Are you prepared, as a professional, to deal with an adult pedophile who asks you for help in his practice and who assures you that he has not committed any sexual abuse?

What if the question in consultation was something like the following?

-My son is accused of having child pornographic material obtained through the Internet and is asked for a prison sentence, what can you do as a psychologist for him?

Think about the answers a little. You’ll most likely come up with this one: this is not my area of expertise, so go to an appropriate professional . Are there any? Do you know who they are?

What if instead of such specific questions they ask you others, like the following one?

-My partner assaults me, threatens me… but I want to continue with him, I love him and I don’t want to denounce him, I want him to change… what can you do as a psychologist for us?

Or, like these:

-My patient, who suffers from an eating disorder, can he commit suicide?

-My teenage son beats up his sister and his mother, and we don’t know what to do, shall we call the police, can you help us?

-In our organization there is a valuable middle management that harasses the workers, or at least that is what the gossip says, what can we do?

– Can a father, who has just separated from his wife as a partner abuser, but who otherwise shows no personal or social problem, have custody of his children?

These and similar questions, all related to violence and its forms, are appropriate (and difficult) questions for psychology professionals to answer .

Unfortunately, many psychologists do not have specialized training in these problems, sometimes not even generic. Every day it is more likely that a professional psychologist will be faced with problems derived from violence, because there is a great social demand to solve the problems generated by violence. And the professionals of Psychology are in the first line of those called to this task.

Are you prepared as a professional psychologist to intervene in violence issues? If you have not yet faced this type of demand, it will not be long before you have it on your table . And this statement is valid for almost any area of psychology (clinical, forensic, sports, school, social…).

Training for the prevention of violence from Psychology

In the training programmes for the degree and university degree in Psychology, somewhat less in the postgraduate and masters programmes, training on violence is very scarce and is always subsidiary to other subjects (psychopathology, legal, social, school, etc.).

If we look today for the educational offer in matters of violence we will find a scarce offer of subjects or university courses that have it in the centre of interest. Fortunately, little by little, especially in the contexts of continuous training and specialisation (postgraduate courses, professionals…), this training offer is increasing and the panorama is changing. But the professional demand is growing faster than the training offer.

In this article, we want to deal with the training of psychology professionals in the techniques and procedures for assessing the risk of violence , the basic core of the intervention, the first step in the prevention of violence, this very harmful behaviour.

Assessing the risk of violence

We professionals are useful to the extent that, with our decisions and interventions, we solve the problems that are presented to us. And the essential problem of violence – to prevent it – is its repetition. It is necessary to prevent violence from appearing, but if it does, it is fundamental to avoid its repetition . We professionals can help in this task as long as we know how to anticipate new or future violent acts.

A first fundamental idea, the abc of violence prevention training, is that the probability of serious violent behaviour occurring is low, sometimes very low (even if it seems the opposite to us in the light of the media) and therefore effective prevention must be adjusted to that probability . Neither over nor underestimate the risk of it appearing.

But we psychologists are not fortune tellers, we only know (and this is of enormous value) how to estimate the probability of some behaviors happening or others. Getting the forecast right is our challenge, even though there will always be a range of error . And errors in the management of violence are very important.

In professional practice, a false positive (warning that the wolf is coming without coming) is as serious as a false negative (trusting that the wolf will not come when it is already peeping through the door). But if we have to choose a mistake, in matters of violence, better a false positive than a false negative. The consequences of false negatives are always very negative, and sometimes irreversible.

All psychologists (junior or senior, with more or less specialized training) know that the problem of violence and aggression is serious and that the social tolerance that used to exist with this problem has disappeared. But we know that violence is a genuinely psychological problem. In the face of violence, in the face of the demands that it produces, we psychologists cannot avoid our professional responsibility , even when the demand comes from the authors of the violence or their environment.

Preventing violence is an important task of applied psychology. The demands of this type that are made on us must be met, because aggression and violence (in all its formats and types and whether we talk about the aggressor or the victim) are behaviors, or fantasies, and are part of the beliefs, of the attitudes of people.

Aggressive and violent behaviour is accompanied by intense emotional changes and is strongly determined by feelings and affections. Criminological research informs us that 80% of homicides and murders are related to revenge and hatred, and many sexual aggressions are also related to this. The expression of violence in patients with personality disorders or severe mental disorders and even in patients with neurodegenerative disorders are important and the source of many problems and discomfort.

What to do?

In adults, young people and adolescents, as well as in children, violence is a problem that psychology knows how to prevent. But, as in any professional activity, the competence of the technician is directly related to his or her education and training. There is a general consensus that the best solution, if not the only one, for the problems of violence, is prevention . Reading this phrase can irritate more than one person, because it seems like a mantra that serves as a wild card to respond to almost all social problems. But that does not mean that it is not one of the basic premises for avoiding violence. The prevention of violence does not seek to find the solution to violence, but to avoid its appearance and above all to avoid its reappearance, its aggravation and worsening.

