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hOWITWASTOBE.docRunning Head: Written Report 1
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Violence Risk Assessment Report
Name: Doe, Bob
File Number:
Date of Birth:
Date of Report:
Identification and Reason for Referral
Bob is a 51 year old Caucasian male who has been divorced twice. He currently lives alone and has no children. Bob has been an employee of xxx company for the past five years and has recently applied for a promotion, which he was not selected for. Bob has been referred by his current manager for a psychological assessment following receiving an anonymous email that raised concerns that Bob may have been overheard muttering threats. Bob denies making these threats and granted the police permission to search both his car and personal workspace, which revealed no evidence of any weapons.
Evaluation Procedures
Prior to the clinical interview, I informed Bob of my role as well as the nature and purpose of the evaluation. Bob was informed that the assessment was not confidential and that the results of the assessment would be summarized in a report to his employer. I informed Bob of the voluntary nature of the evaluation along with the penalties for noncompliance. Bob indicated that he understood all of this information and agreed to comply and proceed with the evaluation. Bob also signed a consent form, authorizing the completion of the evaluation, including obtaining the necessary relevant background information.
As part of the assessment, I reviewed Bob's personnel record, military records, and police records. Bob's personnel records revealed that he has a tendency to report to work late and has even shown up drunk at one point in time. Bob has been an employee of xxx company for just over 5 years. During the first two years of his employment, Bob received above average performance ratings on his annual evaluations. However, during the three most recent years, it was noted that Bob's performance ratings decreased, receiving below average on many of the categories. Bob's attendance problems also began to increase during this time period. Three years ago, he took personal leave to cover one week which he missed from work, which was later discovered that he was in jail during this time. Review of his police record corroborated this showing that he was jailed on a drunk and disorderly charge during this time period. While Bob does not have any other criminal charges, he has multiple traffic violations spanning the period of the past 7 years. Bob also has a permit to carry a concealed weapon, which he did have on his possession during the time of this arrest. Bob's military records indicate that he served two years in the military and was honorably discharged due to a “severe personality disorder that made him unfit for duty”.
Background Information/Interview Data
Bob was born in a small town outside of Cleveland, Ohio on xx xxx, 1963, the second of three children to an intact family. Bob reports that both his mother and his father worked to support the family in blue collar positions. Bob describes his family life as being “normal” and reports no history of substance abuse or mental health problems in his family. Bob denies any history of sexual or physical abuse as a child, stating that he had good parents.
Bob reports that he has an eleventh grade education, stating that he dropped out due to having difficulties at school. He verbalized that he often missed school and that he was often suspended for fighting at school. Bob denies taking any special education classes, although he states that his grades were “okay, I guess they could have been better”. He denied ever repeating any grades and verbalized that he often had difficulty taking tests and exams. He verbalized that he didn't have many friends in school and often socialized with the wrong crowds.
Bob reported that after he dropped out of school his parents kicked him out of the house and he began to work as a delivery driver to support himself. He stated that at this time he moved in with a high school associate and no longer had significant contact with his family. Bob reported an unstable work history for a period of time before joining the military. After his discharge from the military, he was unemployed for a period of time before coming to work at xxx company where he is currently employed.
When questioned about his discharge from the military Bob asserted that he was medically discharged without disclosing any additional information. Bob reports serving two years as a private first class. Bob denies ever having any diagnosis of a personality disorder while serving in the military, stating that he did talk to someone a couple of times while he was in the military, but it was no big deal because he was just going through some personal issues.
Bob denied any history of psychiatric hospitalization or outpatient mental health treatment, including psychotropic medications. Bob denied any history of suicidal thoughts or suicide attempts as well as any thoughts of harming others. Bob denies any preoccupation or weird or unusual thoughts or beliefs. Bob verbalized that he first began to drink alcohol at the age of 17 and denies using any drugs or other illicit substances. He described a significant history of daily use of alcohol and stated that this increased after his discharge from the military. Bob denies having a problem with alcohol, stating that he doesn't drink that much and that he can stop any time he wants to. He stated that he has completed voluntary inpatient substance abuse programs on two occasions, noting that the last time was three years ago, after his drunk and disorderly charge.
Bob verbalized a somewhat irresponsible and unstable relationship history, stating that he has been divorced twice. Bob stated that his first marriage lasted two years and his second marriage lasted only a period of months. Bob denies having any children and states that he currently lives alone. Bob reports that he currently has a “female friend” but denies any significant relationship with this individual.
Bob's unstable relationship history is also apparent in his personal relationships. Bob reports having few friends and no close relationships with his family members. He states that he talks to his parents and siblings on occasions, but indicates that they are not active supports in his life. Bob appears to be a loner and tends to withdraw and isolate when dealing with extreme stress in his life.
