Introduction   Client violence toward social workers has become recognized as a common problem, and major concern has been raised with regard to its impacts on the workers’ practice, and physical and psychological health. More than half a century has passed since the social work profession was established in Iran, and yet client violence and the associated health-related consequences remain unexplored. This thesis aims to address this gap in knowledge. Methods   A national survey was conducted involving 390 social workers from the Centres for Socially Injured People (CSIP), affiliated to the Social Affairs Department of the State Welfare Organization, Iran. The survey included self-administered questionnaires, namely, the Workplace Violence in the Health Sector questionnaire, the General Health Questionnaire-28 (GHQ-28), the Ways of Coping questionnaire, the Burnout Measure, and the Rosenberg Self-esteem Scale. Results   A high proportion of CSIP social workers (67%) have experienced violence. Psychological violence was about three times more common than physical violence. A high tendency of not reporting psychological violence to managers/supervisors was found. Psychological violence was associated with poorer mental health. Social workers with experience of psychological violence were found to be more worried about occurrences of violent events. Worrying about violence was significantly correlated with poorer mental health. Active coping had a direct effect on health, suggesting a poorer health status with more frequent use of active coping. Burnout was experienced by 10.9% of social workers, and 17.4% were found to be at risk of developing burnout symptoms. Low self-esteem and experience of violence were associated with burnout. Conclusion   The results suggest the importance of not neglecting cases of client violence and of putting the health and safety of social workers on top of the agenda. A victimized social worker with limited resources at work needs to note that coping skills may reduce the impact of stressors, not only by changing the stressors themselves, but also by changing how the social worker responds to them.

This qualitative study used a phenomenological approach to understand the experience of six therapists who had been threatened with harm or attacked by a client or a relative of a client in an outpatient setting. Semi-structured interviews were employed to collect data which were then analyzed using thematic coding. While some of the results of this study are consistent with existing literature on attacks on clinicians in acute inpatient settings, many of the study findings suggest that the experiences of therapists working in an outpatient setting who are threatened by a client or a relative of client are unique to that setting. Clinical implications are discussed. / Master of Science

Syftet med föreliggande uppsats var att undersöka hur socialsekreterare inom familjeavdelningens utredningsenhet förhåller sig till situationer av hot och våld på arbetsplatsen och även till det förebyggande arbete som bedrivs för att undgå att hotfulla situationer uppstår. För att uppnå studiens syfte används en kvalitativ metod i form av fem intervjuer. I intervjuerna sökte vi svar på frågeställningen: Vilka kunskaper om åtgärder har socialsekreterarna fått, om hur de ska agera utifall hot och våld uppstår i möten med klienter på arbetsplatsen? Vilka strategier använder socialsekreterarna sig av för att inte hotfulla och våldsamma situationer ska uppstå i möten med klienter? Det insamlande materialet har bearbetats genom inspiration utifrån en hermeneutisk ansats och analyserats utifrån KASAMteorin och de teoretiska begreppen mentalisering, organisationskultur samt coping. Studiens resultat visar att det förekommer få hotfulla situationer inom familjeavdelningens utredningsenhet. Det kan istället handla om kränkningar via telefon och mejl. Det framkommer att socialsekreterarna har en medvetenhet genom att de förbereder sig inför möten med klienter för att försöka sätta sig in i hur klienten kommer att uppleva mötet. Samtliga betonar vikten av att bemöta klienten med respekt. Resultatet visar även att intervjupersonerna anser att det finns ett bra stöd hos kollegor och chefer. Dock saknar de en bredare utbildning kring hur de ska agera om hot eller om en våldsam situation uppstår. Majoriteten av intervjupersonerna ansåg att ålder och arbetslivserfarenhet kan vara av betydelse för hur man upplever om man är med om otillåten påverkan. Det framkommer av intervjupersonerna att arbetslivserfarenhet är något som påverkar vilka försiktighetsåtgärder de tar i sitt privatliv, för att privatlivet inte ska påverkas av ens yrkesval. Just erfarenheten kan påverka att de upplever vissa situationer som mindre hotfulla. Även socialsekreterarnas ökade kunskaper påverkar hur de agerar i situationer som präglas av hot och våld. De får en viss acceptans för vilken situation klienten befinner sig i. / The aim of this study was to examine how social work professionals in child protection relate to situations of client related threats and violence, in the workplace, and also how they reason about the preventive work, in order to avoid threatening situations. In order to achieve the purpose, we used a qualitative approach, consisting of five individual interviews. In our semistructured interviews we looked for answers to the following questions: What knowledges about work-related measures did the social work professionals receive, on how to act when threats and violence arise in meetings with clients in the workplace? What strategies do the social work professionals use to avoid threatening or violent situations that can arise in meetings with their clients? We have, throughout our research process, been inspired by the hermeneutic method. The analysis was based upon Antonovskys KASAM (sense of coherence)-theory and theoretical concepts of mentalization, organizational culture and coping. The results show that only a few threatening situations occurred in the physical workplace of the five social work professionals. More common were threats expressed by phone and email. It appears that social workers have an awareness, preparing for meetings with clients to try to understand how the client will experience the meeting. All stresses the importance of responding to client with respect. The results also show that the interviewees believe that they receive good social support from colleagues and managers; they do, however, lack a broader perspective of education on how to act during threatening or violent situations. Majority of the interviewees felt that age and professional experience can be of importance in the interpretation of the situation. It is found by the interviewees that the work experience is something that affects what precautions they take in their private life, to private life should not be affected by one's choice of profession. They meant that these factors can affect the experience of threats and violence and how one interprets situations of violence and threats. The interviewees mentioned that they feel more confident in how to act when they need to diffuse a violent situation. They also meant that, as social work professionals working in child protection, you get a certain acceptance of the different kinds of situations your clients live through, the older you get.

