Transcript Threat Assessment in the School Setting

Threat Assessment in the School
Setting
Nancy Rappaport, MD
Harvard Medical School
Background Data on School
Violence
• School characteristics that are associated
with higher rates of school violence are
large school size, problematic leadership
and presence of gangs in the school.
Source: Kaufman, P., Chen, X., Choy, S.P., et al. (2000), Indicators of school
crime and safety, 2000. US Department of Education (NCES 2001-017) and US
Department of Justice (NCJ-184176): Washington, DC.
Background Data on School
Violence
• Children and adolescents are three
times as likely to be victims of serious
violent crime away from school than
they are on school grounds.
Source: Kaufman P, Chen X, Choy SP, et al. (2000), Indicators of school crime and
safety, 2000. US Department of Education (NCES 2001-017) and US Department of
Justice (NCJ-184176): Washington, DC.
12%
Percent
10%
8%
6%
4%
2%
0%
Student Victimization
Statistics
1995
1999
6th
8th
10th 12th
Grade
Percentage of students ages 12-18 who reported criminal victimization at
school during the previous 6 months
Source: U.S. Department of Education (National Center for Education Statistics), U.S. Department of Justice
(Bureau of Justice Statistics), Indicators of School Crime and Safety 1999.
Most Common Types of School
Violence
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•
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Interpersonal disputes
Assaults without weapons
Assaults between (male) students
Before and after school, during transitions
between classes, during lunch
How Is School Violence
Measured?
• Self-Report Surveys
• Studies do not report using response
reliability or validity checks
• Public Health Model
Source: Cornell DG, Loper AB (1998), Assessment of violence and other high-risk behaviors with a
school survey. School Psychology Review 27: 317-330.
Ambiguous Questions
• “In the past thirty days, how many
times have you brought a weapon to
school [gun, knife or club]?” (YRBS)
• Multiple weapons
• Choice of time period
• Level of severity
Source: Kann L, Kinchen SA, Williams BI, et al. (1998), Youth risk behavior surveillance - United
States, 1997. Journal of School Health, 68, 355-369.
School Violence Statistics
• In a 2001 survey of high school
students, 17.4% had carried a
weapon to school during the 30
days preceding the survey.
Source: Grunbaum J, Kann L, Kinchen SA, et al. (2001), Youth risk behavior surveillance - United
States, 2001. Surveillance Summaries, 28 June 2002.
Expulsions for Bringing Firearms
to School
• 57% involved high school students
• 33% involved junior/middle school students
• 10% involved elementary school students
Gun-Free Schools Act Report: School Year 1998-1999, U.S. Department of Education, October 2002
Reprinted by permission
“Battered Teacher Syndrome”
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Depression
Elevated Blood Pressure
Interrupted Sleep
Headaches
Source: Bloch, AM (1976), The battered teacher. Today’s Education, 66:58-62.
• School violence is an important part of the daily lives of
children in schools… It affects where they walk, how they
dress, where they go and who their friends are. As long as
teachers treat violence at arms’ length, as something that is
someone else’s problem, they will continue to neglect the
opportunity to intervene in a crucial aspect of the children’s
lives. By ignoring school violence, the name-calling, the
shoving, the fighting, the harassment, they are condoning it.
children see teachers walking by, pretending not to notice,
and they learn that the way we treat others, the way we
interact on the street or in the playground, is nobody’s
business but our own. Teachers must talk about violence, they
must recognize it, examine it, dissect it, and let children see
and understand its secrets and its sources. Without this
examination it remains an ugly secret that society cannot
understand or control.
Source: Epp JR, Watkinson AM (1997), Systemic violence in education: Broken promise. Albany:
State University of New York Press.
Crimes Against Teachers
Nonfatal crime s against te achers at
school by instructional level
Per 1, 000
150
100
K-5
6-8
50
9-12
0
Tot al
Theft
Violent
Serious
Violent
On average, each year from 1993 to 1997 there were 131,400 violent crimes against
teachers at school, as reported by both public and private schools. This translates into a
rate of 31 crimes for every 1,000 teachers and a rate of 53 thefts for every 1,000 teachers.
