Open coding yielded 18 codes organised into three themes and subthemes. Due to the interconnected nature of many of the codes, researchers had to be cautious when synthesising and analysing the data. Table 1 displays the codes that were identified, while Table 2 shows the themes and subthemes that emerged. Table 3 shows the frequency of the codes within the specified themes.
Table 1
Codes and code definitions
|
Code no
|
Code name
|
Code definitions
|
|
1
|
Prevention and management of client violence
|
Client violence is clinically managed to prevent or lessen the perceived level of threat. This intervention is frequently at an administrative or organisational level.
|
|
1.1
|
Data management
|
Collecting, storing, and using current and historical data about client violence in a secure, efficient, and cost-effective manner.
|
|
1.2
|
Policies
|
The strategy or philosophy of an organisation with respect to responding to client violence. This is largely preventative or administrative in nature, and it includes recommendations for policy inclusion. Precautions for field engagement and safety buddies are also included.
|
|
1.3
|
Safety committees
|
The necessity, role, or need for a safety committee in a social work organisation to address client violence.
|
|
1.4
|
Safety training
|
The necessity of social worker training and the types of training that should be considered.
|
|
2
|
Office safety
|
The process of ensuring that employees and visitors are safe while at work.
|
|
2.1
|
Arriving at work
|
Processes for ensuring safety from the moment the social worker entered the employment building's premises.
|
|
2.2
|
Preparation for clients
|
When preparing for client meetings, the social worker should have procedures in place to ensure safety.
|
|
2.3
|
Creating safe interview settings
|
Procedures and approaches that can be used to ensure client safety during office interviews.
|
|
2.4
|
Security in the office
|
Physical methods that could help to improve overall office safety.
|
|
3
|
Field visits
|
Being safe while rendering services in the field. Includes all aspects from the time when the social worker leaves the office, until the time of their safe return.
|
|
3.1
|
Planning a visit
|
The tasks conducted by the social worker prior to conducting field visits.
|
|
3.2
|
During a visit
|
The safety considerations that social workers should keep in mind from the time they enter the field until they leave. This may include aspects that some may regard as “common sense”, as well as some crisis intervention strategies.
|
|
3.4
|
After a home visit
|
Safety precautions once the social worker leaves the service rendering area and returns to the office.
|
|
4
|
Transportation
|
While transporting a client between two points, safety risks must be considered. The condition of the vehicle is also important when considering these risks.
|
|
4.1
|
Transporting clients
|
Requirements of general safety when transporting clients, with a special focus on conditions relating to children.
|
|
4.2
|
Assessment at pick-up
|
Factors to consider when a social worker picks up a client for transportation. There is also some safety advice to ensure that the transportation process is as safe as possible.
|
|
4.3
|
Travelling to site
|
Precautions that the social worker should take while travelling to the service delivering site.
|
|
4.4
|
Vehicle condition
|
The general safety conditions of the transportation vehicle are specified, safety checks of the vehicle are included.
|
|
5
|
After an incident
|
Anything that happens following a client violence incident is included in post-incident protocols, which includes, but is not limited to, investigations and support.
|
|
5.1
|
Reporting
|
Reporting is the act of disclosing details about a client violence occurrence. The motivation or practices supplied by organisations to improve this process fit into this category.
|
|
5.2
|
Post-incident protocols
|
Anything that happens following a client violence incident is included in post-incident protocols, which includes, but is not limited to, investigations and support.
|
Table 2
Themes, theme definitions, and relevant codes
|
No
|
Themes
|
Theme definitions
|
Codes
(Refer to Table 1)
|
|
Theme 1
|
Employers inspired a culture of safety and security in the work-environment.
|
To protect social workers from client violence, employers provided guiding principles, attitudes, and key determinants to aid in the coordination of plans, goals, and policies.
|
1.1; 1.2; 1.3; 1.4; 2.3; 2.4; 4.2; 4.4; 5.1; 5.2.
|
|
Subtheme 1 (a)
|
Protecting social workers from post-incident trauma.
|
Following acts of client violence, employers implemented protocols to manage the incidents and to protect social workers from additional trauma.
|
1.1; 1.2; 5.1; 5.2.
|
|
Subtheme 1 (b)
|
Continuous training contributed to improved skills.
|
Social workers were provided with ongoing training to empower them to deal with client violence.
|
1.1; 1.3; 3.2; 5.2.
|
|
Theme 2
|
Social workers prioritised their safety by using their clinical skills.
