Tuesday, January 17, 2012

Safety Tips for Social Workers [2 of 2]



Today, Charles Ennis, a former police officer on a Mental Health Emergency Services Unit in Canada, is back to provide you with some priceless tips on how to keep safe.
 
As mentioned in the first part of the interview, Charles has not only trained people on how to be safe when working in the field with the mentally-ill but has also co-authored the book on social worker safety entitled: The Safe Approach: Controlling Risk for Workers in the Helping Professions.
So without further ado, Charles, what are some safety steps that social workers should take when making solo house visits?  

Solo house visits are never a good idea in my view. Any police officer who deals with domestic violence will tell you that the initial contact with a client is one of the most vital and risky parts of an investigation. Police officers always attend homes where domestic violence is occurring in pairs.

Your first contact with clients in the field is at their door. Never stand in front of the door when knocking. Doors offer no protection from firearms. Standing in front of the door places you in the most likely line of fire. 


Of course, if you knew that someone inside was armed and dangerous, you wouldn't be standing in front of their door at all. You would have called the police and taken appropriate measures to ensure your safety. Yet you don't always know what is on the other side of that door.
Another concern is that some doors open outwards. Standing in front could result in you getting knocked over when the door is opened. The other concern is the amount that you will be able to see once the client opens the door. 

The primary worker should stand against the wall on the door knob side of the door. This forces the client to open the door completely to see you, and allows you to see in. This allows you to see the room behind the client, revealing the presence of additional people and the state of the room.

If what you see raises safety concerns, you can now take appropriate action. If you stand on the other (hinge) side, clients can open the door a crack and peek out, concealing the client and the inside of the house. You won't know what you are walking into until you have actually entered.

I recall a case where we had arrived at an apartment to check on the well being of a woman with children who was the victim of spousal assault. The woman told us that her abusive husband was not home. However, because of the way that we had positioned ourselves, this woman had to open the door fully to see us. This allowed us to see the living room behind her.

On a coffee table in front of the living room sofa, we observed two steaming cups of coffee. Two smoking cigarettes were resting on the ashtray on this same table. We entered and found the abusive husband hiding in the hall closet. He had forced his way into the home shortly before our arrival. The victim had lied to us under duress. 

The husband was arrested for violating a court order prohibiting contact with the victim. If we had stood on the other side of the door, the victim might not have opened it wide enough for us to make these observations. We might have unknowingly left her in a position of extreme risk.
If you hear a dog inside the house, hold the door shut by the door handle and ask the client to secure the dog. Even if the dog is not violent, it can frequently be an unwelcome distraction when you are trying to interview the client.

Always have the client open the door. If clients ask you to come in without opening the door for you, insist that the client open it. It is best that you meet the client at the door and continue your risk assessment before you enter.

If clients say that they cannot come to the door, ask why. This is often a concern when dealing with elderly or incapacitated clients. Try to get a look inside through a window to confirm why it is that they cannot come to the door, if you aren't aware of any good reason.

When the door is answered, ask to speak to the person whom you are visiting, for example, the parent. Often whoever answers the door will try to ask questions about your identity and the nature of your visit. Persons who live with the client, or are friends with them, may want to protect the client from what they perceive as ‘unjustified state interference.’ Give them as little information as possible, and be non-threatening. A good approach is to introduce yourself and tell the person at the door that there are some things that you need to discuss with the client.

Once you have the clients you want to speak with at the door, again identify yourself. Give the reason for your visit and let the clients know that you would like to speak with them inside, in private. Have your identification handy so that there can be no mistake about who you are, and what organization you represent. If the client is going to react negatively to your authority, this is the time to find out, not after you have entered and the door is closed behind you.

If, at this point, the clients tell you in a violent and hostile manner to go away, and that they do not want to speak with you, generally you should listen to them and leave. You may need to advise them that the matter is important, and that you will be returning.

I have had great success at reminding people that we have a job to do, and that their refusal to cooperate does not mean that the matter will be dropped. Often once the client realizes that you mean business, and if you are being honest about your agenda, then they will often agree to speak with you.

What are some safety strategies that social workers may employ in agency/hospital settings?

The room at your office in which you interview the client should be well lit and uncluttered. Earth tones for the walls are best for their soothing influence. A calendar on the wall is useful.

The room should be free of anything such as metal toys or glass ashtrays that an irate client could use as projectiles. If there is a phone in the room, it should be secured to the wall or table to prevent it from being picked up and thrown. It is useful to equip the room with windows so that other workers in the office can see what is going on inside. This could be one-way glass.

Another option is having a receptionist, supervisor, or other staff member monitor the activity in the room via closed circuit TV. If recording equipment is being used, it should be hidden, but the social worker conducting the interview should tell the client that they are being recorded.

