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Preventing workplace violence: every year, an estimated 1.7 million American workers become victims of workplace violence. More than 600 are murdered while on duty. EAPs can be crucial components of efforts aimed at reducing the impact of violence in the workplace.

According to the Labor Department's Census of Fatal Occupational Injuries, (1) homicide is the third leading cause of occupational death for all workers, exceeded only by motor vehicle incidents and falls. The vast majority of these homicides, approximately 75 percent, occur during a robbery or other crime.

For women, domestic violence often plays a role in occupational fatalities. While only 4 percent of all homicides were committed by a relative or other personal acquaintance of the victim in 2002, 16 percent of the homicides of women in the workplace were committed by current or former husbands or boyfriends.

Unfortunately, homicides are only the tip of the much larger iceberg of workplace violence. Roughly 1.7 million U.S. workers are victimized by workplace violence each year, a rate of 13 incidents for every 1,000 employees based on data collected during the period 1993-1999. (2)

Employers' costs stemming from incidents of workplace violence can be staggering. While precise data are not available, the average cost per workplace homicide during the 10-year period 1992-2001 was $836,533. (3) Additional costs can be attributed to items such as decreased employee morale and post-traumatic stress counseling. The National Violence Against Women Survey (4) found that a physical assault by an intimate partner or ex-partner resulted in an average of seven days of work lost for the victim in 1995. In addition, there are often legal implications for failing to provide a safe workplace and for negligent hiring, firing, and retention.

To help address the complexity of workplace violence, a typology has been developed to help categorize incidents into a useful framework. Originally developed by the California Occupational Safety and Health Administration in 1996 (5) and refined by the University of Iowa in 2001, (6) these categories help employers, researchers, counselors, and worker advocates clearly discuss workplace violence in attempts to better understand its causes. The four categories are:

* Criminal intent, where the perpetrator has no legitimate business relationship with the establishment (the primary motive traditionally has been theft, but terrorism has gained increased attention in recent years);

* Customer/client, where the perpetrator has a legitimate relationship with the establishment but becomes violent during the course of a normal business transaction, such as in the healthcare, education, and law enforcement industries;

* Worker on worker, where the perpetrator is a current or former employee of the business and attacks a current worker; and

* Domestic violence in the workplace, where the perpetrator has no legitimate business with the establishment but has a personal relationship with the victim (women are targeted more often than men, but all workers, male and female, can be affected).

Understanding the different sources of workplace violence and addressing the causes within this context will help workplace violence prevention teams develop policies and interventions tailored toward an individual company's needs. Employee assistance professionals are vital components of such teams. They are the work organization's experts on the human component of analysis and planning and have well-established competencies in key program functions, including organizational consultation, education, and evaluation. Their skills and expertise, along with those of human resources and employee relations professionals and security and safety/health officials, help form the comprehensive approach necessary for preventing violence in the workplace.


Comprehensive workplace violence prevention programs approach Violence from three perspectives: identifying risk factors, preventively managing risk factors, and planning an effective response if a threat or Violent act should occur. The EAP's role in responding to workplace violence incidents is now widely acknowledged. Most organizations realize the EAP plays a key role in assessing the needs of those affected by Violence, providing emotional first aid and referring individuals who need additional help to other professional and community resources. However, the EA professional's potential for contributing to risk identification and management is not always as well understood.

The EA professional's role in workplace violence prevention flows particularly from one of the key EAP direct services defined in the FAP Standards and Guidelines for Employee Assistance Programs. (7) That direct service is organizational consultation. According to the Standards and Guidelines, "The employee assistance program shall provide consultation to the organization regarding issues, policies, practices and events that may impact employee well-being ... The intent of this standard is to ensure the EAP functions as an integral part of the organization and adds its unique contributions to the realization of the organization's mission and goals." (19-20).

Clearly, according to these standards, the EAP should add its expertise to identifying risk factors and planning for an emergency response. In addition, two other direct EAP services, education and evaluation, provide the EA professional with skills and knowledge that can also be invaluable in a workplace violence prevention program.

We do not advocate that the EAP house the organization's workplace violence program or keep its records. Structurally, the EA professional may be designated a member of an interdisciplinary team to plan an organization's workplace violence program; in other situations, the EA professional may prefer to maintain a certain distance from the team by being designated a consultant rather than a member. The precise structure is less important than the care that must be taken to ensure that the ethics and professional practices of the EAP and all other professionals involved are respected and built into the team's functioning.


