1898-1998 100 Years of Professional Social Work Committee for the Study and Prevention of Violence against Social Workers Safety Guidelines Revised March 1996

(NASW Massachusetts Chapter, National Association of Social Workers, 14 Beacon Street, Boston, MA 02108)

Work related violence against social workers is a fact of life. It is pervasive and must be addressed by every school of social work, agency and individual worker. Violence includes physical assault, verbal assault, harassment and the threat of assault. Many occurrences of violence can be anticipated and their impact lessened; some may be prevented entirely. If agencies have well conceived safety policies and procedures in place, client and worker safety will be maximized and the agency's liability will be minimized.

NASW Massachusetts Chapter's Committee for the Study and Prevention of Violence Against Social Workers recommends that every agency and private practitioner develop safety policies and procedures that address prevention, intervention and aftermath strategies. Listed below is an outline of requirements for developing a comprehensive policy and safety plan. This outline is general. Each agency or private practice must develop specific guidelines that address their unique characteristics.

I: Safety Plan of Action

A written safety plan specific to the function and layout of each agency, or branch or division of an organization must be developed. Both staff input and expert consultation are important in the planning. Each safety plan must be detailed and comprehensive so that all staff members, clinical and non-clinical, know what to do in case of emergency. The plan must be reviewed and practiced on a regular basis if it is to be useful. A comprehensive safety plan should include:

• How to recognize signs of agitation.
• What to do at first signs of agitation.
• Code words and phrases to signal for help without increasing the client's agitation
• Format for ongoing assessment of a client's level of dangerousness.
• Format for intervention including:
  • When and how to attempt de-escalation.
  • When and how to use non-violent self-defense, physical evasion, force deflection and disengagement skills.
  • When and how to call security or police.
  • When and how to evacuate building.

II. Exterior and Physical Layout

• Maintain and furnish the facility so that it presents an organized, calm and respectful appearance to clients. Pay particular attention to the waiting area.
• Ensure adequate lighting inside and out.
• Be aware of traffic patterns with special attention to where clients can go unescorted. If the location of bathrooms and coffee area allows unescorted clients to walk through the building, be aware of the risks.
• Establish a risk room where potentially violent or agitated clients can be seen. This room should be furnished in a sparse, neutral manner, and located in a centrally located area with ready access to help.
• Evaluate the need for safety equipment including buzzers and alarms in offices.
• Furnish offices to allow a comfortable distance between client and worker and to permit easy exit for both. Eliminate items that may be thrown or used as weapons.
• Routinely inspect exterior and interior layout and all safety equipment to ensure all is in working order.

III. Rules, Regulations and Procedures

• Establish a format for taking a required history of violence as a part of regular intake procedure.
• Establish a format for communicating violent history to staff when current danger exists.
• Ensure adequate staffing at all times; no one should work in a building alone.
• Communicate safety policies to clients, when indicated.
• Orient new search to safety policy and plan.
• Formulate and post a policy re: providing services to clients who carry or have guns and weapons.
• Formulate and post a policy re: providing services to clients who are under the influence of alcohol or drugs.
• Provide ongoing supervision, consultation and training in:
  • details of safety policy and plan with regular updates.
  • assessment of client's potential to become violent.
  • treatment and clinical interventions with violent clients.
  • de-escalation techniques.
  • non-violent self-defense, physical evasion, force deflection and disengagement skills.
  • Tarasoff decision - the duty to warn and protect.
  • aftermath of client violence.
• Address institutional practices that unintentionally contribute to client violence.
• Develop a policy on home visits which include:
  • leaving itinerary with office staff so worker location is known at all times.
  • phoning office frequently when in the field.
  • providing portable phones and other safety equipment.
  • providing options for escorts: staff or police.
  • giving permission not to go when risk of violence is high.
• Establish relationships with security and police. Let them know what you do and what you need from them.
• Design a program to address the aftermath of client violence. Address the physical and emotional needs, short and long term, of the assaulted worker, worker's family, coworkers and affected clients as well as a format for debriefing and communicating with all staff following an occurrence of violence.
• Develop a format to address the consequences of violent behavior with the client. Include the effect of the violence on services. Develop a format to determine when and how legal action against the violent client will be taken.
• Log and communicate to staff all work-related occurrences of violence including threats.
• Re-evaluate policies, procedures and training needs following an occurrence of violence.
• Develop a "Risk Assessment" tool and train all staff to use it.