|
The importance of clinical social work skills in dealing with client violence is underlined.
|
1.2; 1.4; 2.2; 2.3; 3.1; 4.3; 3.2; 3.3; 4.1; 4.2; 4.4.
|
|
Subtheme 2 (a)
|
A thorough risk assessment was encouraged.
|
Social workers were motivated to undertake holistic risk assessments to identify circumstances where client violence may occur.
|
1.1; 1.2; 2.2; 3.1; 4.3; 3.2; 4.1; 4.2; 4.4.
|
|
Subtheme 2 (b)
|
Transparent communication between the social worker and the client.
|
Clear communication is a crucial element in managing client violence.
|
2.3; 3.1; 3.2.
|
|
Subtheme 2 (c)
|
Social workers reflected on their own vulnerabilities.
|
In terms of client violence, psychological readiness, self-awareness and study of vulnerabilities are effective preventative methods.
|
2.1; 3.1; 4.3.
|
|
Theme 3
|
Actively implementing initiatives to ensure the safety of social workers.
|
Initiatives that led to improved safety during office work, field visits and safe travelling.
|
1.2; 1.3; 1.4; 2.1; 2.2; 2.3; 2.4; 3.1; 3.2; 3.3; 4.1; 4.2; 4.3; 4.4; 5.2.
|
|
Subtheme 3 (a)
|
Logistical strategies to ensure safety.
|
Logistical solutions for supporting social workers in a time-efficient manner are investigated.
|
2.3; 2.4; 3.1; 3.2.
|
|
Subtheme 3 (b)
|
Safety strategies while travelling.
|
Specific measures for assisting social workers while on the road are identified.
|
2.1; 4.3; 3.2; 3.3; 4.2.
|
|
Subtheme 3 (c)
|
Improve safekeeping by using new technology.
|
Modern technology was used to help protect social workers from client violence.
|
1.2; 2.4; 3.2; 4.2; 4.3.
|
|
Subtheme 3 (d)
|
Ensure safety by involving trusted others.
|
When the social workers thought they were in danger, they involved trusted others.
|
2.3; 2.4; 3.1; 3.2; 4.2.
|
|
Subtheme 3 (e)
|
Interaction between the organisation and the social worker.
|
The overall safety of social workers appears to be supported when there is communication between the social worker and the employer.
|
2.3; 2.4; 3.1; 3.2; 3.3; 4.3;
|
Table 3
Code frequencies
|
No
|
Code Name
|
Theme 1
|
Theme 2
|
Theme 3
|
Total
|
|
1.1
|
Data management
|
23 (92,0%)
|
02 (8,0%)
|
-
|
25 (100,0%)
|
|
1.2
|
Policies
|
41 (89,1%)
|
04 (8,7%)
|
01 (2,2%)
|
46 (100,0%)
|
|
1.3
|
Safety committees
|
17 (89,5%)
|
-
|
02 (10,5%)
|
19 (100,0%)
|
|
1.4
|
Safety training
|
42 (54,5%)
|
31 (40,3%)
|
04 (5,2%)
|
77 (100,0%)
|
|
2.1
|
Arriving at work
|
-
|
06 (40,0%)
|
09 (60,0%)
|
15 (100,0%)
|
|
2.2
|
Preparation for clients
|
-
|
15 (93,8%)
|
01 (6,2%)
|
16 (100,0%)
|
|
2.3
|
Creating safe interview settings
|
02 (3,2%)
|
05 (7,9%)
|
56 (88,9%)
|
63 (100,0%)
|
|
2.4
|
Security in the office
|
10 (19,2%)
|
01 (2,0%)
|
41 (78,8%)
|
52 (100,0%)
|
|
3.1
|
Planning a visit
|
01 (1,1%)
|
38 (42,2%)
|
51 (56,7%)
|
90 (100,0%)
|
|
3.2
|
During a visit
|
01 (1,0%)
|
42 (43,3%)
|
54 (55,7%)
|
97 (100,0%)
|
|
3.3
|
After a visit
|
-
|
05 (29,4%)
|
12 (70,6%)
|
17 (100,0%)
|
|
4.1
|
Transporting clients
|
01 (2,6%)
|
15 (39,4%)
|
22 (58,0%)
|
38 (100,0%)
|
|
4.2
|
Assessment at pick-up
|
-
|
16 (61,5%)
|
10 (38,5%)
|
26 (100,0%)
|
|
4.3
|
Travelling to site
|
-
|
17 (44,7%)
|
21 (55,3%)
|
38 (100,0%)
|
|
4.4
|
Vehicle condition
|
01 (4,3%)
|
04 (16,6%)
|
19 (79,1%)
|
24 (100,0%)
|
|
5.1
|
Reporting
|
17 (100,0%)
|
-
|
-
|
17 (100,0%)
|
|
5.2
|
Post-incident protocols
|
41 (97,6%)
|
-
|
01 (2,4%)
|
42 (100,0%)
|
Theme 1: Employers inspired a culture of safety and security in the work environment
This theme developed as overlapping guiding principles, attitudes and key determents that aided the coordination of policies and guidelines to safeguard social workers, were clustered. Significant codes included data management, policies, reporting, safety committees, safety training and post-incident protocols and all seemed to inspire a culture of safety and security in the work environment. Given the interconnectedness of these codes, Figure 3 shows the five most frequent codes in relation to the main theme:
Table 4 explores the subthemes, followed by a comprehensive discussion of Theme 1 and its subthemes.
