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Tragedies Spark Worker-Safety Awareness

Many Think Client Violence 'Won't Happen Here'

Violence or threats of violence are reasonably common for social workers during their careers.

The deaths of a young woman, a troubled teenager and the murder of social worker Greg Gaul on an icy day late in January brought almost unbearable shock and grief to the Des Moines social work community and the entire city.

It also renewed the questions of whether social workers and their agencies are doing enough to protect those who deal with clients who are sometimes unstable and occasionally violent or intent on homicide and whether emphasis on safety could limit social workers' ability to be effective with clients.

* * *

Gaul was "beloved," the kind of social worker others aspire to be, said his business partner John Stanley. "Most don't have the same amount of qualities Greg had in abundance the patience and kindness."

The former seminarian had an uncommon amount of success for his 41 years. An MSW graduate of the University of Minnesota, four years ago he helped start Lifeworks, a successful agency that contracts with the State of Iowa to provide in-home child welfare and juvenile justice services.

He was a well-known and well-respected figure among the law enforcement officials, attorneys, judges, social workers, educators and juvenile offenders in the Des Moines area.

"Greg and I started a business together with the philosophy that many people didn't have opportunities and need to have doors opened for them and that the basis of therapy is to be kind and gentle to people," said Stanley.

Gaul had a wife and six children age 10 and under, with another child expected in the spring. Yet he found time to be active in his church and to be a baseball coach, Cub Scout leader and black belt in tae kwon do, involving his children in his pastimes, and he volunteered at a prison for women.

He bought his shoes and shirts at a Salvation Army thrift store. "He was a casual guy. That's what helped people relate to him," said Stanley.

"But he took very seriously what he did. Everyone who came in contact with Greg felt he gave something of himself to them."

Friends don't remember what he was wearing his last day alive.

* * *

"Violence has a low base rate and doesn't happen frequently enough to make it easy to predict," said Christina Newhill, associate professor of social work at the University of Pittsburgh.

Yet violence or threats of violence are reasonably common for social workers during their careers, especially in certain areas of practice, according to data from a 1993 study Newhill conducted of 800 NASW members from Pennsylvania and 800 from California.

Of the 1,129 social workers who responded, 42 percent had experienced no incidents of violence, 25 percent reported property damage, 50 percent were threatened and 24 percent reported attempted or actual physical attacks. The incidence rate of violence or threats of violence was highest in the criminal justice field (79 percent), followed by drug and alcohol services (76 percent) and children and youth services (75 percent). Others were mental health services, 64 percent; developmental disability, 56 percent; school social work, 54 percent; health care, 49 percent; and aging, 44 percent.

Males were almost twice as likely to report physical attacks as females, 39 percent to 21 percent, perhaps because it is perceived as more socially acceptable to attack a man, and sometimes men are asked to act as a sort of security force at agencies, although they have no training for it, Newhill said.

Newhill began to look at the issue of violence to social workers after the 1989 death of Californian Robbyn Panitch, 26, who had recently graduated from the University of Southern California. Panitch was employed in a walk-in clinic when a delusional man walked into her office, closed the door and stabbed her 30 times. Nobody heard anything because the office was soundproof. She had talked to her supervisor about being afraid of the client, and things could have been done to make her safer, said Newhill.

"Agencies feel it doesn't happen very often, and when it does, it's not going to happen here," she said. "Only after a tragedy occurs is action taken. They are in denial."

* * *

Gaul had no inkling that the teenager who was to end his life was a threat, said Stanley. If he had he would have asked the child's juvenile court officer or the police to accompany him to the home. "There was nothing in [the teenager's] past to create a major level of concern."

The 16-year-old's parents divorced in 2002. According to news accounts, he had problems living with his mother and moved in with his father and a woman the father lived with in an upscale neighborhood near Des Moines. The teenager, who reportedly had a history of petty theft of beer, using a car without the owner's permission and drinking, was typical of many teens in the juvenile justice system.

The situation deteriorated late in January, when a 21-year-old recent college graduate was hired to live at the house to keep an eye on the youth while the father and his girlfriend were on vacation out of the country.

When the teenager didn't attend classes on Tuesday, Jan. 27, Gaul received a call from the mother of the young house sitter asking him to check on her daughter.

