10 Safety Tips for Therapists
| TLDR Working one-on-one with patients behind closed doors often leaves therapists vulnerable to unpredictable behavior, physical violence, and harassment, especially when dealing with individuals experiencing acute mental health challenges. To address these risks, here I advocate for proactive safety measures like panic button systems, de-escalation training, secure office environments, and clear professional boundaries. These tools and strategies empower therapists to protect themselves while continuing to provide the critical care their patients need. |
"I don't think psychologists think enough about the safety measures that they might have in place, in case things do go awry,"
Phillip Kleespies, PhD, clinical psychologist at a VA hospital in Boston
Through my focus on improving the lives and wellbeing of workers across every industry, I've had countless conversations with professionals about workplace safety and how it affects their ability to do their jobs. However, if there is one group that consistently stands out as especially vulnerable, then it must be behavioral health therapists. Their work, often carried out one-on-one and in private settings, requires immense trust—not just from their patients, but from the therapists themselves.
Put simply, while the vast majority of people suffering from mental health problems will never become violent, patients struggling with complex issues are more likely to display erratic and aggressive behavior. As a result, therapists can be at an increased risk of experiencing violence or intimidation in the workplace.
So, in this article, I want to share a few key insights on how therapists can prioritize their safety without compromising the quality of care they provide. Additionally, by developing healthcare security and creating safer work environments, organizations can improve staff retention and ensure that patients get the care they deserve. Here, we take a look at some personal safety tips, some of the main risks faced by therapists, and how your facility can take action to mitigate the risks faced by lone workers.
Personal Safety Precautions — 10 Practical Tips for Therapists
I'm often inspired by the stories I hear from professionals who have implemented small but effective changes to their routines to prioritize safety. For therapists, this might include:
1. Consider Your Vulnerability
No one really wants to think of themselves as vulnerable, especially when they're at work. However, it's very important to be aware of your vulnerabilities when treating patients. One very simple measure you can take to protect your well-being is to keep the door to your premises locked at all times when it's not in use. This will help you to control who comes in and out of your office and could help to keep you safe if a violent patient, or one of their family members, comes around unannounced.
Before starting therapy sessions, screen potential clients for any behaviors that may indicate violent tendencies. This could include a history of self-harm, domestic violence, aggression with a family member or a criminal record. If you decide to go ahead and treat a person you think may become violent, make sure you take extra steps to ensure your personal safety both during and after your therapy sessions.
2. Establish Clear Boundaries
Setting and maintaining clear professional boundaries is critical for both your safety and the effectiveness of therapy. Make it clear to patients what behavior is acceptable during sessions, and don't hesitate to stop a session if they violate these boundaries. Establish a policy for handling inappropriate behavior and communicate this to your patients upfront.
3. Use Neutral Body Language
When interacting with patients who may become agitated, pay attention to your own body language. Avoid gestures or postures that could be interpreted as confrontational or defensive. Keeping your hands visible and maintaining a calm demeanor can help de-escalate tense situations.
4. Pay Close Attention to Your Surroundings
One of the most effective safety measures you can take is to be aware of your surroundings. Before seeing patients, take the time to remove any objects that could be used as weapons from the space. This might include things like paperweights, vases, glass bottles, and ornaments, as well as removing jewelry and earrings.
You should also ensure you place yourself between the door and your patient. This will allow you to leave the room quickly if a patient becomes aggressive and should help you to avoid becoming trapped.
5. Be Aware of Toxic or Dangerous Environments
As a therapist, you're likely to pay close attention to the mood and mental well-being of your patients. If the environment starts to feel dangerous or toxic, try to summon help via a panic button or by calling a colleague on the phone.
Often, calling someone else into the room can help to defuse a situation and change the mood of a session. If the atmosphere continues to darken, your colleague may be better placed to call for back-up. If you believe that there's a risk of violence before treatment starts, tell another caregiver of your concerns so that they can check on you during your session.
6. Keep Emergency Contacts Handy
Have a list of emergency contact numbers readily accessible in case of an incident. This list should include numbers for local law enforcement, nearby colleagues, and building security. Store these contacts on your phone, and consider having a printed list in your treatment room for quick access.
7. Conduct Regular Safety Drills
Practice emergency procedures regularly with your team or office staff. Simulating scenarios, such as an aggressive patient or an intruder, helps ensure everyone knows how to respond quickly and effectively under pressure. This preparation can be invaluable in real-life situations.
8. Educate Yourself on De-escalation Techniques
Take time to learn and practice de-escalation strategies. Techniques such as active listening, maintaining a calm tone, and validating emotions can often help diffuse a potentially volatile situation. Regular training in these skills can make a significant difference in managing aggressive behaviors.
9. Invest in Safety Devices
Safety devices should be an integral part of any comprehensive safety plan. For example, you could look at installing a panic button duress system to allow you to silently call for help if a patient becomes aggressive.
Having a panic button at your fingertips when you're in your treatment room will ensure you get help fast if a patient becomes violent. One of the benefits of panic buttons is that they're completely silent. This avoids the need for an audible alarm that could further aggravate the situation. Therapists in private practice may prefer to utilize a 911 panic button solution that alerts authorities to their location in the event of a dangerous scenario.
