Impact News

Responding to Violence, Suicide, Psychosis and Trauma

Dangerous Behaviour: Open Programme Workshop, London, 25.04.15

Due to the cutbacks it has become near impossible for individual applicants to attend the “Difficult, Disturbing & Dangerous Behaviour” workshop which is now almost exclusively an “in-house” bespoke programme. None-the-less, Mosaic Training are hosting an open course in London on 25th April. As this may be the only opportunity this year and you are interested, you should act quickly. The workshop costs only £89.95 and details can be found here

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Filed under: Impact Training, Other Mental Health, psychosis, self-harm, Suicide, trauma, Violence, , , , , , ,

Skills in Managing Dangerous Psychotic Behaviour – Part Two

The second part to my YouTube discussion of Psychosis Containment Skills is now available at

Enjoy!

Iain

Filed under: Other Mental Health, psychosis, Violence, , , , , , , , , , , , , , , ,

Managing Dangerous Psychotic Behaviour – On YouTube

Iain Bourne discusses the principles underpinning Psychosis Containment Skills – or the interactive, face-face professional skills used in responding to immediately dangerous  psychotic behaviour. Features include the relationship between psychosis and violence; dysphoric vs reactive drivers; how to spot whether the psychosis is driving the behaviour; the differential role of hallucinations, delusions and paranoia; the involvement of persecutory and command auditory hallucinations; the psychotic vs non-psychotic world; changes in the sensory filtering system; personal space and catastrophic reactions.

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Facing Danger in the Helping Professions

Just received a copy and I have to say it’s a great read! Get a copy – available via Amazon or through the Open University Press – recommend it to friends and review it on Amazon.

Filed under: Impact Training, Other Mental Health, psychosis, trauma, Violence, , , , , , , ,

Different Worlds; working with hallucinations, delusions and paranoia

This dramatic course delivered by Dr Iain Bourne is being made available by Sitra

24th October 2012 in Southampton

Filed under: Impact Training, Other Mental Health, psychosis, , , , , ,

Open Courses “Different Worlds: working with hallucinations and delusions”

SITRA are now offering individual places on the “Different Worlds” course focussing on working with people who experience hallucinations and delusions:

SITRA – Different Worlds

Different worlds: Hallucinations and delusions

23 May 2012, London

25 May 2012, Southampton

24 October 2012, Southampton

This course is ideal for anyone who is working with service users with severe mental health issues. By the end of the course, participants will:

Have a better understanding of different types of hallucinations and their origins.
Have learned about a range of strategies to help service users cope with auditory hallucinations.
Know how to respond to services users in a psychotic crisis.
Have a greater awareness of different types of delusions and paranoid states.
Have a greater awareness of different approaches to the treatment of hallucinations, delusions and paranoia.
Price: Members £89/Non-members £129

Trainer: Dr Ian Bourne

Book now

Filed under: Impact Training, psychosis, , , , , ,

Adolescents At Risk Of Developing Psychosis Benefit From Early And Network-Oriented Care

Date: 15 May 2009 – 3:00

Family and network oriented, stress-reducing care improves level of overall functioning and mental health in adolescents at risk of developing psychosis, suggests a recent Finnish study. Jorvi Early psychosis Recognition and Intervention (JERI) project at Helsinki University Central Hospital (HUCH), Jorvi Hospital, Finland, is a project with an early intervention team for adolescents at risk of developing first-episode psychosis. As developing psychosis has been suggested to be a result of a combination of acute life stressors and trait-like vulnerability to psychosis, the intervention is based on the idea of multiprofessional, need-adapted, community-, family- and network-oriented, stress-reducing, overall functioning supporting and low-threshold care. The JERI team meets with adolescents at ages 12-20 in their natural surroundings, e.g. at school or at home, together with their parents and community co-worker, who has originally contacted the JERI team because of unclear mental health problems. The aim of the team is to recognize potential risk cases and reduce the stress level by family and network intervention. A follow-up study was performed to test how presented intervention will help adolescents at risk. Data was collected between January 2007 and May 2008. During the intervention, mean scores rose statistically significantly on overall functioning and scores on quality of life, depression, anxiety and pre-psychotic symptoms decreased statistically significantly, showing an improvement in overall functioning and mental health in adolescents at risk of developing first-episode psychosis. Adolescents did not receive other therapy or any antipsychotic medication. “JERI- intervention seems to improve level of overall functioning and support mental health in adolescents at risk of developing first-episode psychosis, even though further study with larger number of subjects, with a proper control group and with a longer follow-up time is needed”, says Dr. Niklas Granö, the leader of the research.

