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
C2 - 29638238
SN - 0303-7339
VL - 60
SP - 241
EP - 249
JO - Tijdschrift voor Psychiatrie
JF - Tijdschrift voor Psychiatrie
IS - 4
ER -