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Exploring factors that influence nurses: judgements of violence risk in a female forensic population
- Authors:
- ALLEN Sian, BEECH Anthony R.
- Journal article citation:
- British Journal of Forensic Practice, 12(1), February 2010, pp.4-14.
- Publisher:
- Emerald
Prior examination has shown that a clinician’s judgement of dangerousness is flawed when used alone. This is the reason why assessments, such as the Violence Risk Appraisal Guide, have become part of crime reduction in prison, probation and forensic mental health services in the UK and elsewhere. Many studies have examined the accuracy of standardised assessments in predicting violence risk, but there is less research on clinical staff members’ perceptions of violence risk and whether such perceptions are based on the literature. This study examined how nursing staff in a secure forensic unit make judgements about female patients’ level of risk and whether a patient's lack of engagement in therapy was a significant factor. Findings show that staff accounted for the following historical factors when making judgements: past aggression; substance misuse; symptoms of psychosis; and personality disorder. Staff also accounted for the following clinical factors: lack of insight; non-compliance; and lack of motivation. A positive therapeutic alliance between patient and key-worker, high levels of self-confidence in staff members, a supportive nursing team and an institution with good procedural security were perceived to be protective factors.