Question: What to do with a verbally aggressive client

Hi everyone,

I'm a very, very new psychology student and who is in her first work placement as part of gaining my qualifications. It would be safe to say i've learnt all the theory and am now trying my hand at the practical! I'd like to ask the forums opinion on handling a client who is verbally aggressive- regardless if you are a practising professional or a consumer yourself.

The environment: My placement is in a residential complex for mentally disabled individuals. Our role is to help with the day to day living needs of the client, whether it be remembering to take medication, driving them to medical appointments and helping them out with domestic duties. The clients are free to come and go as they please and have a fair degree of freedom, although they are expected to come back home in time for whatever medications they need to have (some of them have physical medical conditions which require constant medication).

The client: The aggressive client in question has a diagnoses of schizophrenia and is unhappy about being having to live in this house. His complaints have ranged from the staff's cooking to the building itself, the activities available to him, society, my star sign (?) etc. He is verbally abusive not just to staff but with his housemates as well, which quite upsets them.

I suppose it is not really what he complains about which is upsetting but HOW he does so, which is namely, at the top of his voice and with language i'd expect from a sailor! He will continue on with his tirade, for sometimes up to half an hour, even after the person who is supposed to be on the receiving end has left the room.

The Question: Most of the staff at the complex ignore him and advise his housemates to walk away and ignore his provocations too. I want to add that i don't believe they do this to 'punish' him. I think they do it because if they respond to him he will continue with his verbally aggressive behaviour, whereas if they walk away he will eventually calm down.

So I guess I was wondering if people think this seems like an ok strategy? I mean to walk away while someone is still talking? It seems rude to me but in all honesty responding to him seems to 'feed the fire' even when it's done so in a respectful, neutral way. Will it make it worse in the long run from anyones experience?

Hi Mazey,

You have already talked to the other staff members there, it seems, but I think you should talk to them again. I believe that a consensus about how to handle the patient is important. The consensus at the moment is to ignore him - right? - but it does'nt seem to be working. You could let the staff know that you will be trying some new tactics over the next few weeks, to make the patient feel more welcome/loved. Once they know your intentions, then you should go about actually trying to improve the situation.

Ignoring him isn't working. When people walk away from him, it will confirm his opinion that 'everyone' is against him. Whilst you cannot be his friend, you can certainly reason with and understand him. For example, if he says that he's sick of being at the place, then you could reply with "I know... ...I know... ...but you won't be here forever - okay?". Speak with a reassuring, calm, and caring voice. This guy might just need to see that not everyone is against him. If he has been ignored his entire life, then ignoring him now won't do any good.

I say this based on having spent a few weeks in a psychiastric hospital as a patient, and based on my 5 years on this website.

Kevin