10. Guard Your Privacy
Although you may feel a close bond with the people you're treating, it's important to protect your privacy at all times when treating patients. Don't tell patients any personal details about yourself or your loved ones and try to avoid giving patients your personal phone number, address or social media handles. In general, the less your patients know about you, the better.
Working one-on-one with vulnerable patients? Talk to us about how other therapists are building safer practices.
Contact UsRisks and Hazards Faced by Therapists
"We don't see ourselves as potential targets, but we are."
Due to the sensitive nature of their profession, therapists generally work with their patients one to one and behind closed doors. Many of these patients will be suffering from chronic or acute mental health issues, making them more likely to be unpredictable and display violent behavior.
According to OSHA, healthcare workers account for nearly as many violent injuries as all other industries combined, and so understanding the risks and hazards within the industry is crucial to better protection. Below, I discuss some of the most common issues faced by therapists and others working in the healthcare industry.
Unpredictable Patient Behavior
Therapists often work with individuals experiencing acute or chronic mental health conditions, some of whom may exhibit erratic or violent behavior. Patients can become agitated, angry, or aggressive during sessions, particularly when discussing sensitive topics.
Physical Violence
Healthcare professionals, including therapists, are at a heightened risk of workplace violence. The Occupational Safety and Health Administration (OSHA) reports that healthcare workers experience nearly as many violent injuries as all other industries combined. This highlights the physical danger therapists face when managing aggressive or volatile patients.
Stalking and Harassment
The close therapeutic relationship can sometimes blur boundaries for patients, leading to stalking, harassment, or unwanted attention. This can happen during or after therapy, especially if a patient becomes overly attached or fixates on the therapist.
Working Alone
Therapists often work alone in private offices or during home visits, which can leave them vulnerable. Being isolated makes it harder to summon help quickly in emergencies, whether due to an aggressive patient or another safety threat.
Burnout and Mental Fatigue
Therapists are frequently exposed to their patients' traumatic stories and emotional struggles, which can take a toll on their mental health and lead to burnout. This emotional fatigue can make it harder for therapists to stay alert and responsive to potential threats.
Lack of Security Measures
Many therapy offices lack robust security infrastructure, such as surveillance systems, panic buttons, or secure entrances. This leaves therapists more exposed to external threats, such as intruders or unannounced visits from agitated individuals.
Inadequate Training in Crisis Response
Therapists may not always receive sufficient training in recognizing warning signs of violence or using de-escalation techniques. Without these skills, they are at greater risk of being caught off guard in threatening situations.
Cultural and Gender-Based Risks
Female therapists, in particular, may face additional risks of harassment, intimidation, or gender-based violence. Similarly, therapists from minority or marginalized communities may encounter unique vulnerabilities, including discriminatory or aggressive behavior from patients.
Environmental Risks
The physical environment can also pose risks. Poorly lit parking lots, isolated office buildings, or inadequate locks can create unsafe conditions, especially during early morning or late-night hours.
Increased Risk of Retaliation
Patients who feel dissatisfied or rejected during therapy might react with hostility. Retaliatory actions can include verbal abuse, property damage, or even physical threats against the therapist.
In a profession as vital yet challenging as therapy, prioritizing safety is not just about protecting the therapist — it's about ensuring the continuity of care for those who rely on them. By integrating practical tools like panic button systems, fostering ongoing training in de-escalation techniques, and creating secure and supportive environments, we can empower therapists to work with confidence and focus.
STAFF SAFETY
Protect Your Therapists So They Can Protect Their Patients
Therapists work behind closed doors with vulnerable patients. A staff duress system gives them a silent, instant way to call for help without escalating the situation.
Sources
American Psychological Association. (2008, April). Dealing with client violence. Retrieved December 5, 2024, from https://www.apa.org/monitor/2008/04/client-violence
ROAR for Good. (n.d.). Behavioral health panic buttons. Retrieved December 5, 2024, from https://www.roarforgood.com/behavioral-health-panic-buttons/
ROAR for Good. (n.d.). Hospital security procedures. Retrieved December 5, 2024, from https://www.roarforgood.com/blog/hospital-security-procedures/
ROAR for Good. (n.d.). Staff duress system. Retrieved December 5, 2024, from https://www.roarforgood.com/staff-duress-system/
Occupational Safety and Health Administration. (n.d.). Workplace violence in hospitals. Retrieved December 5, 2024, from https://www.osha.gov/hospitals/workplace-violence
ROAR for Good. (n.d.). Contact us. Retrieved December 5, 2024, from https://www.roarforgood.com/contact-us/
Riggio, R. E. (2024, June). Is your body language offensive to others? Psychology Today. Retrieved December 5, 2024, from https://www.psychologytoday.com/intl/blog/cutting-edge-leadership/202406/is-your-body-language-offensive-to-others
ScienceDirect. (2022). Article on safety science. Retrieved December 5, 2024, from https://www.sciencedirect.com/science/article/pii/S2212657022000253