The results of the interview with the employee (a description of your mock interaction with and the mental status examination of the employee)
Bob appearance was professional, he was dressed casual, clean cut, and seemed ready to move forward with the interview. Bob was polite and did not show any signs that he would not cooperate during the evaluation. His speech was clear and made sense, he spoke in a normal tone; furthermore, Bob did not move in any unusual way. There were no signs that Bob was confused or not aware of his surroundings, when asked what day it was Bob answered correctly and kept good eye contact throughout the evaluation. Bob appeared to be in good spirits and has a positive attitude. He did not show any signs of having any illusions or anxiety; both his short-term and long-term memory seemed to be just fine. After speaking with Bob throughout the interview one would say Bob’s intelligence level is that of an average individual. However, there were moments during the interview where Bob seemed to be cautious; in regards to deception there were slight signs seen.
Psychological Testing
The psychological testing involved giving Bob the Workplace Assessment of Violence Risk, also referred to as the WAVR-21. This is a 21 item assessment that measures and identifies workplace-related targeted or intended homicide or serious assault according to Kienlen (n.d.). It indicates violence or targeted violence within a workplace; this could be intimidation, bullying, threatening, harassing and stalking. It is indicated by Kienlen (n.d.) this assessment is a rationally derived that is a 21 item instrument regarding risk factors of violence and threats within a workplace. This is done by breaking down one’s violent thinking into different categories. As Kienlen (n.d.) indicates there are three categories this is done, the first category is Motives for Violence; second category is Homicidal Ideas, Violent Fantasies or Preoccupation; and last but lease Violent Intentions and Expressed Threats This includes the important difference in Bob's thoughts about violence, this will help in getting information to how serious Bob is with acting out on any plans of violence. It is important to know not everyone who thinks about violence really acts out in a violent way. After viewing the scores Bob received it did indicate Motives for Violence and Homicidal Ideas, Violent Fantasies or Preoccupation, however, Violent Intentions and Expressed Threats was not present.
The Psychopathy Checklist-Revised, also known as PCL-R, this was given to Bob and entails a designed clinical interview that is supported with available background documents in order to assess the presence of psychopathic traits. People who score high are viewed as having personality traits categorized by having a disregard for the others and their rights, lack of empathy, inclinations to manipulate and show no remorse for any harm they have caused. The PCL-R, has been recognized for the validity in calculating future violence with the score of 30 or higher (Clark, et al., 2000). The PCL-R is comprised of four facets that make up two larger factors. The first factor measures selfish, callous, remorseless use of others and has proven to be positively correlated with signs of narcissism, machiavellianism, and dominance. Bob's factor one score was 9. Based on a normative sample of male offenders, Bob's factor 1 score was slightly lower compared to his peers. The second factor measures chronic, unstable antisocial behaviors and has proven to be positively correlated with signs of impulsivity, pleasure seeking and substance abuse. Bob's factor two score was 16. Based on normative samples of male offenders, Bob's factor 2 score was significantly higher compared to his peers.
Summary Scores
PCL-R Total Score: 25
PCL-R Factor One Score: 9
PCL-R Factor Two Score: 16
WAVR-21
1) Motives for Violence: Present
2) 2) Homicidal Ideas, Violent Fantasies or Preoccupation: Present
3) 3) Violent Intentions and Expressed Threats: Absent
Diagnostic Impressions
Axis I: Alcohol Dependence
Axis II: Antisocial Personality Traits
Opinions/Recommendations
It should be advised that the accuracy of this prediction of risk is limited at the time of its formulation, and that this accuracy decreases with time. In general, the reliability of such predictions tend to decrease significantly after a period of 6 months. The opinion of this writer has been generated based on the associated risk factors which would result in the possibility that Bob creates a significant risk of harm to another person or damage to the property of another person within the workplace setting. Factors not related to the workplace setting may contribute to Bob being at a greater risk for violent, criminal, or nuisance behaviors.
There are a number of factors that give rise to concern about Bob's potential risk to others. Bob has a history of substance abuse, has been diagnosed with a previous personality disorder, carries a concealed weapon, has a history of unstable relationships, and has a history of irresponsible behaviors.
Bob's military record indicated the presence of a “severe personality disorder that made him unsuitable for duty”. Individuals with such personality disorders tend to blame others, have a low tolerance for frustration, are impulsive and are mistrusting of others, making it difficult for them to form relationships with coworkers and supervisors. They often lack motivation and are known to be poor self-observers. Bob's low tolerance for frustration has been evident in the comments that have been overheard by his coworkers to which he responded that he was simply having a bad day.