The first step in developing a workplace violence prevention program is to evaluate the risk factors at the worksite and determine the organization's ability to address the situations related to those risk factors. One of the most effective methods of assessing the potential for workplace violence is to develop a system for documenting violent incidents. Implementing a mandatory reporting system to monitor violence within the workplace will allow for the collection of data that can evaluate the presence of risk factors and serve to develop a targeted intervention strategy.

Violence prevention teams often solicit employee input into the threat identification process through questionnaires, focus groups, or other data collection techniques. This practice is helpful at many levels. First, it can alert the team to risk factors they have missed and confirm their judgment about those they have identified. It also sends a message to employees that the organization cares about them and opens the way to additional dialogue in the future.

Research has documented a number of potential risk factors that may increase a worker's risk for assault and/or injury, and the nature and function of the work organization will determine which factors apply to a particular setting (see Figure 1). The EA professional can contribute in several ways to the collection of data and assessment of these risks.


Risk Factors for Workplace Violence

* Contact with the public

* Exchange of money

* Delivery of passengers, goods, or services

* Mobile workplaces, such as a taxicab, police cruiser, or pizza or other delivery

* Working with unstable or volatile persons, such as in healthcare or criminal justice settings

* Working alone or in small numbers

* Working late-night or early-morning hours

* Working in high-crime areas

* Guarding valuable property

* Working in community-based settings

Because of their educational and professional backgrounds, EA professionals can help raise awareness of various risk factors. For example, team members may believe the organization has no problem with intimate partner violence because they aren't aware of specific cases. All organizations face this risk, particularly if they hire women, but victims are often reluctant to come forward for reasons ranging from embarrassment to fear of losing their jobs. The EA professional can emphasize the need to have organizational strategies to encourage victims to come forward and help the organization recognize this as a marker of improvement in the workplace violence prevention program.

Because EA professionals help employees resolve work-related problems and consult with supervisors about management issues, they may be aware of situations that employees find frightening or otherwise stressful. Employees may, for example, fear certain customers of the organization, or they may work in a high-crime area with poor lighting. Without violating the confidentiality of individuals, EA professionals can call such issues to the attention of the workplace violence prevention team.

From patterns of EAP utilization, the EA professional may discern that some areas of the organization produce an unusually high number of cases involving heavy work stress, conflicts in the workplace, poor relationships between employees and supervisors, or other signs of systemic organizational problems. While most employees handle these stresses without resorting to violent behavior, the stress factors may nevertheless increase an organization's potential for violence between employees.

If an EA professional knows of a problem that is limited to one or a few workers, it may be difficult or impossible to raise the issue without potentially violating these clients' confidentiality. In some cases, clients may choose to give written consent for a discussion of their concerns by the team; in other cases, the EA professional may only be able to speak in broad generalities to effectively maintain the trust of both managers and employees.

The EA professional often will emerge as the team member who can best facilitate discussion when other team members find themselves misunderstanding one another. One strategy for fostering understanding among members of an interdisciplinary team is to conduct tabletop exercises with hypothetical cases. A set of case studies for this purpose is available in the Office of Personnel Management's Dealing with Workplace Violence: A Guide for Agency Planners, available on the Web at (8) By reviewing these studies early in the planning process and asking whether such scenarios could occur in their workplace, team members can use the cases as part of the risk assessment process while also becoming acquainted with colleagues' ethical concerns, ways of approaching problems, and use of technical language.


The second step in building a workplace violence prevention program is to develop a strategy that addresses the risk factors identified in the risk assessment and incorporates response vulnerabilities. Three general approaches focus on the elimination or modification of identified risk factors:

* Environmental designs refer to physical security measures and engineering controls to deter potential perpetrators (Figure 2);

* Administrative controls are aimed at developing secure workplaces through the use of safety programs, policies, and business procedures (Figure 3); and

* Behavioral strategies represent training methods used to help employers and employees anticipate, recognize, and respond to potential violence in their workplaces (Figure 4).


Environmental Designs to Address Risk Factors

* Procedures for handling cash, such as locked drop safes and limits on available cash

* Cashless transactions, including the use of ATM account cards and/or debit cards

* Physically separating workers from the general public or clients through the use of bullet-resistant glass (as in some banks), higher and deeper counters, and other design changes

* Lighting for better visibility

* Security devices such as cameras, alarms, card-key access systems, and geographic locating devices

* Personal protective equipment such as bulletproof vests

* Hiring security firms that specialize in preventing workplace violence


Administrative Controls to Address Risk Factors

* Clear policies regarding workplace violence prevention

* Adequate staff-to-client ratio

* Security guards/receptionists to control access to work areas

* Clear procedures for reporting violent incidents

* Threat management procedures


Behavioral Strategies to Address Risk Factors

* Training in customer service and related issues

* Training in de-escalation techniques, especially in healthcare and other settings where conflict may reasonably be anticipated

* Training in non-violent response, especially in robberies and other crime situations

EA professionals can play multiple roles in the development of environmental designs, administrative controls, and behavioral approaches to prevent workplace violence. When environmental and administrative strategies are being considered, the EA professional can provide a human factors perspective. Will these strategies make an employee feel isolated or claustrophobic? Will an employee be able to communicate adequately with customers? Will the changes affect how customers perceive the organization?

