Group Safety

• Refuse to treat certain clients if they are inappropriate, e.g., sexual.
• Do not disclose personal data to clients.
• Prohibit clients from appearing at home.
• Location.
• Specify intolerable client behaviors.
• Discuss safety issues with loved ones.
• Do not list personal information in public directories.
• Develop a contingency plan for summoning help.
• Avoid working alone, and use extra staff.
• Train in the management of assaultive behaviors.¹ 
• Take appropriate measures to manage aggression.
• Be mindful of supplies and objects issued before, during, after sessions, or in the environment, e.g., chairs, glassware, ligatures that may cause strangulation.² 

Acute Inpatient Hospital Settings:

1. Conduct Risk Assessments: Regularly perform risk assessments to identify potential safety hazards in the treatment environment.³ 
2. Develop Crisis Intervention Plans: Create and train staff on crisis intervention plans tailored to the specific needs and risks associated with the patient population.⁴ 
3. Utilize Personal Protective Equipment (PPE): Ensure appropriate use of PPE, especially when dealing with patients who may have infectious diseases.⁵ 
4. Implement Structured Environments: Design therapy environments to minimize risks, including secure storage for potentially harmful items and maintaining clear, unobstructed pathways.⁶ 
5. Ensure Adequate Staffing Levels: Maintain appropriate staffing levels to provide adequate supervision and support during therapy sessions.³ 

Jail Settings:

1. Conduct Thorough Screenings: Perform comprehensive screenings of inmates to assess their mental health, risk of violence, and suitability for group or individual therapy.⁷ 
2. Create a Secure Therapy Environment: Use secure rooms with minimal furnishings and no access to potentially harmful objects.⁸ 
3. Establish Clear Policies and Procedures: Develop and enforce clear policies for managing aggressive or disruptive behavior, including the use of restraints if necessary.⁹ 
4. Maintain Confidentiality: Ensure that all interactions with inmates maintain confidentiality to build trust and respect.⁷ 
5. Implement Staff Training: Provide regular training for staff on how to handle and de-escalate potentially violent situations, including techniques specific to correctional settings.⁸ 

1. Guy, J. D., Brown, C. K., & Poelstra, P. L. (1992). Safety concerns and protective measures used by psychotherapists. Professional Psychology: Research and Practice, 23(5), 421–423. https://doi.org/10.1037/0735-7028.23.5.421[↩]
2. Foster, C., Bowers, L., & Nijman, H. (2007). Aggressive behaviour on acute psychiatric wards: prevalence, severity and management. Journal of advanced nursing, 58(2), 140-149.[↩]
3. Happell, B., & Koehn, S. (2011). Attitudes to the use of seclusion: has contemporary mental health policy made a difference?. Journal of Clinical Nursing, 20(5‐6), 765-773.[↩][↩]
4. Duxbury, J. A. (2015). Reducing restrictive practices: developing a research agenda. Journal of Psychiatric and Mental Health Nursing, 22(10), 89-91.[↩]
5. Sax, H., Clack, L., Touveneau, S., & Pittet, D. (2013). At the frontline of infection control: perceptions of infection control personnel in acute-care hospitals. Journal of Hospital Infection, 84(1), 1-9.[↩]
6. Mahoney, J. S. (2006). Interdisciplinary teamwork in acute care inpatient psychiatric treatment: The promise of the future. Archives of Psychiatric Nursing, 20(6), 297-298.[↩]
7. Soderstrom, I. R. (2007). Mental illness in offender populations: Prevalence, duty and implications. Journal of Offender Rehabilitation, 45(1-2), 1-17.[↩][↩]
8. Clarke, J. G., & Adashi, E. Y. (2011). Perinatal care for incarcerated patients: a 25-year-old woman pregnant in jail. JAMA, 305(9), 923-929.[↩][↩]
9. Steadman, H. J., Osher, F. C., Robbins, P. C., Case, B., & Samuels, S. (2009). Prevalence of serious mental illness among jail inmates. Psychiatric Services, 60(6), 761-765.[↩]