Fear gripped me. This routine psychotropic
medication delivery and in-home assessment
visit had gone terribly wrong. The look I saw
in my client's eyes indicated to me that he had
lost control of himself and that he was intent
on killing me. We were alone in his house.
While in the kitchen I listened to him describe
in great detail how he was going to slowly kill
me by dismembering me piece by painful
piece, shoot me in the stomach, decapitate me
and bury me in the backyard. What were
probably only minutes felt like hours. It was
clear to me that the client I had worked with
for one year was not his usual self and was
decompensating. I tried to remain calm as I
scanned the room, looking for a way to escape.
Somehow I came to the decision to slowly
back out of the house towards the front door,
while continuing to talk calmly to my client as
he described his murderous plans. In my mind
as I was halfway to the front door, I thought I
was on my way to safety. Suddenly, he
grabbed my arm and swung me into the living
room, effectively cutting me off from my exit.
Out of the blue, my captor became distracted
with the collection of videos on the other side
of the room, while continuing to describe
deadly scenes from each movie. Seizing the
moment I turned and ran out, sprinting to the
car. Safely I got in my car, locked the doors,
and sped off back to my office.
My life was significantly disrupted for
months after this incident. Nightmares interrupted
my sleep. I was overwhelmed with feelings
of shame and doubt. I began to question
my judgment at every turn. Should I quit?
Maybe I'm not cut out for social work? My
reactions altered the work patterns of my coworkers.
Because I no longer felt comfortable
going alone to a client's home, I requested a
coworker accompany me on my outreach visits.
The responses amongst my colleagues were
mixed--some acknowledged the event as traumatic,
others overtly and covertly expressed
sentiments such as, "This is part of the job so
just deal with it" and "If you are too afraid to
deal with clients' needs, you do not belong in
this type of work."
I didn't quit. In fact, since this incident I
was promoted to a supervisory position and
continue to work diligently with clinicians and
agency administration to develop a comprehensive
staff safety policy that goes beyond
current policies dealing primarily with facility
issues. My ability to cope with this traumatic
incident was certainly impacted by my enjoyment
of the challenge of the work and core
belief that I am a conscientious and competent
mental health professional. However, it was
the knowledge and supportive presence of my
supervisor that was key in helping me return
to my previous levels of professional and personal
sense of confidence.
Client violence toward social workers is not a rare occurrence. In a study of licensed social workers in a western state, Rey (1996) found that violence against social workers occurs across settings. Griffin (1995) reported that social work cases have become more complex (for example, substance abuse and mental illness and homelessness) and that treatment is provided in a societal context fraught with greater violence. Community-based social workers face greater peril than their office-based counterparts because they often provide services in unsafe neighborhoods and have limited to no immediate support available if something should go wrong. Key indicators of potential violence include positive symptoms of schizophrenia, medication noncompliance, active drug or alcohol use, mandated clients, and a history of violence (Shergill & Szmukler, 1998; Weinger, 2001). Even in the midst of writing our final drafts of this article, we sadly read that Nicole Castro, a 23-year-old social worker in Maryland was murdered while serving a mentally ill client during a "routine visit" (O'Neill, 2002). …