UNDERSTANDING AND RESPONDING TO VIOLENCE IN THE WORKPLACE Department of Health and Human Services ABRIDGED GUIDELINES March 1997
VIOLENCE
IN
THE

WORKPLACE

IMPORTANT
PHONE
NUMBERS/ LOCAL

RESOURCES

(COMPLETE
THIS
AT
LOCAL

LEVEL)

Your
Supervisor: Building Security: Building Health Unit: Human Resources

Staff:

Employee
Assistance
Program:

Crisis
Management

Team:

Local
Law
Enforcement: Fire Department: Others: National Domestic Hotline:

800-799-
SAFE
or

800-787-
3224
(TDD)
1
VIOLENCE
IN
THE

WORKPLACE

VIOLENCE
IN
THE

WORKPLACE

1
2

u u
INTRODUCTION

PURPOSE
OF
THIS

HANDBOOK

The
purpose

of
this

handbook

is
to
provide

guidance

to
all
employees

of
the

Department
of
Health

and
Human

Services

(HHS)
on
managing

violent
or

potentially
violent
situations.

It
is
intended

to
make

employees

aware
of
the

potential
for
violence

in
the

workplace,

to
increase

their
ability

to
recognize

early
warning

signs
of
potentially

violent
situations,

and
to
understand

how
to

respond
to
actual

or
potential

incidents.

For
those

who
want

to
learn

more,

it
is

recommended
that
the
lengthier

version
of
this

guideline

be
read.

It
can

be

obtained
from
your
personnel

office
or
the

HHS

home

page
on
the
Internet

(www. dhhs.
os. gov). BACKGROUND
AND
DEFINITION

Violence
is
a
complex

phenomenon

that
appears

to
be
increasing

in
the

workplace.
An
average

of
20
workers

are
murdered

each
week

in
the

United

States.
The
majority

of
these

murders

are
robbery-related

crimes.
In
addition,

an

estimated
1
million

workers

are
assaulted

annually
in
U. S.

workplaces.

Most
of

these
assaults

occur
in
service

settings

such
as
hospitals,

nursing
homes,
and

social
service

agencies.

Factors
that
place

workers

at
risk

for
violence

in
the

workplace
include
interacting

with
the
public,

exchanging

money,
delivering

goods
or
services,

working
late
at
night

or
during

early
morning

hours,
working

alone,
guarding

valuables

or
property,

and
dealing

with
violent

people
or
volatile

situations.
(from
Violence

in
the
Workplace:

Risk
Factors

and
Prevention

Strategies;
National
Institute
for
Occupational

Safety
and
Health;

June
1996;

p.

ix) In HHS,
workplace

violence
is
defined

in
a
broad

and
inclusive

manner.
It
is
an

action
(verbal,

written
or
physical

aggression)

which
is
intended

to
control

or

cause,
or
is
capable

of
causing,

death
or
serious

bodily
injury
to
oneself

or

others,
or
damage

to
property.

Perpetrators
include
customers

and
clients

of
HHS

programs,

employees

and

managers,
and
persons

who
have

no
relationship

to
the
Department.

Violence

can
also

occur

as
a
result

of
domestic

situations

that
spill

over
into
the
worksite.

ROLES
AND
RESPONSIBILITIES

Preventing
and
responding

to
actual

or
potential

incidents

of
workplace

violence

is
the

responsibility

of
everyone

at
HHS,

no
matter

what
level
or
role.

All
employees

(including
managers
and
supervisors)

are
responsible

for:


their

own
behavior

and
interacting

responsibly

with
fellow

employees

and
their
supervisors;


promptly
reporting,
anonymously

if
necessary,

any
acts

of
violence,

threats,
and
similar

disruptive

behavior
in
the

workplace

to
appropriate

authorities;  cooperating
fully
in
investigations/ assessments

of
allegations

of

workplace
violence;


seeking
appropriate

assistance
(e. g.,
Employee

Assistance
Program
or

other
counseling)

if
they

are
experiencing

stressful
personal
or
work

circumstances,
generating
from
any
source,

which
may
adversely

affect

their
productivity

or
lead

to
unacceptable

behavior;
and


informing

appropriate

persons
in
the

agency

about
restraining

orders

and
other
protective

court
orders

related

to
domestic

situations

so
that

assistance
can
be
offered

at
the

worksite.

Managers
and
supervisors

are
additionally

responsible
for:


ensuring
that
all
employees

are
fully

informed

of
and

understand

HHS

workplace
violence
policy
and
procedures;


being
cognizant

of
situations

that
have

the
potential

to
produce

violence

and
promptly

addressing

them
with
all
concerned

parties;


being
sensitive

to
stress

generated

by
the
workplace

and
considering

changes
that
could

alleviate

work-related

stress;


encouraging

employees
who
show

signs
of
stress

or
evidence

of

possible
domestic
violence
to
receive

assistance,

such
as
that

provided

by
the

Employee

Assistance
Program;
and


documenting

and
responding

to
allegations

of
workplace

violence
in
a

timely
fashion,

evaluating

the
results

and
taking

necessary

action
or

assisting
the
Crisis

Management

Team.

Additionally,
other
components

of
the
Department

have
special

responsibilities

in
preventing

and
responding

to
workplace

violence.
The
Servicing

Personnel

Office,
the
security

office,
the
Employee

Assistance
Program,
the
training

office,

the
unions,

and
the
safety

officers

may
assist

in
investigating

and
intervening

in
2
VIOLENCE
IN
THE

WORKPLACE

VIOLENCE
IN
THE

WORKPLACE

3
4

these
situations;

provide
technical

assistance

and
support;

and
provide

help
for


bomb
threats;

employees
showing
signs
of
stress

as
well

as
for
worksites

experiencing

conflict


actions
which
damage,

destroy,
or
sabotage

property;

and

and
organizational

change.


physically

aggressive
acts,
such
as
shaking

fists
at
another

person,

u u
LEARN

THE
WARNING

SIGNS

INTRODUCTION While they are often
preventable,
it
is
still

difficult

to
determine

whether
or
not

any
particular

workplace
situation
is
potentially

violent.
This
is
an
emotional

and
complex

topic,
and
decisions

about
what
to
do

in
certain

situations

are
not

always
straightforward

or
made

in
a
clearheaded

state
of
mind.

In
many

cases,

employees
ignore
warning

signs
because

they
believe

they
are
not
important,

"that's
just
the
way

Joe
is",
or
that

it
is
none

of
their

business.

In
other

situations,
employees
react
based

on
fear

and
what

they
believe

is
the

profile

of
a

potentially
violent
person,

not
necessarily

observed
actual
behavior.

Another

major
hindrance

is
not

knowing

where
to
go

to
get

help

in
making

determinations
regarding
real
and
potential

risks.

Actual
threats
should
always

be
taken

seriously

and
responded

to
immediately.

When
there
is
not

an
actual

threat,
judgement

and
senses

should

be
trusted.

"The

gut
feeling

that
one
gets
when

talking

to
people

should
be
respected.

If
one

feels

that
someone

is
dangerous,

that
person

should
be
considered

dangerous."

(from

Violence
in
the

Workplace

,
S.

Anthony

Baron,
1993,
p. 29)

FORMS
OF
VIOLENCE

There
are
many

forms

of
workplace

violence.
The
one
form

that
frequently

receives
the
most

attention

is
workplace

homicide.
While
violence

is
a

substantial
contributor

to
death

on
the

job,

it
also

takes

many
forms
that
are
non-

fatal.
Some
examples

of
non-fatal

forms
of
violence

are:


verbal
abuse
including

offensive,
profane
and
vulgar

language;


threats
(direct
or
indirect),

whether
made
at
work

or
at
home,

in
person

or
through

letters,
phone
calls,
or
electronic

mail;


physical
assault
upon
oneself

or
another

person;


throwing

or
striking

objects;


intimidating

or
frightening

others;


harassing,

stalking,
or
showing

undue
focus
on
another

person;


concealing

or
using

a
weapon;

kicking,
pounding

on
desks,

punching

a
wall,

angrily

jumping

up
and

down,
screaming

at
others.

Because
of
the

nature

of
the

services

provided

by
HHS

programs,

these
types
of

non-fatal
incidents
may
be
perpetrated

by
our

clients

or
patients,

particularly

in

health
settings.

They
may
also
be
committed

by
co-workers.

It
is
important

to
recognize

that
violent

incidents

in
the

workplace

may
include

acts
of
domestic

violence.
Often,
co-workers

and
supervisors

believe
that

domestic
violence
is
something

that
is
not

their

concern,

but
a
private

family

matter
that
should

not
be
brought

to
work.

But
the
problem

is
pervasive

in
the

workplace.
In
a
recent

study,
domestic

violence
accounted

for
27%

of
violent

events
in
the

workplace.

(from
Workplace

Violence
Prevention

Reporter ;

October
1996)
If
the

victim

has
sought

shelter,

the
workplace

is
sometimes

the

place
she
can
be
found.

Occasionally,

therefore,
the
perpetrator

will
show

up
at

the
partner's

worksite
to
carry

out
acts

of
violence

against
her
or
anyone

trying

to
protect

her.

LEVELS

OF
VIOLENCE

Potentially
or
actual

violent

situations

typically
escalate
if
not

defused.

Dr.
S.

Anthony
Baron,
author
of
Violence

in
the

Workplace

(1993),
identifies

three

levels
of
violence

and
the
warning

signs
that
typically

occur
at
each

of
the

levels.

These
levels
may
be
seen

in
clients

and
patients

of
HHS

programs,

among
co-

workers,
and
others

who
have

no
connection

to
this

Department.

They
are:

Level
One
(Early

Warning

Signs)

The
person:  refuses

to
cooperate

with
those

in
authority;


spreads
rumors
and
gossip

to
harm

others;


consistently

argues
with
employees/ clients/

patients;


belligerent

toward
employees/ clients/

patients;


constantly

swears
at
others;

and/ or


makes
unwanted

sexual
comments.

Level
Two
(Escalation

of
the

Situation)

The
person:
3
VIOLENCE
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6


argues
increasingly

with
customers,

vendors,
employees,

and

does
not
necessarily

mean
a
violent

act
will

occur.

They
may
be
indicators

of

management;
another
type
of
problem.

Examples

of
performance

indicators
are
listed

below.


refuses
to
obey

agency

policies

and
procedures;


sabotages

equipment

and
steals

property

for
revenge;


attendance

problems


verbalizes

wishes
to
hurt

employees

and/ or
management;


impact
on
supervisor's/ manager's

time


sends
sexual

or
violent

notes
to
employees

and/ or
management;

and/ or


decreased

productivity


sees
self
as
victimized

by
the
Department

(me
against

them).


inconsistent

work
patterns

Level
Three
(Further

Escalation,

Usually
Resulting

in
an
Emergency

Response)


safety
issues

The
person

frequently

displays
intense
anger
resulting

in:


recurrent
suicidal
threats;


recurrent
physical
fights;


destruction

of
property;


utilization

of
weapons

to
harm

others;

and/ or


commission

of
murder,

rape,
and/ or

arson.

A
Note

About

Domestic

Violence

Except
when
those
involved

in
domestic

violence
are
co-workers,

most
incidents

are
perpetrated

by
individuals

outside
the
agency.

It
is
unlikely,

therefore,

that

the
levels

of
violence

described

above
will
be
evident.

There
will,
however,

be

early
warning

signs
that
this
type

of
violence

is
escalating

outside
the
workplace.

The
victim

may
show
symptoms

such
as
increased

fear,
emotional

episodes,

signs
of
physical

injury,
and
other

evidence

of
physical

stress
such
as
excessive

phone
calls.
Victims,

as
well

as
perpetrators,

also
show

signs
of
work

performance
deterioration
as
described

in
the

next

section.

By
intervening

when

the
early

warning

signs
occur,

even
though

the
violence

may
not
yet
have

been

committed
at
work,

it
may

prevent

a
serious

incident

from
occurring.

PERFORMANCE
INDICATORS
In
addition

to
the

indicators

described
above,
there
are
also

a
number

of

additional
performance

problems
that
may

be
warning

signs
of
potential

trouble.

Research
into
incidents

of
workplace

violence
discloses
without
exception

the

presence
of
at
least

several

of
the
characteristics

described
below.
These
signs

may
show

up
in
perpetrators

of
violence,

those
who
are
victims,

those
who
fear

violence
because
they
are
being

threatened,

and
those

involved

in
domestic

violence.
Although

it
is
possible

that
only

one
of
these

indicators

will
occur,

it
is

more
likely

that
a
pattern

will
occur

or
that

they

will
represent

a
change

from

normal
behavior.

Remember

that
the
presence

of
any

of
these

characteristics


inappropriate

reactions


concentration

problems


poor
health

and
hygiene


unusual/ changed

behavior


evidence

of
possible

drug
or
alcohol

use/ abuse


evidence

of
serious

stress
in
the
employee's

personal
life


continual

excuses/ blame


unshakable

depression

THREAT
ASSESSMENT Determining the seriousness

of
a
violent

or
stressful

situation
and
how

to
best

intervene
is
the

basis

of
a
threat

assessment

which
is
best

handled

by
a
local

Crisis
Management

Team.
The
team

is
a
group

of
specialists

convened
to

investigate
and
assess

a
violent

or
potentially

violent
situation.

Depending

on

the
situation,

the
team

may
intervene

to
diffuse

threatening

occurrences

or
to

implement
an
action

plan.

If
help

is
needed

in
assessing

whether
a
situation

(such
as
those

described

in

levels
1
and

2
above)

is
potentially

violent
contact
the
designated

Crisis

Management
Team
leader
found
at
the

front

of
this

handbook

OR
any
member

of

the
team,

if
the

leader

is
not

available.

The
call
should

be
made

immediately.

If

the
situation

has
escalated

as
described

in
level

3
(above),

contact
emergency

numbers
(such
as
911)

before

contacting

the
Crisis

Management

Team.
Do
not

wait
if
there

is
imminent

danger.

If
no

Crisis

Management

Team
has
been

established

in
your

location,

contact
a

supervisor
or
one

of
the

programs

listed
in
this

section

for
assistance

in
making

a

threat
assessment.

Again,
contact
appropriate

law
enforcement

personnel
if
there

is
imminent

danger.
4
VIOLENCE
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7
8
u u
WHAT

TO
DO
IN
A
VIOLENT

SITUATION

INTRODUCTION Workplace violence,
and
threatening

and
similar

disruptive

actions,
are

prohibited
because
they
adversely

affect
safety,

morale
and
productivity.

Ignoring
an
employee

or
customer

who
exhibits

these
behaviors

sends
the

message
that
such
behaviors

are
acceptable.

Consequently,

the
behaviors

are

likely
to
continue

and
may

even
increase

in
frequency

and
severity.

It
is

therefore
critical
to
identify

and
report

the
behaviors

described
above
at
the

earliest
possible

moment
so
that

appropriate

action
can
be
taken.

When
the

violent
or
potentially

violent
person
is
an
employee,

it
is
also

important

to
note

that
if
it
becomes

necessary

to
take

disciplinary

action
later
based

on
the
threat

or
act,

the
fact

that
the
Department

took
the
behavior

seriously
will
strengthen

the
basis

for
the
disciplinary

action.

To
help

prevent

serious
incidents

in
the

workplace,

early
intervention

into

potentially
violent
situations

is
recommended

.
Employees

are
urged

to
make

use
of
the

resources

available
to
help

in
managing

conflict
and
stress

that
may

lead
to
violence.

Available
resources
include
but
are
not
limited

to
supervisors,

Employee
Assistance
Program
counselors,

union
representatives/ stewards,

human
resources

and
employee/ labor

relations
specialists,

building
security

personnel,
and
EEO

specialists

or
counselors.

Employees
are
also

urged

to
stay

alert
to
and

act
quickly

when
there
are
threats

from
customers

or
patients

of
HHS

programs. If, however,
early
intervention

is
not

effective,

this
section

describes

procedures

for
handling

threatening,

intimidating,

violent,
or
similar

disruptive

behaviors

when
they
escalate.

This
section

will
also
describe

some
procedures

for

handling
bomb
threats

and
ideas

for
helping

those
affected

by
domestic

violence.

WHEN
EARLY
WARNING

SIGNS
OCCUR

(LEVEL
1)


OBSERVE

AND
DOCUMENT

(in
detail)

the
behavior

in
question

right
after
it
happens.


REPORT

concerns
to
supervisor

and
other

appropriate

officials.
If
the

offending
person
is
an
employee

and
is
the

reporting

employee's

immediate
supervisor,

the
employee

should
notify
the
next

level

of

supervision.
If
the

offending

person
is
not

an
employee,

the
supervisor
5
VIOLENCE
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VIOLENCE
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9
10

of
the
employee

reporting
the

incident
is
still

the
appropriate

-
Ask

the
person

to
sit
down;

see
if
he

or
she

is
able

to
follow

individual
to
receive

and
provide

initial
response

to
the

report.

directions.


CONTACT

HHS'
local
Crisis
Management

Team
to
alert

members

to

any
concerns

and
seek

their
help
in
assessing

the
situation

(if
you

feel
it

is
necessary,

submit
information

anonymously).


If
the

offending

person
is
an
employee,

the
supervisor

should
MEET

with
him
or
her

to
discuss

concerns.

Follow
the
procedures

below.
(Note

that
many
of
these

steps
may
also
be
useful

for
dealing

with
clients/ patients

of
HHS
programs.) -Schedule

private
time
and
place.

-
Get

straight

to
the

point.

-
Ask

the
employee

for
his
or
her

input.

-
Ask

the
employee

what
should

be
done

about

the
behavior.

-
Ask

how
you
can
help.

-
Identify

the
performance

and/ or
conduct

problems

that
are
of

concern. -Identify
the
steps

you
would

like
to
see

to
correct

problems.

-
Set

limits

on
what

is
acceptable

behavior
and
performance.

-
Establish

time
frames

to
make

changes

and
subsequent

IN
AN
EMERGENCY

(LEVEL
3)

consequences
for
not
meeting

the
deadlines.

-
Reward/ recognize

the
desired

performance

or
conduct.

-
Frequently

at
this

level

it
is
only

necessary

to
remind

the

individual
of
the
Department's

policies.

