Counselling and Clinical Psychologists’ Experience of Client Violence in the Workplace

Violence and abuse from clients within the healthcare system is a growing
problem which can affect the personal and professional identity, and psychological
wellbeing of healthcare professionals. Previous research and literature has focused on
the risk of violence from particular client groups and understanding the aetiology of
aggressive and violent behaviour towards healthcare professionals. There is a lack of
research which explores psychologists’ experiences of client violence, and professional
organisations have provided scant or no guidelines that could support psychologists
who have experienced violence at work.
To address the gaps in the present literature, this research qualitatively explored
how psychologists make sense of their lived experiences of client violence in the
workplace. Three counselling psychologists and four clinical psychologists who had
previously experienced client violence were interviewed to take part in this research.
Data was analysed using interpretative phenomenological analysis (IPA). IPA was
selected for its idiographic nature, as it was hoped that the findings would provide a
deeper understanding of psychologists’ experience of client violence from their
personal account. IPA can also assist in developing guidelines for a specific purpose to
support professionals in their work, which was a secondary aim of the research.
The findings revealed that psychologists can undergo different types of
experiences after being attacked by a client, and experiencing and responding to client
violence has a significant effect upon their professional identity. Three superordinate
themes emerged from the IPA, which relate to the different phases after an experience of
client violence. The first theme - ‘the moment to moment experience of client violence’
- relates to the exact instant the incident took place and how the client’s aggression had
taken the psychologist by surprise. The second theme - ‘post incident experience’
-describes how participants tried to make sense of their experience of client violence, such as by creating a formulation. The final theme - ‘issues concerning professional
identity’ - refers to the participants' need to show that they can cope with client violence
due their professional self-image of being a psychologist. More broadly, the findings
revealed how the professional self-image of psychologists affects their beliefs about
how they ‘should’ be able to work therapeutically with violent clients and be able to
manage and understand it.
It is recommended that further research explores the prevalence of psychologists
who experience client violence, and the type of work settings in which this is most
likely. Moreover, both neophyte and qualified psychologists would benefit from specific
training in how to respond safely to violent client behaviour, and from the publication of
professional guidelines to help them understand the possible risks of violence, decisionmaking
when confronted with violent clients, and how to recognise and process the
potential psychological repercussions of violence incidents.