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October 1, 2002
Vol. 60
No. 2

The Shrink in the Classroom / Fighting School Violence

The Shrink in the Classroom / Fighting School Violence - thumbnail
Although educators and policymakers have been grappling with the issue of violence in schools for decades, a spate of horrific in-school homicides has catapulted violent behavior in schools to public attention. Educators, psychologists, psychiatrists, social workers, political scientists, anthropologists, and sociologists have all weighed in on the possible causes. Sifting through the theories can be overwhelming, and implementing effective violence prevention programs is often frustrating. No wonder, then, that teachers and administrators often feel defeated when they confront the dangerously aggressive behavior of some pupils.
Although school violence at any level is absolutely unacceptable, U.S. schools are not more dangerous now than in years past. In fact, school violence has significantly declined since 1993, according to the most recent report issued by the U.S. Department of Education (Twemlow, Fonagy, Sacco, O'Toole, & Vernberg, 2002). According to the report, the overall number of acts of violence, the instances of students bringing firearms to school, and students' tendency to join school-related gangs have all decreased. Students are at much greater risk of suffering from violence outside schools than from within schools. These findings are the direct result of concerted efforts at both national and local levels to decrease violence in school environments, and they remind us that attempts to curtail violence in educational settings can have a positive effect.
Nonetheless, many students and teachers continue to feel unsafe in their classrooms and hallways. The media sensation that follows massacres like the one at Columbine may obscure the everyday sense of threat and unease that continues to plague students in rural, suburban, and urban environments. Attempts to prevent and curtail violence must address all aspects of the problem.

Psychiatric Causes

Violent behavior and the intent to act violently are potential symptoms of numerous psychiatric disorders. Conduct Disorder, a state of persistent disregard for social conventions and rules and manifesting as criminal and antisocial behavior before the age of 18, is perhaps the most frequently mentioned diagnosis among violent youth. In addition, substance abuse and dependence can contribute substantially to violent acts, either by reducing inhibitions among otherwise nonviolent students or by creating a climate through drug transactions in which violence is central. More rarely, impulsive behavior found in conditions such as Attention Deficit Hyperactive Disorder can lead to violent outbursts. Bipolar Disorder among children and adolescents has attracted increasing attention during the past few years and has been implicated in rare but sometimes strikingly aggressive behavior. Finally, diagnoses such as Oppositional Defiant Disorder, Antisocial Personality Disorder, and a range of psychotic disorders have been associated with the development of violent behavior among youth.
The diagnosis of any of these conditions does not constitute a prediction of violent behavior. In fact, the psychiatric prediction of violence in any setting is difficult, and we should not make assumptions about any student without conducting a careful and thorough evaluation.

The Evaluation

The prediction and assessment of violent behavior or intent is at root a legal issue. Even to plan a violent act is, after all, criminal behavior. Most schools have a designated protocol for dealing with these unsettling issues. Although law enforcement and school personnel are almost always part of the evaluation teams, mental health clinicians usually play a crucial role in assessment and intervention.
Studies of violent behavior among children and adolescents have revealed a fairly consistent list of risk factors for aggressive acts. In addition to certain psychiatric diagnoses, characteristics such as low verbal IQ, immature moral reasoning, poor parental modeling, poor social skills, and lack of social supports have all been associated with the development of violent behavior in children. Studies examining characteristics particular to the school environment have found that a weakly structured school and a student's poor academic performance, low commitment to education, and, perhaps most important, poor attachment to the school are all strong indicators of potential violence. In addition, schools that tolerate physical and social aggression, especially when perpetrated by elite student groups within the school, are increasingly at risk for the outbreak of violence on or around school grounds.
These characteristics alone are not sufficient to predict the occurrence of violence. Clinicians and school officials must pay special attention to potential motives for and means of committing violence. They must be willing to discuss provocative and threatening journal writing and art projects with students and with designated school authorities who decide what actions to take to protect the student and the school.
Listening to students who express concern about another student's behavior is particularly important. Studies of extremely violent behavior in schools have found that those who commit high-profile acts of violence have almost always made their intentions known to peers through direct or indirect communications. Educators must foster a setting in which students are comfortable making their concerns known to teachers and peers.

School Intervention

Recent innovative approaches show promise for addressing violent behavior in schools. Multisystemic Treatment, which involves multiple and active interventions for young people who commit violence, has attracted increasing attention during the past decade. Unlike traditional models, where social service organizations and clinicians meet with young people in separate settings, Multisystemic Treatment involves direct intervention in the settings in which the child has encountered the most problems. Interventions encourage a more structured parenting style and communication and affection within the family; foster positive peer relations; and establish lines of communication between parents and teachers by using such programs as after-school activities to promote academic growth. Recent studies suggest that Multisystemic Treatment reduces violent behavior, decreases the costs of caring for potentially violent youth, and improves academic performance (Borduin, 1999).
Another promising approach provides a psychological paradigm for analyzing school environments (Twemlow, Fonagy, & Sacco, 2001). Using this model, students learn that acts of violence involve all members of the school community, who engage in an often covert power dynamic. In all violent and threatening acts, each member of the school community falls into one of three categories: bully, victim, or bystander. A bully may attack his or her victim while others watch or are tacitly aware of the attack. Among bystanders, some operate as “puppet masters,” somehow orchestrating and egging on the behavior, while others are more ambivalent. Studies of very violent behavior have shown that those who act as puppet masters play prominent roles in the promulgation of violence. Successful school interventions in pilot programs have involved active discussions and role-playing of violent and threatening encounters, with an emphasis on the role that all members of the community play. The use of this paradigm with peer and adult mentors who mediate disputes has also been helpful.
In general, interventions both to curb and to address student violence must be multifaceted. Serious psychiatric disorders indicate the need for counseling and possibly medication. The treatment plan must integrate legal considerations.
Schools are an important setting for addressing violent youth, and the extent to which students feel attached to their school has direct bearing on the likelihood of later and ongoing violence. Schools, therefore, are a necessary part of the complicated equation that will ultimately make learning and development safer and more rewarding for everyone.

Borduin, C. (1999). Multisystemic treatment of criminality and violence in adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 39(3), 242–249.

Twemlow, S. W., Fonagy, P., & Sacco, F. C. (2001). An innovative and psychodynamically influenced approach to reduce school violence. Journal of the American Academy of Child and Adolescent Psychiatry, 40(3), 377–379.

Twemlow, S. W., Fonagy, P., Sacco, F. C., O'Toole, M. E., & Vernberg, E. (2002). Premeditated mass shootings in schools: Threat assessment. Journal of the American Academy of Child and Adolescent Psychiatry, 41(4), 475–477.

Steven C. Schlozman has contributed to Educational Leadership.

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