Risk Assessment and violence in the context of a psychotic episode – can violence be predicted?

a client who has paranoid schizophrenia is attending a treatment planning conference This is a topic that many people are looking for. g4site.com is a channel providing useful information about learning, life, digital marketing and online courses …. it will help you have an overview and solid multi-faceted knowledge . Today, g4site.com would like to introduce to you Risk Assessment and violence in the context of a psychotic episode – can violence be predicted?. Following along are instructions in the video below:
Hiya donald you missed the group again donald im sorry if youre feeling feeling upset can we maybe talk about this later. Okay. Thats a good idea something christmasy.
Yeah. Donald. Whats wrong you cant behave like that listen.
George ive talked something weve got more time okay. There is something going on with him. Its not a problem.
Why dont you get it the man snow not getting hce to come and help you cecilias been allocated for it. Oh great thats good see you later hi. Donald i need some medication.
Some recipe you need it now. Yeah. Um.
I was just gonna make a phone call for tyler. Give me a few minutes. And ill come and talk to you about it.
No i need it no okay. Lets go into the interview room. And you can tell me whats been happening adama talk.
A won some lorazepam donald. Weve discussed this many times before your care plan has identified that there are times. When you need help on award.
But that the first stage of that is for you to try the exercises sully showed you in a ot that colleen has been working on with you if they dont work then we talk to you about how we can help just one medication. You know why why is always you makes it difficult for me. The other nurses they just give me what i want why are you picking on me.
Im not picking on you its important that we stick to your care plan. Its not that i dont want to give you the medication when you need it but im trying to help you build your coping skills. Thats why colleen agreed the care plan with you thats not what you were doing stuff.
You met who you would you say sit who you im on a new tyler. You are dirty foul and cheating bastard yeah. Whatever man wiser ones open your mouth again.
I dare you to open your mouth again fuck yourself may about to blow more hello donald mind. If i come in sallys waiting for you in the moving on group are you going through. I can take you not going today.
I dont know if youve spoken to colleen about that. But youre still booked into the group to attend care. But okay sallys expecting you and colleen to put it in the diary that youd be going this morning piss off leave me alone.
No dont no please dont swear at me. Like that im just trying to find out whether or not youre going to the group. Know if youve agreed to something especially.
A group. Its important that you try to keep that up its not just sally. Thats expecting you other members of the group are as well that should have been discussed with you when you joined it okay well should i tell sally donald.
I dont know whats wrong with you or why you dont want to attend the group. I would like to help you with this but i cant if you wont talk to me about him. Ill leave a note for colleen so she knows and maybe you can talk to her about it when youre ready donald i have you know got your trousers on thats the point where are they you know my favorite ones.
Im a man got me. Yeah yeah. I was gonna put them on but theyre not there where are they i dont know donald.
But you shouldnt come out your room. Without your trousers on why did we go back and try. And see if we can find them no.
George is that them hey georgie was my room yesterday and he must have nicked them the thing. I cant figure out is why you know hes that is he messing with me hes trying to like play my mind. He said.
Why would he do that i am sure that george hasnt taken your trousers. No im sure he hasnt donald. But lets go back and t.
Really see if we can frame them come on im. Not that old. Ive seen.
Many. Georges taken ok ok. Ah.
Lets then donald yeah. Thats them. But i looked in there a minute ago may 1.
There they one there how did they get there i mean that means georges like taking them out. And then hes put them back. There ok just trying to main cam donald ok.
I cant i cant remain calm. I need my lorazepam. I dont want to be outside.
Ive told you before i dont want to be here. Okay. Why dont you finish getting dressed and ill consult your medication.
Ok ok. Yeah gets ill see you in a minute hi donald have a sports grip thats alright tyler went over the boy into machine. No i wasnt even trying to hit the ball.
Dont look bastard no it did it deliberately i cant be here. I just want to go back to baltimore. Why would you want to do that i dont like it coming you know i said that before just too much stuff going on right send me back to borden todd.
Youre doing so well. Honestly. You doing really well you get so much to look forward to i cant stay here clean.
I just can i talk to a doctor about it just take a minute maybe. This is to do with the football and tyler. Think of something nice your moms coming to visit this weekend isnt she yeah.
But she visited me in baltimore and she before you come visit me there again cant you kelly. Its much easier for her to visit you here have you told her how you feel hmm dimension. Im supposed to on the phone yesterday.
Dont know shed bring me in a new book about the first world war you know this ones about own passion.

a client who has paranoid schizophrenia is attending a treatment planning conference-0
a client who has paranoid schizophrenia is attending a treatment planning conference-0