Some agencies have set up rooms for receiving especially volatile clients that have one entrance for the clients to enter and leave. A table separates the client from the interviewer. A separate door behind the interviewer provides an emergency exit should the client act out violently. If interviewing the client in your office, situate your desk so that the client is not between you and the door.

Having a room reserved solely for interviews is preferable to using your own office for several reasons. If you must use your office to conduct interviews, you will constantly be clearing away office equipment such as staplers, hole punches, or telephones that the client may pick up and throw. You'll have to clear away any sensitive documents or files that you don't want clients to see. Having a room other than your office in which you can conduct interviews will eliminate this problem. 

If your background investigation has revealed safety concerns, be sure to notify your supervisor prior to the client's arrival so that all of the necessary preparations for the visit can be made. Sometimes clients may call in anger and tell the social worker that they are on their way to the office. If this occurs or if the client you are expecting has a propensity for violence, be sure to let the receptionists know so that they won't be taken by surprise.

Don't schedule client visits for times such as lunch hours or training days when there will be few if any staff members around who may offer assistance to you if you need it. Be sure to notify your supervisor if you are conducting an interview or assessment in the office late in the day. People are often anxious to leave at the end of the day and you don't want to find yourself in the position of being all alone with clients in the office with no one to offer assistance if you need it.

When clients arrive, take note of their emotional state and demeanor. It is better not to even start an interview or assessment in the first place if it is clear from the outset that the client is likely to get out of control.

The reception area should be visible to the administrative staff, and there should be a locked gate or door separating it from the rest of the office. Display signs in the waiting area that indicate zero tolerance for violence. Have clients sign in at the reception desk and escort them both to and from the office where the interview or assessment is being conducted.

It has been our experience that clients wandering around the office pose a greater threat to personal safety and security. Any staff member who notices a stranger wandering about the office should politely question them as to their business there. Having reception issue temporary visitor identification is a good way to control unwanted guests.

You should consider using a partner to assist you in interviewing or assessing clients. One of you will be the primary interviewer, doing all of the talking. This avoids over stimulating the client. The other should quietly make notes and observe. This back up worker will be in a better position to observe the client's body language.

The presence of an extra worker can often discourage violence on the part of an angry client: There is safety in numbers. It is advantageous to utilize a back up worker who is familiar with the client. If you are the only one who has had contact with the client, this is an excellent opportunity to introduce the client to another worker who can handle the client's concerns in case of your absence from the office.

If you become aware that the tension between you and the client is escalating, it may be time to terminate your interview. You can offer to meet with the client again at a later date when emotions have cooled, if appropriate. If clients continue to escalate or threaten violence, escort them from the building. Have other staff members assist you if necessary.

It is a good idea to develop a system of innocuous phrases or gestures that you can use as a signal to summon assistance without alerting the client. One signal may indicate that you require the assistance of another staff member. Another may indicate that you require the immediate assistance of the police. 

Such signals can be passed using your office's paging system, intercoms, or telephone. It is a good idea to have the interview room equipped with a hidden panic alarm button for cases when you are interviewing volatile clients.

Finally, would you recommend that social workers take a self-defense class?

Self-defense classes are excellent for maintaining fitness, and for that reason alone are a good idea. 

The only way to become competent in hold release techniques and related martial arts moves that a social worker may need on rare occasions is to regularly practice them.

Thanks so much, Charles, for sharing with us all this invaluable safety advice! And thanks again, Marianna @AuntieStress, for your kind introduction!

Please feel free to share your thoughts or questions come to your mind about social worker safety below :)

You May Also Enjoy:
Social Worker Safety [1 of 2]
Social Work Podcast: Client Violence: Interview w/Dr. Newhill
New Social Worker: Safety and Social Work
Social Media and Social Work Education: Like Oil & Water?Acknowledge Your Past Achievements
How To Start Up a Private Practice
18 of My Favorite Reader Comments from 2011 

5 comments:

  1. Thanks for sharing these ideas. It's always important for us to consider our personal safety and easy for me to take for granted sometimes. Useful post!

    ReplyDelete
  2. I'm so glad you found Charles' guidance helpful, Ermintrude :)

    I have to say that I found myself thinking that I did not have some of these important precautions in place in either one of my placements but thankfully, all was well. Going forward, these are definitely tips I will be taking into account!

    ReplyDelete
  3. Thanks for the information.

    Precautions is so important because we have know idea where the consumers are at times. There are such a high livel of mental illness that we really have to put on our thinking caps all the time.

    ReplyDelete
  4. Great tips...thanks so much for your expertise Charles, and for doing the interview Dorlee!

    ReplyDelete
  5. Joanne - Thanks for stopping by and sharing your feedback! Totally agree with you that taking precautions is a good idea.

    Nancy - It was my pleasure :) I am most grateful to Charles for being so kind as to share his expertise about social worker safety with us.

    ReplyDelete