title: Management of violent patients in a psychiatry walk-in clinic.
abstract: The authors discuss a systems approach for managing violent psychiatric outpatients. Multiple care-giving and brief, as needed visits within an outpatient walk-in clinic setting can provide empathic care for those violent patients who become too threatened by the intimacy of individual therapy, and who often reject treatment. The walk-in clinic can provide the violent patient and his therapist sufficient "distance" from each other, so that excessive transference and countertransference reactions--which can lead to acting out and violence--are diluted. Case vignettes illustrate how the walk-in clinic can treat violent patients falling under a variety of diagnoses, and prepare them for eventual acceptance of more traditional therapies. This approach may assist community clinics who are increasingly involved in the treatment of violent patients.
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000628:therapy; D001883:Borderline Personality Disorder / Q000628:therapy; D003130:Combat Disorders / Q000628:therapy; D003419:Crisis Intervention; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D009289:Narcissism; D010044:Outpatient Clinics, Hospital; D012563:Schizophrenia, Paranoid / Q000628:therapy; D012565:Schizophrenic Psychology; D014754:Violence