Table 4
Subtheme 1(a) and 1(b)
|
Subtheme 1 (a): Protecting social workers from post-incident trauma
|
|
Related codes
|
Supporting quotes
|
|
Data management
|
“To reduce risk and ensure safety for all staff and personnel, agencies should have data management and reporting systems in place to keep track of reports of threats, physical acts of violence, and any destruction of property” [20].
|
|
Policies
|
“A policy stating any act of workplace violence is prohibited and is cause for discipline measures” [31].
“Providing prompt assistance to the employee” [15].
|
|
Reporting
|
“To reduce risk and ensure safety for all staff and personnel, agencies should have data management and reporting systems in place to keep track of reports of threats, physical acts of violence, and any destruction of property” [15, 20].
|
|
Post-incident protocols
|
“All workers, including supervisors and management, should be encouraged to discuss safety concerns with their staff and supervisors should offer time for their employees to hold conversations regarding safety” [31].
“When responding to incidents, employers should provide immediate aid and support to any injured employees and conduct the measures needed to prohibit any other individuals from being injured” [15].
|
|
Subtheme 1(b): Continuous training contributed to improved skills
|
|
Related codes
|
Supporting quotes
|
|
Data management
|
“Regularly gather and disseminate information about all safety risks including assaults, threats, and abuse and develop strategies for managing them via case consultations, training and education, and policy development” [15].
|
|
Safety committees
|
“…provides ongoing proactive risk assessment that identifies line staff at risk for violence, precarious settings and working conditions, as well as orientation and in-service training on practices that can reduce or minimize or eliminate factors associated with elevated risk” [15].
|
|
During a visit
|
“Utilize your learned clinical skills to deescalate the situation, remain calm, show respect, and never make promises you cannot keep” [21].
“Keep it from escalating; use your attained skills to stay calm and listen attentively” [37].
|
|
Post-incident protocols
|
“This bill provides states with critical resources… facilitate safety training programs, provide support services for social workers who have been victims of violence, or track incident data to mitigate future offenses against social workers, among other important uses” [14].
|
According to literature [15, 31], agencies should produce, cultivate and manage an organisational culture that promotes safety and security for their employees. Promoting a proactive approach to workplace violence prevention is one of the most effective strategies to maintain a safe workplace environment [31]. Safety policies and procedures can be developed in consultation with frontline workers and then disseminated to all employees or even members of the general public for review [31]. Following the completion of a safety policy, the employers and employees' oral and written commitments can support effective implementation [15,22], whereafter a data-management system can be developed.
A data-management system (DMS) is a system or database set up by an employer to keep track of all instances of workplace violence (including client violence) [15, 31]. The purpose of a DMS is to reduce risk and promote the safety of all staff and personnel [15, 16, 20, 31]. A functional DMS can be used to detect protocol vulnerabilities or gaps that might have facilitated or contributed to, or failed to prevent, incidents of client violence. A DMS is only effective if data are recorded continuously and systems are updated on a regular basis [26]. Social workers must be encouraged and supported to report incidents of client violence. The NASW [15] states that data should be recorded on the type of incident, location, pervasiveness, and occurrence. If records are available, they must also include the names of all parties involved, the date, time, and location of the incident, a description of the event, and the extent of any injuries [31].