WHEN
THE
SITUATION

HAS
ESCALATED

(LEVEL
2)


DOCUMENT

(in
detail)

the
behavior

in
question

immediately.

security
and
the
Federal

Protective

Service)
for
that
particular

facility,


Immediately

CONTACT
the
supervisor,

the
local

Crisis
Management

Team,
and
appropriate

law
enforcement/ security

officials
in
your

area.


If
necessary,

SECURE
your
own
safety

and
the
safety

of
others,

including
contacting

people
who
are
in
danger

(make
sure
emergency

numbers
for
employees

are
kept

up-to-

date
and
accessible).


When
appropriate,

CONTACT
others
who
can
assist

you
such

as

employee
relations,
union,
and
the
Employee

Assistance
Program.


If
you

encounter

an
angry

employee

or
customer:

-
Call

for
assistance,

if
possible.

-
Set

ground

rules/ boundaries.

-
Get

others

away
from
the
person.

-
Avoid

an
audience.

-
Remain

calm,
speaking

slowly,
softly
and
clearly.

HANDLING
BOMB
THREATS -Ask questions relevant

to
the

person's

complaint

such
as:

"What
can
you

do
to
try

to
regain

control

of
yourself?";

"What
can
I
do

to
help

you
regain

control?";

"What
do
you

hope

to
gain

by
committing

violence?";

"Why
do
you

believe

you
need

to
be
violent

to
achieve

that?" -If the
person

does
not
calm

down,

try
matching

the
loudness

of
his
or
her

voice

and
gradually

bring
your
voice

down
to
a

calm
level

-
Try

to
direct

the
aggressive

tendencies
into
another

kind
of

behavior
so
that

the
person

sees
he
or
she

has
choices

about

how
to
behave.


If
the

offending

person
is
an
employee,

the
supervisor

should
again

MEET
with
him
or
her

to
discuss

concerns

and
begin

or
continue

progressive
discipline
(if
appropriate).

Any
individual

observing
violent
or
threatening

behavior
which
poses
an

immediate
danger
to
persons

or
property

is
expected

to:


REMAIN

CALM.


First
SECURE

the
safety

of
him/ herself.


CALL
911
and
other

appropriate

emergency
contacts
(such
as
building

especially
if
the

situation

requires
immediate

aid
of
medical

and/ or
law

enforcement
personnel.


COOPERATE

with
law
enforcement

personnel
when
they
have

responded
to
the

situation.

Once
law
enforcement

personnel
are
on
the

scene,
they
will
assume

control
of
the

situation.

Witnesses

be
prepared

to
provide

a
description

of
the

violent

or
threatening

individual,
details

of
what
was
observed,

and
the
exact

location

of
the

incident.


CONTACT

members
of
the

Crisis

Management

Team
so
they

can

convene
as
quickly

as
possible.


If
you

are
personally

confronted

by
an
angry

or
threatening

person,

follow
the
procedures

noted
in
the

previous

section
(Level
2).
6
VIOLENCE
IN
THE

WORKPLACE

VIOLENCE
IN
THE

WORKPLACE

11
12

The
U.
S.
Department

of
Justice

has
prepared

the
following

information

on

support
and
assistance.

Not
only

is
the

person

at
risk

for
more

and
usually

handling
bomb
threats.

It
is
an
unnerving

experience

for
anyone

to
receive

a

escalated
violence,
but
it
has

a
negative

impact
on
the
productivity

of
the

entire

telephone
threat.
But
there

are
ways

to
minimize

personal
threat
and
still

workplace.
Below
are
some

ideas
for
helping

the
co-worker

affected
by
domestic

concentrate
on
gathering

information

that
may

help
law
enforcement

personnel

violence.

identify
the
person

making

the
threat.

Below

is
a
set

of
questions

to
help

focus

on
noticing

important

information

and
asking

the
right

questions

if
a
bomb

threat


Talk
to
the

person

about
your
concerns.

Let
her
know

that
you
are

is
received

over
the
phone.

Try
to
write

down
exactly

what
the
caller

says
and

afraid
for
her
safety

and
the
safety

of
her

children.

Remind
her
that

it
will

only

then
call
law
enforcement

personnel
immediately.

Obtain
the
following

get
worse.

Let
her
know

that
you
will
assist

her
in
locating

resources

information.
and
developing

a
safety

plan.


telephone

number
where
the
call

was
received


Recommend

that
she
call
the
National

Domestic

Violence
Hotline
for


exact
time
of
call

more
information

about
domestic

violence
or
to
help

her
find

local


exact
words

of
caller

resources.
The
number

is
800-799-

SAFE
(7233)

or
for

the
hearing


answers
to
these

questions:

impaired
800-787-
3224.
Also
recommend

that
she
contact

the
HHS

-
When

will
the
bomb

explode?

Employee
Assistance
Program
where
she
can
also

get
help

in

-
Where

is
the

bomb?

understanding
and
responding

to
the

problem.

-
What

does
it
look

like?


Recommend

that
a
workplace

safety
plan
be
developed

in
case

an

-
What

kind
of
bomb

is
it?

incident
occurs
at
the

workplace.

Think
about
the
safety

of
the

-
What

is
your

name?

individual
as
well

as
everyone

around
her.
Don't

be
a
hero

if
the

-
What

is
your

address?

perpetrator
shows

up
at
work.

Follow

the
safety

plan
and
go
for
help.

-
Where

are
you

calling

from?

-
Why

did
you

place

the
bomb?


Make
special

note
of
the

following

information.

-
caller's

voice
(calm,

excited,

disguised,

accent,
etc.)

-
caller's

sex

-
caller's

age
(as
determined

by
voice)

-
voice

familiar

to
you?

-
background

noise

-
names

of
those

threatened

DOMESTIC
VIOLENCE
In
the

event

that
the
perpetrator

shows
up
at
work

(or
is
a
co-worker

of
the

partner)
with
the
intent

of
harming

the
partner

and
any
others

who
happen

to
be

in
the

way

or
involved,

follow
the
procedures

described
above
in
responding

to

the
immediate

crisis.

If
you

know

someone

at
work

who
is
being

affected

by
domestic

violence,

whether
or
not

the
perpetrator

has
shown

up
at
work,

it
is
important

to
provide


Contact
the
Employee

Assistance
Program
for
more

information.

u u
AFTER

THE
FACT

FIRST
THINGS

FIRST

No
matter

how
effective

HHS'
policies

and
plans

are
in
detecting

and
preventing

incidents,
there
are
no
guarantees

against
workplace

violence.
Even
the
most

responsive
employers
face
this
issue.

After
a
violent

or
traumatic

event
has

occurred,
there
are
immediate

procedures

that
must

be
put

into

place

to
address

certain
questions

and
needs.

Every
work
organization

should
have
the

procedures
put
in
place

BEFORE

an
incident

occurs.
Experts
recommend

that
these
procedures

be
tested

through

role-playing

hypothetical
cases
with

management
and
members

of
the

Crisis

Management

Team.
Below
is
a
list

of
such

procedures.

There
may
be
additional

ones
based

on
the
specific

location

of
the

event.



Notify
the
chain

of
command

in
HHS,

including

the
Crisis

Management

Team.
Contact

the
Office

of
the

General

Counsel,

the
Employee
7
VIOLENCE
IN
THE

WORKPLACE

VIOLENCE
IN
THE

WORKPLACE

13
14

Assistance
Program
and
other

Departmental

units
that
can
be
of


introductory

-
normalize

event;
support

assistance
(if
not

already

on
your

local
Crisis
Management


fact
phase

-
let

people

talk
about

what
happened

(heard,
saw,
etc.)

Team),
if

appropriate.

The
Crisis

Management

Team
will
immediately


thought
phase
-
move

from
cognitive

experience

to
emotional

coordinate
the
debriefing

process.


reaction
phase
-
feeling/ emotional

state


When
appropriate,

notify
local
authorities,

medical,
fire,
police.


symptoms

phase
-
determining

the
signals

of
life

changes

such
as


Determine

the
immediate

safety
of
the
workplace-

do
areas

have
to
be

physical
complaints

and
behavioral

changes

secured,
are
there

employees

who
need

to
be
evacuated,

etc.


teaching
phase
-
cognitive

learning
about
symptoms;

normalizing


Find
out
what

information

is
available

on
the
incident-

who
are
the

experiences
and
reactions

witnesses,
were
pictures

taken,
what
are
the
local

authorities


reentry
phase
-
plan

of
action;

follow-up;

referral
to
additional

investigating
and
what

is
HHS'

proper
relationship

with
them.

information
sources
and
long-term

counseling,

if
necessary


Determine

if
there

are
public

relations

concerns
and,
if
so,

contact

public
affairs
for
control

of
this

information,

reporters,
etc.

The
phases

last
different

periods
of
time

for
each

person,

particularly

the
later


Determine

if
there

are
people

to
be
notified

who
are
external

to
the

ones.
An
individual

may
get
stuck

at
a
certain

phase
depending

on
the
factors

organization
such
as
family

members.

discussed
in
the

previous

section.


Locate
any
equipment

that
needs

to
be
utilized

to
handle

the
crisis

such

as
computers

to
access

employee

records,
cellular
phones,
first
aid,
etc.


Show
employees

and
customers

that
the
Department

cares
about
them.

HOW
TRAUMAS

AFFECT
EMPLOYEES

While
it
is
difficult

to
predict

how
an
incident

will
affect

a
given

employee,

several
factors
influence

the
subjective

intensity
of
trauma.

These
factors


Be
sensitive

to
the

"invisible"

or
emotional

injuries
described

above.

include
the
duration

of
the

event,

the
amount

of
terror

or
horror

the
victim


Observe
the
ripple

effect
of
these

events;

the
range

of
those

impacted

experienced,
the
sense

of
personal

control
(or
lack

thereof)

the
employee

had

typically
grows.

during
the
incident,

and
the
amount

of
injury

or
loss

the
victim

experienced

(i. e.,


Be
sure

the
employee

is
not

always

isolated.

loss
of
property,

self-esteem,

physical
well-being,

etc.).
Other
variables

include


Control
media
access

to
employees.

an
employee's

previous
victimization

experiences,
recent
losses
such
as
the


Do
not
joke

about

the
event.

death
of
a
family

member,

and
other

intense

stresses.


Do
not
trivialize

the
event

-
"It

could

have
been
worse".

THE
CRITICAL

INCIDENT
DEBRIEFING

PROCESS

Providing
crisis
intervention

and
counseling

assistance
within
the
first

24
to
72

hours
after
a
violent

event
is
essential.

Jeffrey
Mitchell,

from
the
University

of

Maryland,
developed
a
protocol

for
gathering

information

and
responding

to
the

There
are
a
number

of
things

employees

can
do
to
help

themselves

get
through

a

immediate
emotional
needs
of
employees

who
have
been
traumatized.

It
is

traumatic
event,
particularly

if
a
victim.

In
addition

to
availing

themselves

of

called
the
Critical

Incident

Stress
Debriefing

(CISD)
process.

In
HHS,

this

help
being

offered

by
the
Department,

these
ideas
may
help
with
the

process
will
be
coordinated

by
the
Crisis

Management

Team.
This
counseling

management
of
physical

and
emotional

effects:

process
is
conducted

by
a
professional

with
CISD

training.

The
phases

are

described
below.


Diet
and
exercise:

eat
balanced

meals,
keep
stimulants

to
a
minimum,

CONSIDERATIONS
FOR
MANAGEMENT

Supervisors
and
mangers

play
a
critical

role
in
responding

to
the

immediate

and

long-term
needs
of
employees.

The
following

suggestions

are
provided

for

supervisory
staff
in
handling

employees

after
a
violent

event:


Suggest
help
through

the
EAP

or
other

trauma

interveners

if
symptoms

and
job
performance

changes
do
not
normalize.

HELPING
YOURSELF do not use alcohol and

drugs
to
cope,

exercise

regularly

after
the
first

24
8
VIOLENCE
IN
THE

WORKPLACE

VIOLENCE
IN
THE

WORKPLACE

15
16

hours
following

the
incident.

employees;


Sleep:
maintain

a
normal

schedule,

use
relaxation

techniques

to
help


offering
opportunities

for
advancement

and
professional

development;

fall
asleep.


fostering
family
activities

and
social

opportunities

open
to
all

staff


Talk:
use
social

support

systems,

talk
about

the
incident.

members;


Life-style:

set
realistic

expectations,

maintain
a
normal

schedule,

avoid


maintaining

mechanisms

for
complaints

and
concerns

and
allowing

boredom,
don't
fight
flashbacks,

take
time

to
do
enjoyable

things.

them
to
be
expressed

in
a
non-judgmental

forum
that
includes

feedback

to
the


Get
outside

help
when

needed:

seek
medical

assistance,

plan
for
your

initiator;

safety,
obtain
counseling

for
trauma/ stress,

obtain
referrals

to


taking
threats
seriously

and
taking

appropriate

and
timely

action;

community
facilities.


taking
a
sincere

interest

in
"quality

of
life"

issues

such
as
facilities,

job

u u
PREVENTION

One
of
the

major

components

of
a
workplace

violence
strategy
is
prevention.

Below
are
some

measures

that
can
be
taken

to
reduce

or
prevent

these
types
of

situations. POLICY Become familiar
with
HHS
policies

related
to
workplace

violence.
It
is

imperative
that
all
employees,

including
managers
and
supervisors,

understand

this
policy

and
modify

behaviors

that
are
prohibited.

Customers
and
patients

of

HHS
programs

may
also
need

to
become

familiar
with
these
policies.

All
managers

and
supervisors

should
discuss

the
policies

and
procedures

with

their
staff
members

so
that

they
understand

how
to
handle

intimidating,

threatening,
or
violent

incidents

as
well

as
understand

the
consequences

of
such

behavior
(such
as
disciplinary

and/ or
adverse

action
up
to
and

including

removal

and
criminal

charges).

WORK
ENVIRONMENT The best prevention strategy

is
to
maintain

an
environment

which
minimizes

negative
feelings
such
as
isolation,

resentment

and
hostility

among
employees

as

well
as
provides

for
the
safety

and
security

of
all
employees.

Although
no

workplace
can
be
perceived

as
perfect

by
every

employee,

there
are
several

steps

that
management

can
take

to
help

create

a
professional,

healthy,
and
caring

climate.
These
include:


promoting

sincere,
open
communication

among
management

and

satisfaction
and
recreation

opportunities;

and


maintaining

fair
treatment

and
discipline

for
all
employees

exhibiting

improper
conduct
and
performance.

EMPLOYMENT
SCREENING
Another
essential
prevention

measure
is
careful

and
thorough

screening

of
pre-

employment
references
to
avoid

hiring
potentially

dangerous
individuals.

Prior

to
hiring

an
employee,

the
supervisor/ agency

should
check
with
its
servicing

personnel
office
to
determine

what
employment

screening
techniques

(such
as

interviewing
questions,
background

and
reference

checks,
and
drug

testing)

are

appropriate
for
the
position

under
consideration

and
that
are
consistent

with

Federal
laws
and
regulations.

Pre-employment

screening
is
a
critical

and

sensitive
part
of
workplace

violence
prevention

and
should

receive

due

investigation
and
care

in
its
implementation.

SECURITY Maintaining a
physically
safe
work

place
is
part

of
any

good

prevention

program.
HHS
facilities

use
a
variety

of
security

measures

to
help

ensure

safety.

Compliance
with
these
measures

is
critical

and
is
what

keeps
employees

safe.

These
measures

include:


the
Federal

Protective

Service
or
a
designated

security
officer
to

respond
to
emergencies;


employee

photo
identification

badges
and
individually

coded
card
keys

for
access

to
buildings

and
areas

within

buildings

according

to

individual
needs;

on-site
guard
services;


guard
force
assistance

in
registering,

badging
and
directing

visitors
in

larger
facilities;
9
VIOLENCE
IN
THE

WORKPLACE 17


other
appropriate

security
measures;

and


security
surveys
to
determine

physical
security
posture
of
building( s).

Additional
law
enforcement

assistance
is
available

through
local
police

departments
for
emergency

situations.
Employees
should
notify
the
appropriate

security
office
or
designated

police
of
suspicious

or
unauthorized

individuals
on

HHS
property. EDUCATION Training and education

are
also

critical

components

of
any

prevention

strategy.

The
following

types
of
training

are
effective

in
preventing

violence
and
other

threatening
behavior
and
are
recommended

for
employees

of
HHS:

awareness

programs
for
employees

and
supervisors,

training
for
supervisors

on
effective

job
applicant

screening,

training
on
conflict

resolution

and
stress

management.

EARLY
INTERVENTION Intervening early in a threatening

or
potentially

violent
situation

is
vital

to

preventing
its
escalation.

There
are
many

intervention

options,
and
they

vary

greatly
depending

upon
the
situation.

Early
intervention

may
diffuse

the
initial

situation
and
give

the
supervisor

an
opportunity

to
more

thoroughly

review

options
for
resolution.
10

Result of converting file eap3vilm.pdf

 *Pages 1--37 from MANUREV.PDF*
UNDERSTANDING AND
RESPONDING TO
VIOLENCE IN THE
WORKPLACE

Department of Health and Human Services

PARTICIPANT'S MANUAL
March 1997
1
"WARM UP EXERCISE"
1
Here is a warm up exercise to facilitate introductions and to get you thinking about workplace violence:
READ AND THEN BRIEFLY DISCUSS WITH A SMALL GROUP:

THANK GOODNESS ITS FRIDAY!
You are sitting at your desk quietly winding up your work for the day. It's Friday
afternoon and your thoughts turn to your plans for the weekend. Suddenly you
are startled by some commotion you hear in the hall. You recognize the voices of
your co-workers John and Sarah. Sarah is yelling at John to stop bothering her,
that she is sick and tired of his sexual harassment. John is yelling back at her,
telling her she's crazy and that he can't stand to be with her, much less sexually
harass her. The screaming continues and you step out into the hall to try to
intervene. About that time, John storms off saying to Sarah, "I hope you have a
horrible weekend, I'll make sure that you do!"

Sarah is shaking and runs out the door. You start thinking about what you should
do. All you really want to do is go home and forget this event. It will cool down
by Monday. Something bothers you, though. You know that John is an avid gun
collector and user and that he is rumored to hit his wife. Suddenly you are
worried about Sarah.