When behavioral prevention strategies are being developed, the EA professional may serve as a trainer or a purveyor of external training services as well as a consultant. Topics such as dealing with difficult customers, de-escalating tense situations, and resolving conflicts are familiar to most EAPs, and the EA professional can best ensure that training is delivered effectively.

Much of the everyday work of an EAP contributes to violence prevention. An EAP's overarching goal is a healthy and productive workplace, which is itself a preventive factor in many ways. In a healthy organization, employees feel challenged hut not overwhelmed, trust their leaders, believe in the organization's mission, and see themselves as part of a team. The EA professional contributes to this goal through consultation, teaching, and supervisory and individual assistance. Whether the subject of a training or discussion is resolving conflicts or managing change, it nevertheless contributes to the overall workplace violence prevention mission.


Ideally, all intervention programs should have methods of evaluation to determine their effectiveness. The efficacy and usefulness of workplace violence prevention programs can be determined by collecting data on employee awareness and safety. Because EAPs are charged with evaluating their own programs, EA professionals bring to the table considerable experience in how to design an evaluation process.

Maintenance of existing, effective programs is critical. Some workplace violence prevention plans may require EA professionals to conduct "refresher trainings" periodically to maintain high levels of awareness and safety among employees. In addition, because the nature and function of many businesses will change over time in response to the economy and competitive environment, new risk factors may arise during periods of transition. EA professionals may be instrumental in identifying these new risk factors through continual risk assessment, as discussed earlier.

Numerous resources exist for EA professionals to gather information about workplace violence and related prevention issues. Current statistics, recommendations, and guidelines are available on the Web sites in Figure 5. In addition, other organizations can provide different perspectives on the nature of workplace violence and offer solutions applicable to the EAP's clients.


Workplace Violence Prevention Resources

* National Institute for Occupational Safety and Health

* U.S. Office of Personnel Management

* National Center for Injury Prevention and Control

* Occupational Safety and Health Administration

* Bureau of Labor Statistics

* National Safety Council

* American Society of Safety Engineers

* International Labour Organization

* World Health Organization

While a worksite may never have to deal with a violent incident, proper advance planning can not only reduce employee stress and grief but maybe even save a life. Prevention is the best preparation. The roles EAPs play in prevention efforts are essential to reducing the burden that workplace violence imposes on workers and employers.


(1) Bureau of Labor Statistics. 2002. National Census of Fatal Occupational Injuries, 1993-2002. Washington, D.C.: U.S. Department of Labor.

(2) Bureau of Justice Statistics. 2001. Violence in the Workplace, 1993-1999. Washington, D.C.: U.5. Department of Justice, NCJ 190076.

(3) Biddle, E., et al. 2004. "Societal Costs of Workplace Homicides in the United States, 1992-2001." Submitted to the American Journal of Industrial Medicine.

(4) National Center for Injury Prevention and Control. 2003. Costs of Intimate Partner Violence Against Women in the United States. Atlanta, Ga.: Centers for Disease Control and Prevention.

(5) Barish, R. 2001. "Legislation and Regulations Addressing Workplace Violence in the United States and British Columbia." American Journal of Preventive Medicine (20): 149-154.

(6) University of Iowa. 2001. Workplace Violence: A Report to the Nation. Waterloo, Iowa: Injury Prevention Research Center.

(7) Employee Assistance Professionals Association. 1999. Standards and Professional Guidelines for Employee Assistance Programs. Arlington, Va.: Employee Assistance Professionals Association.

(8) U.S. Office of Personnel Management. 1998. Dealing with Workplace Violence: A Guide jot Agency Planners. Washington, D.C.: U.S. Office of Personnel Management, OWR-09.

Kristi Anderson is an epidemiologist and Lynn Jenkins was chief of the Analysis and Field Evaluations Branch in the Division of Safety Research of the National Institute for Occupational Safety and Health (NIOSH). Mary Tyler is a psychologist in the Office of Personnel Management, the human resources arm of the U.S. government.
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Article Details
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Author:Jenkins, E. Lynn
Publication:The Journal of Employee Assistance
Geographic Code:1USA
Date:Dec 1, 2004
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