In the unfortunate event of an occurrence of client violence, literature underlines the significance of post-incident protocols. Such procedures may include debriefing workers and witnesses as soon as possible after the occurrence [15, 31]. This should be followed by making support services available, such as counselling and referral to employee assistance programmes and other resources such as technical and legal support [12 - 15, 31]. Assessment of medical need and providing medical treatment should be part of post-incident protocols [15, 31] suggests the possibility of financial compensation. Employees may have to rely on their own internal resources for whatever they include in their protocol. The majority of the literature emphasises that after a client violence incident, employers ought to be vigilant with respect to their social workers' stress levels. The long-term effects of client violence can be mitigated by revising routines and addressing the caseload distribution of the affected social worker [15, 22].
Who is responsible for safety policies, DMS, and post-incident processes in the already overburdened South African social work context? According to international literature, safety committees should be established for all social work AODs. The purpose of these committees is primarily to prevent client violence and to ensure the application of policies and development of incident response methods [15, 31]. They are often responsible for establishing, updating, and enforcing policies regarding safety and tracking all known and perceived threats in the workplace [30 – 31]. In addition to risk assessments, the role provides orientation and in-service training on best practices, reducing or minimising risk factors for social workers, as well as identifying and investigating physical measures and technology contributing to and promoting safety [15]. This type of committee meets quarterly or monthly and records its activities [16, 30, 31].
Theme 2: Social workers prioritised their safety by using their clinical skills
The NASW [17] describes clinical social work as the professional application of social work theory and methods for the diagnosis, treatment, and prevention of psychosocial dysfunction, disability, or impairment, including emotional, mental, and behavioural disorders. Referring to clinical skills, the following is noted: “Drawing on knowledge of systems theory, person-in-environment orientation, psychodynamic theory, interpersonal dynamics, and family systems, clinical social workers shall be familiar with social, psychological, cultural, and health factors that influence the mental, emotional, and behavioural functioning of the client” [17].
When overlapping clinical social work skills that can be used to address client violence were grouped together, Theme 2 and its related subthemes emerged. Policies, safety training, client preparation, creating safe interview settings, planning a visit, traveling to site, during a home visit, after a home visit, assessment at pick-up, transporting children, and vehicle condition, were all codes that were important in this theme. Based on the interconnectedness of these codes, Figure 4 shows the five most frequent codes in relation to the main theme:
All subthemes are presented and explored further in Tables 5–7. A concise discussion follows each table.
Table 5
Subtheme 2(a)
|
Subtheme 2 (a): A thorough risk assessment was encouraged
|
|
Related codes
|
Supporting quotes
|
|
Policies
|
“If the client is assessed to be unsafe to transport, or the vehicle is assessed to be unsafe to operate, agency policies should prohibit the social worker from transporting the client” [15].
|
|
Planning a visit
|
“It is important to familiarize yourself with the clients’ file prior to the home visit” [35].
“Speaking to the client prior to the visit helps the worker retrieve important information regarding their client’s situation, any safety precautions that may need to be taken according to the client, or whether or not their client’s situation has changed” [18].
|
|
During a visit
|
“Throughout the visit, workers should be on the lookout for dangers and trust their gut feelings” [31].
“If a student hears a heated argument from inside the house or apartment, the student may decide to re-schedule the visit or call to assess the situation before entering the dwelling” [36].
|
|
Transporting children
|
“Assessments of the child’s state of being should be conducted on an on-going basis throughout the trip” [26].
“Workers should check to see if there are any items in the car that could be used as a weapon and if so, should remove them immediately” [15].
|
|
Vehicle condition
|
“…workers should determine if the car is in proper functioning order” [31].
“If an agency car is being used, workers should take time to orient themselves with how to operate the car including how to turn on the high beams and emergency flashers” [19].
|
Field visits should be carefully planned to include a thorough risk assessment [25, 31]. Planning and risk assessment should consider client factors such as a history of violence, substance abuse, mental illness and the availability of weapons; environmental factors such as high risk events, neighbourhood risks, access and network coverage; worker vulnerabilities such as working alone, visible physical conditions and lack of experience; and factors pertaining to the type of work activities such as removal of a child in need of protection [2, 15, 38]. In preparation for an unexpected event to occur, it is recommended that workers design a safety plan detailing what to do in certain situations before embarking on a visit [38].
Newhill [19] warns that social workers often see home visits as a general concern and an attempt to help, but that clients may observe it as a threat and act accordingly. It can therefore be helpful to notify clients prior to home visits and inform them of the purpose of the visits [15, 31, 35, 38]. The Simmons School of Social Work [36] and Victor [38] state that social workers should continuously assess situations and rather terminate visits when they feel threatened. Quinn and Mason [26] point out that the following home visit scenarios should be rated as high risk: when the person with whom the appointment was scheduled is not present on arrival; when too many persons are on the premises; when too much activity is going on or when obvious weapons or substances can be seen.
