Risk Factors 101
What is a risk factor
Something that increases the chances of a problem behavior from happening (like violent behavior)
In the HCR-20v3 "historical risk factors mainly refer to what time period?
The person's past patterns/ history
childhood, adolescence, and adulthood
What's one common "early warning sign" that someone's violence risk is changing?
Increased agitation/anger, threats, pacing, paranoia, refusing meds, conflict escalation
Why focus treatment on dynamic risk factors? (Clinical)
x
Because they can change - improving them can lower risk
One of your triggers is any insult to your family. A peer on the unit walks up to you and says, " Your mama's so clumsy, she tripped over a wireless connection!" What's the best first step?
Walk away, use a positive coping skill (slow breathing, count to ten, grounding) and notify staff before it escalates.
True or False.
A risk factor means someone "will" be violent.
False- risk factors raise risk; they do not guarantee violence
Which Historical factor involves prior physical aggression, threats, or serious attempts to harm?
H1: A history of Violence
True or False:
Most violence is spontaneous and had no warning signs.
False: Many situations show build-up signs and triggers
True or False:
Managing symptoms is part of violence prevention.
True- fewer symptoms plus better coping often lowers risk
True or False:
A trigger is the same thing as an excuse.
False: triggers explain what affects you; you are still responsible for your choices
Double Points:
What's the difference between static and dynamic risk factors?
Static = cannot change (Historical)
Dynamic= Can change meaning current symptoms, coping, support. (Clinical)
What does H4: a history of problems with Employment focus on?
A pattern of unstable work/school functioning, terminations, poor attendance, or pattern of not getting along with work supervision/peers
What does "trigger" mean in a violent risk context
An event that increases stress and raises the chance of losing control (e.g. conflict, rejection, feeling disrespected)
A patient stops meds because they " feel fine now" What risk does that increase?
Symptoms relapse- increased instability and risk (especially if past symptoms contribute to violence)
Internal vs External triggers?
Internal= thought, feeling, symptoms,
External = events, pother people, situations
Name 2 examples of Dynamic risk factors?
x
Current substance use, currents symptoms, treatment participation (going to groups, Med compliant) Stress, anger, poor coping, lack of support. (Any two)
Which Historical Risk factor covers ongoing issues with alcohol/drugs over time
H5: A history of Substance Use
What is a "protective factor"?
Something that lowers risk (e.g. coping skills, support, medication adherence, structures routine, insight)
How can a patient show risk management day-to-day?
uses coping early, asks for help, walk away from conflict, follow treatment plan
Name two common triggers you might experience here in the hospital?
Feeling disrespected, being told no, loud noises, crowding, waiting, limit setting
Why do we track risk factors for the gradual release process
To guild treatment targets, privilege levels, and safety planning.
Which Historical Risk factor is about repeated difficulty following treatment plans or rules under supervision. (e.g., refusing medications, missing therapy, violating probation)
H10: A history of problems with Treatment or supervision response
Name two protective factors that reduce violence risk?
Med compliant, going to groups, support network, coping plan, avoiding substances. Any two
Why do privilege levels depend on risk factor
x
Privilege depends on risk factor because the team has to make sure the patient can stay safe and follow rules with less supervision
as risk goes down and stability goes up, it shows you can handle more freedom (grounds, community visits, overnight, etc.) If risk is higher, it shows more structure is needed.
When a patient says: When I feel disrespected, I will attack anyone who caused it!" What treatment target would help most?
x
Anger management + coping plan for perceived disrespect (recognizing trigger signs, time out plan, cognitive reframing, communication skills.