Integrating behavioral, psychodynamic, recovery-oriented, and trauma-informed principles to decrease aggressive behavior in inpatient care.

Positive behavioral support plans have been employed since the 1980s in the service of those with developmental disabilities and in school systems and show efficacy for decreasing challenging behaviors and facilitating skill building. Recent years have seen an increased use of positive behavior support (PBS) technology with adults who experience serious mental illness. Inpatient psychiatric units can be traumatizing places as a consequence of the acuity of units and their use of containment methods to address challenging behaviors, such as aggression against others and self-injury.

Trauma-informed behavioral supports (TIBS) for inpatient treatment of individuals who experience BPD.

Trauma-Informed Behavioral Supports (TIBS) is a novel treatment approach targeting aggression against self or against others in individuals who experience borderline personality disorder (BPD). It is based on applied behavior analysis and uses a person-centered and trauma-informed framework. People with BPD hospitalized because of concerning behaviors, [aggression to others, verbal aggression (e.

U.S. Department of Justice Investigation of a State Psychiatric Hospital.

The Department of Justice investigation of state psychiatric hospitals is nothing like investigation by more familiar regulatory agencies such as The Joint Commission or Centers for Medicare and Medicaid Services (CMS). For one, it comes with the threat of serious legal consequences for both the state psychiatric hospital under investigation and the state in general. Although little has been written about this topic, much of what has been written describes a negative, painful, and expansive experience affecting every aspect of the hospital system.

When Trauma Survivors with Psychosis Accuse Staff of Sexual Assault in Inpatient Psychiatric Care.

Inpatient psychiatric settings are now known settings in which sexual assault can occur. When a trauma survivor with psychosis makes an accusation of sexual assault within an inpatient setting, staff and the institution are frequently not well equipped in how to respond. While there is scant literature on how to proceed in such dilemmas there is even more of a dearth on how to effectively provide mental health services, trauma- and culturally informed care, and how to best engage with the individual so that safety can be maintained, and treatment continue.

A pilot study: Positive behavioral support assessment and intervention for individuals with serious mental illness and criminal justice involvement.

Individuals with serious mental illness (SMI) are consistently interfacing with the criminal justice (CJ) system. They are overrepresented in our nation's prisons and jails rather than being in appropriate treatment settings. They also exhibit behavioral challenges in such CJ settings that result in rule violations leading to punitive consequences, such as segregation and isolation, which have deleterious effects on their mental health and well-being.

Implementing a program to reduce restraint and seclusion utilization in a public-sector hospital: Clinical innovations, preliminary findings, and lessons learned.

The Alternative to Restraint and Seclusion State Incentive Grant was a national initiative to reduce restraint and seclusion use in psychiatric hospitals and community based mental health settings sponsored by the National Association of State Mental Health Program Directors. This initiative was implemented in a large public sector psychiatric hospital. It involved the use of a restraint and seclusion prevention project team and a Patient-Staff Steering Committee collaborating on violence prevention.

When Sexual Trauma Survivors with Severe Psychiatric Disabilities Experience Institutional Care.

Individuals with severe psychiatric disabilities face many challenges from their experience of mental health problems, but also from disenfranchisement, marginalization, and stigmatization from a sociocultural experience. Those who are sexual trauma survivors also have unique challenges and intersecting experiences, which are not historically well understood, acknowledged, or treated in U.S.

Positive behavioral support planning in the inpatient treatment of severe disruptive behaviors: A description of service features.

Positive behavior support (PBS) plans are increasingly used on inpatient units to assess and treat serious and dangerous behaviors displayed by patients with serious psychiatric impairment. A contemporary extension of traditional applied behavior analytic procedures, PBS plans integrate theories from several domains with perspectives on community psychology, positive psychology, and recovery-oriented care. Because there is little evidence to suggest that more invasive, punitive disciplinary strategies lead to long-term positive behavioral change (Parkes, 1996), PBS plans have emerged as an alternative to the use of seclusion and restraint or other forms of restrictive measures typically used on inpatient psychiatric units (Hammer et al.

Commentary: Treatment and violence risk mitigation in high-functioning autism spectrum individuals.

The article by Lerner and colleagues will allow forensic clinicians to gain more understanding of how the specific cognitive deficits in persons with high-functioning autism spectrum disorder (HFASD) relate to the propensity of these individuals to engage in cognitive distortions associated with violence. These deficits are relevant to a variety of forensic evaluations of matters such as criminal responsibility. We argue that they also have implications for the treatment and risk mitigation of individuals with HFASD who have engaged in violent behavior.

Instilling hope into forensic treatment: the antidote to despair and desperation.

The importance of hope in the treatment of physical ills is well documented. Less is known about its role in the treatment of mental illness. Hope, the expectation of achieving a goal, figures prominently among the curative influences that help forensic patients recover.

Through the eyes of another: improving the skills of forensic providers using a consumer-informed role-play procedure.

Objective: We describe an intervention aimed at improving the quality of care delivered by forensic clinicians and at exposing them to the principles of client-centered care.

Method: Thirty-five forensic clinicians belonging to various professional disciplines participated in a day-long, multi-modal training developed with the help of former residents of a maximum-security forensic hospital. The main components of the training included a 1.

Commentary: parricides unanswered questions, methodological obstacles, and legal considerations.

Unanswered questions about parricide abound. The scientific literature on parricide is modest and plagued by several methodological problems. In the present article, we seek to describe these problems, propose possible remedies, and review the legal considerations related to parricide.

Serum cholesterol concentrations and non-physical aggression in healthy adults.

Although physical aggression in humans and other primates appears to be negatively associated with total serum cholesterol (TSC) concentrations, the relationship between other forms of aggression and TSC is less clear. A plurality of studies have reported a positive association, some have reported no association, and a minority have reported a negative association. Some authors have speculated that the variability in findings is attributable to inconsistencies in the definitions and measurement of what has often been termed "verbal" aggression.