Module 3 – Violent Clients: Protecting Yourself and Others When Sessions Get Heated

Credit

Speaker

Paul Brasler, LCSW, CAIP Related seminars and products

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Paul Brasler, LCSW, CAIP, has been a licensed clinical social worker for over 20 years. He is the owner of Providence Consulting & Education, LLC, through which he provides clinical supervision and professional education services. Additionally, Paul provides Ketamine-Assisted Psychotherapy and other clinical services as part of a small practice. Paul has extensive experience in working with people in crisis and people living with substance use disorders, including adolescent residential treatment, community mental health settings, hospital emergency departments, Juvenile Drug Court, and private practice.

Paul has been a PESI national presenter since 2016, and he has presented classes across the country on Mental Health Emergencies, High Risk Clients, Resiliency, and a certification course for clinicians working with people with substance use disorders. He has written two books: The Clinician’s Guide to Substance Use Disorders: Practical Tools for Assessment, Treatment & Recovery (PESI Publishing, October 2022) and High-Risk Clients: Evidence-Based Assessment & Clinical Tools to Recognize and Effectively Respond to Mental Health Crises (PESI Publishing, 2019).
Paul has been a PESI national presenter since 2016, and he has presented classes across the country on mental health emergencies, high-risk clients, resiliency, and a certification course for clinicians working with people with substance use disorders. His second book, The Clinician’s Guide to Substance Use Disorders: Practical Tools for Assessment, Treatment & Recovery, PESI Publishing, was published in October 2022. Paul lives in Richmond, Virginia, with his beautiful wife, three sons, a cowardly dog, and two dwarf rabbits who are quietly plotting to destroy the world.

 

Speaker Disclosures:
Financial: Paul Brasler maintains a private practice and has employment relationships with LifeStance Health and Alchemy Wellness. He receives a speaking honorarium, recording, and book royalties from Psychotherapy Networker and PESI, Inc. He has no relevant financial relationships with ineligible organizations.
Non-financial: Paul Brasler has no relevant non-financial relationships.

Alternate Options

Objectives

1. Complete a comprehensive mental health assessment that encompasses a multitude of clinical concerns including mental status, lethality, substance abuse and trauma.
2. Determine when to hospitalize clients struggling with suicidal ideation, substance abuse, medical concerns or violent urges and develop protocols for doing so.
3. Provide coping strategies and support to clients presenting with suicidal ideation by helping to create a safety plan in session.
4. Assess for risk of client violence towards others and develop strategies to safely intervene as well as effectively carry out the clinician’s duty to protect.
5. Determine signs and symptoms of intoxication, withdrawal, or overdose in clients and develop plans for effective intervention.
6. Differentiate between medical and psychological presenting concerns as they relate to case conceptualization.

Outline

• Conduct comprehensive assessments
• Strategies for eliciting the right information
• What to ask yourself as you watch the client
• Can the client provide informed content?
• Limitations of the research & potential risks

• Who is most at risk?
• Implicit & explicit expressions of suicidal ideation & intent
• Lethality assessment to protect client & clinician
• Self-injurious behavior & suicidal ideation
• How to conduct a suicide assessment
• Safety planning for clients with suicidal ideation
• When to hospitalize
• Voluntary vs. involuntary hospitalization
• When clients are not admitted to the hospital

• Dealing with our fears: Clinicians’ safety
• When the clinician is the target
• When others are the target
• De-escalation techniques
• Preventative planning
• When to call 911
• The hospitalization process
• Duty to Protect (formerly Duty to Warn)

• Signs of intoxication
• Imminent risk: Signs & symptoms of overdose
• Identify withdrawal syndromes
• Treatment planning
• Drug basics that clinicians should know
• Need-to-know street names of common drugs
• When and how to refer to a higher level of care

• What could kill the client first?
• Medical emergencies that present with psychological symptoms
• Signs & symptoms of a medical emergency

• Recognize trauma in clients
• Dangers of misdiagnosis & improper treatment
• Strategies for trauma-informed care

• Protect your license with documentation
• Debriefing & supervision
• Address vicarious trauma
• Mitigate compassion fatigue

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