The prevention of violence is a process that has two components, two stages ordered in time, distinct: these are, first, the assessment of risk and, second, the management (intervention) of risk . Generally, psychologists tend to think that prevention consists of intervention (in any of the meanings of this term), but in fact intervention is the second step. The first step is risk assessment. And to the extent that the first step is correct, the intervention will be more effective. A

Before we intervene, we must assess how, when, and with what intensity and frequency we should intervene. That is assessing the risk. Sometimes, this task is confused with that of diagnosis, but they are not the same thing . A diagnosis implies assessment, but it is something more than that; it is to compare and decide on the, for example, presence of a symptom, syndrome or similar in relation to a previous classification system. But from this it is not automatically deduced what may happen in the future with a certain patient and at a specific moment in time, and even less so with violence.

Irrigation assessment techniques

Unfortunately, in Spain we have witnessed three very serious filicides in recent months, committed by women diagnosed with serious depressive disorders, who were caring for the children they murdered. Could they have been prevented?

Anticipating what may happen is what we call forecasting, and in cases of aggressive and violent behavior it is essential, but in most cases, it is not subject to clinical diagnosis. So other resources are needed for this type of prognosis, among which are risk assessment techniques .

Risk assessment techniques consist of (more or less formalized) procedures to collect information, select, evaluate and combine it to make decisions about the likelihood of a certain behavior, physical assault, sexual abuse, threat, self-harm or similar, to happen again in a given time context and scenario.

The most common technique for assessing risk is the “unstructured clinical judgment” equivalent to making a decision based on the expert’s intuition or judgment about the prognosis. The second technique is the so-called “actuarial” one, in which by using a psychometric tool, the prognosis is supported by a mathematical score.

Both techniques are common in psychology and have their strengths and weaknesses. Thus, for example, a strength of “unstructured clinical judgment” is its adaptability to the clinical case, but its weakness is the subjectivity of the outcome. A strength of the “actuarial” technique is its reliability, but its main limitation is its poor adaptability to the unique case.

There is a third technique called “structured clinical judgment”, which combines the strengths of the previous ones and aims to avoid their limitations . The latter, the risk assessment techniques based on “structured clinical judgement” are those that have the greatest current consensus among experts working in violence prevention, because they ensure greater effectiveness in prevention. One of the most important reasons is that they have higher levels of prognostic efficiency.

Learning and competency in the application of “structured clinical judgment techniques” to assess the risk of violence is, for professionals in psychology, a need that requires specialized preparation and is not very complex. Due to our training in evaluation and other similar competences, professionals in Psychology are, we are, very prepared to acquire a high competence in the assessment of the risk of violence and, therefore, to be able to intervene in the problems that the reiteration of aggression and violence generate.

The need for continuing education

Nobody would argue that in these times continuous training is a necessity but, in our field, there is a lack of tradition of continuous training (both on the part of professionals and on the part of the entities in which they are integrated) that must be reconverted into a habitual practice. With the exception of health professionals, who have well established the role of continuous training in their professional environment, in the fields of work with violence (jurists, criminologists, social workers and educators, psychologists, etc.) this reality is in an incipient phase of development.

The Institute of Forensic Psychology (IPF) has been established as a centre of innovation and reference in the professional practice of psychology applied to the law. One of its tasks, to which it has been committed for years, is the specialized training of psychology professionals in the prevention of violence.

In particular, it offers courses and training in violence risk assessment practices in legal, clinical and social intervention contexts . These training resources range from basic training in violence risk assessment techniques to specialised training in areas such as gender-based violence, sexual violence or interpersonal violence in the context of organisations.

One of the training innovations in the professional field, in Spanish, is the development of the so-called webinars, live training resources that take advantage of the facilities of the Internet and social networks to facilitate training processes. Webinars are another step in what used to be called “distance or online training”. The IPF has been promoting this type of courses for more than 5 years and with a great attendance of participants from Spain and Latin America. Of all those who use Spanish as a professional language.

Violence is avoidable, the very serious consequences of it (sometimes loss of life, permanent injuries, disabilities, etc…) suffered by the victims are preventable. Moreover, the social demand of citizens is very clear, there is a total rejection (every day more generalized) of violence and its consequences. There is a formal commitment by politicians and social administrators to fight against this serious scourge that does so much damage to society.

Both the social demand and the political-legal commitment crystallize into a requirement to the professionals – psycho-, social, crime-, educated-, juridical – to intervene effectively in the solution of this problem. And all these professionals have to be prepared to be able to intervene in the prevention of violence. And making professionals perform well in prevention requires that these professionals are well trained and competent in the latest and most modern risk assessment and management strategies.