THINGS TO THINK ABOUT:
1. Do you think you should get involved in this situation?
2. What are you going to do now?
3. Is John a violent person?
2
INTRODUCTION
2
Why do we need training?
Violence is now a topic of concern to everyone in the workplace. It is important to understand workplace violence so it can be recognized, responded to
appropriately, and prevented whenever possible. This training is not meant to be the only mechanism to reduce the risk of violence at your workplace. It is meant
to be one component of a comprehensive effort at your workplace to address workplace violence.

The primary purpose of this training is to:
 Provide training for employees of the Department of Health
and Human Services on managing violent or potentially violent situations.

The goals of the training are:
 To develop and support a work environment which will prevent
and effectively respond to violent situations in the workplace.

 To increase employee understanding of workplace violence in
these basic areas:

Defining Workplace Violence
Identification and Recognition of Actual and Potential
Violent Situations
Response and Intervention
Follow-Up to a Violent Situation
3
INTRODUCTION
3
TO ACCOMPLISH THESE GOALS, WE WILL LOOK AT EIGHT TOPIC AREAS:
Facts About Workplace Violence (Part 1)
What is Violence (Part 2)
Types of Violence at Work (Part 3)
Barriers to Addressing the Problem (Part 4)
Recognizing the Problem (Part 5)
What To Do When You Recognize a Problem (Part 6)
Making It Real and Applying What You Know (Part 7)
Other Things To Consider (Part 8)
4
PART 1: FACTS ABOUT VIOLENCE
4
Workplace violence affects over two million workers each year. The industries with the highest rates of workplace violence include retail sales, service, finance
and real estate.
It seems as though there is an article every day in the newspaper or a professional journal reporting another incident of workplace violence. Be aware, however,
that most incidents occur without receiving attention from the media. It is important for you to understand the facts about workplace violence. Here are
some statistics to help you put this problem in perspective:

48% SAID THAT THERE HAD BEEN A VIOLENT INCIDENT AT
THEIR COMPANIES SINCE JANUARY, 1994.

45% OF EMPLOYEES ARE WORRIED THAT VIOLENCE WOULD
ERUPT AT THEIR WORKPLACES.

39% SAID THAT THEY HAD BEEN VERBALLY THREATENED
57% WERE INCIDENTS INVOLVING EMPLOYEES AT THE SAME
LEVEL

17% WERE INCIDENTS WHERE EMPLOYEES TARGETED THEIR
SUPERVISORS

60% SAID THEY WOULD NOT HAVE BEEN ABLE TO IDENTIFY THE
AGGRESSOR AS ONE WITH A POTENTIAL FOR VIOLENCE (SHRM, 1993)

Source: Society for Human Resource Management, Issues Management Program, 1996 Survey
5
PART 1: FACTS ABOUT VIOLENCE
5
Increasingly, the problem of violence has become a major cost to industry, particularly if the workplace does not have a clear prevention plan. The costs to
organizations are staggering.
Workplace violence affects other areas as well. The National Safe Workplace

Institute has found that adverse impacts on organizations and individuals are wide-ranging and include:
 psychological damage
 property damage, theft and sabotage
 productivity impediments
 diversion of management resources
 increased security costs
 increased workers' compensation costs
 increased personnel costs

COSTS TO THE WORKPLACE
$4.3 BILLION ANNUALLY

AVERAGE INCIDENT COST IS $250,000
Source: " Workplace Violence: First Line of Defense" , The Employment and Labor Law Series, 1994

$55 MILLION IN LOST WAGES EACH YEAR
1.8 MILLION DAYS OF WORK LOST EACH YEAR
Source: Bureau of Justice Statistics (NCJ-178199), July 1994
6
PART 2: WHAT IS VIOLENCE
6
There are many definitions of workplace violence. Some define it as physical types of attacks, or those involving weapons. Some define it as incidents between
co-workers or as incidents that come into work from the outside community.
Workplace violence can occur in a number of different ways and incorporates a wide variety of behaviors. This is the way we have defined it at the Department
of Health and Human Services:

"An action (verbal, written, or physical
aggression) which in intended to control or
cause, or is capable of causing, death or serious
bodily injury to oneself or others, or damage to
property. Violence includes abuse of authority,
intimidating or harassing behavior and threats."
7
PART 3: TYPES OF VIOLENCE AT WORK
7
TYPES OF VIOLENCE AT WORK
There are many different types of violent behaviors that can be exhibited at work.
Some "obvious" types of violence include:

BOMBINGS
SHOOTINGS
HITTING
FIGHTING
SCREAMING
THREATS
However, workplace violence incorporates much more. You may have experienced or witnessed verbal harassment or stalking at work. These are also
types of workplace violence. Some "not-so-obvious" types of violence include:
HARASSING
STALKING
EQUIPMENT SABOTAGE
BUILDING SABOTAGE
OTHER IRRATIONAL RESPONSES (THROWING, DEFECATING, ETC...)

Have you ever witnessed any of these types of behaviors at work?
How did that make you feel?
8
PART 3: TYPES OF VIOLENCE AT WORK
8
ACCORDING TO ONE AUTHOR, THERE ARE FOUR CATEGORIES OF WORKPLACE VIOLENCE:
Source: Joseph A. Kinney, Executive Director of the National Safe Workplace Institute in "Violence in the Workplace", American Society for Training and Development, July 1993
1. EMPLOYER-DIRECTED VIOLENCE. An employee engages in violence against an employer, manager, or supervisor.
2. DOMESTIC-RELATED VIOLENCE. A romantically disaffected partner or would-be partner strikes out against the object of his or her affections.
3. PROPERTY-DIRECTED VIOLENCE. These are employee acts against employers designed to damage company property.
4. COMMERCIAL-DIRECTED VIOLENCE. An employee perpetrates events, including theft of money or property, that also involve violence.
9
PART 4: BARRIERS TO ADDRESSING THE PROBLEM
9
Now that you have a better understanding of the scope, severity and the frequency of workplace violence...
THINK ABOUT WHAT WOULD PREVENT YOU FROM REPORTING POTENTIAL AND/ OR ACTUAL
WORKPLACE VIOLENCE.

Many incidents of workplace violence go unreported because employees are
reluctant to get involved. Keeping silent about workplace violence will not
make the problem go away. In fact, underreporting increases the risk for violence by ignoring warning signs and opportunities for early intervention and

prevention.
This training will help you to recognize an actual or potential violent situation, as well as educate you on what to do once you recognize a problem.
10
PART 4: BARRIERS TO ADDRESSING THE PROBLEM
10
In addition to not reporting incidents and threats, there are a number of other common mistakes that organizations make with regards to their handling of
workplace violence.
COMMON MISTAKES MADE BY ORGANIZATIONS
 Fail to adopt/ publicize a policy
 Fail to train supervisors and managers in implementation of
policy

 Use standard psychiatric or psychological services to assess
threat of violence instead of an interdisciplinary Crisis Management Team

 Ignore vague or indirect threats
 Press charges in court before conducting their own inquiry or
before speaking to employee

 Assign responsibility to one particular function (e. g. legal,
human resources, security, EAP).

The Department of Health and Human Services' Office of the Secretary recently issued guidelines entitled, "Understanding and Responding to Violence in the
Workplace". Copies of these guidelines are available to all employees of the Department of Health and Human Services.

In addition, guidelines for the formation of a Crisis Management Team have also been distributed. These guidelines recommend that a variety of functional areas
be recruited for membership on the team.
Can you think of which areas would be appropriate for inclusion on the
Crisis Management Team?
11
PART 5: RECOGNIZING THE PROBLEM
11
The first step in being able to respond to workplace violence is recognizing what the problem looks like at work. What are the signs of a potential or actual violent
situation? Workplace violence typically follows a behavior pattern.
LEVEL ONE (EARLY WARNING SIGNS)
The person:  refuses
to cooperate with those in authority  spreads
rumors and gossip to harm others  consistently
argues with co-workers  belligerent
toward customers/ clients  constantly
swears at others  makes
unwanted sexual comments

LEVEL TWO (ESCALATION OF THE SITUATION)
The person:  argues
increasingly with customers, vendors, co-workers and
management  refuses
to obey agency policies and procedures  sabotages
equipment and steals property for revenge  verbalizes
wishes to hurt co-workers and/ or management  sends sexual or violent notes to co-workers and/ or management

 sees self as victimized by management (me against them)
LEVEL THREE (FURTHER ESCALATION, USUALLY RESULTING IN AN
EMERGENCY RESPONSE)
The person frequently displays intense anger resulting in:  recurrent
suicidal threats  recurrent
physical fights  destruction
of property  utilization
of weapons to harm others  commission
of murder, rape, and/ or arson

DOMESTIC VIOLENCE (OFTEN TIMES THE INCIDENTS OCCUR
OUTSIDE THE WORKPLACE, HOWEVER, THE WARNING SIGNS MAY
BE RECOGNIZED AT WORK)
The victim may show signs of:  increased fear, emotional episodes, signs of physical injury and/ or other

physical stress (i. e. excessive phone calls)
 deterioration of work performance

Source: S. Anthony Baron, Violence in the Workplace, 1993.
12
PART 6: WHAT TO DO WHEN YOU RECOGNIZE A PROBLEM
12
Workplace violence, and threatening and similar disruptive actions are prohibited
because they adversely affect safety, morale and productivity. Ignoring an individual
who exhibits these behaviors sends the message that such behaviors are acceptable.
It is, therefore, critical to identify and report the behaviors described in this training
at the earliest possible moment so that appropriate action can be taken. For the
training class exercise, review "Thank Goodness Its Friday" on page 1.

WHEN EARLY WARNING SIGNS OCCUR (LEVEL 1):
 OBSERVE and DOCUMENT in detail the behavior immediately.
 REPORT concerns to supervisor and other appropriate officials.
 CONTACT HHS' local Crisis Management Team to alert members to any concerns and seek their help in assessing the situation. This means you should be
familiar with the team members.

 Supervisors should MEET with the employee exhibiting the questionable behaviors using the procedures noted below.

Schedule private time and place.
Get straight to the point.
Ask the employee for his or her input.
Ask the employee what should be done about the behavior.
Ask how you, the supervisor, can help.
Identify the performance and/ or conduct problems that are of concern.
Set limits on what is acceptable behavior and performance.
Establish time frames to make changes and subsequent consequences for
not meeting the deadlines.
Reward/ recognize the desired performance or conduct.
Frequently at this level it is only necessary to remind the individual of
the Department's policies.
13
PART 6: WHAT TO DO WHEN YOU RECOGNIZE A PROBLEM
13
WHEN THE SITUATION HAS ESCALATED (LEVEL 2):
 DOCUMENT (in detail) the behavior in question immediately.
 Immediately CONTACT the supervisor, the local Crisis Management Team, and appropriate law enforcement/ security officials in your area.

 If necessary, SECURE you own safety and the safety of others, including contacting people who are in danger.
 When appropriate, CONTACT other who can assist you such as employee relations, union ,employee assistance program.
 If you ENCOUNTER an angry employee or customer: Call for assistance, if possible.
Set ground rules/ boundaries.
Get others away from the person.
Avoid an audience.
Remain calm, speaking slowly, softly and clearly.
Ask the person to sit down; does he or she follow directions?
Ask questions relevant to the person's complain such as:

"What can you do to try to regain control of yourself?"
"What can I do to help you regain control?"
"What do you hope to gain by committing violence?"
"Why do you believe you need to be violent to achieve that?"

l If the person does not calm down, try matching the loudness of his or her
voice and gradually bring you voice down to a calm level. l
Try to direct the aggressive tendencies into another kind of behavior so
hat the person sees he or she has choices about how to behave.

 Supervisor should again MEET with the employee exhibiting the behaviors.
14
PART 6: WHAT TO DO WHEN YOU RECOGNIZE A PROBLEM
14
Think about how the situation with John and Sarah. It could escalate. What are
some possible case scenarios? How will you respond?

IN AN EMERGENCY (LEVEL 3):
Any individual observing violent or threatening behavior which poses an immediate
danger to persons or property is expected to:

 REMAIN CALM.
 First SECURE your own safety.
 CALL 911 and other appropriate emergency contacts (such as building security and the Federal Protective Service) for that particular facility, particularly if the
situation requires immediate aid of medical and/ or law enforcement personnel.

 COOPERATE with law enforcement personnel when they have responded to the situation. Once law enforcement personnel are on the scene, they will
assume control of the situation. Witnesses be prepared to provide a description
of the violent or threatening individual, details of what was observed, and the
exact location of the incident.

 CONTACT members of the Crisis Management Team so they can convene as quickly as possible

 If you are personally confronted by an angry or threatening person, FOLLOW the procedures described in Level 2.
15
PART 6: WHAT TO DO WHEN YOU RECOGNIZE A PROBLEM
15
The U. S. Department of Justice has prepared the following information on handling
bomb threats. Below is a set of questions to help notice important information and
asking the right questions if a bomb threat is received over the phone. Try to write
down exactly what the caller says and then call law enforcement personnel
immediately.

----Reproduce the Section Below and Keep In An Accessible Place At Your Workstation------

HANDLING BOMB THREATS
Obtain the following information about the threat.
 telephone number where the call was received
 exact time of call
 exact words of the caller
 answers to these questions:

When will the bomb explode?
Where is the bomb?
What does it look like?
What kind of bomb is it?
What is your name?
What is your address?
Where are you calling from?
Why did you place the bomb?

 Make special note of the following information.
caller's voice (calm, excited, disguised, accent, etc.)
caller's sex
caller's age (as determined by voice)
voice familiar to you?
background noise
names of those threatened
16
PART 6: WHAT TO DO WHEN YOU RECOGNIZE A PROBLEM
16
In the event that the perpetrator of domestic violence shows up at work (or is a co-worker
of the partner) with the intent of harming the partner and/ or any others who
happen to be in the way or involved, follow the procedures described previously to
respond to the immediate crisis.

If you know someone who is being affected by domestic violence, whether or not
the perpetrator has shown up at work, it is important to provide support and
assistance. Not only is the person at risk for more and usually escalated violence,
but the situation has a negative impact on the productivity of the entire workplace.
Below are some ideas for helping the co-worker affected by
domestic violence.

DOMESTIC VIOLENCE
 Talk to the person about your concerns. Let her know that you are afraid for her safety and the safety of her children. Remind her that it will only get worse. Let
her know that you will assist her in locating resources and developing a safety
plan.

 Contact the Employee Assistance Program if you need more information.
 Recommend that she call the National Domestic Violence Hotline for more information about domestic violence or to help her find local resources. The
number is 800-799-SAFE (7233) or TDD 800-787-3224. Also recommend that
she contact the HHS Employee Assistance Program where she can also get help
in understanding and responding to the problem.

 Recommend that workplace safety plan be developed in case an incident occurs at the workplace. Think about the safety of the individual as well as everyone
around her. Do not be a hero if the perpetrator shows up at work. Follow the
safety plan and go for help.
17
PART 7: MAKING IT REAL AND APPLYING WHAT YOU KNOW
17
EXERCISES AND CASE STUDIES
This section contains one exercise and a number of case studies that will
encourage you to utilize the information learned in the training and to think about
the best ways to handle the issue of violence in the workplace.

Instructions for this section:
Your trainer will ask you to work in small groups. For these exercises, you
should follow the steps below.

1. Read the assigned case studies.
2. Discuss "Things to Think About" and formulate responses.
3. Have someone in your group take notes and present your
responses to the larger group.
4. Ask you trainer for assistance when needed.

F Turn to page 27 when you have completed this section.
18
PART 7: MAKING IT REAL AND APPLYING WHAT YOU KNOW
18
CASE 1: HELPING MARY
Mary is a co-worker in your agency. She has been a valuable employee to your
group and one of the most respected experts in her field. You notice lately,
though, that she is more reserved and is absent quite a bit. You hear her quietly
crying or having a fight with someone on the phone frequently. She is a bit jumpy
while she is at work, always looking over her shoulder when she goes
somewhere.

You ask her to lunch one day and voice your concern. Mary says she is having
some problems at home but that it is nothing to worry about; she can handle it
herself. Several weeks later you notice that Mary's fear has escalated. She rarely
leaves the building. When she must leave, she moves quickly, always covering
her face. She works erratic hours. Her fear is really beginning to affect everyone
at work. You are all concerned for her but don't know what is going on. You
begin to wonder if there is a real danger, both to Mary and to the rest of you who
work with her.

THINGS TO THINK ABOUT:
1. Do you believe this is a situation that requires further action on your
part? Why or why not?

2. What are the appropriate interventions in this situation? Think about
those things that you and the other co-workers can do, what Mary's
supervisor can do, what security staff can do, and what any other
agency staff can do.

3. Are there other protections that should be considered for Mary and her co-workers?
19
PART 7: MAKING IT REAL AND APPLYING WHAT YOU KNOW
19
CASE 2: THE UNHAPPY CUSTOMER
Your job in this Department is to assist recipients of substance abuse grants. It
involves working with customers face-to-face each day. Since there are many
recipients of these grants, it is impossible to know all of them personally. Due to
recent budget cuts, some of the grantees have been eliminated.

Some of the discontinued recipients have been calling you. They are extremely
upset and have even screamed at you. One even threatened to get even since you
ruined his life. You ignore these calls and threats, attributing the behavior to the
situation of losing their livelihoods. In fact, you actually feel sorry for them and
decide you would also be upset if you lost your program.

One morning, you are sitting in your office and a man bursts in and starts waving
a gun at you. You do not recognize him. He starts screaming, "It's time to get
even and don't act like you don't know what I'm talking about!"

THINGS TO THINK ABOUT:
1. Detail what you would do in this situation.
2. Could this situation have been prevented? If so, what are some of the
preventative actions you and your Department could have taken?
20
PART 7: MAKING IT REAL AND APPLYING WHAT YOU KNOW
20
CASE 3: THE BURNT OUT ADMINISTRATOR
In the last few months, your agency has undergone a reorganization. You are the
computer network administrator and have been working very hard to reconfigure
everyones' computers. You have been putting in a lot of hours at night so you
cause as little disruption as possible. You are starting to feel extremely stressed.
Your attitude has been bad and you don't particularly like coming to work. You
tell yourself that this will end soon, after the new system is put in place.

