BEHAVIORAL THREAT ASSESSMENT Utah Crisis Counseling Workshop May 21, 2018 Denise Bulling, PhD, LIPC, CTM

Acknowledgement: Many of these slides are based on presentations designed jointly with Dr. Mario Scalora

Workshop Objectives 1. Certify/Recertify individuals serving as Utah’s cadre of crisis counselors 2. Apply crisis counseling skills to threat mitigation 3. Demonstrate ability to assess behavioral risk factors 4. Assign levels of concern to risk patterns 5. Identify multi-disciplinary intervention options to manage threat over time

Overview ■ Morning – Principles of Threat Assessment – Risk Factors – Information Gathering ■ Afternoon – Levels of Concern – Interventions – Practical Exercise

What is Threat Assessment?

The Problem  99 Mass Shootings in USA Since 1982 (Follman, Aronsen, & Pan, 2018)  823 Dead & 1,279 Injured

 15% Women and 6% Men are stalked in their lifetime (CDC, 2011)  2 Million workers REPORT being a victim of workplace violence each year (OSHA)

 17.7% Students (grade 9-12) seriously considered suicide (YRBS, 2015)

Myths ■ It won’t happen here ■ The concern should be mainly about homicides ■ There is no warning ■ If someone is intent to do harm, there is nothing I can do about it

Some Violence is Preventable

There are observable behaviors and warning signs for some types of violence

Targeted violence

Predatory or Instrumental Violence

Affective or Reactive Violence Flickr – Images licensed under creative commons attribution

Types of targeted violence – Workplace Violence ■ ■ ■ ■

– – – – – – – –

Strangers Customers/Patients Co-workers Domestic Violence spill-over

Harassment Bullying Sexual Assault Physical Assault Threats (direct & veiled) Suicide Terrorism Violent Extremism

Targeted Violence ■ Attacks are not impulsive acts ■ Action is Opportunistic ■ Acts are part of a campaign waged in asymmetrical conflict

Principles of Threat Assessment

Targeted Violence & Terrorist/Violent Extremist Strategies ■ Surveillance activity prior to attack ■ Rehearsals or trial runs, disciplined approach ■ The element of surprise for unsuspecting victim(s) ■ Use of explosives, secondary devices and diversionary tactics ■ Use of Internet to communicate threats, strategize among cohorts, document activities, learn tactics and recruit followers ■ Suicide missions ■ Warning signs often overlooked or ignored ■ Strategies set the bar for future events in terms of escalating fear, destruction and notoriety

Principles of Threat Assessment

Definitions Targeted Violence

Threat Assessment

• Subject • Intent to cause harm • Target/Object of Focus

• Fact based • Focus on behavior patterns • Assessing movement toward attack

(Borum, Fein, Vossekuil,& Berglund, 1999; Fein & Vossekuil, 1998; Fein, Vossekuil, & Holden, 1995; Reddy,Borum, Berglund, Vossekuil, Fein & Modzel eski, 2001)

(Borum, Fein, Vossekuil & Berglund, 1999)

Threat Management • Manage subject behavior • Disrupt or prevent targeted violence (Meloy, Hart & Hoffmann, 2014)

Principles of Threat Assessment

Threat Assessment

Violence Risk Assessment

Context

Guides Front Line Work

Assists legal discussions

Process

“Hot” – Rapid

“Cold” – Slow

Goals

Protect Victim or Target

Manage Perpetrator

Structure

Flexible – Discretionary, Case-driven, Inductive

Fixed – not discretionary, groupdata, deductive

Time Horizon

Short-term; dynamic focus

Long-term, historic or disposition focus

Meloy, Hart, & Hoffmann, 2014

Principles of Threat Assessment

Threat Assessment ■ Focuses on troubling behavior rather than troubled people ■ Preventative versus reactive ■ Allows for assessment and monitoring of patterns of contact ■ Allows for a coordinated response with other agencies ■ Uses interventions that promote and emphasize dignity and respect

Assessment Process

Principles of Threat Assessment

■ Assessment is evidence based and considers : – Motivation for the behavior in question. – Communication about ideas and intentions. – Unusual interest in targeted violence. – Evidence of attack-related behaviors and planning. – A capacity to carry out an act of targeted violence.