Before embarking on any field visit, an inspection of vehicles should be part of the risk assessment to ensure that it is in proper functioning condition and safe to use [2, 15, 26, 32]. This includes ensuring a full tank of gas, enough water, working head- and taillights, a working horn and emergency safety equipment like jumper cables, road flares, and a spare tyre with a jack, a flashlight and a first aid kit [15, 18, 37].
When transporting clients or children, social workers should continuously assess if the client is displaying signs of aggression, if the client is under the influence of drugs, and if the client is in possession of a weapon [15, 26, 31]. In addition, social workers should ensure that the vehicle is free from any objects that can be used as weapons (for example, pens, pencils, magazines, books, handheld devices, hot beverages) before allowing clients into their vehicle [15]. If either the client is assessed to be unsafe to transport, or the vehicle conditions are assessed as unsafe to operate, AOD policies should prohibit the social worker from engaging. Law enforcement could be called to transport the client in such instances [26, 31].
Table 6
Subtheme 2(b)
|
Subtheme 2(b): Transparent communication between the social worker and the client
|
|
Related codes
|
Supporting quotes
|
|
Creating safe interview settings
|
“Set clear limits, on what you will not tolerate, i.e., intoxication, violence, 51A” [26].
|
|
Planning a visit
|
“Workers may wish to notify their client by phone that they will be visiting their home and advise them of the purpose of the visit, if possible” [18].
“Try to schedule the appointment by telephone or letter so that the client will know to expect you and be prepared” [38].
|
|
During a visit
|
“When introducing themselves, workers should clearly state who they are, and why they are there” [31].
|
|
Combined codes
|
“All employees must wear their ID badges when on duty, both in the office and in the field” [31].
|
Effective communication techniques are part of clinical skills, and transparent communication between social workers and their clients can lessen the risk of client violence. When a social worker contacts a client during the planning or preparation phase, it is important to identify him-/herself and explain the purpose for involvement to ensure that effective engagement can commence [18, 38]. This might help a client feel at ease with the process and establish a relationship with the social worker [26].
Social workers are urged to wear identity badges when they work in the office, out in the field, or when they are transporting clients [15, 31, 37]. When meeting a client for the first time, the social worker should again introduce him-/herself and describe the aim of the consultation [2, 19, 26, 37]. Clear communication practices are considered as mutually beneficial in considering the safety of social workers and clients.
Table 7
Subtheme 2(c)
|
Subtheme 2(c): Social workers reflected on their own vulnerabilities
|
|
Related codes
|
Supporting quotes
|
|
Arriving at work
|
“… refrain from talking to unknown persons when walking into their workplace” [37].
|
|
Planning a visit
|
“If you are highly allergic to certain domestic animals then you should take that into account before conducting home visits. Many clients live with cats, dogs and other pets” [38].
“Lack of experience or appearing timid, vulnerable, lost, or confused can contribute to violence” [15].
|
|
Travelling to site
|
“Workers should refrain from providing those that are unfamiliar with their name, street address, and information regarding where they work. If they encounter anyone as they walk to their client’s home, workers should keep normal, confident eye contact” [31].
“Limitations of cell phone coverage in areas that social workers may visit” [15].
|
Clinical qualities such as psychological preparedness and self-awareness appear to be crucial, and social workers are urged to reflect on their own vulnerabilities. Despite open communication, literature advises against disclosing personal information to clients, such as addresses and phone numbers [31, 37]. Social workers should also be conscious of their surroundings and refuse unsolicited help from strangers [37].
It is critical to include previous experience with client violence, as well as any bias or stereotyping that leads to over- or underreaction to safety concerns, during the assessment and planning process [15]. Practical considerations such as allergies, the probability of contracting diseases, and even the appearance of social workers should all be part of self-awareness and introspection.
Theme 3: Actively implementing initiatives to ensure the safety of social workers
This theme is highlighted in the research because it includes practical initiatives that can help safeguard social workers against client violence when at work, on field visits, and while traveling. Since all of the codes were part of this theme and its subthemes, Figure 5 depicts the five most common codes in relation to the main theme, followed by each subtheme's unpacking.
Table 8–12 is used to extract subcodes relevant to Theme 3, followed by a description of each.