”Det (o)hanterliga klientvåldet” är en kvalitativ intervjustudie med syftet att undersöka socialsekreterares upplevelser och hantering av klientvåld i deras yrkesutövning. Mer än var tredje socialsekreterare drabbas av klientvåld och det är även en av de mest förekommande orsakerna till utbrändhet och uppsägning. I studien utfördes sex stycken semistrukturerade intervjuer vars material analyserades med en tematisk analys. Coping- och resiliensteorin har använts som teoretisk tolkningsram för att förstå det empiriska materialet. Resultatet visade att klientvåld är situationsbunden och påverkar socialsekreterare olika. Vanligt förekommande copingstrategier var att söka socialt stöd i sin omgivning, förminska våldet och skilja på sin professionella och privata roll. Resultatet visade även att socialsekreterare härdas av klientvåld när de får erfara det upprepade gånger. / “The (un)manageable client violence” is a qualitative interview study aiming to explore social workers experiences of client violence and how they cope with the issue in their professional role. More than every third social worker is said to have been exposed to client violence and it appears to be one of the most common reasons of why social workers get burned out or quit their jobs. Six semi-structural interviews were conducted in the study and got analyzed with a thematical analysis. The coping- and resilience theory were used to understand the empirical material. This study’s result showed that client violence depends on the situation and affects the social workers differently. Common coping strategies tended to be searching for social support in their surroundings and separating the professional and the private self. The result also showed that the client violence does not feel as violent after being exposed to it repeatedly.

Social workers tend to find themselves in threatening situations associated with their clients. Threat and violence against social workers is not a new phenomenon but can instead be described as “a part of the work”. When clients turn to social services for help, they are automatically at a disadvantage and in order to receive help they need to submit themselves to a lot of demands. This can lead to a feeling of power impotence and not having power over your own life. If a person has a feeling of not being in power over his or her own life it can contribute to clients apprehending the social system as unfair and the frustration that comes with this feeling can lead to violent acts in hope of regaining the power. Studies also show that violence against social workers is something that is increasing and to deal with this organisations have developed certain guidelines for social workers to follow. The aim of this study is to examine these different guidelines in the organisations and to see how they affect the social worker, the client and their relationship. This study reviews different articles that discuss the issue and the study also reviews the guidelines for tackling this issue in seven different organisations. The result of the study shows that the guidelines contains tools for both organisation and the socialworker to manage threat and violence.The result also shows that the social worker is victimized but at the same time both power and advantage lies in the hands of the social worker.

The purpose of this narrative study is to highlight social workers' experiences of threats and violence within their profession, as well as the variety of resources to fend off, remedy and manage the risk of threats and violence. The present problem is how threats and violence are underreported, partly due to social workers' views on their own profession and a work climate that might not encourage reporting incidents. Previous studies have shown high prevalence of threats and violence within social work and consequences that follow, such as high levels of stress, leading to burnout. Other studies found that the fear of being exposed to threats and violence can result in self-censorship, thereby limiting autonomy and professional judgment. Through interviews we found that social workers had experienced violence and threats of different sorts, primarily verbal threats. The overall perception was of understanding nature due to injustice that many clients face, resulting in expressions of strong emotions. However, some social workers described their work as characterized by imminent threats, rather than fear of being exposed. The preventing resources provided at the workplace are described as mostly effective and fulfilling of its purpose, while others find that they create unnecessary distance between them and clients. The social workers perceive themselves as fairly prepared for violent or threatening situations, mainly through their education, but emphasize experience over any type of education. They also emphasize the support from colleagues and managers as valuable and important resources. By highlighting the narrative of social workers we hope to bring awareness to this issue and encourage an open dialogue.