Principles of Threat Assessment

Assessment Process Assessment factors (cont.):

– Feelings of hopelessness or despair (including suicidal ideation or attempts) or recent losses, real or perceived (including losses of status). – A belief that violence is a solution to his or her problems. – Concern by others about the student’s potential for harm. – Leakage of intentions – Factors in the subject’s life and/or environment or situation that might increase or decrease the likelihood of attack

Principles of Threat Assessment

Threat Assessment ■ Movement of Idea to action ■ Targeted violence is not random or spontaneous ■ Not all threats are created equal ■ Related psychological concepts of Justification & Resignation to perform targeted violence

J A C A

ustification lternatives

onsequences bility

Debecker, G. (1997). The Gift of Fear. New York: Little, Brown

Principles of Threat Assessment

Targeted Violence is a Process ■ Violence is goal-directed behavior: The subject forms a goal, then forms intent to work toward it and then forms behavioral plans consistent with the goal and intent. ■ When the sequence is slow, we call it deliberate or pre-meditated

(Meloy, Hart & Hoffmann, 2014)

Principles of Threat Assessment

Targeted Violence Results from an interaction

Threat Assessment Principles 1. Threat, approach, and attack behavior are the products of discernible processes of thinking and behavior 2. Most people who attack others perceive the attack as a means to a goal 3. An individual’s motives and target selection are directly connected 4. Targeted acts often precipitated by a personal or significant stressor

Threat Assessment Principles ■ The key to investigation and resolution of threat assessment cases is identification of the subject’s attack-related behaviors.

Critical Issues ■ “Making” a threat vs. “posing” a threat ■ Risk must be viewed as a probability estimate over time that changes with context ■ Critical Information may come from a variety of sources (e.g., family, coworkers, other targets of interest) ■ Risk management must be viewed as a “shared” responsibility

Pathway to Violence Model

Preparation

Ideation Grievance

Research & Planning

Calhoun & Weston, 2003.

Breach

Attack

PATHWAY TO VIOLENCE

Grievance

Calhoun & Weston, 2003.

Motive or Reason Behind the Action

PATHWAY TO VIOLENCE Ideation Grievance

Calhoun & Weston, 2003.

Thoughts about violence as a justifiable alternative

PATHWAY TO VIOLENCE Research & Planning

Ideation Grievance

Calhoun & Weston, 2003.

Researching and planning how, when and where violent act may occur

PATHWAY TO VIOLENCE Preparation

Ideation Grievance

Calhoun & Weston, 2003.

Research & Planning

Getting equipment, supplies, etc. to make the plan happen

PATHWAY TO VIOLENCE Preparation

Ideation

Breach

Research & Planning

Grievance

Calhoun & Weston, 2003.

Getting close to the target – breaching security

PATHWAY TO VIOLENCE Preparation

Ideation Grievance

Research & Planning

Calhoun & Weston, 2003.

Breach

Attack

Threat Assessment Teams are Multidisciplinary • Union reps • Human Resources • Behavioral Health • Faculty • Medical Chiefs • Nursing

• Security • Law Enforcement • Facility Personnel

Public Affairs – Command/Directors – Outside Experts - Security

Principles of Threat Assessment

Law Enforcement Multi-disciplinary Community Team

Friends & Family

Schools

Coworkers / Workplace

Threat Assessment Teams ■ Meet regularly and as needed in crisis situations – Review potential and active threat cases – Coordinate and monitor implementation of interventions ■ Threat teams vs. Safety teams vs. Crisis teams – Function determines team focus Safety – environment and practices Threat assessment & Management – prevention/ intervention Crisis – intervention / post-vention

Principles of Threat Assessment

Barriers to Reporting ■ Fear – For personal safety (e.g., retaliation – Of being accused of profiling – Of being viewed s over-reacting – Of being viewed as incompetent or unable to deal with problem situations ■ Not sure who to report to ■ Disbelief that something would happen

Principles of Threat Assessment

Facilitating Reporting Ways to Report

Receiving the Report

■ Multiple modes of reporting

■ Give reporter feedback on whether they should be concerned

■ Anonymous reporting ■ Awareness of what to report ■ Awareness of how report will be handled

■ Provide victim feedback about level of concern and safety planning tips ■ Reinforce reporting a concern

