Establishing best practice in violence risk assessment and violence prevention education for nurses working in mental health units.

OBJECTIVES: To explore and evaluate extant and potential methods used in risk assessment and aggression prevention training. This study was also designed to consider the most appropriate method for educating nurses in use of a novel risk assessment instrument linked to a structured nursing intervention protocol (the electronic application of the Dynamic Appraisal of Situational Aggression and Aggression Prevention Protocol). BACKGROUND: Organisational and personal concerns have led to the development of training programs designed to prevent and manage aggression in mental health units. DESIGN: This descriptive qualitative study explored experts' opinions about effective training approaches. METHODS: Data were collected via focus groups (a total of four discrete groups), with each of the four focus groups repeated after four weeks. A semi-structured guide was used to guide the focus group discussions. RESULTS: Seventeen experts with experience coordinating and facilitating training in prevention and management of aggression in mental health units in New Zealand and Australia participated in this study. Three themes emerged from the data 1) existing training can be "like pulling teeth without anaesthetic" 2) the need to "breathe life" into the training and 3) a vision of the "gold standard" for practice and training. CONCLUSIONS: Training is optimal when it is place-based, responsive to local needs and inclusive of relevant clinical, cultural, consumer/carer and contextual factors. Training may benefit from a focus on the application of the knowledge, skills and attitudes learnt and there is a need for ongoing reinforcement of training in the clinical setting, beyond initial introduction and provision of information and orientation to relevant skills.

Remote forensic evaluations and treatment in the time of COVID-19: An international survey of psychologists and psychiatrists

Workplace restrictions associated with the coronavirus (COVID-19) pandemic have resulted in increased tele-service use by forensic psychologists and psychiatrists. This article describes the results of a survey of 295 psychologists and psychiatrists concerning their experiences and opinions of forensic tele-service work. Participants identified a range of benefits to using audiovisual (AV) conferencing technologies, including efficiency, convenience, ease of access, safety, client comfort, and flexibility. However, issues were also reported, including concerns that some aspects of the mental status examination, specifically appearance and behavior and affect, may be difficult to assess. There were also some clinical conditions that were considered by participants to be unsuitable for tele-servicing. Although most participants believed that the therapeutic relationship was less satisfactory when using AV conferencing as compared with face-to-face interactions, on average, participants were satisfied with the therapeutic relationship that was developed. Further, some participants (n = 38, 27.1%) reported that clients had expressed a preference for remote engagement, but a similar number reported that some had expressed concerns about receiving treatment remotely (n = 38, 26.4%). Although recent training and experience were associated with confidence, perceived confidence, and satisfaction with tele-services, fewer than half of participants (n = 112, 44.8%) had received training in tele-service use. Overall, there appears to be a range of benefits to using tele-services for remote forensic assessment and treatment practice, but there are issues that need to be considered, and best-practice guidelines require development. (PsycInfo Database Record (c) 2021 APA, all rights reserved)