Gaul, who colleagues say used his therapeutic skill and wits to defuse tense situations, probably had no apprehension when he approached the house that morning. He didn't know that the teenager had murdered the sitter two days earlier.

After shooting Gaul, the teenager fled in Gaul's car and the next day committed suicide with a shotgun while being pursued by police in Colorado.

* * *

Gaul's death is a "message to the rest of us to continue to be thoughtful about what we do," said Leila Carlson, executive director of the NASW Iowa Chapter. "It's easy to get into routines and not treat each case individually, there is so much to get done."

Carlson arranged for Newhill to present a three-hour chapter workshop on workplace safety on March 31 and to meet with a small group of Iowa agency executives so that the discussion on agency safety will continue in Iowa

"The most important thing is for the agency to say openly, 'Let's talk about safety and make it a regular topic at staff meetings,'" said Newhill. Violence to social workers is often underreported, she said. Social workers sometimes think they will be blamed and don't tell supervisors, or sometimes they report it and supervisors don't have a good response.

Newhill's workshop in Iowa was slated to cover a number of characteristics of clients that could alert social workers to potential violence, as outlined in her recent book Client Violence in Social Work Practice: Prevention, Intervention and Research. These include:

  • Individual and clinical risk factors, such as certain psychiatric symptoms like violent fantasies, personality features like impulsivity, personality disorders and substance abuse.
  • Biological risk factors, like low intelligence quotient and neurological impairment.
  • Historical risk factors, like a history of violence, early exposure to violence, and unsteady employment.
  • Environmental risk factors, like level and quality of social support, peer pressure and access to weapons.

Newhill said the workshop would also cover guidelines for how to make clinical assessments and environmental assessments to determine the potential for client violence and an assessment of social worker safety. The guidelines include inquiring about the client's potential for violence toward others and self, getting to know a neighborhood ahead of time by consulting with colleagues and police and finding out who will be in the home and potential danger there.

Other workshop segments were to cover safe settings for interviews; intervention techniques with potentially violent clients, like speaking softly, avoiding intense direct eye contact and avoiding early interpretations and insights; the physical environment of an office, such as panic buttons or pre-arranged methods to summon help; and how to dress, tucking in scarves and neckties and wearing no necklaces or earrings.

* * *

Hundreds of people lined up outside Holy Trinity Catholic Church for Gaul's wake, delaying the start of his memorial service. They packed the church again the next day at his funeral, filling the balcony, standing around the sanctuary walls and sitting on the steps outside.

The Des Moines Register covered Gaul's death and that of the 21-year-old house sitter extensively. "The local press has been very kind, writing stories about Greg and his work and the field of social work and its difficulties," said Stanley.

Many professions including police work, fire fighting and military service bring inherent danger, "but it's easy to forget those people who help troubled kids," said the Register.

"Social work is a job where workers are generally unappreciated, underpaid and overworked. These highly educated people could choose to work in other professions. After a few years in the field, many do. . . . But there are those workers who persevere. They stick with the job because they care about kids and know what they do matters."

* * *

Agencies need general strategies for safety, said Newhill. These include:

  • Raising consciousness so that client violence is seen as a legitimate practice concern.
  • Administrators and supervisors taking the lead in promoting safety.
  • Offering high quality in-service safety training.
  • Developing a user-friendly means of reporting and tracking incidents of violence.
  • Establishing protocols with other organizations that agencies have interdependent relations with regarding safety.

* * *

Determining the level and intensity of a safety program is difficult, said Stanley, Gaul's business partner and friend. "I've been a social worker for 18 years and never had anybody even spit at me."

Gaul always had a positive outlook, and "I don't think he would want people to respond in fear or hold it [his murder] against people or for it to impact on their ability to work," said Stanley. "Rather than worrying that something could happen to me, I will work on being gentler and kinder to my clients. That's the message I would have gotten from Greg."

"Some danger is part of being human. Humans are capable of incredible good things and incredible horrific things. You just don't know."

Still, said Stanley, Lifeworks, like many other agencies, holds serious and ongoing discussions about how to keep its social workers safe and alive.

Contributions to aid Gaul's family can be sent to the Greg Gaul Memorial Fund, First American Bank, 2805 Beaver Ave., Des Moines, IA 50310.

 
 
 
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