acquired brain injury: Two Single Case

Design studies. . . .425 Bert ter Mors

GGZ Oost Brabant, Brain Injury Department, Huize Padua, Boekel, The Netherlands

Chapter 19 – Training and education of interdisciplinary staff

Violence against Children: Raising Awareness amongst Arab women Students. . . .430 Amal Taha-Fahoum Ph.D

Sakhnin College for Teacher Education, Sakhnin, Israël

Integration of the Audio-Visual Moylan Assessment of Progressive Aggression

Tool (MAPAT) in a USA State Wide Training Program of Mental Health Workers . . . .434 Sharon L. Ciarlo RN, BSPA, MHSA, Lois Biggin Moylan PhD, RN, CNS

Connecticut Department of Mental Health and Addiction Services, USA

Violence in the health care setting: Empowering nursing students through the use

of de-escalation training. . . .440

“When experienced psychiatric nurses handle high risk of violence” – An elucidation of experienced psychiatric nurses’ experience of nursing in

dealing with a high risk of violence . . . .444 Thor Egil Holtskog

Oslo University Hospital, Regional Sikkerhetsavdeling, Asker, Norway

Change the patient or change the team? – Using Non-Violent Resistance (NVR)

to change a team and decrease violence in inpatient settings. . . .446 Nick Goddard

De Bascule, Amsterdam, The Netherlands

The Experiences with Nurses Trainings Concerning Prevention of Violence in the

Czech Republic in years 2010 – 2013 . . . .448 Jaroslav Pekara, Marie Trešlová

Praha, Czech Republic

Using milieu therapy in a forensic psychiatric unit, experience and challenges . . . .451 Thor Egil Holtskog, Bjarne Dahl

Regional Sikkerhetsavdeling RSA, Oslo University Hospital, Asker, Norway Reducing aggression on a psychiatric unit through interdisciplinary

staff education . . . .452 Helen Karpilovsky

California State University Chico, School of Nursing, Chico, California, USA

Implementation of violence risk assessment tool in clinical settings – experiences

and observations. . . .453 Tero Laiho, Nina Seppänen

Helsinki University Central Hospital, Helsinki, Finland

Doing What We Know When We Know It: Translating Research into Practice. . . .454 Bob Bowen, Michael R. Privitera, MD

University of Rochester School of Medicine and Dentistry in Rochester, New York, USA Evaluation of changes in perceived self-efficacy in managing patient

aggression after completing workplace prevention training . . . 459 Stéphane Guay, Richard Boyer, Juliette Jarvis, Natasha Dugal

Trauma Studies Center, Institut universitaire en santé mentale de Montréal, Quebec, Canada

Training in management of aggressive behaviour - strengths and difficulties. . . .462 Adriana Mihai, Julian Beezhold, Loredana Buftea, Jon Snorranson, Cristian Damsa

County Emergency Hospital, Targu Mures, Romania

Experience of staff using manual restraint techniques. . . .463 Jón Snorrason MSc., Guðmundur Sævar Sævarsson MSc., Hilmar Thor Bjarnason MSc.

Landspitali University hospital, Reykjavík, Iceland

Reducing violence in Acute Inpatient Psychiatry. . . .465 Julian Beezhold, Lisa Vescio

Milestones Hospital, Salhouse, Norfolk, United Kingdom

The training impact on management of agitation . . . .467 Cristian Damsa, Adriana Mihai

Geneva, Switzerland

Training in management of aggressive behaviour – experience in Romania. . . .468 Adriana Mihai, Lajos Domokos, Raluca Tirintica, Alina Radu, Aurel Nirestean

Targu Mures, Romania

Interaction Skills Training (IST): Improving the efficacy of interaction and

cooperation under non-cooperative circumstances. . . .469 Jan Boogaarts & Bas van Raaij

Bureau de Mat, Haarlem, The Netherlands

Unclear & Present Danger – Synthetic Stimulants & Synthetic Marijuana. . . .470 Susan Vickory, Rhonda Tierney

VA Boston Healthcare System, Boston, USA

Implemention of SOAS-R and BVC in a new youth forensic emergency Unit. . . .471 Elisabeth Myhre, Peter Jantzen

Child and Adolescent Psychiatry Capital Region of DK, Adolescent Forensic Unit, Copenhagen, Denmark

Human Defence System (HDS) (Menselijk Verdedigingssysteem)(MVS). . . .472 Edward Kudding & Hans Fleury

The Netherlands

Index of Names. . . .474 Index of Keywords . . . .477 Announcement 9^th European Congress on Violence in Clinical Psychiatry . . . .479 Supporting Organisations. . . .480