Sequence and Means of Prevention

In order to lessen the harmful consequences and causes of these waves of workplace violence, some means of prevention must be implemented according to a sequence of three phases or action times: before (primary prevention), during (secondary prevention) and after the attacks (tertiary prevention).

• Training that meets the required qualifications for a job and is appropriate for the kind of tasks involved contributes to preventing and defusing conflicts in the workplace. Skills that match the job to be carried out and the needs of the clientele or the public concerned, as well as supervision by employees who are experienced, reliable and capable of managing complex situations can help address the psychological aspects of workplace violence. For example, specific advice should be given on how and when to end an exchange with a client or customer in order to protect the employee from violence.
  
• A steady flow of intraining and a transparent system of communication can help reduce the risks of violence from clients or customers, patients, family and friends, or the public, given that tension levels will be lower if people are better informed. These measures reduce tensions and frustrations between employees. A steady flow of intraining is crucial for lifting taboos tied to intimidation, collective persecution and sexual harassment. Mutual support between co-workers and between supervisors and subordinates is also essential.
  
• Workspace design in general and the installation of systems for protecting personnel in particular vary according to the site and the field of activity. Workspace design includes ventilation and heat control, room size and noise level. In a waiting room, for example, it is also essential to provide a sufficient number of seats, which are comfortable, as well as sufficient washrooms, which are clean.
  
• Organizing the work and modifying positions can help reduce the root causes and risks of violence, and this approach is more cost-effective than investing in means to protect individuals. Persistently unresolved organizational problems cause psychological tensions to rise between employees and affect the quality of services provided to clients. It is essential to properly orchestrate the design and accomplishment of tasks:  
• clearly specify which responsibilites and tasks are assigned to each person,
• make sure there is sufficient staff to carry out the tasks that need to be accomplished, especially during peak periods, in order to avoid excessive waiting periods and delays in service to clients or customers, patients or the public,
• rotate staff for the most demanding jobs,
• improve the circulation of staff among different areas of activity; in short, redefine work practices and modify positions accordingly.

Protecting employees who work alone requires the following measures:

• silent alarms,
• video cameras,
• controlled access,
• protective barriers between the employee and the client or customer, or a secure area where a threatened employee can take shelter; in short, each situation calls for its own unique and clever mix of simple, discreet alarm devices, designed to get a very rapid response from co-workers, security or the police. In the case of public transport, for example, the driver should have as little money as possible at his disposal through the use of zone-based payment systems or pre-paid passes, and there should be a sufficient number of vehicles in operation to avoid overly long waiting periods, as well as a simple and efficient radio system. These are all means of limiting the risk of attack by passengers .

Workplace conflict, task management problems and difficult relations with clients or the public are all circumstances where preventive measures against violence combined with dialogue usually succeed in avoiding clashes. Nevertheless, sometimes these measures are absent or insufficient and this situation can transform a peaceful organizational environment into one that is both hostile and dangerous.  

Here are the best tips for defusing a violent crisis. First of all, it is helpful to know that there are four (4) phases in a crisis:

1. Alarm or Protest
2. Escalation
3. Violent Act
4. Lowering of Tension and Recovery

The four phases are defined as follows:

• The alarm or protest phase is when the attacker becomes nervous and agitated (wringing hands or clothes, looking all around).
• The escalation phase indicates that the tension is rising (threats, anger, panic, provocation).
• The third phase is when the violent act occurs (verbal agitation becomes physical violence).
• The final phase is when the tension comes down and recovery begins (agitation decreases, there is guilt and remorse).

Messages to communicate at the start of the crisis:    

• These messages hinge on matching verbal and body language that express self-confidence, attentiveness, calm, support and empathy.
• The personal space needed by someone in crisis is larger than usual (in North America, one metre or about one arm's length).
• It is also important to watch the attacker's body language, backing up if he backs up or otherwise indicates that you are too close.
• Ideally, it is preferable to adopt a position wherein you are standing sideways to the attacker rather than face-to-face as in combat, or with your back to him as though you felt indifferent to him. 

 If the crisis begins when you are sitting down:

• You should stand up gently and avoid sudden movements.
• Your hands should not be in your pockets or on your hips, but rather open, with no finger-pointing, and all hand gestures should be slow or restrained.
• A neutral, attentive and non-condescending facial definition and a reassuring tone of voice also help to defuse a crisis.
• Lastly, you should disassociate yourself from your emotions by focusing on the person who is in crisis so as to help him and sincerely try to understand him. It is important to keep in mind that the attacker is also someone trying to regain his equilibrium.  

It is helpful to identify the professionals who can help at each stage in managing a violent crisis:

• The alarm phase is always the most favourable for one person to defuse a crisis.
• The escalation phase requires intervention by at least two people.
• The phase involving the violent act should be left to experts (police, security guards, psychologists, negotiators specialized in hostage-taking). It is very risky to try to be a hero at this stage. The best thing to do is to look for an exit and leave very quickly, backing up slowly until you are farther away.
• The recovery phase, when there is guilt and remorse, is the best stage to offer assistance, but again, this should be left to people who have experience or who have credibility in the eyes of the attacker.

The first mistake a great number of organizations make is not being prepared to manage a violent crisis in the workplace. The second is not acting immediately following an incident or incidents under the pretext that the effects or consequences will not show up right away.

Victims of violent acts can experience all kinds of reactions:

• anxiety,
• feelings of vulnerability and powerlessness,
• sleep disorders,
• trouble concentrating,
• greater fear,
• shame,
• frustration,
• a change in values,
• a very strong grudge and the desire for revenge.

The importance of reporting and recording cases as well as properly managing the return to work

Professionals from the fields of psychiatry, psychology, social services or nursing all emphasize the importance of getting help as soon as possible in order to avoid serious, difficult or incapacitating consequences. The faster help is sought, the more effective it will be. It is a good idea for members of the organization to set up individual and group meetings for victims with people who are specialized in assisting victims of criminal acts or with community support groups for victims of violence. The managers of those affected should also attend these meetings. It is also crucial to record the cases of workplace violence in order, after the fact, to better detect the factors that contributed to it within the organization and to evaluate the effectiveness of existing measures. All staff members should know where and how to report violent acts and suggest solutions without fearing prejudice or disciplinary action. The literature does not refer to any specific way to manage the return of victims and attackers to work and their readjustment to the workplace. In the most serious cases, the possibility of returning to the same workplace cannot really be envisaged. The issue then becomes getting the person back into the job market. In Quebec, when it comes to returning to work and re-adjusting to the workplace, victims of violent acts, both criminal and non-criminal, are regulated by the same process as victims of industrial accidents or occupational diseases.