There thats me you know you know more about that war than anyone ive ever met you could write your own book cover that donald honestly you should really think about that its all those drawings that youve done it all that knowledge maybe one day. Listen i just need to go and help with the lunches. But ill see you later okay.
Donald sally. Wants to have a chat with you can she come in yeah. Hey.
George. As my mum rang about organizing. A visit you know of dramas.
Chuck yeah. Your wine yeah ill let you know ill just be outside okay. Thanks colleen was telling me you wanted to make some changes to your ot program.
That right suppose so dont take a seat. Oh thanks do you mind if i just go through a couple of things with you now. Then ive got some ideas that might interest you okay.
Ah. Youve been attending the sports. Group.
Do you want to keep that one going. Yeah. I want to keep in shape.
With my a bit more of that okay you missed a few other things do you find it hard to wake up in the morning not really it depends. Whats on i dont always as you okay were actually about to restart. A group.
Which is part of a bigger program and i wondered if that might interest you more its the independent living program. But we call it the moving on group moving on whats that there what it says really. Its a way of supporting people to move on from here to move to a lower level of security or even into the community.
So it focuses on some of the key skills they might need to develop like shopping. Cooking. Budgeting.
Meeting new people that sort of thing. Yeah. Ive got to the office and sort out my mums visits.
Okay yeah im fine i just kept the offer okay do you want me to get you some information on the group maybe later yeah maybe. But if you want to talk about it again then let me know yeah okay while i remember clean yeah i spoke with donald about the movie non group. Im not sure how kini is i mean he did say to let him know when it starts.
So maybe. Thats a good sign. Ill give you one of our leaflets.
So you can give that to him i mean im going to encourage them to get along. Theres as much help as they can get hi. Donald oh.
Youre good to go. Today. Yeah.
Are you today. Killeen right. What united to intonate major their plan.
Yeah cannot be watching it very clean. Yeah. So what you think then are you going to go to grit later no i dont always you know im you know sally that we duty.
Yeah. She could review it with c program with you if you like you could ever think about it well itd be more self or am. I doing my bit more history of sport or something lets see shall we so i get sally to come.
And see you then yeah. Okay see. In a bit.
Ill be united and finally donald diagnosis is paranoid schizophrenia index offenses. Two counts of gbh six years ago. But hes also served time for wounding with intent section 3741 general ops and for those of you who dont know one.
And its been here for about 18 months after been transferred from broadmoor. Very threatening behavior. There were two unprovoked attacks on to patients and members of staff about a year ago.
Very very unpredictable. Although it has been pretty stable over the past while i would say it can be very difficult if his routine is challenged for example today stable in mid and mental state. Hes used all these cigarette breaks and he slept well last night.
He doesnt go to or tea. This morning. And its a nice care plan to do that so i need to have a think about whether were fully meeting.
These needs or if it requires something more thats for me to think about alright. Yeah okay have a good shift donut hello. You may not remember my name there weve been introduced before you work on a book a word yes since nadia youre what manage eyes the way.
Ive been asked to come and talk to you about whats happened yesterday. How about yesterday. The incident involving george nothing really happened not much to say.
Donald george is still in hospital. It wasnt my fault i wanted to know what happened from your perspective. Im gonna talk about it the police still gonna charge me yes but i definitely dont want to talk about it look this isnt about your arrest or what will happen with the legal process.
I wanted to know what had been happening that you assaulted george particularly and if there was anything we could do to help its all about him you should ask him what was he doing was it affecting you its the way he eat grins at me. Yeah and the way he like walks about the places. Things that he does yeah.
And he will like look at me and the way he grins like he knows whats gonna happen im not sure what you mean he controls all of the nurses everything that happens in here. Yeah. Hes behind it whats he even controls.
Nadia and the doctors. Professor bridges. Yes.
How does he do that now maybe. He knows things about them or its just cause. Hes been here for a long time.
And do you think he was using his influence against you no i wasnt thinking. It was real. It was happening do you know why he would be doing that influencing people against you he never liked me last year.
I hit his mason bird um sonya yeah.

a client who has paranoid schizophrenia is attending a treatment planning conference-1
a client who has paranoid schizophrenia is attending a treatment planning conference-1