One morning, after a particularly long night, you come in to work and sit down to
read your e-mail messages. There is a message from a very angry employee
whose computer has crashed and she needs your help immediately. You walk
around to her space and the woman starts to verbally attack you.

She screams, "YOU ARE SO STUPID! ONLY STUPID PEOPLE WOULD
MESS UP A COMPUTER THE WAY YOU DID. WHY DON'T YOU GET A
JOB THAT YOU CAN HANDLE? DON'T YOU FEEL ASHAMED FOR
WHAT YOU HAVE DONE TO ME?"

THINGS TO THINK ABOUT:
1. What are your thoughts about this woman right now?
2. Based on these thoughts, how do you think you will respond to her?
3. What are some effective thoughts that would let you see this situation in
a different light?

4. What are some things you can do to handle the stress you are feeling at
work lately?
21
PART 7: MAKING IT REAL AND APPLYING WHAT YOU KNOW
21
CASE 4: THE STRANGE VISITOR
In the middle of the day, you leave your office to go the restroom. You notice
that the back emergency door has been propped open to let in the cool breeze.
Once you are in the restroom you notice a woman acting very strange. She is
talking to herself and seems to be agitated. You have never seen her before and
she does not have an ID badge on. When you leave the restroom, she follows
you to your office. She states she is a job applicant but no one will talk to her
and she doesn't know where to go. Her voice starts to get more frantic.

You offer to take her to the personnel office but she refuses to cooperate and
becomes belligerent. She begins to scream about how the government is out to
get her. It becomes clear that this woman is going to be a problem. You wonder
how she ever got past the guard.

THINGS TO THINK ABOUT:
1. Now that this situation has escalated, what are the best ways to
intervene?

2. Would you be concerned about the physical security precautions in your
building? Why or why not? If you are concerned, what would you do to
address these concerns?
22
PART 7: MAKING IT REAL AND APPLYING WHAT YOU KNOW
22
CASE 5: THE SUSPICIOUS CALLER
You are a health care worker at the agency's clinic in Wotakki. As you are filling
out your patient charts one evening, you hear the phone ring at the nurse's station
and pick it up. The caller's voice is muffled, as if he had a handkerchief over the
receiver. You also think you hear traffic in the background so it makes it even
harder to hear. He starts talking very quickly and says, "I DON'T LIKE WHAT
YOU ARE DOING AT THAT CLINIC AND I WANT IT TO STOP. I HAVE
A BOMB PLANTED IN THE BUILDING AND PLAN TO SET IT OFF VERY
SOON. YOU WILL BE SORRY NOW FOR WHAT YOU DID!" He hangs up
the phone.

THINGS TO THINK ABOUT:
1. What would you do now?
2. Based on this conversation, what information would you provide to law
enforcement personnel?
23
PART 7: MAKING IT REAL AND APPLYING WHAT YOU KNOW
23
CASE 6: ANOTHER VISIT WITH JOHN
Monday morning
This morning you receive an anonymous note from a female employee in your
Department who has accused John of sexual harassment. The note states that he
has placed several calls to this employee's home and asked her out on dates. The
employee has refused and has asked John to stop calling her. The employee
complaint was anonymous, but because you only have 25 female employees in
your area, you have been able to narrow it down to five possibilities, based upon
facts you received in the complaint. The complaint also alleges that while the
female employee was standing at the copy machine, John rubbed up against her
and made a comment about being physically attracted to her.

John is a 56 year old employee who has worked for the Government for 28
years. While John has not been a stellar employee, his performance has been
adequate and he has received regular pay increases consistent with his longevity.

During the last five years, John has applied for 2 promotions and has been turned
down both times. On those 2 occasions, he was disappointed that he was not
chosen and made negative comments to his co-workers about affirmative action.
However, it did not seem to have a significant impact on his work.

About six months ago, John and his wife of thirty years separated. They have
three grown children, none of whom live in this area. While John didn't really
talk about his separation and the details, there were some quiet rumors that John
was abusing his wife. In addition, there have been many rumors over the years
that John has an alcohol problem. However, since he has a very good attendance
record and his performance is adequate, his supervisors decided to respect his
privacy and not look into the rumors.
24
PART 7: MAKING IT REAL AND APPLYING WHAT YOU KNOW
24
John has only a few friends at work. In his spare time, he is an avid hunter and
competitive pistol shooter. In fact, he has won several national awards in
competitions sponsored by the NRA. To your knowledge, he has never brought a
firearm into the workplace.

Next day 8: 00 am
You read the complaint carefully again several times after not having slept well
all night. You decide to contact the human resources office and speak to a
special investigator who regularly conducts sexual harassment investigations.
Since you do not know the identity of the complainant, it is impossible for you to
conduct any interviews of that person. The human resources investigator calls
John to come join you for a discussion.

9: 00 am
John arrives and you and the investigator inform him that someone has
complained about his behavior. You ask him if he will cooperate with the
investigation. John expresses outrage that his reputation is being tarnished and
demands to know the identity of the accuser. You tell him the complaint was
anonymous, but he does not believe you. He insists that he is a good loyal
employee with many years of services who is being unfairly maligned by some
"bitch." This language and this type of behavior are fairly unusual for John.

F Case 6 continued on next page.

THINGS TO THINK ABOUT:
1. What are you going to do now?
2. Do you want to change any plans you made at the beginning of this
training?
25
PART 7: MAKING IT REAL AND APPLYING WHAT YOU KNOW
25
Toward the end of the meeting with John, he becomes belligerent and says, "You
have some nerve; I have worked here for 28 years and done a damn good job.
Now, you have accused me of sexual harassment. This is outrageous." Then his
face becomes beet red and he says, "I'll show all of you; nobody messes with me.
I'm going to teach all of you a lesson you'll
never forget!" With that, John bolts out of the meeting, walks out and grabs his
coat, looks back and says, "I'll be back later, after I've taken care of a few
things."

THINGS TO THINK ABOUT:
1. What would you do now?
2. Would you involve others at this point? What are the consequences if
you do?

3. Do you think John has made a threat?
4. Do you think a request for a medical exam is appropriate at this time?
26
PART 7: MAKING IT REAL AND APPLYING WHAT YOU KNOW
26
CASE 7: THE BICKERING CO-WORKERS
You are the supervisor of a large group of employees. Over that last few
months, you notice that two of you employees, Bob and Ed have not been getting
along. They have been calling each other names and have been raising their
voices at each other. You have ignored this up until now thinking, "Boys will be
boys." But the situation has escalated now and you are afraid one of them will
harm the other. Co-workers are starting to complain that they are afraid and that
they can't concentrate with the disruptions. When you try to sit them down and
talk to them, they are belligerent and tell you to stay out of the situation. They
tell you this has nothing to do with work and they will handle it on their own.
They get up and leave your office.

THINGS TO THINK ABOUT
1. Do you think this is a violent situation? Why or why not?
2. What would you do at this point?
3. Do you think disciplinary action is warranted? If so, identify the
behavior or conduct that is inappropriate. What is your recommended
action?

4. Would you consider terminating these employees if the behavior did not
stop? If so, what precautions would you take to assure the safety of
everyone involved?
27
PART 8: OTHER THINGS TO CONSIDER
27
AFTER THE FACT
No matter how effective HHS' policies and plans are in detecting and
preventing incidents, there are no guarantees against workplace violence.
When violent incidents occur, it is essential that the response be timely,
appropriate to the situation and include proper recognition that the employees
have been traumatized and their aftermath as just begun.

HOW TRAUMAS AFFECT EMPLOYEES
1. Stage One: This is the "shock" stage where the employee
experiences emotional reactions characterized by shock, disbelief,
denial or numbness. Physically, the employee experiences shock or
fight or flight survival reactions in which the heart rate increases,
perceptual senses become heightened or distorted, and adrenaline
levels increase to meet a real or perceived threat.

2. Stage Two: This is the "impact" stage where the employee may feel
a variety of intense emotions including anger, rage, terror, grief,
sorrow, confusion, helplessness, guilt, depression or withdrawal.
This stage may last a few days, a few weeks, or a few months.

3. Stage Three: This is the "reconciliation stage" in which the
employee tries to make sense out of the event, understand its impact,
and, through trial and error, reach closure on the event so it does not
interfere with the ability to function and grow.

Source: "Helping the Employee Recover from the Trauma of Workplace Violence", Kenneth Wolf
et al, EAP Digest, March/ April 1994.
28
PART 8: OTHER THINGS TO CONSIDER
28
THE CRITICAL INCIDENT DEBRIEFING PROCESS
Jeffrey Mitchell, University of Maryland, developed a protocol for gathering
information and responding to the immediate emotional needs of employees who
have been traumatized. It is called the Critical Incident Stress Debriefing (CISD)
process. In HHS, this process will be coordinated by the Crisis Management Team.

Critical Incident Stress Debriefing
 occurs within the first 24 to 72 hours after a violent event;
 is conducted by a mental health professional with CISD training; and
 involves a number of phases (lengths of time vary for each person). These phases are:

 introductory: normalize event; support
 fact phase: let people talk about what happened (heard, saw, smelled, etc.)

 thought phase: move from cognitive experience to emotional
 reaction phase: feeling/ emotional state
 symptoms phase: determining the signals of life changes such as physical complaints and behavioral changes

 teaching phase: cognitive learning about symptoms; normalizing experiences and reactions
 re-entry phase: plan of action; follow-up; referral to additional information sources and long-term counseling, if necessary.
29
PART 8: OTHER THINGS TO CONSIDER
29
CONSIDERATIONS FOR MANAGEMENT
Supervisors and managers play a critical role in responding to the immediate and
long-term needs of employees. The following suggestions are provided for
supervisory staff in handling employees after a violent event.

HELPING YOURSELF
There are a number of things employees can do to help themselves get through a
traumatic event. In addition to availing themselves of assistance offered by the
Department, these ideas may help with the management of physical and emotional
effects.

 Be sensitive to the "invisible" or emotional injuries described earlier.
 Observe the ripple effect of these events as the impact usually grows.
 Be sure the employee is not always isolated.
 Control media access to employees.
 Do not joke about the event.
 Do not trivialize the event, i. e. "It could have been worse".
 Suggest help through the EAP or others who intervene in traumatic situations if symptoms and job performance changes do not normalize.

 Eat balanced meals. Keep stimulants to a minimum and do not use alcohol and drugs to cope.
 Exercise regularly, especially within the first 24 hours of the incident.
 Get plenty of sleep.
 Talk about the incident with social support systems.
 Maintain a manageable schedule.
 Avoid boredom.
 Seek outside help when needed.
 Plan for your future safety.
30
PART 8: OTHER THINGS TO CONSIDER
30
PREVENTION
One of the major components of a workplace violence strategy is prevention. The
following is a list of measures intended to reduce or prevent these types of situations.

1. POLICY It is important that all employees, including managers and
supervisors, understand the policy and modify behaviors that are prohibited.

2. WORK ENVIRONMENT Treat co-workers with respect and work to
minimize negative feelings such as isolation, resentment and hostility among
employees.

3. EMPLOYMENT SCREENING Carefully and thoroughly screen pre-employment
references to avoid hiring potentially dangerous individuals.

4. SECURITY Use a variety of security measures to help ensure safety.
5. WEAPONS Possession or use of firearms and other dangerous weapons
on the property of all HHS facilities is illegal. (Certain exceptions apply 18
U. S. C. Section 930( c).) Any HHS employee who violates prohibitions on
possession of a weapon in HHS facilities will be prosecuted and/ or
appropriately disciplined.

6. EDUCATION Awareness and tactical training for all employees,
including supervisors and managers, is a crucial step towards reducing or
preventing workplace violence. In addition, training on conflict resolution
and stress management offers techniques and skills to deal effectively with
conflict and reduce stress.

7. EARLY INTERVENTION Early intervention is vital and helps to
prevent the situation from escalating to violence.

EXERCISE FOR PUTTING YOUR ENERGY TO WORK
31
PART 8: OTHER THINGS TO CONSIDER
31
The best way to handle violence in the workplace is to prevent it from occurring.
Take a few minutes to think about how you can contribute to the prevention of
workplace violence. List three things you can do now and describe any help you
will need in carrying out these ideas:

1.

2.
3.
We Hope You Found This Training Useful !
32
RESOURCE GUIDE
32
BELOW ARE SOME ADDITIONAL RESOURCE WITHIN THE DEPARTMENT OF
HEALTH AND HUMAN SERVICES.

HHS Workplace Violence Intervention and Prevention Group (Ad Hoc; Policy Oversight)
Contact: ASMB, Office of Human Resources
Telephone: (202) 690-8229

Centers for Disease Control and Prevention
National Institute for Occupational Safety and Health (NIOSH)
4676 Columbia Parkway
Cincinnati, OH 45226-1998
(800) 356-4674

NIOSH provides an array of training material, including videos, and search services. The toll-free
number is open from 9: 00 a. m. -4: 00 p. m. EST. Upon request, information sheets can be faxed.
A 3-packet guide, "Homicide in the Workplace" is also available.

National Institutes of Health
National Institute of Mental Health (NIMH)
5600 Fishers Lane, Room 7C02
Rockville, MD 20857
(301) 496-4513

In addition to other literature, NIMH publishes two free publications on depression (which has
been found to be a factor in workplace violence), "What To Do If An Employee Is Depressed" and
"Managing Depression in the Workplace."

National Domestic Violence Hotline
(800) 799-SAFE or (800) 787-3224 (TDD)

U. S. Public Health Service
Office on Women's Health
200 Independence Avenue, S. W., Room 730B
Washington, DC 20201
(202) 690-7650

Provides information, brochures, fact sheets, etc. on all matters related to women's health including
violence against women.
33
IMPORTANT PHONE NUMBERS OF LOCAL RESOURCES
(COMPLETE THIS AT THE LOCAL LEVEL)

33
Keep this posted at your workstation
Your Supervisor:
Building Security:
Building Health Unit:
Human Resource Staff:

Fire Department:

Employee Assistance Program:
Crisis Management Team:
Local Law Enforcement:
National Domestic Hotline: 800-799-SAFE or
800-787-3224 (TDD)
34
34
THIS PAGE WAS INTENTIONALLY
LEFT BLANK
35
35
VIOLENCE IN THE WORKPLACE
Participant Feedback

Agency:_____________________________________________________
Position:_____________________________________________________
Date:________________________________________________________

Thank you for participating in this training workshop. Please take a moment to
complete the following evaluation form. Your feedback and comments will be
helpful for future training of Federal employees.

PLEASE CIRCLE THE NUMBER THAT BEST REPRESENTS YOUR
RESPONSE TO THE STATEMENT.
Agree Disagree

1. The workshop adequately addressed 1 2 3 4 5
its stated goals.

2. I found this workshop beneficial and useful. 1 2 3 4 5
3. The manual and the overheads were 1 2 3 4 5
easy to follow.

4. The time allotted for this training was 1 2 3 4 5
appropriate.

5. The trainer was effective. 1 2 3 4 5
6. Overall score for this training. 1 2 3 4 5
The thing I liked best about this training is:____________________________
The thing I liked least about this training is:____________________________
Additional comments:_____________________________________________
Thanks !
36
36
37

Result of converting file eap3vilo.pdf

 *Pages 1--22 from Untitled*
VIOLENCE IN THE
WORKPLACE

Department of Health and Human Services

OVERHEAD #1
1
The training will focus on
EIGHT topic areas:

Q Facts About Workplace Violence
Q What is Violence
Q Types of Violence at Work
Q Barriers to Addressing the Problem
Q Recognizing the Problem
Q What to do When You Recognize a Problem
Q Making It Real and Applying What You Know
Q Other Things to Consider

OVERHEAD #2
2
ACTS OF VIOLENCE
IN THE
WORKPLACE

Q 48% OF EMPLOYEES SAID THAT
THERE HAD BEEN A VIOLENT
INCIDENT AT THEIR COMPANIES
SINCE JANUARY, 1994.

Q 45% OF EMPLOYEES ARE WORRIED
THAT VIOLENCE WOULD ERUPT AT
THEIR WORKPLACES.

Source: Society for Human Resource Management,
Issues Management Program, 1996 Survey

OVERHEAD #3
3
WORKPLACE
VIOLENCE

Q 39% OF EMPLOYEES SAID THAT THEY HAD
BEEN VERBALLY THREATENED IN THE LAST
YEAR

Q 57% WERE INCIDENTS INVOLVING
EMPLOYEES AT THE SAME LEVEL

Q 17% WERE INCIDENTS WHERE AN EMPLOYEE
TARGETED HIS/ HER SUPERVISOR

Q 60% SAID THAT THEY WOULD NOT HAVE
BEEN ABLE TO IDENTIFY THE AGGRESSOR AS
ONE WITH A POTENTIAL FOR VIOLENCE
(SHRM, 1993)

Source: Society for Human Resource Management,
Issues Management Program, 1996 Survey

OVERHEAD #4
4
COSTS TO THE
WORKPLACE ARE
RISING

$4.3 BILLION ANNUALLY
AVERAGE INCIDENT COST IS $250,000
Source: "Workplace Violence: First Line of Defense", The Employment and Labor Law
Series, 1994

$55 MILLION IN LOST WAGES EACH
YEAR

1.8 MILLION DAYS OF WORK LOST
EACH YEAR

Source: Bureau of Justice Statistics (NCJ-178199), July 1994

OVERHEAD #5
5
THE DEPARTMENT OF HEALTH
AND HUMAN SERVICES'
DEFINITION OF WORKPLACE
VIOLENCE

"AN ACTION (VERBAL, WRITTEN, OR PHYSICAL AGGRESSION) WHICH IS
INTENDED TO CONTROL OR CAUSE, OR IS CAPABLE OF CAUSING,
DEATH OR SERIOUS BODILY INJURY TO ONESELF OR OTHERS,
OR DAMAGE TO PROPERTY. VIOLENCE INCLUDES ABUSE OF
AUTHORITY, INTIMIDATING OR HARASSING BEHAVIOR AND
THREATS"

OVERHEAD #6
6
OBVIOUS TYPES OF
WORKPLACE VIOLENCE

 BOMBINGS BOMBINGS
 SHOOTINGS SHOOTINGS
 HITTING HITTING
 FIGHTING FIGHTING
 SCREAMING SCREAMING
 THREATS THREATS

OVERHEAD #7
7
NOT-SO-OBVIOUS TYPES
OF WORKPLACE
VIOLENCE

  HARASSING HARASSING

  STALKING STALKING
  EQUIPMENT SABOTAGE EQUIPMENT SABOTAGE
  BUILDING SABOTAGE BUILDING SABOTAGE
  OTHER IRRATIONAL OTHER IRRATIONAL
RESPONSES (THROWING, RESPONSES (THROWING,
DEFECATING, ETC.) DEFECATING, ETC.)