Bob's history of substance abuse is indicative of tendencies of impulsivity, irresponsibility, lack of regards for others, and his poor coping skills. Bob reports that he used alcohol heavily after discharge from the military and has been in at least two outpatient substance abuse programs. His substance abuse has also led to him missing time at work, being late for work, and ultimately to his criminal record, as he was arrested for being drunk and disorderly. Bob's use of alcohol as a coping mechanism displays his minimal insight into his personality disorder as well as a need for healthy coping mechanisms and support systems.
Bob's irresponsibility is also displayed throughout his personnel record. Bob has been late for work on many occasions and has even shown up drunk on one occasion. Bob's previous two employee evaluations have been less that optimal, with both of them indicating scores of below average performance in many categories. These two performance evaluations have resulted in Bob receiving only 1% of of the 5% maximum salary increase both years. Bob's comments on the performance evaluations indicated that he did not agree with the ratings that he was given. Bob also verbalized that he believed that his manager favored other employees over him, and believes that is the reason for the negative comments and ratings as well as the reason that he has been passed up for two promotions that he believes he was more than qualified for. This writer believes that Bob is a disgruntled employee with some built up resentment towards his current supervisor. It would be recommended that Bob be considered for transfer into a similar position within a different department of the company, under different supervision, minimizing contact with current supervisor. Bob's feelings of bias and unfair treatment currently appear to be isolated towards current supervisor and are not aimed at management or the company as a whole. It would be recommended that Bob be removed from this supervisor's subordination as soon as possible, and contact between this supervisor and Bob be limited and monitored when absolutely necessary.
While Bob has a permit to carry a concealed weapon, this writer is inclined to question the reasoning behind the need to carry this weapon. Bob resides in a neighborhood with low crime statistics and records reveal that this permit was obtained four years ago, during the time that Bob reports drinking heavily. While Bob denies obtaining this permit with the intention of harming anyone, his prior military training and propensity for impulsiveness would incline this writer to question these motives.
Bob received a score of 25 on the PCL-R, which is currently one of the most reliable measures of psychopathy. While Bob did not score in the psychopathic range, his score is indicative of strong psychopathic tendencies. He has a history of unstable relationships, as indicated by his multiple divorces. He irresponsibility has been shown in his tendency to show up at work late and his substance abuse issues.
Nevertheless, Bob's pattern of behaviors do not suggest that, even with the strong presence of antisocial traits, that he poses a significant risk of violent behaviors. These patterns are supported by Bob's scores on the WAVR-21, which indicate that while he has the presence of motives for violence and preoccupation with violent fantasies, there is a definite absence of violent intentions. I anticipate that Bob will continue to have difficulties with authority figures, both in the workplace and with legal authorities and will possibly continue to express this frustration in unhealthy manners. Reviewing his pattern of behaviors, it appears that the severity of his actions along with the potential risk for harming others continues to decrease over time rather than increase.
After interviewing Bob and considering these factors, it is this writer's professional opinion that Bob is at a moderate risk for violent behaviors in the next five years. While Bob does currently display some risk factors that raise concern for his risk of violence, he also has some mitigating factors that decreases this risk. While Bob has minimal insight into his personality disorder, he at least displayed some recognition that his actions are not socially acceptable and that they could potentially lead to problems in the workplace. In addition to this, Bob is currently at an age where the base rate for violence continues to decrease.
Bob's moderate risk for violence is usually not an indication of life-threatening behaviors, but is typically an indication that an individual is experiencing difficulty coping with the problems in their life. Bob may continue to display symptoms such as irritability with others, acting out in anger, erratic behaviors, substance abuse and indirect threats towards others. Given the low base rate of previous violence in Bob, this write opines that the possibility of Bob acting out in a violent manner will begin to decrease over time.
While I cannot state that Bob poses absolutely no risk to others, it is reasonable to conclude that whatever risk he may pose would be further diminished by appropriate treatment. This writer believes that Bob is functioning at a high enough level that the risk can be managed through appropriate treatment. It would be recommended that Bob participate in cognitive behavioral psychotherapy aimed at addressing many of his antisocial traits. Issues to be addressed should include Bob's low tolerance for frustration, impulsivity, lack of regard for others, lack of accountability, poor coping skills, and lack of social supports. This psychotherapy should focus on assisting Bob with identifying warning signs and triggers as well as developing healthy coping skills and support systems.
References:
Clark, D., Grann , H., Hare, R., & Thornton, D. (2000). Psychopathy and the predictive validity of the PCL-R: An international perspective. Behavioral Sciences and the Law. 18:623-645. Retrieved on July 14, 2014 from
Kienlen, K., (n.d). Review of the WAVR-21: A structured professional guide for the workplace assessment of voilence risk (second edition). Minnesota Threat Assessment and Forensic Professionals. Retrieved on June 23, 2014 from http://www.workplaceviolence911.com/docs/WAVRReviewFinalWPV911-313.pdf