And he was one of the nurses that held me down yeah and i could see in his eyes. Then he did not want me you didnt speak to him about it. Whats the point whos the nurses are the same you know you say something about one of them and they can do things to you how might they do that they can do anything and they can give you drugs anything you go to sleep.
And then like you dont wake up yeah. Ive seen in prison. Yeah.
And everyone just thinks youve suicided yourself it sounds very scary to be somewhere i feel so vulnerable that anyone can do anything to you at any time not just anyone nurses. We wouldnt do that donald why would you think that did you think thats george was planning to do something to you you ready hand. What had he done okay right so this somebodys moving on saying this group yeah.
But he knew that i didnt want to move on yeah and he was just setting me up and they were all in on it yeah him and sully donald that was me that spooked hibbert that remember i spoke to you about new ways of doing things did you not feel ready to move on moving on. I mean what does that even mean. Whats that all about how you know it doesnt make any sense that they know i want to get out of here and lead a normal life you know.
But they wont let me out when i wanted to go before you know i should never ever have gone to broadmoor in the first place. You know all these groups and all the staff and teams of stuff then i hope in me. Its not what its really all about you know and i cant take the pressure.
I mean like moving on where am i gonna move on to you know thats why i said take me to broadmoor. I cant stand this pressure and i said i said to them move me to broadmoor they just wont listen so this idea of you starting a moving on group. Its unsettled.
You and you thought that this was another example of george using his influence and it was being used against you yeah. I dont want to talk about it i can understand that things might be difficult to talk about but it also sounds very unpleasant feeling like you are without anyone able to help you what can you do im not sure thats why you some more what any other things about george. Thats made you think he was doing things to you you said about the way he green.
The way the way he walked about the ward okay so like something would happen to me. Yeah and like george would be standing. There grinning or hed be talking to like sally or or id ask him for some like prn and he wont give me any everyone else would but not george what about that incident with your trousers.
Exactly how did all this leave you feeling what you mean well you we were just thinking about these things yeah. I guess. I didnt sleep properly were you thinking about it a lot all the time.
When you were when you were thinking about these things would you feel any different for instance would you not just anything happening physically in what way would your breathing change. Yeah. Yeah.
Yeah yeah. I felt like um. I couldnt breathe properly.
Yeah. And like my stomach was all churning. It was really really weird yeah.
And that was just like these times where i felt like i couldnt walk properly. Yeah and i was trying to figure out how is he able to do their judge. Yeah.
George were there what any other physical. Things happening. So youd be experiencing all these things like breathing changing and feeling strong guy or tommy channing.
And youd be having these thoughts. While you having the same sort of thoughts and feelings. When you hit sonia like the same thing happen in there and with the other uhits about the same time.
Yeah. How would the nurses have known how you were feeling. I dont know how im gonna tell them i know.
But what might they have seen that was different about you hmm. I was a bit more irritable getting to more arguments you know i spent a lot more time in my room. Youve often done that donald what would be different yeah.
But i usually i read. But not when im like this whats that yeah i just i cant i just cant think about anything else so you stopped reading and youre spending a lot of time in your room. What else might be necessary sometimes crying my room sounds like youd be very distressed.
Why did you hit george yesterday. Why not another day its so dry it had been building yeah i nearly hit him the day before. But i managed to stop myself yeah and so i kind of like shoved him instead.
But then i got scared and i went to my room. And then i i couldnt sleep and i was just thinking about it over and over and then i wake up then i fall asleep. And id still be thinking about it.
And then then i was up by 6 00 gone. And i knew he was on duty in the morning. Because ive been asking yeah.
And i was just waiting for like this pressure about the group you know and also just waiting for him or one of the is to say something like you know why arent you with the group or you should be doing they should be doing that lock up like im a kid or something like like theyre in charge of me you know i mean. Thats why i said i dont want that i just want to go back to broadmoor. But they wont listen to me so thats what you were thinking how will you feel it was gonna explode.
You know people dont know yes because i can hold it in but i had to do something and then when sally came in that was it how do you mean that i just been thinking over and over about all this stuff yet. And i just had to like find a way to get rid of like just that feeling of dread or whatever. It was yeah and then like to know i just kind of plunk ow next thing.
I know everyones jumped on me and theyre holding me down and theres okay because like i feel okay and then everyone lets go off me. And i just feel calm just feel i dont feel like that you know i dont feel like im going to explode. I hate hate.
Im sure thats the case. Im trying to understand that last part you feeling like you have to do something im going to suggest a scale donald from one to ten. Suppose that ten is the point at which you assault someone at what point on that scale can you not stop yourself the the point at.
Which you feel like youre going to have to hit someone hmm. A and where were you most of the time since finding out about the moving on group about five five thats bitchy aroused. Where are you now thats a five or six.
What can we do to keep everyone safe now move me to broadmoor that may or may not happen. But what about now. I dont know well now that you told me about what youve been thinking any things that happened to you physically could you tell the other nurses.
If those feelings and thoughts were coming back probably what could you do if they were starting to come back. And you were feeling like you might have to hit someone again. Ill take my medication you know thats why thats george for but ii.
Just says no we can give you lauras apartment haloperidol. But is there anything you can do i could do those breathing exercises sally and colleen gave me to do come out my room more you know i get like worse. When i just sit.
And think about it maybe i could tell you where i am on that scale that would be useful and were going to keep an s with you all the time for now once i shift. I think it would be useful if you and in us spent ten minutes. Talking about how youre coping with your thoughts and feelings how safe you feel.
And if theres any as we should do to help and were really cool. But i am feeling a little bit tired now i think i might need a nap. Okay.
Im going to get what weve just talked about written out as a care plan. Id like you to have a look at it and if you agree with whats in it you sign it and that will be an agreement between us. .

a client who has paranoid schizophrenia is attending a treatment planning conference-2
a client who has paranoid schizophrenia is attending a treatment planning conference-2

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