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About this book

Assessing and managing violence places a heavy burden on practitioners in social work, criminal justice and health care settings. Milner and Myers examine current explanatory theories of violence and how these influence assessment and intervention. Using case studies and a variety of agency documents, the strengths and weaknesses of these approaches are weighed up and a framework is presented to help workers looking to effect positive change.

Table of Contents

Chapter 1. Introduction

Abstract
Our starting point in writing this book is that everyone who works with people in whatever capacity will at some time have to respond to violence; whether this is a young child telling a nurse of an abusive experience, an adult with learning disabilities telling their carer about experiencing harassment, a young woman explaining to her social worker that she has aggressive feelings towards her baby, a boy who has sexually abused his sister talking to their youth offending team worker, or a frail older man in hospital who tells the community care manager he does not want to go home because his wife physically assaults him. You will come across these situations as a student on placement or as a qualified practitioner working with people, and responding to violence is an increasingly common element within social and health education and training programmes. When you turn to a book for guidance on how to deal effectively with these complex manifestations of violence, you will quickly discover that the literature divides unhelpfully into two distinct types. First, there are a number of books telling you how to work with people who are violent (mainly men and mainly groupwork). Second, there is a vast literature on how to respond to the victims of violence (mainly female and individual counselling).
Judith Milner, Steve Myers

Chapter 2. Assessing Violence

Abstract
The core of many professional interactions with violence is assessment, underpinned and reinforced by a plethora of governmental and departmental policy initiatives in crime, health and social care. This focus on assessment, or in it’s guise of ‘risk’ assessment, leads to approaches that can be rather mechanistic in nature, providing the busy professional with a series of protocols and instruments that all make claims to ‘truth’ in the prediction of future violent acts. This in itself may be of use to those under pressure and clearly if the assessment can be done quickly and effectively, based on evidence, then future victims have been protected through the identification of those who have the propensity for committing further damage. However, there are difficulties with this approach both in concept and in practice which we will explore. We will look at some key issues in the assessment of violence in this chapter, exploring how assessment is, and can be, constructed, with a view to illuminating some of the benefits and pitfalls of varying approaches to assessment.
Judith Milner, Steve Myers

Chapter 3. Grief and Loss: Psychodynamic Approaches

Abstract
This chapter has three main components: how interpersonal violence is understood in terms of a response to grief and loss (attachment theory); how the theory informs risk assessment; and the implications for prevention and intervention. As attachment theory evolved from psychoanalytic theory and practice, Freudian personality development will be briefly explained. Klein’s development of Freudian ideas on aggression is also explored, and the differences between object relations and attachment theories are outlined. The research evidence supporting attachment theory as an explanation for interpersonal violence is presented, particularly the work of Ainsworth and colleagues and of Main. The clinical implications of attachments for the prediction of violence and the assessment of risk are explored using the examples of child, sibling, peer, spouse and elder abuse. The practice implications of a theoretical explanation which does not have a distinct therapy are critically analysed.
Judith Milner, Steve Myers

Chapter 4. ‘Wrong-Thinking’: Cognitive Behavioural Approaches

Abstract
We now explore the use of an approach that is based on the notion that people learn particular behaviours and can re-learn in order to change. This chapter will outline how the theory explains violent behaviour; how it is used in the prediction of violence and the various forms it takes in managing violent behaviour. This theory has become an increasingly influential one in the development of policies, protocols and practices to tackle violence and has made claims to be the only effective approach (Cullen and Freeman-Longo, 1995); the most effective (Baldock, 1998; Kemshall, 2000) or the most favoured (www.​youthjustice-board.​gov.​uk). Cullen and Freeman-Longo encapsulate this position by stating that: ‘The only way you can change this [violent] behaviour is by observing your patterns of thoughts, feelings and behaviours, understanding your cycles, learning the skills and practicing new responses’ (1995: 8).
Judith Milner, Steve Myers