OVERHEAD #8
8
REASONS FOR
UNDERREPORTING

Not Clear What and When to Report
No Clear Process
Afraid of Not Being Taken Seriously
Afraid of Negative Consequences
Shame and Embarrassment
No Trust in System

Source: Crisis Management Group, Inc., 1995

OVERHEAD #9
9
COMMON MISTAKES MADE
BY ORGANIZATIONS

Q Fail to adopt/ publicize policy
Q Fail to train supervisors and managers in
implementation of policy

Q Use standard psychiatric or psychological
services to assess employee threat of violence instead of an interdisciplinary

Crisis Management Team

Q Ignore vague or indirect threats

Q Press charges in court before conducting
their own inquiry or speaking to employee

Q Assign responsibility to one particular
function (e. g. legal, HR, security, EAP)

OVERHEAD #10
10
LEVELS OF VIOLENCE
LEVEL ONE (Early Warning Signs)

The person: Q
refuses to cooperate with those in authority

Q spreads rumors and gossip to harm
others

Q consistently argues with
employees/ clients

Q belligerent toward customers/
clients/ employees

Q constantly swears at others

Q makes unwanted sexual comments

OVERHEAD #11
11
LEVELS OF VIOLENCE
LEVEL TWO (Escalation of the Situation)

The person: Q argues increasingly with customers,
vendors, employees and management
Q refuses to obey agency policies and
procedures

Q sabotages equipment and steals
property for revenge

Q verbalizes wishes to hurt employees,
clients and/ or management

Q sends sexual or violent notes to
employees and/ or clients

Q sees self as victimized by the
Department (me against them)

OVERHEAD #12
12
LEVELS OF VIOLENCE
LEVEL THREE (Further Escalation, Usually Resulting

in an Emergency Situation)

The person frequently displays intense anger resulting in:

Q recurrent suicidal threats
Q recurrent physical fights
Q destruction of property
Q utilization of weapons to harm
others
Q commission of murder, rape,

and/ or arson

OVERHEAD #13
13
LEVELS OF VIOLENCE
DOMESTIC
VIOLENCE

Often times the incidents occur
outside the workplace, however,
the warning signs may be
recognized at work.

The victim may show signs of:
Q increased fear, emotional

episodes, signs of physical injury
and/ or other physical stress
Q deterioration of work performance

OVERHEAD #14
14
WHEN EARLY WHEN EARLY
SIGNS OCCUR SIGNS OCCUR
(LEVEL 1) (LEVEL 1)

OBSERVE REPORT CONTACT OBSERVE REPORT CONTACT

OVERHEAD #15
15
WHEN THE SITUATION WHEN THE SITUATION
HAS ESCALATED HAS ESCALATED
(LEVEL 2): (LEVEL 2):

 DOCUMENT IN DETAIL

 CONTACT SUPERVISOR, CRISIS
MANAGEMENT TEAM, LAW ENFORCEMENT, SECURITY

 SECURE SAFETY
 CONTACT OTHERS LIKE THE EAP,
UNION, AND/ OR EMPLOYEE RELATIONS

 ASK RELEVANT QUESTIONS

 IF AN EMPLOYEE, SUPERVISOR AND
OFFENDING PERSON SHOULD MEET AGAIN

OVERHEAD #16
16
ASK QUESTIONS RELEVANT ASK QUESTIONS RELEVANT
TO THE PERSON'S TO THE PERSON'S
COMPLAINT SUCH AS: COMPLAINT SUCH AS:

What can you do
to try to regain
control of
yourself?

What can I do to
help you regain
control?

What do you
hope to gain
by committing
violence?

Why do you believe
you need to be
violent to achieve
that?

OVERHEAD #17
17
HOW TRAUMAS AFFECT
EMPLOYEES

c Stage One:
 "Shock Stage" (ex. shock, denial,
disbelief or numbness)
 fight or flight survival reactions

d Stage Two:
 "Impact Stage" -a variety of intense
emotions (ex. anger, sorrow, guilt)
 May last anywhere from a few days to a

few months

e Stage Three:
 "Reconciliation Stage"-employee tries to
make sense of the event

OVERHEAD #19
18
PREVENTION
POLICY
WORK ENVIRONMENT

EMPLOYMENT
SCREENING SECURITY

WEAPON LAWS
EDUCATION
EARLY
INTERVENTION

OVERHEAD #22
19
IN AN EMERGENCY IN AN EMERGENCY
(LEVEL 3) (LEVEL 3)

Q REMAIN CALM

Q CALL 911 AND OTHER APPROPRIATE
EMERGENCY CONTACTS

Q COOPERATE WITH LAW ENFORCEMENT
PERSONNEL

Q CONTACT MEMBERS OF THE CRISIS
MANAGEMENT TEAM

Q IF PERSONALLY CONFRONTED, USE
PROCEDURES IN LEVEL 2

OVERHEAD #18
20
CONSIDERATIONS
FOR MANAGEMENT

Q BE SENSITIVE
Q OBSERVE THE RIPPLE EFFECT
Q BE SURE THE EMPLOYEE IS NOT
ALWAYS ISOLATED

Q CONTROL MEDIA ACCESS

Q DO NOT JOKE ABOUT THE EVENT
Q DO NOT TRIVIALIZE THE EVENT
Q SUGGEST HELP THROUGH THE EAP
AND OTHER TRAUMA SPECIALISTS

OVERHEAD #20
21
HELPING YOURSELF!
Q EAT RIGHT: keep stimulants to a minimum
and do not use alcohol/ drugs to cope

Q EXERCISE: regularly and at least within the
first 24 hours following the incident

Q SLEEP: get plenty of it!

Q TALK: take advantage of social support
systems

Q LIFE-STYLE: set a realistic schedule, avoid
boredom, take time to do enjoyable things

Q GET HELP: don't be afraid to seek outside
help when needed

Q FUTURE: plan for your future safety

OVERHEAD #21
22

Result of converting file eap3vilp.pdf

 *Pages 1--6 from U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES*
UNDERSTANDING AND
RESPONDING TO
VIOLENCE IN THE
WORKPLACE

Department of Health and Human Services

PACKAGE INSTRUCTIONS
March 1997
1
1
U. S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
UNDERSTANDING AND RESPONDING
TO VIOLENCE IN THE WORKPLACE

PACKAGE INSTRUCTIONS

INTRODUCTION
One of the major issues affecting the quality of worklife today is violence. Until the 1990s,
workplace violence was virtually unknown. Studies now show that violence at work is steadily
increasing. Fear about violence among workers has also increased. The Department of Health
and Human Services (HHS) is not immune from these alarming trends.

To look at this issue in HHS, a working group was formed in 1995 by the Office of the Secretary,
Assistant Secretary for Management and Budget, Office of Human Resources. Membership
included representatives from almost every OPDIV, labor, security, the Employee Assistance
Program, employee relations, safety, and others concerned about the health and well-being of
HHS employees. The group (and a number of sub-committees) met regularly for more than a
year. This package is the result of these efforts.

The HHS working group developed a comprehensive strategy for addressing violence at the HHS
worksite. The strategy is general so that it can accommodate the various sites and programs
within the Department. It is recognized that certain locations and operations in HHS have more
unique and greater risk factors. These risk factors should be addressed in an expanded version of
this package that will meet any special needs. Prevention was a key component of the strategy.
Prevention efforts included the creation and distribution of a brochure for all employees and
announcements on earning and leave statements. Ideas on prevention are also threaded
throughout the written guidelines discussed below.

Another important aspect of the strategy was the development of written guidelines to assist
OPDIVs and all employees in establishing workplace violence initiatives and in recognizing and
responding to threatening situations. A number of focus groups were held to obtain employee
feedback on the guidelines. There was strong support for the written guidelines in every focus
group. Many changes were made as a result of the information gathered but the basic concept of
written guidelines stayed intact. There were many suggestions to make an abridged version of the
written guidelines that contained the very important information on recognizing and responding
to violent or threatening situations. It was also recognized that a longer version was necessary for
some people, particularly those more intimately involved with the issue, so a decision was made
by the working group to provide both versions. They are included in this package.
2
2
One more critical element of a comprehensive workplace violence strategy is the establishment
of crisis management teams that can help determine the seriousness of threatening situations, or
to help respond to actual violent or traumatic events. It was determined that this type of activity is
best handled at the local level since it requires the input of local violence experts and emergency
response personnel. To assist with the selection, establishment, and operation of these teams, a
brief set of guidelines was developed and is included with this package.

Finally, the working group and the focus groups strongly believed that training for all employees
on recognizing and responding to workplace violence would be essential for any successful
initiative. A model training curriculum was developed and is also included in this package. It
contains a trainer s guide, a participant s manual, and a set of camera-ready overhead images.
The curriculum includes basic information on recognizing and responding to workplace violence
as well as case studies to apply the knowledge. It is intended for all audiences but has certain case
studies for supervisors.

Each segment of the package will be described in more detail below. Following each description
are any special instructions for photocopying or assembling the materials. The package contains
a hard, camera-ready copy of each segment. In addition, each is contained in the set of diskettes.

YOU MAY NEED TO DO SOME EDITING BEFORE PRINTING FROM THE
DISKETTES BECAUSE THE CODES IN YOUR LOCAL PRINTER MAY ALTER THE
DOCUMENTS.

WRITTEN GUIDELINES
Purposes: &
to educate employees on the nature of workplace violence &
to educate employees on the roles, responsibilities, and policy considerations with regard to
workplace violence &
to educate employees on recognizing and responding to workplace violence &
to provide ideas for prevention and other resources

Suggested Audience: &
all employees of HHS but particularly those involved with the implementation and on-going
operation of a workplace violence strategy &
those involved in providing assistance to employees in threatening situations such as the
Employee Assistance Program, employee relations, or security

Suggested Distribution: &
employees involved in planning, establishing, and administering a workplace violence
strategy &
all human resources staff &
those responsible for security and safety operations
3
3
& health unit
& on-site contract staff particularly security
& any others involved in assessing and responding to actual potentially violent situations (such

as senior management and unions)

Assembly Instructions: &
This document can be photocopied directly from the camera-ready copy found in this
package. &
The document is also available on the computer diskette found in this package. The
document is in WordPerfect 6.1 for Windows. &
If changes are made to the diskette be sure the final page numbers in the Table of Contents
are correct before printing. &
Chapter 4 contains (at the end) a policy letter signed by Secretary Shalala. This must be
copied and inserted separately if using the diskette to print. The letter is NOT contained on
the diskette.

WRITTEN GUIDELINES (ABRIDGED VERSION)
Purposes: &
to educate employees on the nature of workplace violence &
to briefly introduce employees to the roles and responsibilities related to workplace violence &
to educate employees on recognizing and responding to workplace violence &
to provide ideas for prevention

Suggested Audience: &
all employees of HHS

Suggested Distribution: &
all employees of HHS &
on-site contract staff particularly security

Assembly Instructions: &
This document can be photocopied directly from the camera-ready copy found in this
package. Use standard 8.5 x 11 paper. Use 2-sided copying. &
The document is also available on the computer diskette found in this package. The
document is in WordPerfect 6.1 for Windows. &
If changes are made to the diskette be sure the final page numbers are correct before
printing. &
The end of this document contains a policy letter signed by Secretary Shalala. This must be
copied and inserted separately if using the diskette to print. The letter is NOT contained on
the diskette. &
If using the diskette for printing, choose booklet printing under printing options. Your
printer will print half the document, then will instruct you to manually insert those pages for
4
4
the printing of the second half of the document. If your printer has the capability, choose
duplex printing. If your printer does not have duplexing or does not allow you to manually
insert paper, print with booklet printing then take the entire document and rotate every other
page. Select duplex printing on your copier and copy the document. Finally, fold the
document in half for booklet form. Again, the policy letter signed by Secretary Shalala is not
contained on the diskette and must be inserted.

CRISIS MANAGEMENT TEAM GUIDELINES
Purposes: &
to provide guidelines for HHS decision makers in contemplating the establishment of crisis
management teams locally &
to provide assistance on administrative matters for those actually establishing the teams &
to provide assistance with the on-going operations of the team

Suggested Audience: &
all persons involved in deciding on and establishing local crisis management teams &
all persons who are members of the on-going crisis management team

Suggested Distribution: &
same as above

Assembly Instructions: &
This document can be photocopied directly from the camera-ready copy found in this
package. &
The document is also available on the computer diskette found in this package. The
document is in WordPerfect 6.1 for Windows. &
If changes are made to the diskette be sure the final page numbers in the document are
correct before printing.

TRAINING CURRICULUM
Purposes: &
to educate employees on the nature of workplace violence &
to educate employees on the roles, responsibilities, and policy considerations with regard to
workplace violence &
to educate employees on recognizing and responding to workplace violence &
to provide ideas for prevention and other resources

Suggested Audience: &
all employees of HHS
5
5
Suggested Distribution: &
training officers &
those involved in making decisions about OPDIV and STAFFDIV-wide training &
crisis management team members

Assembly Instructions:
The Trainer's Guide and the Participant's Manual require large amounts of disk space.
You will probably need to edit them before printing from the diskettes because the codes in
your local printer will alter the documents. Most of the editing should involve only
margins and tabs.

& The training curriculum is made up of three distinct documents: a Trainer s Guide, a
Participant s Manual, and a set of overhead transparencies. &
These documents can be photocopied directly from the camera-ready copy found in this
package. &
The documents are also available on the computer diskettes found in this package. The
Participant s Manual is in Microsoft Word 6.0. The set of overheads is in Microsoft
PowerPoint 4.0. The Trainer s Guide is in Microsoft Word 6.0 with Microsoft PowerPoint
4.0 slides inserted throughout the document. &
If changes are made to the diskettes be sure the final page numbers in each document are
correct before printing. &
The Trainer s Guide is for use by those actually conducting the training. The Participant s
Manual is the written material to be distributed to all who attend the training. The overheads
are to be used by the trainer, if he or she decides to use an overhead projector. The
overheads must be copied onto transparent sheets before they can be used. &
If using the diskette for printing the Trainer s Guide and the Participant s Manual, be sure to
select duplex printing on either your computer printer or your copier. These documents
have been created so that they require two-sided printing starting with page 1 (the
document covers are not to be included).
6

Result of converting file eap3vilt.pdf

 *Pages 1--79 from REVTRAIN.PDF*
UNDERSTANDING AND
RESPONDING TO
VIOLENCE IN THE
WORKPLACE

Department of Health and Human Services

TRAINER'S GUIDE
March 1997
1

2
INTRODUCTION TO TRAINING INSTRUCTIONS
1
Purpose:
This training program has been developed in response to the growing number of
workplace violence incidents in the United States. In a memorandum issued to all
employees of the Department of Health and Human Services (HHS) in January of
1996, Secretary Shalala explained that to address the issue of workplace violence in
HHS, a project team was formed to develop comprehensive guidelines to help the
Department respond to and prevent violence in the workplace. This team was also
responsible for developing this training program.

Format:
We have tried to create a format that is easy for you, the trainer, to follow. This
guide is to be used in conjunction with the Participant's Manual. The Trainer's
Guide has additional explanations and answers in order to help you facilitate a
training class. The Participant's Manual has additional narrative text to enhance the
flow of the document. It is expected that participants will keep their manuals after
training is completed.

This Trainer's Guide has been organized as follows:

1. Training instructions and EVEN numbered pages are on
the LEFT side of the guide.

2. Corresponding overheads, case studies and ODD
numbered pages are on the RIGHT side of the guide.
3
INTRODUCTION TO TRAINING INSTRUCTIONS
2
Symbols:
You will notice that there are various symbols in the left margin of the training
instructions. These symbols are meant to provide you with a quick visual
instruction cue. The key for the symbols is noted below:

? Ask the participants
3 Display and read overhead
F Instruct participants to turn the page
& Allow participants time to read the section
! Highlight text on visual overhead
 Explain or discuss

! Emphasize
` Use flip chart

Equipment and Class Size:
This training has been designed for a classroom format. It is suggested that no more
than 25 employees participate in each class.

This training requires the following equipment:
 Overhead projector
 Highlight markers
 Pencils/ pens for participants
 Tape
 Screen
 Flip chart/ colored markers
4
INTRODUCTION TO TRAINING INSTRUCTIONS
4
Preparation:
A crucial component to this training program is the use of transparent overheads.
You have received copies of the overheads in your training package. You will need
to copy the enclosed overheads onto transparencies in order to use them with
an overhead projector.

In addition, you will need to distribute the Participant's Manual, a copy of which is
included in your training package. Reproduce copies for all participants before the
training begins.

Be sure to reserve conference room space that is sufficient for your class size.

This training is meant to be interactive. Therefore, it is imperative that anyone
facilitating this training be familiar with the information in both the Trainer's Guide
and the Participant's Manual. Carefully read through both documents prior to the
actual training.

This curriculum contains a tremendous amount of information with close time
frames. It is the responsibility of the trainer to monitor the time and to direct the
group through the training within the time allotted for each section. Avoid lengthy
conversation. If the participants have any special questions, issues or problems that
were not addressed due to time constraints, encourage them to speak to you
afterwards.

Things to Keep in Mind:
 Pace is important. Practice and time yourself.
 Always do a "dry run" of the presentation ahead of time.
 Always arrive early enough to allow sufficient time for classroom set-up. There is always the possibility that you will experience some problems

prior to the start of training.
Good Luck!
5

6
5
While participants are entering the room:
3 1. DISPLAY Overhead #1: Violence in the Workplace.
2. GREET Participants.
When it is time to begin training:
1. INTRODUCE yourself and state your role or position with the Department of Health and Human Services.

