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Interviewing violent patients.

S W Twemlow1

  • 1The Austen Riggs Center, 25 Main Street, Stockbridge, MA 01262-0962, USA. Stuart.Twemlow@Austenriggs.net

Bulletin of the Menninger Clinic
|January 5, 2002
PubMed
Summary

This study outlines a clinical approach for interviewing violent patients, prioritizing clinician safety and interview utility. It stresses monitoring subjective states, diagnostic knowledge, self-awareness, and self-care for effective patient interaction.

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Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Forensic Mental Health

Background:

  • Interviews with violent patients present unique safety and efficacy challenges for clinicians.
  • Effective management requires a structured approach considering both patient and clinician psychological states.

Purpose of the Study:

  • To outline a clinical attitude for interviewing violent patients.
  • To enhance clinician safety and the utility of interview findings.
  • To provide a framework for managing challenging patient interactions.

Main Methods:

  • Emphasis on careful monitoring of subjective states in both patient and clinician.
  • Integration of clinical knowledge of Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and psychodynamic diagnoses.
  • Focus on clinician self-awareness, including transference and countertransference.
  • Inclusion of self-care strategies: attention to personal needs, de-escalation, and self-defense skills.

Main Results:

  • A comprehensive clinical attitude enhances safety and usefulness of interviews with violent patients.
  • Monitoring subjective states is crucial for effective clinical encounters.
  • Clinician self-awareness and self-care are integral to managing patient violence risk.

Conclusions:

  • A multi-faceted approach incorporating diagnostic acumen, self-awareness, and self-care is essential for clinicians working with violent patients.
  • Establishing a safe therapeutic context is paramount.
  • This clinical attitude promotes a safer and more productive therapeutic environment.

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