Textbook of Violence Assessment and Management

Textbook of Violence Assessment and Management
Edited by Robert I. Simon and Kenneth Tardiff; Washington, DC:
American Psychiatric Publishing, Inc, 2008
638 pages • $99.00 (hardcover)

The foreword to the Textbook of Vio­lence Assessment and Management promptly reminds readers that the mental health system has been invested in the prediction and prevention of violence since its inception. In a field dedicated to promoting wellness via the management of cognition, emotion, and behavior, violent thoughts, feelings, and actions are of primary concern. When psychiatric illness or psychological distress manifests as violence, the costs in terms of human suffering are extreme, wreaking havoc in the lives of patients, clinicians, and society at large-often with irrevers­ible consequences.

The clinical management of potential violence, in which accurate prediction and effective prevention are already extraordinarily challenging, is further complicated by the medicolegal complexities that surround these issues. Appropriately then for most mental health professionals, an encounter that involves potential violence generates levels of vulnerability and apprehension that are uncommonly encountered in other clinical contexts. The lessons organized by Simon and Tardiff in the Textbook of Violence Assessment and Management offer much to mitigate practitioner anxiety with up-to-date knowledge, clinical skill, and medicolegal savoir faire.

The editors’ experience shines through in the organized and thought­ful progression of chapters. The book, which opens with a section devoted to assessment principles, includes an outstanding chapter on structured risk assessment of violence. The section that introduces and clarifies actuarial techniques is superb and makes a powerful argument for more widespread use of such tools. A section dedicated to various mental disorders and conditions follows and includes mood disorders, schizophrenia, posttraumatic stress disorder, substance abuse, personality disorders, neurological and medical disorders, and impulsivity and aggression. The associations between these various mental disorders and violence are explained, as are treatment implications. Appropriately, violence is broadly conceived of as having internal and external foci, such that assault and suicide are both meaningfully addressed.

A section devoted to treatment settings follows; it specifically addresses the challenges and legal considerations that are unique to out­patient, inpatient, and emergency service risk assessment.

Safety considerations for patients, staff, and the public are carefully delineated. Medical and psychotherapeutic mo­dalities are broadly reviewed. A chapter on seclusion and restraint thoughtfully outlines the indications, techniques, special care considerations, and documentation requirements that are warranted when intervention is required. Special populations and topics are covered in the concluding chapters. Sexual violence and the particular nuances that surround assessment of risk, recidivism, and treatment options are carefully considered in an outstanding chapter.

For a book of its size and scope, this text proves remarkably approachable for cover-to-cover reading, and the time invested is exceptionally rewarding. As the book clearly explains, any clinician who labors under the notion that his or her practice escapes the need for such a resource is engaged in denial. It is difficult to imagine limits to this book’s target audience; any mental health clinician at any stage of career development should be attending to the lessons offered here. The adage to “never worry alone” is echoed throughout the volume, and while no book will effectively replace consultation with a trusted colleague, having this book at hand may be the next best thing.

The Textbook of Violence Assessment and Management now occupies the most accessible real estate on this reviewer’s bookshelf.