Principles of Threat Assessment

What should be reported? ■ Anything that raises suspicion or concern ■ Displays signs of serious mental illness AND engages in problematic contact behavior ■ Harassing, following or stalking behavior ■ Problematic contacts – Referring to someone’s safety or security – Making concerning or hostile reference to an individual or group that is threatening

Information Gathering

Screening Considerations: The following factors may allow for a case/situation to be screened out subsequent to a preliminary investigation:  Behavior of concern is isolated and not part of a pattern of behavior  Behavior of concern is nuisance activity with no threatening or intimidating activity  Threatened behavior or behavior of concern is vague and indirect  Information contained within the communicated threat is inconsistent, implausible, or lacks detail  Content related to the behavior of concern suggests person is unlikely to carry it out

Information Gathering

Information Gathering – Sources of information ■ Victim / Target ■ Subject (if known) ■ Family / Friends of Subject ■ Law Enforcement Records ■ Work / School Records

• Need to be strategic—Need to uphold discretion and confidentiality • What source should be approached? • Who gathers the information and when?

Information Gathering

Information Gathering – Threat assessment approach ■ Initial assessment of threat and accessibility of target

Nature and intensity of threat posed Nature of the contact behavior Is the subject identifiable? Subject factors Why is the subject acting now? Are precipitating stressors present for the subject? Does the subject have the means to carry out the threat? What is the subject’s proximity to the target? What information is still required to properly assess the situation? What interagency cooperation may be required to fully assess and manage the situation? – What protective factors are in place? – – – – – – – – –

Information Gathering

Interview Strategies – Careful use of confrontation – accusatory vs. fact finding ■ “Do not engage to enrage” (Gavin DeBecker)

– Keep them talking – Direct questions regarding dangerousness not always useful – Use What if questions – Be empathetic – Be sensitive of need to protect victims and sources during interviews

Information Gathering

Information from Victim / Target ■ Pattern of behavior (e.g., harassing, threatening behavior) – When did it begin? – When was it worse? ■ What made you feel most uncomfortable? ■ What is your biggest concern if this behavior does not stop? ■ Any other suspicious behavior? (e.g., hang up calls, vandalism, missing objects)

Information Gathering

Information from Subject ■ Pattern and nature of contacts ■ If mentally ill, have subject educate you regarding their thoughts and symptoms – Do not challenge or agree with delusional thoughts when trying to get information) ■ “What do you want from….?” or “What would you like to see happen?” ■ “What if” questions (If subject does not get what he/she wants, e.g., “What will happen if she does not want to see you?”

Risk Factors

There is no “PROFILE”

Risk Factors

Observable / Behavioral Risk Factors  Detailed plans  Threat or plans announced or expressed  Weapon acquisition  Fascination with weapons  Desire for revenge  Inappropriate interest in violence or perpetrators of violence  Blaming others for difficulties and problems  Violent rehearsal or fantasy activity  Anger, frustration, dark side in writings  Evidence of attack-related behaviors and planning  Hopelessness/despair, recent losses (real or perceived  Believe that violence is a solution  Indicators of intensity of effort

Risk Factors

Leakage – Leakage in the context of threat assessment is the communication to a third party of an intent to do harm to a target (Meloy, 2011) – Leakage occurs when a subject “intentionally or unintentionally reveals clues to feelings, tho – Thoughts, fantasies, attitudes or intentions that signal an impending violent act” (O’Toole, 2000)

Risk Factors

Subject – Behavioral  History of grievance with the person or object of focus?  Prior arrest record or prior harassment / threat-related activity?  Problematic contacts with other agencies or groups?  Recent life stressors?  Presence of serious mental illness symptoms?

Risk Factors

Subject – Motivation  Nature of subject’s motivation? Bottom line: The More Personal, the Higher the Concern  Person / Object of focus identified / held responsible?  Motives driven by mental illness?  Seeking revenge / retaliation for perceived injustice or harm?  Desire for revenge communicated?

Risk Factors

“Intimacy Effect” The predictive level of threats as pre-incident indicators of violence increase in proportion to the degree of intimacy between the subject and target – Intimacy as perceived by the subject!

Risk Factors

Object/Person of Focus  Subject views person/object of focus as responsible for current situation or difficulties?  Subject & person / object of focus had prior conflict?  Consistent focus on person / object of focus?  Sharing of grievance(s) of person/object of focus to others?  Shift of person/ object of focus?