Source: U.S. Department of Education (National Center for Education Statistics), U.S. Department of Justice (Bureau of
Justice Statistics), Indicators of School Crime and Safety 1999.
Multiple-Victim Homicide Incidents
Number of Incidents
at School
6
5
4
3
2
1
0
1992-93
1993-94
1994-95
1995-96
1996-97
1997-98
Source: 1999 Annual Report on School Safety. The School Associated Violent Deaths
Study, Center for Disease Control and Prevention and the US Department of Education,
2000.
• A 14-year old girl in Pennsylvania
spoke honestly during a class
discussion of the Colombine tragedy.
She stated that she could understand
how a person could be driven by hurtful
others to a point of wanting to explode
and hurt someone. She was quickly
escorted to the principal’s office,
physically searched for weapons, and
then suspended from school.
Source: National Public Radio (6 May 1999), All things considered. Transcript by Burrelle’s Information
Services, Livingston, NY
Characteristics of Students
Exhibiting Violent Behavior
Typically Violent Student
“Classroom Avenger”
• Often from families in
• Premeditated
assailant involved
turmoil with a history
with shooting
of abuse and neglect
multiple students
• Failing academically
• Often comes from
• Struggling with
rural or suburban
impulsive behavior,
areas and different
poor frustration
family backgrounds
and academic
tolerance and limited
achievement, with
concentration
little prior
Source: Twemlow SW, Fonagy P, Sacco FC, O’Toole ME, (2002), Premeditated mass shootings in schools:
withPsychiatry
the 41:475-477.
Threat assessment.involvement
J Am Acad Child Adolesc
Guidelines for Assessment
• High-level threats include direct, specific
threats where the student has concrete plans to
execute his threats
• Medium-level threats can be concrete with
descriptive detail but lack discernable
preparation plans.
• Low-level threats are those threats that seem
exaggerated; the student has inconsistent
details of a plan
Source: Fein RA, Vossekuil B, Pollack WS, et al. (2002), Threat Assessment in schools: A guide to managing threatening
situations and to creating safe school climates. United States Secret Service and United States Department of
Education, Washington, D.C.
Classification of Risks
• Individual traits describe a wide range of
behaviors such as low frustration tolerance,
poor coping skills, recent rejection, and signs
of depression
• Family dynamics highlight difficult parentchild relationships including parents denying
their child’s troubled behavior and providing
minimal supervision
Source: Twemlow, S.W., Fonagy, P., Sacco, F.C., O’Toole, M.E. (2002), Premeditated mass shootings in schools: Threat
assessment. J. Am. Acad. Child Adolesc. Psychiatry, 41:475-477; Browne, J.A., Losen, D.J., Wald, J. (2001), Zero tolerance:
Unfair, with little recourse. New Directions for Youth Development, 92:73-99.
Classification of Risks, ctd.
• School problems are teasing, and a school
climate that encourages a code of silence
and reinforces bullying behavior
• Community factors may inhibit or stimulate
aggression depending on the availability of
guns, immersion in deviant peer groups, and
easy access to drugs and alcohol
Assessment Guidelines
• Has there been any communication that suggests
ideas or intent to attack?
• Has the student shown deviant fantasies of
revenge?
• Has the student engaged in attack-related
behaviors?
• How organized is the student’s thinking and
behavior?
• Is the student experiencing hopelessness,
desperation and/or despair?
Assessment Guidelines (ctd.)
• Does the student have a trusting relationship with
at least one responsible adult?
• Does the student see violence as an acceptable-or
desirable-way to solve problems?
• Is the student’s conversation and “story”
consistent with his or her actions?
• Are other people concerned about the student’s
potential for violence?
• What circumstances might affect the likelihood of
an attack?
Zero Tolerance: Can Suspension
and Expulsion Keep Schools
Safe?