Chapter 5. Challenging Men, Supporting Women: Feminist Approaches

Abstract
This chapter examines how men’s violence to known women and their children is understood in terms of patriarchy (the structural dominance by men within society); how this theory influences risk assessments; and the implications for prevention and intervention. As the term patriarchy is used mostly in feminist research and theorizing, the various forms of feminism will be briefly explained. The impact of ‘second wave’ feminism on professional practice (supporting women; challenging men) and government policy will be explored, particularly the work of Dobash and Dobash, and Pence and Paymar. The limitations of this theory as an explanation for all family violence is also discussed, with reference to elder abuse, same-sex violence, female sexual abuse, and female-on-male violence.
Judith Milner, Steve Myers

Chapter 6. ‘Mad and Bad’: Mentally Disordered Offenders

Abstract
Increasingly mental health services have had to engage with responding to and managing violence and the potential for violence with people that they work with. This has been influenced by political and media representations of violence associated with those who have mental health problems, with legislative initiatives that have raised questions about civil liberties and how we view people who commit violent offences. The responsibility placed on practitioners in mental health services to prevent violence by their service users is a taxing one, and these demands can be impossible to meet in any absolute way.
Judith Milner, Steve Myers

Chapter 7. Safety Building: Solution-Focused Approaches

Abstract
This chapter outlines a very different approach from the preceding ones in that it does not attempt to explain and categorize violent behaviour at all on the grounds that it is not necessary to understand a problem to arrive at its solution, and it is more profitable to concentrate on competencies rather than deficiencies, strengths rather than deficits, and safety rather than risk. Thus there is very little in this chapter on the similarities between people who are violent and even less on the prediction of risk. Instead, there is a great deal on solutions and signs of safety. The basic principles and techniques of solution-focused practice are described, followed by a detailed discussion of assessment and intervention using a signs of safety approach. As the approach has been extensively evaluated, outcome research is detailed, plus examples of how solution-focused practice ‘works’ in a variety of service-provider settings.
Judith Milner, Steve Myers

Chapter 8. Deconstructing Problems: Narrative Approaches

Abstract
In this chapter we will look at a further approach based within a postmodern framework, that of narrative therapy, and how this can be used to understand and respond to violence. As the term implies, narrative approaches are interested in the stories that people live their lives by and consider that these stories can often be unhelpful and limiting, influenced by the larger and more powerful stories that society has generated in making sense of the world. These powerful stories, or dominant discourses (Foucault, 1965), can have a pervasive influence on how we live our lives and how we are allowed to think about ways of being. Narrative approaches seek to make these ways of being transparent and to develop new stories that are less problematic. Telling and retelling stories of peoples’ lives is a key element of this thinking, particularly with a view to developing alternative stories that are more relevant for, and local to, the people involved. Although it shares certain commonalities with solution-focused approaches, it is more interested in deconstructing the past in order to move forward and takes a more explicitly ‘political’ stance through the recognition of power relations within society and how these impact on people’s behaviour and potential for change (Morgan, 2000). Thus gender, sexuality, class and ‘race’ are central (though not exhaustive) concepts that are considered within any narrative work.
Judith Milner, Steve Myers

Chapter 9. Conclusion: Towards Effective Practices with Violence

Abstract
In the Introduction we identified the move from a more welfare position to one of increasing punitiveness, and we have argued that current criminal justice practices make no attempt to understand violent behaviour, the emphasis being on offending — especially where this is prolific and/or violent — rather than the person. Technocratic and managerial approaches to violence have reinforced this loss of the individual within a welter of protocols and enforced practices that create a climate of despair and inevitability about offending behaviour, leading to the increasing frustration of workers who are directed to engage service users in limited ways of working of dubious effectiveness, particularly in the Probation Service (McIvor, 2004). We enter this arena from a position of respect for service users and for those who are subjected to violence, taking an explicit position that direct work can be effective when it recognizes and responds to the specific person, rather than the narrow construction of ‘an offender’.
Judith Milner, Steve Myers
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