Risk Factors

Context  Suspicious people or items and changes in typical patterns of activities surrounding the person or object? (eg school)  Recent events elsewhere suggesting “copy-cat effect”  Personal anniversaries  Recent or upcoming crisis for subject?  Upcoming events of concern?

Risk Factors

Content ■ Personalized motive ■ Mental illness symptoms, particularly those ■ indicating threat to self or lack of bodily/personal control ■ Intent to approach ■ Language regarding justified violence (extremist rhetoric) tied to above

James & colleagues (2007, 2008); Mullen & colleagues (2009); Schoeneman-Morris, Scalora, Chang, Zimmerman, and Garner (2007)

Risk Factors

Trends in Electronic Communications ■ Threatening language is more prevalent ■ More intense politically driven activity and rhetoric ■ More extremist language ■ Victims set higher threshold for reporting electronic threats

Suspicious writing/ posts • Communicated verbally or symbolically • All threats taken seriously • “Specific and plausible” suggests more serious • Presence of emotional content • Recognizable stressors From: O'Toole, Mary Ellen. The school shooter: A threat assessment perspective.

From Kip Kinkel’s Spanish Homework Pages

Risk Factors

Bomb Threats • Stretch resources. Can be a diversion tactic to spread resources so another crime can be committed somewhere else. • Test initial responses. The perpetrator may want to look at who responds, how they respond, and response time. • Draw a target, or targets, out into the open. • Draw everyone to a location where it was easier to plant a bomb. (Is there an actual device or devices outside—in a car, perhaps?) • Simply threaten. Most typical scenario—a threat. If the perpetrator wants mass casualties, he or she will not warn about a device.

Risk Factors

Triggers ■ Loss ■ Rejection ■ Deteriorating mental health ■ Civil or Criminal action ■ Financial problems ■ Relationship changes ■ Anniversary or significant date

WARNING SIGNS - BEHAVIORS OF CONCERN

■ Negative job event

Risk Factors

Contact Behavior ■ Multiple prior contacts ■ Multiple types of contact behavior (e.g., letters, email, face-toface contact) ■ Nature and focus of threatening language ■ Shifts/escalation of behavior ■ Nature of motive ■ Intensity of effort ■ Intensity of focus Calhoun (1989); Scalora & colleagues (2002); Scalora, Zimmerman, & Wells (2008); Mullen & colleagues (2009)

Level of Concern

Level of Concern

Low Level of Concern Further assessment is not yet warranted ■ Behavior poses a minimal risk to the object/person of focus ■ Information/investigation suggests low potential for harm to a targeted individual, group or institution ■ No inappropriate approach behaviors exhibited ■ Subject’s interest can generally considered at a nuisance, non-threatening an non-dangerous level

Level of Concern

Moderate Level of Concern Monitor for escalation of concern ■ Moderate potential for disruptive or threatened behavior of concern ■ Information/investigation suggests a moderate potential for harm or serious disruption to a targeted individual, group or institution ■ Subject considered to have threatening, inappropriate , or otherwise unusual interest toward a target and has exhibited the ability or interest to harm the object/person ■ Though immediate risk of harm or serious disruption is not likely after initial investigation or management strategies are in place, the situation needs further monitoring

Level of Concern

High Level of Concern / Risk Action required to contain likelihood of harm ■ Information/Investigation indicates a likelihood of harm or serious disruption toward a targeted individual, group or institution. ■ Further investigation is required ■ Imminent harm is possible ■ Immediate investigation is initiated with focus on obtaining collaborative data concerning the subject’s location, behavior and lethality ■ Additional steps necessary (possibly contact law enforcement agencies or contact subject) to initiate safety measures

Level of Concern

In General….  The more direct and detailed a threat is, the more serious the risk of its being acted on.  A threat that is assessed as a HIGH concern/risk will generally require immediate law enforcement intervention  The distinction between levels of threat may not be always be obvious or there will be overlap or fluctuation between categories.  It may be prudent to assume a higher level of risk/concern until it is ruled out

Interventions

Interviewing ■ Use Disaster Psychological First Aid Skills – Be Aware of Your Non-verbal behaviors – Use the L shaped Stance (Safety Stance) – Treat the person with Respect & Dignity – Use Active Listening Skills – Ask Open Ended Questions that are nonjudgemental