Table 8
Subtheme 3(a) related to Theme 3
|
Subtheme 3(a): Logistical strategies to ensure safety
|
|
Related codes
|
Supporting quotes
|
|
Creating safe interview settings
|
“Leave door open during session, if there are others around who could come to your aid” [26].
“Ordinary objects can be easily used as a weapon by someone in an angry state” [15].
|
|
Security in the office
|
“Know the location of all safety aids and systems” [18].
“Secure entrances to employees’ workspaces that are separate from public spaces” [15].
|
|
Planning a visit
|
“Before departing on a field visit, workers should ensure they are wearing appropriate clothes and shoes that allow for ample movement” [31].
“If a visit outside of the office is required, and the potential for danger exists, workers may work to schedule their client meeting in a public place” [38].
|
|
During a visit
|
“Keep a clear path to the exit door” [2].
“Do not enter an elevator with people who are suspicious-looking or make you feel uncomfortable in any way” [38].
|
A sense of safety in the office
According to Nordesjö [22], safe working conditions are insufficient if social workers refuse to accept responsibility for implementing the measures that have been offered. Social workers should be aware of the locations of all safety aids and systems and be trained on accessing and implementing them [18]. Apart from technological measures (which are explained in more detail further on), practical features such as well-lit hallways, visually open meeting places and secure entrances to employee workspaces can all help to create a sense of security in the workplace [15, 16].
Creating secure interview environments
Interview rooms and offices where consultations with clients are held should have secure access and be kept separate from waiting areas and public spaces [15, 31]. It is, nonetheless, beneficial if the room is visible to other AOD employees [35]. Contemplate what is in the room, whether there are many exits, and where each individual might sit when deciding where the meeting should be conducted [36]. Furniture can be strategically placed to allow the social worker to sit closest to the entrance for easy exit while also facing the door to monitor access [5, 16, 31, 37]. Furthermore, Hardy [5] and the Simmons School of Social Work [36] urge AODs to leave adequate space in interview environments that no individual will feel trapped, which may escalate the risk of violence.
While many social workers prefer a closed office door during a client meeting to preserve client privacy, it is recommended that professionals leave the door partially or entirely open [16, 20). This can indicate to the client in a nonverbal way that others are close and listening or observing, reducing the likelihood of violent behaviour. Another important strategy for social workers is to keep the presence of potential weapons, such as a fire extinguisher, moulded plastic chairs, office décor, staplers, paper weights, or sharp items, such as a letter opener or pair of scissors, to a minimum [5, 15, 16, 20, 31, 32, 35, 37].
Planning for site visits
It is critical to plan ahead of time to ensure that logistical procedures are in place to keep social workers safe. Social workers should determine whether client interviews can be done in the office, or if a home visit is required. If the risk of danger appears to be severe, the social worker may also try to arrange for the meeting to take place in a public place [38]. If a home visit is necessary, it should be scheduled as early in the day as possible to ensure that social workers could get assistance in emergency situations [20]. In addition, social workers should avoid arranging too many home visits in one day to protect their own vulnerability [19].
Wearing appropriate attire makes it easier to move around and makes social workers less likely to be targeted [35]. When working in the field, it is essential to wear suitable clothing and shoes, considering social workers are frequently required to walk, stand, or climb stairs [18, 37, 38]. These clothing may be semi-formal in nature, yet still project a professional image. Jewellery, lanyards, keychains around necks, ties, or earrings should be considered a safety hazard as clients can easily grab them and cut off social workers' breathing [2, 5, 18, 26].
Protecting social workers at clients' residences
Literature recommends several strategies to protect social workers at clients’ residences, as these are client’s comfort zones. Social workers should take care to respect clients from the time of arrival by not slamming vehicle doors or strolling on client lawns, but rather knocking or using doorbells appropriately [37, 38]. Although client privacy is emphasised, it is good if social workers enter the home through a door that is visible from the street and position themselves between the client and the exit [2, 18, 31, 37, 38]. If given a choice, social workers should avoid consulting with the client in the kitchen where possible weapons (knives and boiling water) are kept, the bedroom where clients are most comfortable, or any secluded, unlit spaces such as the basement [2, 31, 37].
Stowe [31] and Taylor [32] recommend that the social worker waits to be invited to sit down and then choose a seat that is inviting and non-confrontational. It is best to sit in a chair with a straight back since it's easier to get up in an emergency [37]. The social worker can scan the home for others present and keep an eye on the front door if anyone enters the home [31]. If there are too many significant others present, or if weapons or substances are prevalent, social workers should end the interview and leave the client's home immediately [26]. It is important that social workers never put themselves in situations that are dangerous to them.
