It’s you. Ready, as a professional, to take care of an adult pedophile who asks you for help in your consultation and assures you that you have not committed any sexual abuse?
What if the question in consultation was some sort of next?
-My son is accused of obtaining child pornography material from the internet and being asked for a prison sentence, what can you do. As a psychologist for him?
Think about the answers a bit. It is very likely that this will happen to you: this is not my specialty, call a suitable professional. There is? You know. Who are they?
What if instead of such specific questions, others asked you, like the following?
-My partner attacks me, threatens me … but I want to continue with him, I want him and I don’t want to denounce him, I want him to change … What can you do. As a psychologist for us?
Or, like these:
-Can my patient, who suffers from an eating disorder, commit suicide?
-My teenage son beats his sister and his mother, and we don’t know what to do, we call the police ?, Come on. Can you help us
-In our organization, there is a valuable middle command that harasses the workers, or at least that’s what the rumors say, what can we do?
-A father, who has just separated from his wife as an abusive partner, but who, on the other hand, shows no personal or social problem, can he have custody of his children?
Problems of this type and others similar, all linked to violence and its forms, these are appropriate (and difficult) questions for psychology professionals to answer.
Unfortunately, many psychologists do not have specialized training in these problems, sometimes not even generic. Every day, a professional psychologist is more likely to be confronted with problems arising from violence, as there is a strong social demand to solve the problems that violence generates. And psychology professionals are at the forefront of those who are called upon to meet this need.
It’s you. Ready as a psychologist to intervene in questions of violence? If you haven’t faced this kind of demand yet, it won’t take long to get it on the table.. And this statement applies to almost all areas of psychology (clinical, forensic, sports, school, social …).
Psychology violence prevention training
In the bachelor’s and undergraduate degree programs in psychology, somewhat less in the postgraduate and master’s degrees, training on violence is very rare and is always subsidiary to other subjects (psychopathology, legal, social, academic , etc.).
If we look today for the training offer on issues of violence, we will find a limited number of topics or university courses that have it in the center of interest. Fortunately, little by little, especially in the context of continuing education and specialization (postgraduate courses, professionals, etc.), this training offer is multiplying and the picture is changing. But professional demand is faster than the supply of training.
We want to deal, in this article, with training psychology professionals in violence risk assessment techniques and procedures, The basic core of the intervention, the first step to the prevention of violence, this behavior so harmful.
Assessing the risk of violence
We the professionals are useful insofar as, by our decisions and interventions, we solve the problems which arise. And the main problem with violence – to prevent it – is its recurrence. Violence must be prevented from happening, but if it does, it is essential to prevent it from happening again. Professionals can help in this task as long as we know how to anticipate new or future violent events.
A first fundamental idea, the basics of violence prevention training, is that the probability of the occurrence of serious violent behavior is low, sometimes very low (even if it seems the opposite in light of the media) and, for example, therefore, effective prevention must be adapted to this probability. Don’t overestimate or underestimate the risk involved.
But psychologists are not fortune tellers, we only know (and this has enormous value) to estimate the likelihood of one behavior or another to occur. Our challenge is to get the right forecast, even though there will always be a range of error. And the mistakes in dealing with violence are very important.
In professional practice, a false positive (warning that the wolf comes without coming) is as serious as a false negative (trusting that the wolf will not come when it is already coming out of the door). But if you have to choose an error, when it comes to violence, a false positive is better than a false negative. The consequences of false negatives are always very negative and sometimes irreversible.
All psychologists and psychologists (junior or senior, with more or less specialized training) know that the problem of violence and aggression is serious and that the social tolerance that once existed with this problem has disappeared. But we know that violence is a real psychological problem. Faced with violence, faced with the demands that it produces, psychologists cannot shirk our professional responsibility.Even when the request comes from the perpetrators or their environment.
Prevention of violence is an important task in applied psychology. The demands of this kind that we make must be met, because aggression and violence (in all its formats and types and whether it is the aggressor or the victim) are behaviors, or fantasies, and are part of people’s beliefs, attitudes.
Aggressive and violent behavior is accompanied by intense emotional changes and is strongly determined by feelings and affections. Criminological research informs us that 80% of homicides and murders are linked to revenge and hatred, as are many sexual assaults. The expression of violence in patients with personality disorders or severe mental disorders and even in patients with neurodegenerative disorders is important and a source of many problems and discomfort.
What to do?
In adults as well as in young people and adolescents, as well as in children, violence is a problem that psychology can prevent. But, as in any professional activity, the skill of the technician is directly related to his training and coaching. There is a broad consensus that the best, if not the only, solution to the problems of violence is prevention. Reading this phrase may irritate more than one, as it seems like a mantra that serves as a wild card to answer almost any social issue. But it is still one of the basic principles for avoiding violence. The prevention of violence does not seek to find a solution to violence, but to prevent it from appearing and especially from reappearing, from getting worse.