Interventions

Interview Issues: Mental Illness ■ Principle of “rationality within irrationality” ■ Do not argue with delusions ■ Mental illness not equal limited intelligence ■ Have subject educate regarding issues involved ■ Careful use of confrontation ■ Direct questions regarding dangerousness not always useful-- use of indirect or third party perspective questions

Interventions

Interview Issues: Mental Illness ■ “What if…” questions ■ Role of external stressors as triggers ■ Exceptions to when not acted on hallucinations/delusions or other symptoms ■ Do not neglect role of alcohol ■ Recognize need for future contacts

Interventions

Intervention / Management ■ Safety planning ultimate goal ■ Need to motivate parties to stay engaged with safety plan ■ Need for liaison and coordination with law enforcement ■ Balancing monitoring versus intervention ■ Need for collateral contacts

Interventions

Intervention / Management Persons with troubled behavior who leave or are removed from school/workplace may not stop being a threat or risk. Community approach is necessary, crossing jurisdictions

Just because you vote somebody off the island, doesn’t mean they can’t swim back…. Dr. Mario Scalora

Interventions

Low Level Concern – Options ■ Document ■ Monitor ■ Follow-up

Interventions

Moderate Level of Concern – Options ■ Document ■ Safe Separation ■ Discipline ■ Mental Health/Substance use assessment ■ Restrictions ■ Mentoring ■ Legal remedies (charges, protection order)

USE CONNECTIONS AND CONSEQUENCE MANAGEMENT STRENGTHEN CONNECTIONS MONITOR BEHAVIOR FOR CHANGES BE ALERT FOR TRIGGERS RE-ASSESS OFTEN

Interventions

High Level of Concern - Options ■

Involve Law Enforcement to contain threat – Hospitalization, Arrest, Psych Assessment

Plus moderate level of concern options ■

Document

■

Safe Separation

■

Discipline

■

Mental Health/Substance use assessment

■

Restrictions

■

Mentoring

■

Legal remedies (charges, protection order)

Interventions

Management Considerations ■ Designate a single Point of Contact – To Liaise with Subject – For Team Members to Provide Information ■ Have Agreements in place among team members – How & what information is shared – Confidentiality – Documentation agreements – Coordinate signatures for releases

Interventions

Management Considerations ■ Families of Subject – Useful when rational and coherent – Not useful when irrational, mental illness or dislike law enforcement ■ Court System – Pros: Good source of information; monitoring; – Con: Time delay; orders may be contrary to interest of school/workplace

Interventions

Management Considerations ■ Protection Orders or Stay Away Orders (Ban & Bar) – Orders are likely to be violated if….  history of prior violations  certain symptoms of mental illness (paranoia)  behavioral pattern of resistance to authority  history of violence  dispute of longstanding duration  perception of provocation or escalation by victim

Interventions

Management Considerations ■ Mental Health Assessments – Not an intervention unless properly staged – Can use current treatment provider if amenable – MUST include RISK ASSESSMENT and not just presence/absence of mental health symptoms – Commitment or hospitalization is temporary…. ■ Provide written behavioral observations to assessor/clinicians ■ Get releases signed as soon as possible

Interventions

Management Considerations ■ Exceptions to Privilege – If released by subject (parent or guardian) – If court ordered – Suspected child or elder abuse – Risk or harm to self or others (“Tarasoff”) – HIPAA exceptions for law enforcement

Post Incident: Mitigation of Secondary Issues

■ Mitigation of secondary sources of risk/threat posed – Hoax activity – Efforts by range of persons to probe security – Secondary attacks – Confidence in security response – Counter-surveillance Issues

Practical Exercise ■ Work at your Table as a Threat Assessment Team

Resources ■ Association of Threat Assessment Professionals http://www.atapworldwide.org/ ■ Helpful Books – International Handbook of Threat Assessment (Eds. Meloy & Hoffmann) – Violence Assessment & Intervention (Cawood & Corcoran) – Contemporary Threat Management: A Practical Guide for Identifying, Assessing and Managing Individuals with Violent Intent (Calhoun & Weston) ■ Helpful tools – RAGE-V – WAVR-21