During the interview, some clients could have blaring televisions or radios, and Stowe [31] recommends asking them to turn it off. If a client has pets in their home, social workers are allowed to request that the pets be restrained during the visit [38]. If a dog approaches a social worker, they should stand tall and not move, allow the dog to approach them, avoid facing their back to the dog, use loud, strong commands, protect their neck and face, and try to give the dog something to chew or play with [2, 31].
Table 9
Subtheme 3(b)
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Subtheme 3(b): Safety strategies while travelling
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Related codes
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Supporting quotes
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Arriving at work
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“Visually check parking lot when you arrive at work” [37].
“When exiting the vehicle and approaching the office building, workers should scan the environment and check the outside of the building for safety before entering” [31].
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Travelling to site
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“All personal items should be left in the car or trunk of the car and hidden from public eyesight during travel” [2].
“Ask to see identification of anyone stopping to assist you” [35].
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During a visit
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“Keep keys with you and lock doors when no one is in car” [26].
“During the interview, workers are encouraged to keep their car keys and a functioning cell phone on them in a place that allows those items to be reached easily” [20].
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After a visit
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“Once the visit has concluded, workers should prepare to approach their vehicle by having their keys ready to unlock their vehicle” [18].
“Scan front and back seat and floor before getting in” [31].
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Transporting clients
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“Know the proper use and installation of a child safety seat that is appropriate for the child’s age and size” [15].
“Clients should be seated behind the passenger seat” [31].
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Several strategies have been identified to protect social workers while travelling. Aside from assessing the vehicle's condition, literature suggests that valuables and personal goods should not be displayed when visiting sites [2, 18, 31, 32, 36]. Instead, it is recommended to keep them secured in the trunk and to carry a modest amount of cash, keys, and a cell phone in a waist pack, a compact cross-body bag, or on the individual’s person [26]. When travelling, social workers should be mindful of their surroundings and travel in well-lit, easily accessible areas. When arriving at a destination, it is recommended that vehicles be parked in the direction of departure and in a manner that provides for simple access and that prevents the possibility of being trapped or blocked in by other vehicles [17, 18, 20, 31, 32].
While a social worker conducts a consultation, their car keys should be easily accessible and when the consultation is concluded, workers should approach their vehicles with their keys ready to unlock [18, 25, 32]. Stowe [31] advises that the social worker should inspect the front seat, backseat and floor, before getting into the vehicle. If workers perceive they are being followed while traveling, they should immediately go to the nearest police or fire station. An alternative option is an open gas station or business and to contact the police department [31, 37]. Workers should remain in their vehicles, lock the doors, and sound the horn or flash their lights to attract attention [32]. It is allowed to ask personal identification from anyone who offers to help [18].
Similar strategies are applicable when arriving back at the office. Social workers are advised to remain in their vehicles, visually scan the parking lot for unidentified vehicles or individuals and record the license plate number of any unusual vehicles [31]. Additionally, social workers should scan the area and inspect the outside of the building for safety hazards before approaching the office building [37].
Other safety strategies during travel may include safety measures for the specific client population: when transporting a young child, child safety locks should be activated and age-appropriate car seats should be used; when transporting an adult, clients should sit behind the passenger seat [15, 26, 31]. It is emphasised that social workers should at all times adhere to the state’s regulatory requirements during the client transportation process.
Table 10
Subtheme 3(c)
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Subtheme 3 (c): Improve safekeeping by using new technology
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Related codes
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Supporting quotes
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Policies
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“Each cell phone or laptop is connected to a GPS system online alerting management of their worker’s whereabouts at all times” [31].
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Security in the office
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“The ability to alarm others of an emergency or need for emergency assistance through the use of technology” [31].
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Travelling to site
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“Mobile safety devices may incorporate GPS and/or audio/video recording…” [15].
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During a visit
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“Keep GPS-enabled mobile phone applications activated at all times while in the field” [15].
“In general, a cell phone is very useful for students doing home visits” [35].
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Transporting clients
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“Use a mobile phone app such as BSafe that by touch or voice activates an SOS alert, including your location and live GPS tracking” [35].