2. INFORM the group that you are about to begin a training workshop on Workplace Violence.
3. STATE that the training will last approximately two hours.
4. EXPLAIN that in the FIRST HOUR, you will be reviewing some basic information regarding workplace violence. In the SECOND HOUR,
the group will be applying this information to case studies.
5. ADVISE the participants that there will be no breaks and, if necessary, they should excuse themselves from the room.

6. STATE that you will be using an overhead projector and SUGGEST that anyone who cannot clearly see the screen move to another seat.
7. STATE that this training program is meant to be interactive.
8. ENCOURAGE participant questions and comments.

? 9. ASK if anyone has any questions before you begin.

F F Instruct participants to turn to page 1.
7
TRAINING INSTRUCTIONS
6
VIOLENCE IN THE
WORKPLACE

Department of Health and Human Services

OVERHEAD #1
8
7
WARM UP EXERCISE
Have the participants do this warm up exercise to facilitate introductions and to get them thinking about workplace violence. Instruct the class to break up into small
groups.

& & 1. ASK participants to READ "Thank Goodness Its Friday!" on page 1 of the Participant's Manual (and on the opposite page in your guide)
and briefly discuss the questions in Things to Think About in small
groups.

 2. DISCUSS the exercise with the entire group. Ask participants to
share their answers. Do not discourage any responses. Include the
responses noted below if they are not mentioned in the discussion.

1. Always take responsibility for intervening in situations that
are potentially violent.
This is obviously a volatile, and therefore potentially violent,
event.

2. Document (in detail) the behavior as soon as it happens.
Report your concerns to a supervisor (either yours or
John/ Sarah's).
Contact the local Crisis Management Team to alert members
to any concerns and seek their help in assessing the situation.

3. You don't know if John is a violent person but he is behaving
a manner that indicates there is potential for violence.
Any person can be violent under the right circumstances.
More information about John would help assess the situation.

F Instruct participants to turn to page 2.
9
TRAINING INSTRUCTIONS
8
THANK GOODNESS ITS FRIDAY!
You are sitting at your desk quietly winding up your work for the day. It's
Friday afternoon and your thoughts turn to your plans for the weekend.
Suddenly you are startled by some commotion you hear in the hall. You
recognize the voices of your co-workers John and Sarah. Sarah is yelling at
John to stop bothering her, that she is sick and tired of his sexual harassment.
John is yelling back at her, telling her she's crazy and that he can't stand to be
with her, much less sexually harass her. The screaming continues and you step
out into the hall to try and intervene. About that time, John storms off saying to
Sarah, "I hope you have a horrible weekend, I'll make sure that you do!"

Sarah is shaking and runs out the door. You start thinking about what you
should do. All you really want to do is go home and forget this event. It will
cool down by Monday. Something bothers you, though. You know that John is
an avid gun collector and user and that he is rumored to hit his wife. Suddenly
you are worried about Sarah.

THINGS TO THINK ABOUT:
1. Do you think you should get involved in this situation?
2. What are you going to do now?
3. Is John a violent person?
10
9
1. REVIEW the primary purpose and the goals of this training on page 2 of the Participant's Manual (and below) with the group.
F Instruct participants to turn to page 3.
The primary purpose of this training is to:
 Provide training for employees of the Department of Health
and Human Services on managing violent or potentially violent situations.

The goals of the training are:
 To develop and support a work environment which will prevent
and effectively respond to violent situations in the workplace.

 To increase employee understanding of workplace violence in
these basic areas:

Defining Workplace Violence
Identification and Recognition of Actual and Potential
Violent Situations
Response and Intervention
Follow-Up to a Violent Situation
11
TRAINING INSTRUCTIONS
10
THIS PAGE WAS INTENTIONALLY LEFT BLANK
12
11
INTRODUCTION (continued)
3 1. DISPLAY AND READ ALOUD Overhead #2: Topic Areas to be Addressed.

 2. EXPLAIN that the training will address each of these topic areas.
 3. EXPLAIN that Part 7 includes case studies and the exercises
which are meant to be interactive.

? 4. ASK if there are any questions.

F Instruct participants to turn to page 4.
13
TRAINING INSTRUCTIONS
12
The training will focus on
EIGHT topic areas:

n Facts About Workplace Violence
n What is Violence
n Types of Violence at Work
n Barriers to Addressing the Problem
n Recognizing the Problem
n What to do When You Recognize a Problem
n Making It Real and Applying What You Know
n Other Things to Consider

OVERHEAD #2
14
13
Part 1: FACTS ABOUT WORKPLACE VIOLENCE (5 minutes)
3 1. DISPLAY AND READ ALOUD Overhead #3: Acts of Violence in the Workplace.

 2. EXPLAIN that violence in the workplace is a serious and growing
threat and affects over one million workers each year. According to the National Institute for Occupational Safety and Health (NIOSH),

homicide is now the SECOND highest work-related cause of death in the United States (1996). The victims of workplace violence not only
include those killed or injured, but also the victims' families, friends and co-workers.

3 3. DISPLAY AND READ ALOUD Overhead #4: Workplace Violence.
 4. EXPLAIN that these statistics reflect a survey of Human Resource
Professionals. Note that 60% said they would not have been able to identify the aggressor as one with a potential for violence.

! 5. EMPHASIZE THAT EMPLOYEE REACTIONS SHOULD BE BASED ON ACTUAL BEHAVIOR AND NOT ON WHAT ONE
BELIEVES IS THE PROFILE OF A PERSON*.
*Explain that this will be discussed further in a later section.

? 6. ASK if there are any questions.

F Instruct participants to turn to page 5.
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TRAINING INSTRUCTIONS
14
ACTS OF VIOLENCE
IN THE
WORKPLACE

n 48% OF EMPLOYEES SAID THAT
THERE HAD BEEN A VIOLENT
INCIDENT AT THEIR COMPANIES
SINCE JANUARY, 1994.

n 45% OF EMPLOYEES ARE WORRIED
THAT VIOLENCE WOULD ERUPT AT
THEIR WORKPLACES.

Source: Society for Human Resource Management,
Issues Management Program, 1996 Survey

OVERHEAD #3

WORKPLACE
VIOLENCE

n 39% OF EMPLOYEES SAID THAT THEY HAD
BEEN VERBALLY THREATENED IN THE LAST
YEAR

n 57% WERE INCIDENTS INVOLVING
EMPLOYEES AT THE SAME LEVEL.

n 17% WERE INCIDENTS WHERE AN EMPLOYEE
TARGETED HIS/ HER SUPERVISOR.

n 60% SAID THAT THEY WOULD NOT HAVE
BEEN ABLE TO IDENTIFY THE AGGRESSOR AS
ONE WITH A POTENTIAL FOR VIOLENCE.
(SHRM, 1993)

Source: Society for Human Resource Management, Issues Management
Program, 1996 Survey

OVERHEAD #4
16
15
Continuation of Part 1: FACTS ABOUT WORKPLACE VIOLENCE
3 1. DISPLAY AND READ ALOUD Overhead #5: Costs to the Workplace Are Rising.

 2. DISCUSS the other areas, in addition to cost, that are affected by
workplace violence. For example, workplace violence can cause:

 psychological damage;
 productivity impediments;
 diversion of management resources; and/ or
 increased costs.

? 3. ASK the participants to give examples of the four areas noted above in #2.

` 4. WRITE their responses on the Flip Chart. Include any of the
following examples which were not mentioned.

 Examples of psychological damage include: substance abuse,
trauma, mental health services, survivor guilt, suicide.

 Examples of productivity impediments include: increased turnover,
absenteeism, lower morale.

 Examples of diversion of management resources include: response
to crisis, costly litigation.

 Examples of increased costs include: security costs, workers'
compensation costs, personnel costs (recruitment, training, etc...).

F Instruct participants to turn to page 6.
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TRAINING INSTRUCTIONS
16
COSTS TO THE
WORKPLACE ARE
RISING

$4.3 BILLION ANNUALLY
AVERAGE INCIDENT COST IS $250,000
Source: "Workplace Violence: First Line of Defense", The Employment and
Labor Law Series, 1994

$55 MILLION IN LOST WAGES EACH
YEAR

1.8 MILLION DAYS OF WORK LOST
EACH YEAR Source: Bureau of Justice Statistics (NCJ-178199), July 1994

OVERHEAD #5
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17
Part 2: WHAT IS VIOLENCE? (5 minutes)
? 1. ASK the participants to think about the range of behaviors included in a definition of workplace violence.

3 2. DISPLAY AND READ ALOUD Overhead #6: HHS Definition of Workplace Violence.
? 3. ASK the group to identify any surprising or key phrases in this definition.
! 4. HIGHLIGHT their responses on the overhead with a marker.
? 5. ASK participants to explain their responses. Ask the group if this definition defines the following behaviors as workplace violence:

 sending threatening email.
 slamming your hands on desk during an argument with a co-worker.

These behaviors are considered violent!
? 6. ASK if any of the participants have ever witnessed violent behavior at their work and ask them to describe the behavior.

` 7. Have the participants call out their responses and write them on the
Flip Chart. Keep the responses displayed in order to compare them with Overheads #7 and #8 in part 3.

F Instruct participants to turn to page 7.
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TRAINING INSTRUCTIONS
18
THE DEPARTMENT OF HEALTH
AND HUMAN SERVICES'
DEFINITION OF WORKPLACE
VIOLENCE

"AN ACTION (VERBAL, WRITTEN, OR PHYSICAL AGGRESSION) WHICH IS
INTENDED TO CONTROL OR CAUSE, OR IS CAPABLE OF CAUSING,
DEATH OR SERIOUS BODILY INJURY TO ONESELF OR OTHERS,
OR DAMAGE TO PROPERTY. VIOLENCE INCLUDES ABUSE OF
AUTHORITY, INTIMIDATING OR HARASSING BEHAVIOR AND
THREATS"

OVERHEAD #6
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19
Part 3: TYPES OF VIOLENCE (5 minutes)
The Flip Chart responses from the previous section should still be displayed.

3 1. DISPLAY AND READ ALOUD Overhead #7: Obvious Types of Violence. Compare with Flip Chart.

3 2. DISPLAY AND READ ALOUD Overhead #8: Not-so-Obvious Types of Violence. Compare with Flip Chart
? 5. ASK the participants if they can identify any other types of violent behaviors. Add their responses to the Flip Chart.
? 6. ASK if any of the participants have ever witnessed these types of behaviors at work and, if yes, ask how that made them feel.

F Instruct participants to turn to page 8.
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TRAINING INSTRUCTIONS
20
OBVIOUS TYPES OF
WORKPLACE VIOLENCE

 BOMBINGS BOMBINGS
 SHOOTINGS SHOOTINGS
 HITTING HITTING
 FIGHTING FIGHTING
 SCREAMING SCREAMING
 THREATS THREATS

OVERHEAD #7

NOT-SO-OBVIOUS TYPES
OF WORKPLACE
VIOLENCE

  HARASSING HARASSING

  STALKING STALKING
  EQUIPMENT SABOTAGE EQUIPMENT SABOTAGE
  BUILDING SABOTAGE BUILDING SABOTAGE
  OTHER IRRATIONAL OTHER IRRATIONAL
RESPONSES (THROWING, RESPONSES (THROWING,
DEFECATING, ETC.) DEFECATING, ETC.)

OVERHEAD #8
22
21
Continuation of Part 3: TYPES OF VIOLENCE AT WORK
1. REVIEW the Four Categories of Violence on page 8 of the Participant's Manual and on the opposite page of this guide.

! 2. EMPHASIZE that #2 on page 8 notes Domestic Violence.
 3. EXPLAIN that the October 1996 issue of Workplace Violence
Prevention Reporter notes that 27% of workplace violence incidents were a result of domestic problems.

 4. EXPLAIN that Part 6 will describe intervention procedures for
domestic violence.

F Instruct participants to turn to page 9.
23
TRAINING INSTRUCTIONS
22
ACCORDING TO ONE AUTHOR, THERE ARE FOUR
CATEGORIES OF WORKPLACE VIOLENCE:

Source: Joseph A. Kinney, Executive Director of the National Safe Workplace Institute in "Violence in the
Workplace", American Society for Training and Development, July 1993

1. EMPLOYER-DIRECTED VIOLENCE. A person engages in violence against an employer, manager, or supervisor.
2. DOMESTIC-RELATED VIOLENCE. A romantically disaffected partner or would-be partner strikes out against the object of his or her affections.
3. PROPERTY-DIRECTED VIOLENCE. These are acts against employers designed to damage company property.
4. COMMERCIAL-DIRECTED VIOLENCE. A person perpetrates events, including theft of money or property, that also involve violence.
24
23
Part 4: BARRIERS TO ADDRESSING THE PROBLEM (10 minutes)
? 1. ASK the participants to think about what would prevent them from reporting potential and/ or actual workplace violence.

` 2. WRITE at least four responses on the flip chart. If you have time for
discussion, ask the participants the following questions:

 Do you know what and when to report?
 Do you have a clear understanding of the process?
 Do you think you will be taken seriously?
 What are some of the consequences of reporting? How will it
affect you, your career, and the perpetrator?

 Do you think you will cause shame and embarrassment to
yourself, to the perpetrator or to your place of employment?

 Do you trust the system to handle the matter in an effective
and efficient manner?

3 3. DISPLAY AND READ ALOUD Overhead #9: Reasons for Underreporting.

! 4. EMPHASIZE that these are important issues to think about now because workplace violence should be addressed immediately and
these concerns may cause delays.

F F Instruct participants to turn to page 10.
25
TRAINING INSTRUCTIONS
24
REASONS FOR
UNDERREPORTING

Not Clear What and When to Report
No Clear Process
Afraid of Not Being Taken Seriously
Afraid of Negative Consequences
Shame and Embarrassment
No Trust in System

Source: Crisis Management Group, Inc., 1995

OVERHEAD #9
26
25
Continuation of Part 4: BARRIERS TO ADDRESSING THE PROBLEM
3 1. DISPLAY AND READ ALOUD Overhead #10: Common Mistakes Made By Organizations. The third bullet emphasizes the importance
of utilizing input from different areas within the workplace.

? 2. ASK the participants if any of their workplaces have made these mistakes in the past. If any of the participants answer yes, encourage
them to share the content of this training with their co-workers and administrators.

 3. EXPLAIN that the guidelines created for the Department of Health
and Human Services recommend the formation of a Crisis Management Team. The guidelines suggest that certain functional

areas be recruited for membership on the team.

? 4. Ask the participants which areas they think are appropriate for inclusion on a Crisis Management Team. Name any of the areas
listed below which were not mentioned.
 building security
 medical staff
 Employee Assistance Program (EAP)
 union (s)
 employee/ labor relations
 public affairs
 General Counsel
 violence experts such as assessment professionals
 senior management
 health unit
 law enforcement personnel
 safety office or safety committee member

F F Instruct participants to turn to page 11.
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TRAINING INSTRUCTIONS
26
COMMON MISTAKES MADE
BY ORGANIZATIONS

n Fail to adopt/ publicize policy
n Fail to train supervisors and managers in
implementation of policy

n Use standard psychiatric or psychological
services to assess employee threat of violence instead of an interdisciplinary

Crisis Management Team

n Ignore vague or indirect threats
n Press charges in court before conducting
their own inquiry or speaking to employee

n Assign responsibility to one particular
function (e. g. legal, HR, security, EAP)

OVERHEAD #10
28
27
Part 5: RECOGNIZING THE PROBLEM (15 minutes)
! 1. EMPHASIZE that the first step in being able to respond to these situations is to recognize what the problem looks like at work.
Frequently, performance problems may be warning signs of potential trouble.

? 2. ASK the group to consider the performance indicators or warning signs of a potential or actual violent situation. Have them call out a list of
warning signs.
` 3. WRITE their responses on the Flip Chart. Compare the responses with
the list of performance indicators below. Add any that were not mentioned. Examples of performance indicators are:

 attendance problems
 impact on supervisor's/ manager's time
 decreased productivity
 inconsistent work patterns
 concentration problems
 safety issues
 poor health and hygiene
 unusual/ changed behavior
 evidence of possible drug or alcohol use/ abuse
 evidence of serious stress in the employee's personal life
 continual excuses/ blame
 depression

! 3. EMPHASIZE that it is important to determine if there is a pattern and not merely a single isolated indicator. THE PRESENCE OF ANY
OF THESE CHARACTERISTICS DOES NOT NECESSARILY MEAN A VIOLENT ACT WILL OCCUR.

Participants should not turn the page.
29
TRAINING INSTRUCTIONS
28
THIS PAGE WAS INTENTIONALLY LEFT BLANK
30
29
Continuation of Part 5: RECOGNIZING THE PROBLEM
 1. EXPLAIN that the behaviors involved in workplace violence
typically follow a pattern and, over time, escalate in severity.

3 2. DISPLAY AND READ ALOUD Overhead #11: Levels of Violence, Level One.

3 3. DISPLAY AND READ ALOUD Overhead #12: Levels of Violence, Level Two.
3 4. DISPLAY AND READ ALOUD Overhead #13: Levels of Violence, Level Three.
3 5. DISPLAY AND READ ALOUD Overhead #14: Levels of Violence, Domestic Violence.
! 6. EMPHASIZE that workplace violence may not follow these levels.
? 7. ASK the group if anyone knows of a case that did not follow this pattern or fell into more than one level at the same time.

F Instruct participants to turn to page 12.
31
TRAINING INSTRUCTIONS
30
LEVELS OF VIOLENCE
LEVEL ONE (Early Warning Signs)

The person:
n refuses to cooperate with those in
authority

n spreads rumors and gossip to harm
others

n consistently argues with
employees/ clients

n belligerent toward customers/
clients/ employees

n constantly swears at others
n makes unwanted sexual comments

OVERHEAD #11
LEVELS OF VIOLENCE
LEVEL TWO (Escalation of the Situation)

The person: n argues increasingly with customers,
vendors, employees and management
n refuses to obey agency policies and
procedures

n sabotages equipment and steals
property for revenge

n verbalizes wishes to hurt employees, clients and/ or management

n sends sexual or violent notes to
employees and/ or clients

n sees self as victimized by the
Department (me against them)

OVERHEAD #12

LEVELS OF VIOLENCE
LEVEL THREE (Further Escalation, Usually Resulting

in an Emergency Situation)

The person frequently displays intense anger resulting in:
n recurrent suicidal threats
n recurrent physical fights
n destruction of property
n utilization of weapons to harm
others

n commission of murder, rape,
and/ or arson

OVERHEAD #13
LEVELS OF VIOLENCE
DOMESTIC
VIOLENCE

Often times the incidents occur
outside the workplace, however,
the warning signs may be
recognized at work.