Hot och våld mot socialarbetare har i Sverige mellan åren 2018 och 2020 ökat från en tredjedel utsatta till hälften. Under 2021 rapporterades nästan häften av yrkesverksamma inom socialt arbete under senaste året ha utsatts för någon form av hot eller våld. Tre av tio känner sig missnöjda med stödet från arbetsgivare efter en hot- eller våldsincident. Syftet för denna uppsats blev att undersöka upplevelser hos socialarbetare av hot och våld från klienter. Frågeställningarna var: Hur ser socialarbetares erfarenhet ut av hot och våld från klienter? och Hur upplever socialarbetare att deras arbetsplatser arbetar med frågan om hot och våld från klienter? En kvalitativ metod användes och fem semistrukturerade intervjuer genomfördes, vilka analyserades med hjälp av dataanalys. Tematiseringen blev våldets former och förekomst, orsaker, påverkan och hantering av våldet. Resultatet analyserades och diskuterades utifrån tidigare forskning samt sociala konstruktioner och organisationsteori. Resultatet visar en upplevelse av hotfulla incidenter på arbetsplatsen. Våldet upplevs orsakas av olika uppfattningar hos klienter och socialtjänst, brist på anmälande av incidenter, samt samhällsförändringar. Våldet påverkar det sociala arbetet i form av att det bidrar till stress och att arbetets kvalitet kan försämras. Ett missnöje finns gällande arbetsplatsernas förebyggande arbete mot hot och våld från klienter. / In Sweden threats and violence against social workers have increased between 2018 and 2020 from one third of social workers being exposed to the half. In 2021 almost half of the social workers were reported to have been exposed to threat or violence. Three of ten feel dissatisfied with the support from employers after an incident. The purpose of this thesis was to investigate experiences among social workers of being exposed to threats and violence from clients. The questions of the study were: What experience do social workers have of being exposed to threats and violence from clients? and How do social workers perceive their workplaces management with client violence? A qualitative method was used and five semi-structured interviews were conducted, which were analyzed by using data analysis. The result was divided in following themes: Type of violence and occurrence, causes, impact and handling. The results were analyzed and discussed based on previous research together with social constructions and organizational theory. The results show an experience of threatening incidents in the workplace. The violence can be caused by clients having another perception than the social services, lack of reporting incidents, and changes in society. Client violence causes stress among social workers and in their working environment, and can lead to poorer quality of the work done by the social worker. There is dissatisfaction with the workplace’s preventive work against threats and violence from clients.

社會工作者處於人身安全高度危險的工作環境中，國內相關的研究卻不豐富。本研究以處在高風險工作環境中的社會工作者為對象，瞭解他們目前遭受案主暴力對待的現況、回應方式，及對暴力風險的知覺情形。研究以郵寄問卷方式進行，資料蒐集範圍包括臺北市家庭暴力暨性侵害防治中心、各區社會福利服務中心、區域級以上醫療及精神醫療院所，發出231份問卷，回收有效問卷共計165份，回收率為71.43％。 首先，研究發現81.8％的社會工作者生涯中曾遭受某種形式的暴力攻擊，其中心理傷害80.6％、身體傷害16.4％、財產損害26.1％，經常發生的地點在「辦公處所」。研究尚發現44％的社工員經驗到多種形式的暴力，更有72％經驗到一次以上，顯見案主的暴力威脅並非偶發事件，高風險領域社會工作者確實面臨案主暴力威脅；邏輯迴歸分析發現，機構年資不長、工作經驗較短者面對暴力的可能性較高。其次，平均而言工作者身體風險知覺較心理及財務風險知覺為高，進一步以迴歸分析發現，尚未取得證照、保護性服務工作者、機構年資低、工作經驗較短者其風險意識較高。第三，受暴經驗與風險知覺有關，過去曾有受暴經驗的社工員整體風險知覺較高。最後，有關正式通報的情形，百分之五十七點四的受訪者表示遭遇心理傷害時會通報、受身體傷害和財務損害者則有近八成會通報，受到「形而外且具體」傷害時呈報上級的情形則更為普遍。 研究建議如下：實務上，機構應有清楚的政策及通報流程以增加暴力事件的可見度、提供員工情緒支持及教育訓練以提昇工作者風險意識及減緩工作恐懼感；工作者本身應改變信念並增加實務工作知能，避免將暴力事件地下化、私有化，及強化與案主工作時的應對技巧。另外，在教育養成上應有更多人身安全的訓練與關注，以避免社會工作學生因過度擔心阻礙其投入職場的信心。最後，政府政策應針對第一線人身安全高風險的社工員給予實質性保障、儘速將人身安全納入社工師法或專門立法，強調暴力「零容忍」的相關政策，以維護社工人員的尊嚴與生命安全。 / Although social workers are at risk of client violence in the workplace, little research on the situation has been done in Taiwan. The present study surveyed 165 social workers practicing in high risk fields in Taipei in terms of their experiences, reaction, and perception of client violence. The following are the findings. First, a prevalence rate of client violence (81.8％) was found. About eighty percent of social workers had experienced some type of psychological assault by clients during their work. Physical attack was reported by 27 workers (16.4％). Property damage was reported by 43 workers (26.1％). In multiple logistic regression, psychological assault was associated with two variables—less seniority and less social work experience. Second, on the average, scores of physical risk perception was much higher than the other two perceptions. Multiple regression showed that workers who were less senior, worked at protection service, with less social work experience, or without license, had higher scores of risk perception. Third, a significant positive correlation existed between client violence and risk perception. Finally, results indicated that only 57.4％ of the subjects who suffered psychological assault had decided to report their experience formally. On the contrary, nearly eighty percent would report when they encountered physical attack or property damage – especially external and concrete harm. Implications for practice, training and policy were discussed.