Results are published in the journal Early Intervention in Psychiatry. Reference: Niklas Granö, Marjaana Karjalainen, Jukka Anto, Arja Itkonen,Virve Edlund and Mikko Roine: An intervention to improve level of overall functioning and mental condition of adolescents at high risk of developing first-episode psychosis in Finland. Early Intervention in Psychiatry (2009; 3: 94-98) Source: Niklas Grano, Ph.D. University of Helsinki

Filed under: Other Mental Health, psychosis, , , , ,

The Dangerous Behaviour Masterclass 3 – Mapping Violence

Sorry for the delay. In the last Masterclass a distinction was made between Difficult and Dangerous behaviour. We have to go into this in greater depth, but at this point in the Masterclass we are simply in the process of mapping out the terrain and identifying important processes and principles. In this mapping process, one dimension can be “dangerousness” while another might be “form.” There are some others, but at this stage let’s just think one step ahead. “Form” describes the type of behaviours involved.

Typically on training courses participants express a concern about a form of behaviour or type of person(s). “What if they are drunk”, “I deal with addicts”, ” I’m really concerned about a stalker”, “Well that’s okay, but what if you’re surrounded by a gang of thugs”, “I can deal with most situations, but what if they are completely crazy?”, “What if someone is completely on a mission to do you some harm?” – and then the additional concern “What if I lose it (panic, freeze, react inappropriately, lose control of myself)?”

All these situations, and more will be dealt with in this Masterclass. Here we will briefly consider “Form” or the perceived type of behaviour with which we might be confronted. I say “perceived” because there is an extremely complex interplay between what goes on in the minds of the protagonists during a conflictual situation – again an issue to which we return.

If Difficult-Dangerous is the “depth” dimension, then what is the breadth? This is the more common arena for academics and there are many formulations to choose from. I choose to go my own way, not out of arrogance but because I arrive at the situation from a different position. I want to know what to do when confronted with all these frightening situations not just to explain them.

For this reason, I see violence as something in motion, and therefore something must be pushing it forward. What could be these “forces?” None of us would worry if they were were static – I could be supremely confident if I knew the person in front of me wouldn’t hit me. The next question, obviously, is then what pushes the behaviour into violence. I have thought about this – motives, drivers, incentives, urges, impulses – actually, in most cases we will never know.

None-the-less, in-practice, it turns out to be very helpful to be able to assess what is driving the aggressor’s behaviour – but a different language is necessary. Here I am suggesting that we label aberrant behaviour as either: Dysphoric, Psychotic or Psychopathic. These are not mutually exclusive – obviously someone could, for example, be impassioned through a delusional belief system. The important practical question is – what is is driving the behaviour? If, somehow, we could remove the driving force, perhaps the behaviour would lessen?

These driving forces, I have briefly described below (their intricacies we will explore later)

DYSPHORIC BEHAVIOUR
This is the most common form most people will encounter. It is fueled or driven by emotion (usually unpleasant and several). It happens because the principal prontagonistics are overcomed by anger, frustration, humiliation, annoyance, irritation, euphoria, etc – and these overide thoughts or other considerations.
PSYCHOTIC BEHAVIOUR
Mental health issues affect one in four of us. It is important to notice also that 80% of violent crime is perpetrated by people with no psychiatric history – alcohol is by far the best predictor of violence. Most psychiatric patients are more worried about what others may do to them than what they may do to others. None-the-less, violence does occur when people become disturbed though drugs, severe intoxication or florid psychosis – and here it is often the fear of the unknown rather than the actual danger that fuels our concerns. The driving factors are confusion, delirium, delusions, hallucinations. Each may be associated by terrifying and potentially violent outcomes, but the question we have to ask is “what is the driving force?” For example, what would be most effective – dealing with the “voices” or reducing the anxiety?
PSYCHOPATHIC BEHAVIOUR
This is behaviour primarily driven by a goal which in the perpetrator’s mind supercedes all other consequences. Often professional criminal activity is ascribed to this grouping. It is important to understand that we are not talking categories of people here, only of behaviour. I don’t suspect that Wayne Rooney considers the feelings of the opposition’s goalie as he slams the ball into the net! This behaviour is primarily predatory but could equally apply to white collar business people and not involve any interpersonal violence.

There is still much more to know! In the next Masterclass we will explore the relation between Dissociation and Violence, and then following that Violence, Dissociation and the Brain. Then we can begin to put the whole picture together again and describe, in detail, good effective practice in violent dyadic situations. From there we will consider issues such as gang/group/ violence, bullying, crisis teamwork skills, personal control issues, post-incident reactions and support – interspersed with with anything interesting and relevant I can throw at you!

Hasta la vista!
Dr Iain Bourne
IMPACT Training & Consultation Ltd
E-mail: impact@dangerousbehaviour.com
Web: http://www.dangerousbehaviour.com

Filed under: Impact Training, psychosis, Uncategorized, Violence, , , , , , , , , , , , ,