The victim may show signs of:
n increased fear, emotional
episodes, signs of physical injury
and/ or other physical stress

n deterioration of work performance

OVERHEAD #14

Source: S. Anthony Baron, Violence in the Workplace, 1993.
32
31
Part 6: WHAT TO DO WHEN YOU RECOGNIZE A PROBLEM
(20 minutes)

 1. EXPLAIN that it is critical to identify, document and report the
behaviors described in this training at the earliest possible moment so
that appropriate action can be taken. Ignoring an individual who
exhibits these behaviors sends the message that such behaviors are
acceptable.

& 2. ASK the participants to review the warm up exercise, "Thank
Goodness Its Friday", on page 1 of their manuals to discuss
interventions.

 3. DISCUSS what to do "When Early Warning Signs Occur" with
regards to "Thank Goodness Its Friday".

You have OBSERVED and DOCUMENTED:
 Sarah and John had an argument.
 Sarah said that she is tired of John's sexual harassment.
 John told Sarah that she's crazy.
 John told Sarah that he can't stand to be around her.
 John threatened that he will make sure Sarah has a horrible weekend.

 Sarah is distraught.
You should REPORT: Report your observations to your supervisor.
You should CONTACT: The Crisis Management Team.

3 4. DISPLAY AND READ ALOUD Overhead #15: When Early Warning Signs Occur (Level 1). Note any differences between the
overhead and the participants' responses.

F Instruct participants to turn to page 13.
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TRAINING INSTRUCTIONS
32
WHEN EARLY SIGNS WHEN EARLY SIGNS
OCCUR (LEVEL 1) OCCUR (LEVEL 1)

OBSERVE REPORT CONTACT OBSERVE REPORT CONTACT

OVERHEAD #15

THANK GOODNESS ITS FRIDAY!
You are sitting at your desk quietly winding up your work for the day. It's
Friday afternoon and your thoughts turn to your plans for the weekend.
Suddenly you are startled by some commotion you hear in the hall. You
recognize the voices of your co-workers John and Sarah. Sarah is yelling at
John to stop bothering her, that she is sick and tired of his sexual harassment.
John is yelling back at her, telling her she's crazy and that he can't stand to
be with her, much less sexually harass her. The screaming continues and you
step out into the hall to try to intervene. About that time, John storms off
saying to Sarah, "I hope you have a horrible weekend, I'll make sure that you

Sarah is shaking and runs out the door. You start thinking about what you
should do. All you really want to do is go home and forget this event. It will
cool down by Monday. Something bothers you, though. You know that John
is an avid gun collector and user and that he is rumored to hit his wife.
Suddenly you are worried about Sarah.
34
33
Continuation of Part 6: WHAT TO DO WHEN YOU RECOGNIZE A
PROBLEM

AN ESCALATION OF JOHN AND SARAH
Continue to use "Thank Goodness Its Friday". Suggest that the group imagine that the
situation has escalated. Start by stating that John returned to the office later that same
day, more enraged than when he left. He was determined to find Sarah.

? 1. ASK the participants to provide some ideas on how to handle this escalated scenario.

3 2. DISPLAY AND READ ALOUD Overhead #16: When the Situation Has Escalated (Level 2). Point out the differences between the ideas
generated by the group and what appears on the overhead.

? 3. Ask the participants to imagine that when the situation escalated, they tried to intervene and John got very angry. On page 13 of their
manual, the participants will find some ideas for what to do in this
situation. One of the suggested steps is to ask John questions relevant
to his complaint to try to calm him down. Tell the participants that
you are now going to look at some of these questions.

3 4. DISPLAY AND READ ALOUD Overhead #17: Ask Relevant Questions.

F Instruct participants to turn to page 14.
35
TRAINING INSTRUCTIONS
34
WHEN THE SITUATION WHEN THE SITUATION
HAS ESCALATED HAS ESCALATED
(LEVEL 2): (LEVEL 2):

n DOCUMENT IN DETAIL

n CONTACT SUPERVISOR, CRISIS
MANAGEMENT TEAM, LAW ENFORCEMENT, SECURITY

n SECURE SAFETY
n CONTACT OTHERS LIKE THE EAP,
UNION, AND/ OR EMPLOYEE RELATIONS

n ASK RELEVANT QUESTIONS
n IF AN EMPLOYEE, SUPERVISOR AND
OFFENDING PERSON SHOULD MEET AGAIN

OVERHEAD #16

ASK QUESTIONS RELEVANT ASK QUESTIONS RELEVANT
TO THE PERSON'S TO THE PERSON'S
COMPLAINT SUCH AS: COMPLAINT SUCH AS:

What can you do
to try to regain
control of
yourself?

What can I do to
help you regain
control?

What do you
hope to gain
by committing
violence?

Why do you believe
you need to be
violent to achieve
that?

OVERHEAD #17
36
35
Continuation of Part 6: WHAT TO DO WHEN YOU RECOGNIZE A
PROBLEM

A FURTHER ESCALATION OF JOHN AND SARAH
Ask the participants to now imagine that the situation with John and Sarah has escalated
further. Provide a scenario that indicates behaviors found in Level 3 (such as John
hitting Sarah).

 1. DISCUSS what to do "In An Emergency" with regards to the case
scenario developed earlier.

3 2. DISPLAY AND READ ALOUD Overhead #18: In An Emergency (Level 3). Point out the differences between the ideas generated by
the group and what appears on the overhead.

? 3. ASK if there are any questions.

F Instruct participants to turn to page 15.
37
TRAINING INSTRUCTIONS
36
IN AN EMERGENCY IN AN EMERGENCY
(LEVEL 3) (LEVEL 3)

n REMAIN CALM
n SECURE SAFETY
n CALL 911 AND OTHER APPROPRIATE
EMERGENCY CONTACTS

n COOPERATE WITH LAW ENFORCEMENT
PERSONNEL

n CONTACT MEMBERS OF THE CRISIS
MANAGEMENT TEAM

n IF PERSONALLY CONFRONTED, USE
PROCEDURES IN LEVEL 2

OVERHEAD #18
38
37
Continuation of Part 6: WHAT TO DO WHEN YOU RECOGNIZE A
PROBLEM

* Instruct participants to reproduce this sheet (page 15 of their
manuals) and keep in an accessible place at their workstations.

 1. DISCUSS procedures for handling bomb threats. Note that most
bomb threats are made by phone to a specific individual. It is
important to remember that you should try to get as much detail and
information as possible. Obtain the following information about the
threat.

 telephone number where the call was received
 exact time of call
 exact words of the caller
 answers to these questions:
 When will the bomb explode?
 Where is the bomb?
 What does it look like?
 What kind of bomb is it?
 What is your name?
 What is your address?
 Where are you calling from?
 Why did you place the bomb?

 Make special note of the following information.
 caller's voice (calm, excited, disguised, accent, etc.)
 caller's sex
 caller's age (as determined by voice)
 voice familiar to you?
 background noise
 names of those threatened

F F Instruct participants to turn to page 16.
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TRAINING INSTRUCTIONS
38
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LEFT BLANK
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39
Continuation of Part 6: WHAT TO DO WHEN YOU RECOGNIZE A
PROBLEM

Participants should be looking at the shaded box on page 16 of their manuals.
 1. DISCUSS procedure for domestic violence intervention (see opposite
page).

! 2. EMPHASIZE that domestic violence typically escalates. It is important to talk to the person about your concerns for her safety.
Resources and help ARE available. Initiate the process and
encourage your co-worker to utilize these services (Encourage
participants to utilize the local EAP number and the National
Domestic Violence Hotline: 800-799-SAFE (7233) or for the hearing
impaired 800-787-3224).

? 3. ASK if there are any questions.

F Instruct participants to turn to page 17.
41
TRAINING INSTRUCTIONS
40
DOMESTIC VIOLENCE
 Talk to the person about your concerns. Let her know that you are afraid for her safety and the safety of her children. Remind her that it will only get worse. Let her
know that you will assist her in locating resources and developing a safety plan.
 Contact the Employee Assistance Program if you need more information.
 Recommend that she call the National Domestic Violence Hotline for more information about domestic violence or to help her find local resources. The
number is 800-799-SAFE (7233) or for the hearing impaired 800-787-3224. Also
recommend that she contact the HHS Employee Assistance Program where she can
also get help in understanding and responding to the problem.

 Recommend that a workplace safety plan be developed in case an incident occurs at the workplace. Think about the safety of the individual as well as everyone around
her. Do not be a hero if the perpetrator shows up at work. Follow the safety plan
and go for help.
42
41
Part 7: MAKING IT REAL AND APPLYING WHAT YOU KNOW
EXERCISES AND CASE STUDIES

This section contains a number of case studies that will encourage participants to
utilize the information learned in the training and to think about the best ways to
handle the issue of violence in the workplace.

Cases 1-5 are general and the content is applicable to all audiences. Cases 6-7 are
more appropriate for supervisors and managers but can be adapted for general
audience use.

It will take about an hour to do these cases studies and exercises. If more time is
available, cases can be discussed in more detail. If less time is available, select just
a few cases for discussion. Suggested points for discussion follow the case
descriptions. The Trainer's Guide has been arranged so that the case study is printed
on the right side of your guide. The left side continues to provide training instructions.
In this section, the training instructions are suggested actions to the case studies.

Instructions for this section:
Divide the class into small groups with at least 3 participants. Assign which case
studies will be handled by which groups. If there is enough time, each group can
discuss every case. Instruct the groups to take the following steps:

1. Read the assigned case studies.
2. Discuss "Things to Think About" and formulate responses.
3. Have someone take notes and present the responses to the larger group.

Include any of the suggested actions noted in the training instructions that were not
mentioned. Make yourself available by walking around the room. Assist any group
experiencing problems. Turn to page 64 when the class has finished this section.

F Participants should turn to page 27 upon completion of the case studies.
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CASE 1: HELPING MARY
Suggested Actions:
1. If Mary's behavior is having a detrimental effect on the workplace, it is a good
idea to take some action whether or not violence is a concern. In this case, there
are some indications that Mary may be in danger and may be the victim of
domestic violence or stalking.

It is important that others get involved in situations like Mary's, rather than see it
as a personal matter best resolved at home. Frequently, women in Mary's
situation do not know where to go for help.

In addition, Mary's workplace is at risk. Domestic violence is frequently carried
out at the workplace, where the partner is most likely to find the woman.

2. You and your co-workers can talk to Mary about your concerns. Let her know
that you are afraid for her safety and the safety of her children. Remind her that it
will only get worse. Let her know that you will assist her in locating resources
and developing a safety plan. Tell her about the National Domestic Violence
Hotline and the Employee Assistance Program.

The supervisor can work with Mary and her co-workers to develop a workplace
safety plan. The plan will outline a course of action in the event that the
perpetrator shows up at Mary's work. Mary may also need to leave to hide from
the perpetrator, take care of physical injuries (if there are any), and to care for
children or others in the household who may also fall victim to the abuse.
Explore sick and annual leave as well as leave under the Family and Medical
Leave Act. Mary should be encouraged to let her supervisor know in advance
when she may be absent or when her work may be affected.

F Training Instructions for case #1 continued on page 44.
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CASE 1: HELPING MARY
Mary is a co-worker in your agency. She has been a valuable employee to your
group and one of the most respected experts in her field. You notice lately, though,
that she is more reserved and is absent quite a bit. You hear her quietly crying or
having a fight with someone on the phone frequently. She is a bit jumpy while she is
at work, always looking over her shoulder when she goes somewhere.

You ask her to lunch one day and voice your concern. Mary says she is having some
problems at home but that it is nothing to worry about; she can handle it herself.
Several weeks later you notice that Mary's fear has escalated. She rarely leaves the
building. When she must leave, she moves quickly, always covering her face. She
works erratic hours. Her fear is really beginning to affect everyone at work. You are
all concerned for her but don't know what is going on. You begin to wonder if there
is a real danger, both to Mary and to the rest of you who work with her.

THINGS TO THINK ABOUT:
1. Do you believe this is a situation that requires further action on your part?
Why or why not?

2. What are the appropriate interventions in this situation? Think about those
things that you and the other co-workers can do, what Mary's supervisor
can do, what security staff can do, and what any other agency staff can do.

3. Are there other protections that should be considered for Mary and her co-workers?
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Continuation of CASE 1: HELPING MARY
Suggested Actions:
Management may also contemplate a temporary change of duty station for Mary
so that her perpetrator does not know her location. The supervisor should also
encourage Mary to seek help through the EAP or other local facilities. Security
staff should be made aware of any civil protections or restraining orders that are
in effect. A picture of the perpetrator may also be provided. Mary may also
require an escort to her car or other buildings if there is a risk of a workplace
incident.

Other human resources staff can provide Mary with information that would help
her make decisions about her household situation. She, for example, may need to
know about her benefits, any work/ family resources, and health unit services.
Training staff may help Mary develop a career and training plan that works
towards the goal of independent financial security.

3. Alert co-workers to any restraining orders or other civil protections so that if the
perpetrator shows up they can request law enforcement assistance.

Follow the established safety plan for Mary. It may include how to evacuate the
premises and how to hide Mary. Don't be a hero if the partner shows up at work.
Contact the appropriate law enforcement staff.
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CASE 2: THE UNHAPPY CUSTOMER
Suggested Actions:
1. First, try to secure your safety. Call 911 or the emergency number for your
location if at all possible.

Remain calm and speak slowly and clearly.
Ask the person to sit down; determine if he is able to follow directions.
Ask him questions relevant to his complaint such as "Why do you believe you
need to be violent because of the funding situation?" Or ask what you can do to
help the person regain control.

If the man does not calm down, try matching the loudness of his voice and then
gradually bring your voice down to a calm level.

Try to direct the aggressive tendencies to another kind of behavior so that he
sees he has choices about how to handle the situation.

2. There were some early warning signs that there might be some trouble around
the grant situation. The situation is stressful in and of itself. Second, the phone
calls were an early warning sign. Third, the fact that you felt sorry for the people
puts you in a vulnerable position. You can feel compassion but must be realistic
about possible reactions to this news.

First, develop a plan of action for informing grantees about the elimination of
their funding. Plans should include anticipating responses by the grantees and the
best way to handle them, even the worst case scenarios.

In this situation, the phone calls should have been documented thoroughly and
reported to your local Crisis Management Team, security and/ or supervisor.
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CASE 2: THE UNHAPPY CUSTOMER
Your job in this Department is to assist recipients of substance abuse grants. It
involves working with customers face-to-face each day. Since there are many
recipients of these grants, it is impossible to know all of them personally. Due to
recent budget cuts, some of the grantees have been eliminated.

Some of the discontinued recipients have been calling you. They are extremely upset
and have even screamed at you. One even threatened to get even since you ruined
his life. You ignore these calls and threats, attributing the behavior to the situation of
losing their livelihoods. In fact, you actually feel sorry for them and decide you
would also be upset if you lost your program.

One morning, you are sitting in your office and a man bursts in and starts waving a
gun at you. You do not recognize him. He starts screaming, "It's time to get even
and don't act like you don't know what I'm talking about!"

THINGS TO THINK ABOUT:
1. Detail what you would do in this situation.
2. Could this situation have been prevented? If so, what are some of the
preventative actions you and your Department could have taken?
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CASE 3: THE BURNT OUT ADMINISTRATOR
Suggested Actions:
1. In most cases, you will receive a number of negative thoughts about this
woman. Focus on how the participants feel. The thoughts will be similar to
this:
" This woman is so disrespectful."
" Doesn't she know I have had no sleep for days?"
" I could strangle this woman right now!"
" I can't stand it when people are such jerks!"
" I am so humiliated; I must really be stupid to have made this

" I hate it when people insult me."
2. Possibilities:
 verbal confrontation
 physical assault
 sabotage your repair job
 cry
 other negative or ineffective responses

3. It is important to change your perspective in this situation so that you can
act more effectively and not expend energy feeling bad, upset, etc.
Instead remember to think effective thoughts and this will help you respond
differently to the situation. These might include:
" This woman must be having a bad day."
" When people are angry, it is hard for them to listen to reason."
" I am doing an important job and am doing it well, even if this

" From this person's perspective, I am probably annoying and
incompetent. But I need to take care of this computer problem and
get on to my other work."

F Training Instructions for case #3 continued on page 50.
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CASE 3: THE BURNT OUT ADMINISTRATOR
In the last few months, your agency has undergone a reorganization. You are the
computer network administrator and have been working very hard to reconfigure
everyone's' computers. You have been putting in a lot of hours at night so you
cause as little disruption as possible. You are starting to feel extremely stressed.
Your attitude has been bad and you don't particularly like coming to work. You tell
yourself that this will end soon, after the new system is put in place.

One morning, after a particularly long night, you come in to work and sit down to
read your e-mail messages. There is a message from a very angry employee whose
computer has crashed and she needs your help immediately. You walk around to her
space and the woman starts to verbally attack you.

She screams, "YOU ARE SO STUPID! ONLY STUPID PEOPLE WOULD MESS
UP A COMPUTER THE WAY YOU DID. WHY DON'T YOU GET A JOB
THAT YOU CAN HANDLE? DON'T YOU FEEL ASHAMED FOR WHAT YOU
HAVE DONE TO ME?"

THINGS TO THINK ABOUT:
1. What are your thoughts about this woman right now?
2. Based on these thoughts, how do you think you will respond to her?
3. What are some effective thoughts that would let you see this situation in a
different light?

4. What are some things you can do to handle the stress you are feeling at
work lately?
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Continuation of CASE 3: THE BURNT OUT ADMINISTRATOR
" I can tell her the reason her computer crashed, but I don't have to
persuade her about it now or be right."
" When she calms down, maybe she will understand."