Skiba RJ, Noam GG (eds.), New
Directions for Youth Development:
Theory Practice Research, Volume
92. Winter 2001, Jossey-Bass Press.
• Currently the majority of public schools
adopt a “zero tolerance” stance for any
kind of violent behavior with no
research to demonstrate the efficacy of
these policies
• Political solution
Source: Editor’s Notes: New Directions for Youth Development, 92:1-6.
• There is a disproportionate
representation of minority students
and students with special needs
being suspended or expelled
Source: Skiba RJ, Peterson RL (1999), The dark side of zero tolerance: Can punishment lead to
safe schools? Phi Delta Kappan, 80:372-382.
• Many students recommended
for expulsion from schools do
not represent danger to other
students or staff and are a
heterogeneous group
Source: Morrison GM, D’Incau B (1997), The web of zero tolerance: Characteristics of students
who are recommended for expulsion from school. Education and Treatment of Children,
20(3):316-335.
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Disconnected group
Socialized delinquent group (31/158)
Troubled group
“First offense” group
Source: Morrison GM, D’Incau B. (2000), Developmental and service trajectories for students with
disabilities recommended for expulsion from school. Exceptional Children,66:257-272.
Federally Mandated Special
Education Protection
• More than ten days of suspension in
one school year
• Expulsion proceedings
Source: Morrison GM, D’Incau B. (2000), Developmental and service trajectories for students with
disabilities recommended for expulsion from school. Exceptional Children,66:257-272.
• Is the offense a “manifestation”
of their disabling condition?
• Determination of their
appropriate placement
Source: Morrison GM, D’Incau B. (2000), Developmental and service trajectories for students with
disabilities recommended for expulsion from school. Exceptional Children,66:257-272.
Five-Step Case Evaluation
Consultation Model
1. Informed consent
2. Referral information
3. Contact with school and other
professionals
4. Student and parent interviews
5. Report and feedback
Conditions of Psychiatric
Evaluation
• Office of Special Education
• Special Education Services
eligibility
• NOT confidential
Selected Specific Behavior
Rating Scales
Source: Connor, D.F. (2002),
Aggression and Antisocial Behavior
in Children and Adolescents:
Research and Treatment. New York:
Guilford.
Scale/ Reference:
Aggression
Age
Conduct Domains
Range
Informants
New York Teacher
Rating Scale (NYTRS;
LS Miller et al., 1995)
6-14
Teachers
Predatory-Affective
Aggression
Questionnaire (Vitiello
et al., 1990)
10-18 Predatory
Other
Aggression,
(Staff,
Affective Aggression Peers)
Proactive-Reactive
Aggression Scale
(Dodge & Coie, 1987)
5-18
Defiance, Physical
Aggression,
Delinquent
Aggression, Peer
Relations
Reactive
Aggression,
Proactive
Aggression
Parents,
Teachers,
Other
Structured
Assessment of
Violence
Risk in
Youth
Source: Bartel P, Borum R, Forth A (2002), Structured Assessment for Violence
Risk in Youth (SAVRY). Consultation Edition.
Children’s Aggression Scale –
Teacher Version (CAS-T)
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Verbal aggression
Aggression against objects and animals
Provoked physical aggression
Unprovoked physical aggression
Use of weapons
Reliability
Source: Halperin JM, McKay K, Grayson RH, Newcorn JH. (2003),
Reliability, validity, and preliminary normative data for the Children’s
Aggression Scale – Teacher Version. J Am Acad Child Adolesc Psychiatry
42:965-971.
CASE STUDIES
Case One
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Individual Factors
Family Factors
School & Peer Factors
Treatment
Situational Factors
Attack-Related Behaviors
Myth of the
“Teenage Werewolf”
• Popular media often insinuates that there
are minimal warning signs for violent
teenagers. In contrast, violent students
often have histories of low frustration
tolerance, impulsivity and angry outbursts.
Adolescents who are at risk often
externalize their anger and are less subtle
about their agitation.
