ColumnsTherapeutic Risk Management for Violence: Stratifying Risk and Characterizing ViolenceWORTZEL, HAL S. MD; BARNES, SEAN M. PhD; GERARD, GEORGIA LCSW; CLARK, KAILY PsyD; BORGES, LAUREN M. PhD; MCGARITY, SUZANNE PhD; NAZEM, SARRA PhD; BAHRAINI, NAZANIN H. PhD; MATARAZZO, BRIDGET B. PsyDAuthor Information WORTZEL: Michael K. Cooper Professor of Neurocognitive Disease, Director of Neuropsychiatry, and Associate Professor in Psychiatry and Neurology, and Faculty for the Forensic Psychiatry Fellowship at the University of Colorado, and Director of Neuropsychiatric Services for the Rocky Mountain Mental Illness Research, Education and Clinical Center (MIRECC) at the VA Rocky Mountain Regional Medical Center (RMRMC), Aurora, CO BARNES and BORGES: Clinical Research Psychologist, Rocky Mountain MIRECC, and Assistant Professor, Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO GERARD: LCSW with the Rocky Mountain MIRECC, Aurora, CO CLARK: Clinical and Research Psychologist with the Rocky Mountain MIRECC, Aurora, CO MCGARITY: Assistant Professor in the Department of Physical Medicine & Rehabilitation at the University of Colorado School of Medicine and staff psychologist at the Rocky Mountain MIRECC at the VA RMRMC, Aurora, CO NAZEM: Clinical Research Psychologist at the Rocky Mountain MIRECC, and an Associate Professor in Psychiatry and Physical Medicine and Rehabilitation, University of Colorado School of Medicine, Aurora, CO BAHRAINI: Associate Professor in Psychiatry, and Physical Medicine & Rehabilitation at the University of Colorado School of Medicine and Director of Education for the Rocky Mountain MIRECC at the VA RMRMC, Aurora, CO MATARAZZO: Director of Clinical Services for the Rocky Mountain MIRECC at the VA RMRMC, and Associate Professor in Psychiatry at the University of Colorado School of Medicine, Aurora, CO The authors declare no conflicts of interest. Please send correspondence to: Hal S. Wortzel, MD, Rocky Mountain MIRECC, Rocky Mountain Regional Medical Center, 1700 North Wheeling Street, Bldg G3, Room 185, Aurora, CO 80045 (e-mail: [email protected]). Journal of Psychiatric Practice: November 2020 - Volume 26 - Issue 6 - p 503-509 doi: 10.1097/PRA.0000000000000510 Buy Metrics Abstract Violence risk assessment is a requisite component of mental health treatment. Adhering to standards of care and ethical and legal requirements necessitates a cogent process for conducting, and then documenting, other-directed violence risk screening, assessment, and management. In this 5-part series, we describe a model for achieving therapeutic risk management of the potentially violent patient, with essential elements involving: clinical interview augmented by structured screening or assessment tools; risk stratification in terms of temporality and severity; chain analysis to intervene on the functions of violent ideation and behavior; and personalized safety plans to mitigate/manage risk. This third column in the series describes other-directed violence risk stratification in terms of both severity and temporality, as well an approach for characterizing (ie, predatory/planned or impulsive/reactive) the violence risk posed by an individual. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.