4. Contact the EAP or other counseling service to help you understand and
deal with your stress.

Exercise, eat right, and find some quiet reflective time.
Muscle relaxation and deep breathing, particularly in the middle of a
stressful situation.

Survey and understand situations broadly and do not take them personally;
the behavior may have nothing to do with you.
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CASE 4: THE STRANGE VISITOR
Suggested Actions:
1. This case is similar to "The Unhappy Customer" but without a weapon
present (at least that we know about) so the response will be similar.

 First, try to secure your safety and the safety of those around you. Call 911 or the emergency number for your location if at all possible.
 Remain calm and speak slowly and clearly.
 Ask the person to sit down; determine if she is able to follow directions.
 Ask her questions relevant to her complaint such as "Why do you believe you need to be violent because of the government?" Or ask what you can

do to help the person regain control.
 If the woman does not calm down, try matching the loudness of her voice and then gradually bring your voice down to a calm level.

 Try to direct the aggressive tendencies to another kind of behavior so that she sees she has choices about how to handle the situation.
 Don't try to be a hero; she may have a weapon that you are not aware of.
 If she leaves the building, direct the security or law enforcement personnel to where she went, if possible. Alert others around you that she may show

up.
2. There does seem to be some reasons for alarm about the physical security
of the building.

First, the door was propped open. Second, the woman entered the building
without an ID or, in the event that you were in a public building, your area
was not secured.

Ask the security or law enforcement staff (or ask your supervisor) to do a risk
audit of your location. This will identify areas in your building that need
corrective action. This request can also be made of the local HHS Crisis
Management Team.
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CASE 4: THE STRANGE VISITOR
In the middle of the day, you leave your office to go the restroom. You notice that
the back emergency door has been propped open to let in the cool breeze. Once you
are in the restroom you notice a woman acting very strange. She is talking to herself
and seems to be agitated. You have never seen her before and she does not have an
ID badge on. When you leave the restroom, she follows you to your office. She
states she is a job applicant but no one will talk to her and she doesn't know where
to go. Her voice starts to get more frantic.

You offer to take her to the personnel office but she refuses to cooperate and
becomes belligerent. She begins to scream about how the government is out to get
her. It becomes clear that this woman is going to be a problem. You wonder how
she ever got past the guard.

THINGS TO THINK ABOUT:
1. Now that this situation has escalated, what are the best ways to intervene?
2. Would you be concerned about the physical security precautions in your
building? Why or why not? If you are concerned, what would you do to
address these concerns?
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CASE 5: THE SUSPICIOUS CALLER
Suggested Actions:
1. Take the threat seriously and immediately report it to your local law
enforcement personnel and HHS Crisis Management Team.

2. You can definitely report the following information:
 the time of the call;
 the phone number receiving the call;
 the exact words of the caller;
 it was a male;
 his voice was excited; he spoke quickly;
 his voice was muffled;
 traffic noise was in the background; and
 bomb is planted in your building.

If you had more time with the caller, you also could have asked for the
following information:

 when the bomb would explode;
 where the bomb was located exactly;
 what the bomb looks like;
 what kind of bomb it is;
 the name of the caller and his address;
 where he was calling from;
 why he placed the bomb in the building; and/ or
 if there were any particular people being threatened.
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CASE 5: THE SUSPICIOUS CALLER
You are a health care worker at the agency's clinic in Wotakki. As you are filling
out your patient charts one evening, you hear the phone ring at the nurse's station so
you pick it up. The caller's voice is muffled, as if he had a handkerchief over the
receiver. You also think you hear traffic in the background so it makes it even
harder to hear. He starts talking very quickly and says, "I DON'T LIKE WHAT
YOU ARE DOING AT THAT CLINIC AND I WANT IT TO STOP. I HAVE A
BOMB PLANTED IN THE BUILDING AND PLAN TO SET IT OFF VERY
SOON. YOU WILL BE SORRY NOW FOR WHAT YOU DID!" He hangs up the
phone.

THINGS TO THINK ABOUT:
1. What would you do now?
2. Based on this conversation, what information would you provide to law
enforcement personnel?
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CASE 6: ANOTHER VISIT WITH JOHN
Suggested Actions:
Part 1
1. Contact John and the human resources staff who handle sexual harassment cases.
Arrange a meeting to discuss the matter.
Based on the event that occurred last Friday, you may want to alert security to be
around your area at the time of the meeting.

Don't assume the letter came from Sarah; it may hinder the investigation.
2. This will depend on what plans were made at the beginning of the training.
Part 2
1. Don't overreact to John's comment but find out more information about what he
meant by the comment.

It is critical to involve John in assessing this situation. Try to contact him to talk
more about the incident.

While you do not want to overreact, you do want to be cautious about this
situation. Alert security staff to the situation. They may choose to follow him
or take extra precautions in guarding his or your work area.

2. Involve John, human resources, and the security staff. In addition, you may want
to contact the Crisis Management Team to help you make an assessment of the
situation.

F Training instructions for case #6 continued on page 58.
CASE 6: ANOTHER VISIT WITH JOHN
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Monday morning
This morning you receive an anonymous note from a female employee in your
Department who has accused John of sexual harassment. The note states that he has
placed several calls to this employee's home and asked her out on dates. The
employee has refused and has asked John to stop calling her. The employee
complaint was anonymous, but because you only have 25 female employees in your
area, you have been able to narrow it down to five possibilities, based upon facts
you received in the complaint. The complaint also alleges that while the female
employee was standing at the copy machine, John rubbed up against her and made a
comment about being physically attracted to her.

John is a 56 year old employee who has worked for the Government for 28 years.
While John has not been a stellar employee, his performance has been adequate and
he has received regular pay increases consistent with his longevity.

During the last five years, John has applied for 2 promotions and has been turned
down both times. On those 2 occasions, he was disappointed that he was not chosen
and made negative comments to his co-workers about affirmative action. However,
it did not seem to have a significant impact on his work.

About six months ago, John and his wife of thirty years separated. They have three
grown children, none of whom live in this area. While John didn't really talk about
his separation and the details, there were some quiet rumors that John was abusing
his wife. In addition, there have been many rumors over the years that John has an
alcohol problem. However, since he has a very good attendance record and his
performance is adequate, his supervisors decided to respect his privacy and not look
into the rumors.

John has only a few friends at work. In his spare time, he is an avid hunter and
competitive pistol shooter. In fact, he has won several national awards in
competitions sponsored by the NRA. To your knowledge, he has never brought a
firearm into the workplace.

Continuation of CASE 6: ANOTHER VISIT WITH JOHN
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Suggested Actions:
3. This is a vague comment. It could be a threat but on the other hand, he may have
meant that he had to go to the dentist. There needs to be more information to
fully assess whether or not this a threat.

4. Under the circumstances cited here, you may not require John to undergo a
medical examination. The agency may offer an examination at any time they
believe there may a medical or psychiatric reason for unacceptable behavior.

There are only a few instances when you can order an examination.
 when the position has medical standards/ physical requirements
 when the agency has an approved ongoing medical evaluation program (usually applicable in a hospital setting where the agency

must ensure that employees have not contracted conditions which
may be of danger to themselves or others)
 in Continuation of Pay/ Workers' Compensation cases to assist in placement efforts, and,

 in reduction-in-force actions if the new position to which the employee would have placement rights has different medical
standards than the one currently occupied by the employee
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CASE 6 (Continued): ANOTHER VISIT WITH JOHN
THINGS TO THINK ABOUT (Part 1):
1. What are you going to do now?
2. Do you want to change any plans you made at the beginning of this
training?

Next day 8: 00 am
You read the complaint carefully again several times after not having slept well all
night. You decide to contact the human resources office to speak to a special
investigator who regularly conducts sexual harassment investigations. Since you do
not know the identity of the complainant, it is impossible for you to conduct any
interviews of that person. The human resources investigator calls John to come join
you for a discussion.

9: 00 am
John arrives and you and the investigator inform him that someone has complained
about his behavior and ask him if he will cooperate with the investigation. John
expresses outrage that his reputation is being tarnished and demands to know the
identity of the accuser. You tell him the complaint was anonymous, but he does not
believe you. He insists that he is a good loyal employee with many years of services
who is being unfairly maligned by some "bitch." This language and this type of
behavior are fairly unusual for John.

Toward the end of the meeting with John, he becomes belligerent and says, "You
have some nerve; I have worked here for 28 years and done a damn good job. Now,
you have accused me of sexual harassment. This is outrageous." Then his face
becomes beet red and he says, "I'll show all of you; nobody messes with me. I'm
going to teach all of you a lesson you'll never forget!" With that, John bolts out of
the meeting, walks out and grabs his coat, looks back and says, "I'll be back later,
after I've taken care of a few things."
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CASE 6 (Continued): ANOTHER VISIT WITH JOHN
THINGS TO THINK ABOUT (Part 2):
1. What would you do now?
2. Would you involve others at this point? What are the consequences if you
do?

3. Do you think John has made a threat?
4. Do you think a request for a medical exam is appropriate at this time?
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CASE 7: THE BICKERING CO-WORKERS
Suggested Actions:
1. Under the HHS definition of violence, this would be considered a violent
situation. The Departmental guidelines state:

"Workplace violence is an action (verbal, written, or physical aggression)
which is intended to control or cause, or is capable of causing, death or
serious bodily injury to oneself or others, or damage to property."

2. Thoroughly document the situations.
Contact employee relations staff and the Crisis Management Team to discuss a
course of action.

If your actions involve another meeting with the co-workers, make sure that a
security person is present at that time.

3. There is at least a concern about insubordination. They walked out of a
meeting in your office and told you to stay out of their business. The employees
are also causing disruptions with other co-workers and may be a danger to
themselves or others. Recommended action may include reprimands or
suspensions. It is also recommended that employees be encouraged to seek
help through the Employee Assistance Program or mediation programs. It
may depend on other circumstances. It is always best to consult a human
resources specialist before a decision is made.

4. Yes, if inappropriate behavior continues, it is documented, and progressive
disciplinary action has been taken, it is appropriate to terminate the
employees. Terminations must be done in a humane manner, maintaining the
dignity of the employees. Have security staff near by when the termination
occurs in case the situation becomes explosive.

CASE 7: THE BICKERING CO-WORKERS
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You are the supervisor of a large group of employees. Over the last few months, you
notice that two of your employees, Bob and Ed have not been getting along. They
have been calling each other names and have been raising their voices at each other.
You have ignored this up until now thinking, "Boys will be boys." But the situation
has escalated now and you are afraid one of them will harm the other. Co-workers
are starting to complain that they are afraid and that they can't concentrate with the
disruptions. When you try to sit them down and talk to them, they are belligerent
and tell you to stay out of the situation. They tell you this has nothing to do with
work and they will handle it on their own. They get up and leave your office.

THINGS TO THINK ABOUT:
1. Do you think this is a violent situation? Why or why not?
2. What would you do at this point?
3. Do you think disciplinary action is warranted? If so, identify the behavior
or conduct that is inappropriate. What is your recommended action?

4. Would you consider terminating these employees if the behavior did not
stop? If so, what precautions would you take to assure the safety of
everyone involved?
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Part 8: OTHER THINGS TO CONSIDER (15 minutes)
 1. EXPLAIN to participants that this section will cover what happens
after a violent event.

? 2. ASK participants if they know how long the effects of trauma last.

3 3. DISPLAY and READ ALOUD Overhead #19: How Traumas Affect Employees

! 4. EMPHASIZE that the effects of traumas on employees can last ANYWHERE from few days to a few months to even a few years.

F Instruct participants to turn to page 28.
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HOW TRAUMAS AFFECT
EMPLOYEES

 Stage One:
 "Shock Stage" (ex. shock, denial,
disbelief or numbness)

 fight or flight survival reactions

 Stage Two:
 "Impact Stage" -a variety of intense
emotions (ex. anger, sorrow, guilt)

 May last anywhere from a few days to a
few months

 Stage Three:
 "Reconciliation Stage"-employee tries to
make sense of the event

OVERHEAD #19
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Continuation of PART 8: OTHER THINGS TO CONSIDER
Participants should be on page 28 of their guide.
 1. DISCUSS the critical incident debriefing process developed by
Jeffrey Mitchell, from the University of Maryland, called Critical Incident
Stress Debriefing (CISD) . Note that in HHS this process will be
coordinated by the Crisis Management Team.

Critical Incident Stress Debriefing:
 Occurs within the first 24 to 72 hours after a violent event.
 Is conducted by a professional with CISD training.
 Involves a number of phases (lengths of time vary for each person) which are listed below.

 introductory: normalize event; support
 fact phase: let people talk about what happened (heard, saw, smelled)

 thought phase: move from cognitive experience to emotional
 reaction phase: feeling/ emotional state
 symptoms phase: determining the signals of life changes such as physical complaints and behavioral changes

 teaching phase: cognitive learning about symptoms; normalizing experiences and reactions
 re-entry phase: plan of action; follow-up; referral to additional information sources and long-term counseling, if necessary

F Instruct participants to turn to page 29.
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Continuation of Part 8: OTHER THINGS TO CONSIDER
 1. EXPLAIN that supervisors and managers play a critical
role in responding to the immediate and long-term needs of
employees.

3 2. DISPLAY AND READ ALOUD Overhead #20: Considerations for Management.

! 3. EMPHASIZE that it is essential to take care of yourself after experiencing a violent event.
3 4. DISPLAY AND READ ALOUD Overhead #21: Helping Yourself. Ask the participants if they have any other suggestions for dealing
with the aftermath of workplace violence.

? 5. ASK if there are any questions.

F Instruct participants to turn to page 30.
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CONSIDERATIONS
FOR MANAGEMENT

n BE SENSITIVE
n OBSERVE THE RIPPLE EFFECT
n BE SURE THE EMPLOYEE IS NOT
ALWAYS ISOLATED

n CONTROL MEDIA ACCESS

n DO NOT JOKE ABOUT THE EVENT
n DO NOT TRIVIALIZE THE EVENT
n SUGGEST HELP THROUGH THE EAP
AND OTHER TRAUMA SPECIALISTS

OVERHEAD #20

HELPING YOURSELF!
n EAT RIGHT: keep stimulants to a minimum
and do not use alcohol/ drugs to cope

n EXERCISE: regularly and at least within the
first 24 hours following the incident

n SLEEP: get plenty of it!
n TALK: take advantage of social support
systems

n LIFE-STYLE: set a realistic schedule, avoid
boredom, take time to do enjoyable things

n GET HELP: don't be afraid to seek outside
help when needed

n FUTURE: plan for your future safety

OVERHEAD #21
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Continuation of Part 8: OTHER THINGS TO CONSIDER
 1. EXPLAIN that prevention is a key component to any successful
workplace violence strategy.

3 2. DISPLAY AND READ ALOUD Overhead #22: Prevention.
? 3. ASK participants to think about how these prevention strategies are utilized or underutilized at their workplaces. Inform participants that
they may want to include their thoughts in the last exercise.

F Instruct participants to turn to page 31.
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PREVENTION
POLICY
WORK ENVIRONMENT

EMPLOYMENT
SCREENING SECURITY

WEAPON LAWS
EDUCATION
EARLY
INTERVENTION

OVERHEAD #22
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Continuation of PART 8: OTHER THINGS TO CONSIDER
EXERCISE FOR PUTTING YOUR ENERGY TO WORK
 1. EXPLAIN that this is the last exercise of the training.

& 2. ASK participants to read the instructions at the top of the page. Allow approximately 5 minutes for participants to consider and document
responses. Ask participants to share their ideas with the group.
3. GO AROUND the room and have each participant state one step they
documented in the exercise.

! 4. THANK all participants for their cooperation and participation. For additional information, refer participants to the resource list in the
back of their manuals. In addition, direct participants to the
"Important Phone Number" list on page 33 of their manuals; suggest
that they fill in the appropriate phone numbers and post in an
accessible area at their work station.

? 4. ASK participants to complete and return the participant's evaluation on page 35 of their manuals before they leave the classroom.
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EXERCISE FOR PUTTING YOUR ENERGY TO WORK
The best way to handle violence in the workplace is to prevent it from occurring.
Take a few minutes to think about how you can contribute to the prevention of
workplace violence. List three things you can do now and describe any help you will
need in carrying out these ideas:

1.

2.
3.
We hope you found this training useful !
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IMPORTANT PHONE NUMBERS FOR LOCAL RESOURCES
(COMPLETE THIS AT LOCAL LEVEL)

75
BELOW ARE SOME ADDITIONAL RESOURCES WITHIN THE DEPARTMENT OF HEALTH
AND HUMAN SERVICES.

HHS Workplace Violence Intervention and Prevention Group (Ad Hoc; Policy Oversight)
Contact: ASMB, Office of Human Resources
Telephone: (202) 690-8229

Centers for Disease Control and Prevention
National Institute for Occupational Safety and Health (NIOSH)
4676 Columbia Parkway
Cincinnati, OH 45226-1998
(800) 356-4674

NIOSH provides a number of publications regarding risk factors and prevention strategies as well as
search services. The toll-free number is open from 9: 00 a. m. -4: 00 p. m. EST. Upon request,
information sheets can be faxed. A 3-packet guide, " Homicide in the Workplace" is also available.

National Institutes of Health
National Institute of Mental Health (NIMH)
5600 Fishers Lane, Room 7C02
Rockville, MD 20857
(301) 496-4513

In addition to other literature, NIMH publishes two free publications on depression (which has been
found to be a factor in workplace violence), " What To Do If An Employee Is Depressed" and " Managing

National Domestic Violence Hotline
(800) 799-SAFE or (800) 787-3224 (TDD)

U. S. Public Health Service
Office on Women' s Health
200 Independence Avenue, S. W., Room 730B
Washington, DC 20201
(202) 690-7650

Provides information, brochures, fact sheets, etc. on all matters related to women' s health including
violence against women.
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Keep this posted at your workstation
Your Supervisor:
Building Security:
Building Health Unit:
Human Resources Staff:

Fire Department:

Employee Assistance Program:
Crisis Management Team:
Local Law Enforcement:
National Domestic Hotline: 800-799-SAFE or
800-787-3224 (TDD)
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