CLINICAL HANDBOOK OF SCHIZOPHRENIA

400 VI. SPECIAL POPULATIONS AND PROBLEMSlence is seen as a product of a dynamic interaction between psychosis, anger, environment,and substance use. These key factors contribute to the likelihood of violence, whichoccurs once a person reaches a threshold and is unable/or does not wish to restrain fromviolence. A good balance between providing optimum medical and psychological interventionsaimed at the key factors in the model and delivering these interventions within an optimumenvironment is key to providing a comprehensive, multidisciplinary approach forworking with people with psychosis and problems with violence and aggression.COMMON MULTIDISCIPLINARY ASSESSMENT PROCESSESBecause inpatient environments comprise a multidisciplinary mix of mental health professionals,it is important that all members of the team work together in meeting clients’needs. It is helpful for one or two individuals to take a lead in coordinating and managingthe care that clients receive.EngagementOften this group of people has traditionally been difficult to engage in treatment, so muchattention needs to center on this difficulty before staff proceeds with complex psychologicalFIGURE 39.1. Clinical formulation to assist in understanding, assessing, and treating people withpsychosis and problems with aggression and violence. From Haddock, Lowens, Brosnan, Barrowclough,and Novaco (2004). Copyright 2004 by Cambridge University Press. Reprinted by permission.