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Literature emphasises the use of modern technology to protect social workers against client violence. If an AOD’s policies allow for it, technology can be used at the office, on field visits, and when traveling. Assuming funds permit, all office entrances can be fitted with coded access, and AOD reception rooms can be equipped with fortified glass to safeguard personnel [31]. Security cameras or metal detector screenings are examples of other secure entry and access possibilities [15]. The majority of the research, however, advocates for alarm systems [15, 22, 35]. or panic buttons that can notify others to a safety threat [15, 20, 21, 31; 32]. The panic button is frequently disguised or actuated via key fobs or mobile devices and it can be linked to public safety departments (police, emergency rooms, fire departments) [5, 14].
According to the NASW [15], personal safety equipment that includes silent panic buttons, a GPS, or audio/video monitoring, can be advantageous when traveling. When conducting field visits, pre-programmed smartphones with GPS-enabled applications can also be useful [15, 26, 35, 38].
Table 11
Subtheme 3(d)
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Subtheme 3 (d): Ensure safety by involving trusted others
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Related codes
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Supporting quotes
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Creating safe interview settings
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“If a worker is concerned about the mood and actions their client is displaying, they should inform their co-workers or supervisor, request a colleague to sit in on the interview, or keep the door ajar to allow others to provide assistance if needed” [31].
“Ask if anyone is available to sit in, at least until you assess the situation” [26].
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Security at the office
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“Establish an employee saferoom, and use a buddy system, a tag-team, or ALERT device” [18].
“Signal a co-worker or supervisor that you need help…” [37].
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Planning a visit
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“When visiting a high-risk client, or a potentially violent client, it is crucial for workers to utilize a buddy system in order to be accompanied by a colleague during the visit” [38].
“…the ability to go out as a team in a potential unsafe environment” [21].
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During a visit
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“Depending on the case and any confidentiality issues, you can possibly get a client’s trusted family member involved and conduct a joint home visit with that person” [38].
“Implement a ‘buddy system’ in the event of an emergency which requires at least two workers to conduct the client visit together” [31].
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Transporting clients
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“Use a ‘buddy system’ - that is, have a second social worker in the vehicle when transporting a client” [15].
“If a colleague is available to accompany the worker, a buddy system should be utilized to ensure safety when transporting clients” [31].
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The National Association of Social Workers introduced the concept of a safety buddy. A safety buddy is someone who collaborates with the social worker to preserve safety and has readily available resources (phone numbers, escape routes) in the event of an emergency. Safety buddies are present during consultations, but their role is to observe for indicators of violence so that they can intervene if necessary [16]. These buddies could be co-workers, employees from other AODs involved in the case, law enforcement officers, or even clients. Colleagues or team members are the most practical to implement, and social workers are encouraged to pair up and conduct home visits on the same day [2, 5, 20, 26, 37, 38]. In some instances, a client can serve as a safety partner and provide guidance on local safety concerns [18]. Individual AODs may have policies that clearly stipulate the roles and responsibilities of the safety buddies.
Table 12
Subtheme 3(e)
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Subtheme 3 (e): Interaction between the organisation and the social worker
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Related codes
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Supporting quotes
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Creating safe interview settings
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“Once appointments are made, workers should share their schedule with their co-workers…” [20].
“A social worker should never see a potentially dangerous client alone without someone else in the agency knowing about the client, the appointment time and the location of the appointment” [35].
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Security in the office
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“Be prepared with code words or phrases that alert your employer and colleagues to an emergency or a dangerous situation” [36].
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Planning a visit
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“Be sure to inform your supervisor and another colleague of your whereabouts” [38].
“Any changes in appointment field visits should be reported to the worker’s supervisor or agency representative” [15].
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Travelling to site
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“Calling the office before entering a client’s home” [31].
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During a visit
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“Keep emergency contacts on speed dial” [15].
“Agree on and use “code” words or phrases to help social workers convey the nature of threats to their managers or colleagues” [15].
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After a visit
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“Following each visit, the social workers should report back to their supervisor or designated agency representative when the meeting is concluded or as soon as it is safe to do so” [15].
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Clear communication practices between the social worker and the employer can ensure that someone will check in and follow up in an event of emergency, or if a social worker does not return when expected [32]. It requires the social worker to provide their supervisor or colleague with a schedule (consisting of home visit addresses and appointment times), estimated time of arrival and departure times (duration of visits), vehicle information (license plate number, make, model, colour) and information on how to reach them [2, 15, 19, 20, 25, 37, 38]. A sign-in/sign-out system may be beneficial for the tracking task.
Although literature [5, 31] recommend calling the office before entering a client's house and notifying them as soon as the consultation is completed. The protocols established by the AOD should always be followed. Any changes in scheduling should be communicated to the appointed AOD representative, if possible [15].