Hoe te handelen bij een patiënt die zich homicidaal uit; literatuurstudie en handreiking

B. S. Frelier, T. J. Holwerda

    Research output: Contribution to journalReview articleProfessional

    Abstract

    BACKGROUND Death threats are common in the therapist's office. Many therapists don't know how to handle these. AIM To provide background information and tools for the practitioner who receives a homicidal threat from a patient. METHOD A systematic literature review of the epidemiology, diagnostics, risk assessment and treatment of homicidal threats. RESULTS During consultation, a death threat is not equatable with the announcement of murder. There are far more instances where the patient does not follow through with their threat. A psychotic disorder, an antisocial personality disorder, alcohol abuse, (bipolar) depression, long-existing (severe) domestic violence, possession of a weapon or a previous conviction for a death threat are important risk increasing factors. The risk assessment evaluates the motives and the proclivity to act. emdr and aggression regulation therapy appear to be effective treatments for underlying trauma and anger. However, psycho-dynamic aspects and feelings of counter transference should also be taken into account during therapy. Three Dutch guidelines about professional secrecy are important when making an assessment about whether or not one should break the rules of confidentiality. CONCLUSION Any practitioner who may be faced with a homicidal patient should have ready access to the relevant guidelines. Mental health institutions are encouraged to actively support this process.
    Original languageDutch
    Pages (from-to)241-249
    JournalTijdschrift voor Psychiatrie
    Volume60
    Issue number4
    Publication statusPublished - 2018

    Cite this

    @article{2b4dfbb6e14e446a83c1391ec78fa1a0,
    title = "Hoe te handelen bij een pati{\"e}nt die zich homicidaal uit; literatuurstudie en handreiking",
    abstract = "BACKGROUND Death threats are common in the therapist's office. Many therapists don't know how to handle these. AIM To provide background information and tools for the practitioner who receives a homicidal threat from a patient. METHOD A systematic literature review of the epidemiology, diagnostics, risk assessment and treatment of homicidal threats. RESULTS During consultation, a death threat is not equatable with the announcement of murder. There are far more instances where the patient does not follow through with their threat. A psychotic disorder, an antisocial personality disorder, alcohol abuse, (bipolar) depression, long-existing (severe) domestic violence, possession of a weapon or a previous conviction for a death threat are important risk increasing factors. The risk assessment evaluates the motives and the proclivity to act. emdr and aggression regulation therapy appear to be effective treatments for underlying trauma and anger. However, psycho-dynamic aspects and feelings of counter transference should also be taken into account during therapy. Three Dutch guidelines about professional secrecy are important when making an assessment about whether or not one should break the rules of confidentiality. CONCLUSION Any practitioner who may be faced with a homicidal patient should have ready access to the relevant guidelines. Mental health institutions are encouraged to actively support this process.",
    author = "Frelier, {B. S.} and Holwerda, {T. J.}",
    year = "2018",
    language = "Dutch",
    volume = "60",
    pages = "241--249",
    journal = "Tijdschrift voor Psychiatrie",
    issn = "0303-7339",
    publisher = "Uitgeverij Boom",
    number = "4",

    }

    Hoe te handelen bij een patiënt die zich homicidaal uit; literatuurstudie en handreiking. / Frelier, B. S.; Holwerda, T. J.

    In: Tijdschrift voor Psychiatrie, Vol. 60, No. 4, 2018, p. 241-249.

    Research output: Contribution to journalReview articleProfessional

    TY - JOUR

    T1 - Hoe te handelen bij een patiënt die zich homicidaal uit; literatuurstudie en handreiking

    AU - Frelier, B. S.

    AU - Holwerda, T. J.

    PY - 2018

    Y1 - 2018

    N2 - BACKGROUND Death threats are common in the therapist's office. Many therapists don't know how to handle these. AIM To provide background information and tools for the practitioner who receives a homicidal threat from a patient. METHOD A systematic literature review of the epidemiology, diagnostics, risk assessment and treatment of homicidal threats. RESULTS During consultation, a death threat is not equatable with the announcement of murder. There are far more instances where the patient does not follow through with their threat. A psychotic disorder, an antisocial personality disorder, alcohol abuse, (bipolar) depression, long-existing (severe) domestic violence, possession of a weapon or a previous conviction for a death threat are important risk increasing factors. The risk assessment evaluates the motives and the proclivity to act. emdr and aggression regulation therapy appear to be effective treatments for underlying trauma and anger. However, psycho-dynamic aspects and feelings of counter transference should also be taken into account during therapy. Three Dutch guidelines about professional secrecy are important when making an assessment about whether or not one should break the rules of confidentiality. CONCLUSION Any practitioner who may be faced with a homicidal patient should have ready access to the relevant guidelines. Mental health institutions are encouraged to actively support this process.

    AB - BACKGROUND Death threats are common in the therapist's office. Many therapists don't know how to handle these. AIM To provide background information and tools for the practitioner who receives a homicidal threat from a patient. METHOD A systematic literature review of the epidemiology, diagnostics, risk assessment and treatment of homicidal threats. RESULTS During consultation, a death threat is not equatable with the announcement of murder. There are far more instances where the patient does not follow through with their threat. A psychotic disorder, an antisocial personality disorder, alcohol abuse, (bipolar) depression, long-existing (severe) domestic violence, possession of a weapon or a previous conviction for a death threat are important risk increasing factors. The risk assessment evaluates the motives and the proclivity to act. emdr and aggression regulation therapy appear to be effective treatments for underlying trauma and anger. However, psycho-dynamic aspects and feelings of counter transference should also be taken into account during therapy. Three Dutch guidelines about professional secrecy are important when making an assessment about whether or not one should break the rules of confidentiality. CONCLUSION Any practitioner who may be faced with a homicidal patient should have ready access to the relevant guidelines. Mental health institutions are encouraged to actively support this process.

    UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85046685577&origin=inward

    UR - https://www.ncbi.nlm.nih.gov/pubmed/29638238

    M3 - Review article

    VL - 60

    SP - 241

    EP - 249

    JO - Tijdschrift voor Psychiatrie

    JF - Tijdschrift voor Psychiatrie

    SN - 0303-7339

    IS - 4

    ER -