The prevention of violence is a process that has two components, two stages ordered in time, different: they are, first, risk assessment and second, risk management (intervention). In general, psychologists tend to think of prevention as intervening (whatever that term means), but in reality, intervention is the second step. The first step is the risk assessment. And to the extent that the first step is successful, the intervention will be more effective. A
Before intervening, it is necessary to assess how, when and with what intensity and frequency we must intervene. It’s about assessing the risk. Sometimes this task is confused with that of diagnosis, but they are not the same. A diagnosis involves valuing, but it is more than that; involves comparing and deciding, for example, the presence of a symptom, syndrome or the like against a previous classification system. But this does not automatically deduce what may happen in the future with a particular patient and at a specific time and less with violence.
Reg valuation techniques
Unfortunately, in Spain, we have witnessed in recent months three very serious filicides, committed by women diagnosed with severe depressive disorders, and who were in charge of the children they murdered. Could they have prevented it?
Anticipating what can happen is what we call predicting, and in cases of aggressive and violent behavior it’s imperative, but in most cases it is not clinically diagnosed. so other resources are needed for this type of forecasting, including risk assessment techniques.
Risk assessment techniques consist of (more or less formalized) procedures for compiling information, selecting it, evaluating it and combining it to make decisions about the likelihood of a particular behavior, physical assault, sexual abuse , a threat, self-harm or other, recur in a given time and scenario context.
The most common technique for assessing risk is “unstructured clinical judgment” is tantamount to making a decision based on intuition or the expert’s judgment on the prognosis. The second technique is the so-called “actuarial” technique, in which using a psychometric tool, the prognosis is based on a mathematical score.
Both techniques are common in psychology and have their strengths and weaknesses. So, for example, a strength of “unstructured clinical judgment” is its adaptability to the clinical case, but its weakness is the subjectivity of the outcome thereof. One of the strengths of the “actuarial” technique is its reliability, but its main limitation is its low adaptability to the single case.
There is a third technique called “structured clinical trial”, which combines the strengths of the previous ones and aims to avoid their limitations.. The latter, risk assessment techniques based on “structured clinical judgment”, are those which currently obtain the greatest consensus among experts working in the prevention of violence, because they ensure greater effectiveness of prevention. One of the most important reasons is that they have higher levels of prognostic efficacy.
Learning and proficiency in the application of “structured clinical trial techniques” to assess the risk of violence is a need for psychology professionals that requires specialized training and is not very complex. Thanks to our training in assessment and other similar skills, psychology professionals are, we are, very prepared to acquire a high level of competence in the assessment of the risk of violence and, therefore, to be able to intervene in the problems that the repetition of aggression and violence engenders.
The need for continuing education
No one would say that in these times, continuing education is a necessity but, in our field, there is a lack of tradition of continuous training (both by professionals and by the entities in which they are integrated) which must be reconverted into current practice. With the exception of health professionals, who have a well-established role in continuing education in their professional field, in the fields of working with violence (lawyers, criminologists, social workers and educators, psychologists, etc.), this reality is in the nascent development phase.
The Institute of Forensic Psychology (IPF) has become a center of innovation and reference in the professional practice of psychology applied to law. One of his tasks, in which he has been involved for years, is the specialized training of professionals in psychology in the prevention of violence.
In particular, it offers courses and training in violence risk assessment practices in legal, clinical and social intervention contexts. These training resources range from basic training in violence risk assessment techniques to specialized training in areas such as gender-based violence, sexual violence or interpersonal violence at the organizational level.
One of the innovations in vocational training, in Spanish, is the development of so-called webinars, live training resources that take advantage of internet facilities and social networks to facilitate training processes. Webinars are one more step than before called “distance or online training”. The IPF has been promoting this type of course for more than 5 years and with a large participation of participants from Spain and Latin America. From all those who use Spanish as a professional language.
Violence can be avoided, the very serious consequences of it (sometimes loss of human life, permanent injuries, disabilities, etc.) suffered by victims are preventable. In addition, the social demand of citizens is very clear, there is a total rejection (more and more widespread) of violence and its consequences. There is a formal commitment on the part of politicians and social administrators to fight this serious scourge which is doing so much harm to society.
Social demand and politico-legal commitment crystallize in a requirement for professionals – psycho-, socio-, penal, educational, legal – to intervene effectively in the solution of this problem. And all these professionals must be prepared to be able to intervene in the prevention of violence. And ensuring that professionals are effective in prevention requires that these professionals be well trained and competent in the most recent and modern risk assessment and management strategies.