Criminal behaviour and mental health : CBMH · 2002
Risk assessment as collective clinical judgement.
СтатьяНазвание и аннотация: Перевод в очереди
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Murphy Denis
Аннотация
INTRODUCTION: Risk assessment occupies an increasingly important position in psychiatry. This paper contends that collective judgement is the optimal method of assessing risk.
THE MEANING OF RISK: Risk has a dual meaning: emotional and judgemental.
RISKS FACED BY STAFF: Assaults, threats and survival anxiety.
THE EFFECTS OF DANGER ON THE GROUP: Staff wariness and resistance, attribution of blame.
THE AMBIGUOUS TASK: For a group to function well it must have a clear task. Custodial roles can lead to ambiguity.
THE EMOTIONS OF LARGER GROUPS: Externally directed hostility, internal homogenization of views.
SOCIAL DEFENCES: Rituals can develop in forensic institutions, as well as militarism. ANTI-THERAPEUTIC CULTURE: Sadism may develop where a marked power differential develops.
THE ROLE OF THE LEADER: Danger intensifies the feelings about leaders, perhaps idealization, perhaps disaffection. Leaders and others need to agree on risk assessment or fragmentation will occur.
THE MODIFICATION OF RISK: The assessment of risk may modify it. Mutual hostility must be reduced. Dialogue and understanding are needed.
A CLIMATE FOR RISK ASSESSMENT: The environment should be less authoritarian and more democratic, so that patients can join a group and internalize its values. Reflective space is also required.
CONCLUSIONS: Risk assessment is best described in terms of human endeavour, not in the language of scientific measurement.
THE MEANING OF RISK: Risk has a dual meaning: emotional and judgemental.
RISKS FACED BY STAFF: Assaults, threats and survival anxiety.
THE EFFECTS OF DANGER ON THE GROUP: Staff wariness and resistance, attribution of blame.
THE AMBIGUOUS TASK: For a group to function well it must have a clear task. Custodial roles can lead to ambiguity.
THE EMOTIONS OF LARGER GROUPS: Externally directed hostility, internal homogenization of views.
SOCIAL DEFENCES: Rituals can develop in forensic institutions, as well as militarism. ANTI-THERAPEUTIC CULTURE: Sadism may develop where a marked power differential develops.
THE ROLE OF THE LEADER: Danger intensifies the feelings about leaders, perhaps idealization, perhaps disaffection. Leaders and others need to agree on risk assessment or fragmentation will occur.
THE MODIFICATION OF RISK: The assessment of risk may modify it. Mutual hostility must be reduced. Dialogue and understanding are needed.
A CLIMATE FOR RISK ASSESSMENT: The environment should be less authoritarian and more democratic, so that patients can join a group and internalize its values. Reflective space is also required.
CONCLUSIONS: Risk assessment is best described in terms of human endeavour, not in the language of scientific measurement.