Treatment System Gaps
• Practical Limitations
• Crisis Response
• Lag Time
Coordinated System of Care
• Access to a psychiatric emergency
room, inpatient unit, outpatient
services
• Shared Responsibility
• School Setting
Multisystemic Response
• Flexibility
• Adolescents with conduct problems
• Department of Mental Health (DMH)
diagnosis
Source: Mattison RE, Spirito A (1993), Current consultation needs of school systems. In: Child and
Adolescent Mental Health Consultation in Hospitals, Schools, and Courts, ed. B Nurcombe, GK Fritz RE
Mattison & A Spirito. Arlington, VA: American Psychiatric Publishing, pp. 161-183; Henggeler SW, Melton
GB, Smith LA (1992), Family preservation using multisystemic therapy: An effective alternative to
incarcerating serious juvenile offenders. J Consulting Clin Psychol, 60:953-961.
Case Two
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Situational Factors
Attack-Related Behaviors
Family Factors
School & Peer Factors
Clinical Prediction of Risk
• Very little research on the accuracy of clinical
prediction of violence in adolescents
• Risk factors, resilience factors, potential
triggers
• Grisso: “I do not know whether this youth
will engage in violent behavior, but the risk
that it may happen is (greater than, similar to,
less than) the risk posed by youths in general
(the
relevant
setting).”
Source: Comer JPin
(1997),
Waiting
for a Miracle:
Why Schools Can’t Solve Our Problems and
How We Can. New York: Dutton. Grisso T (1998), Forensic Evaluation of Juveniles. Sarasota,
FL: Professional Resource Press.
• The importance of advocacy in
modifying the disciplinary
action
Source: Morrison GM, D’Incau B. (2000), Developmental and service trajectories for students with
disabilities recommended for expulsion from school. Exceptional Children,66:257-272.
• There is a key distinction
between predicting violence
and emphasizing preventing
violence by suggesting
appropriate interventions.
Source: Sewell K W, Mendelsohn M (2000), Profiling potentially violent youth: Statistical and
conceptual problems. Children’s Services: Social Policy, Research, and Practice, 3:147-169.
Enhancing Protective Factors
Child Factors
Family
Factors
Good
•Easy Temperament
parent-child
•Higher IQ
relations
•Internal locus of control
•High self-esteem
•Academic competence
•Social competence
•Competence in activities
Extrafamilial Factors
External supports
Friendships
Availability of
Opportunities
Source: Connor DF (2002), Aggression and Antisocial Behavior in Children and
Adolescents: Research and Treatment. New York: Guilford.
Case Three
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Individual Factors
Family Factors
School & Situational Factors
Systemic Assessment
Systemic Violence
• Contextually embedded
• School climate
• Institutional practices that adversely affect
individuals
Source: Furlong MJ, Morrison G (2000), The school in school violence: Definitions and
facts. Journal of Emotional & Behavioral Disorders, 8:71-82.
• Schools can be an arena
where cultural differences
are amplified.
Source: Delpit LD (1995), Other People's Children: Cultural Conflict in the Classroom. New York: New
Press. Lightfoot SL (1978), Worlds Apart: Relationships Between Families and Schools. Basic Books:
New York.
Time Somebody Told Me
Quantedius Hall, “Son of Reality,” Age 12
Time Somebody Told Me
That I am lovely, good and real
That I am Beautiful inside
If they only knew
How that would make me feel.
Time Somebody Told Me
That My mind is quick, sharp
and full of wit
That I should keep on trying
and never quit.
Time Somebody Told Me
How they loved and needed me
How my smile is filled with hope
And my spirit sets them free
How my eyes shine, full of light
How good they feel when they hug me tight.
Time Somebody Told Me
So, I had a talk with myself
Just me, nobody else
‘cause it was time
Source: Franco, B (ed.), 2000. You Hear Me? Poems and writing by teenage boys. Cambridge, MA: Candlewick
Somebody Told Me.
Press.