Impact of the threatening patient on ward communications

Patients and staff may have difficulty facing the realities of a dangerous situation on an inpatient service. The authors describe how, in response to the presence of a potentially violent patient, distorted patient communications in group settings may be reinforced by staff avoidance patterns. Appropriate therapeutic interventions are often delayed until staff members overcome their resistance to acknowledging the signals that frightened patients send. The authors discuss strategies to circumvent and overcome these problems.