Detection, Disruption & Risk
Assessments of Insider /
Outsider Perpetrated Violence
COLORADO HEALTH CARE ASSOCIATED RISK
MANAGERS 2013 ANNUAL CONFERENCE
John Nicoletti, Ph.D., ABPP
Nicoletti-Flater Associates
303-989-1617
www.nicoletti-flater.com
Facebook: Nicoletti-Flater Associates
4/13/2015
© Nicoletti-Flater Associates
WHY COLORADO?
BASIC SAFETY CONSIDERATIONS IN
PREVENTING & DISRUPTING
A VOLATILE ATTACK



Development of a Centralized Data
Collection Point (VORTEX)
Target Hardening
Activation of Dynamic
Countermeasures
4/13/2015
© Nicoletti-Flater Associates
WHAT ARE THE CATEGORIES OF
RISKS?



A risk for Proactive Attack Behaviors
against people or property
A risk for Reactive Attack Behaviors
against people or property
A risk for behaviors that create Social
and Psychological Disruption
4/13/2015
© Nicoletti-Flater Associates
WHO ARE THE ATTACKERS?


Insider – Individuals who are on
your radar before they attack.
Outsider – Individuals who are
not on your radar before they
attack.
4/13/2015
© Nicoletti-Flater Associates
SPECIFICALLY, WHO ARE THE
INSIDERS AND OUTSIDERS?







Employees
Ex-Employees
Family Members
Ex-Family Members
Patients / Customers / Clients
Contractors
Others
4/13/2015
© Nicoletti-Flater Associates
WHAT DOES NOT WORK
IN CONDUCTING A
RISK ASSESSMENT?
4/13/2015
© Nicoletti-Flater Associates
FOCUSING ON WHO INSTEAD OF WHAT

What is a ‘who’?






4/13/2015
Mental Health Diagnosis (i.e., psychotic, bipolar,
etc.).
Ethnicity
Gender
Religious Affiliation
Political Affiliation
Other Affiliations (i.e., Greenpeace, Code Pink,
PEAT)
© Nicoletti-Flater Associates
Individuals with
Mental Illness
Attackers
4/13/2015
© Nicoletti-Flater Associates
DENIAL
4/13/2015
© Nicoletti-Flater Associates
RATIONALIZATION -- Inserting ‘JUST’
in the behavioral description
4/13/2015
© Nicoletti-Flater Associates
BELIEVING IN AN URBAN LEGEND
4/13/2015
© Nicoletti-Flater Associates
WHAT ARE THE TIME &
RESPONSIBILITY CONSIDERATIONS?




Pre-Event Threshold Actions – what you do
before the person gets on your radar.
Event Threshold – what you do when the
person gets on your radar.
Event Horizon – what you do when the
person attacks you.
Post-Event Horizon – what you do to try to
recover and live with what happened.
4/13/2015
© Nicoletti-Flater Associates
Pre-Event Threshold
Actions
4/13/2015
© Nicoletti-Flater Associates
IN DEALING WITH CURRENT
EMPLOYEES:



Document all behavioral actions
Provide employee ongoing
feedback
No surprises
4/13/2015
© Nicoletti-Flater Associates
If They Broadcast It –
Believe It!
4/13/2015
© Nicoletti-Flater Associates
Skip the “Tea Leaf”
Reading
If a coded behavior
occurs, go to a
countermeasure.
4/13/2015
© Nicoletti-Flater Associates
AREAS OF RESPONSIBILITIES
Employees – Detectors
 Supervisors/Managers – Detectors
& Disruptors
 Agency Response Team –
Disruptors

4/13/2015
© Nicoletti-Flater Associates
There are two timelines in
violence.
4/13/2015
© Nicoletti-Flater Associates
TWO KEY TIME CONSIDERATIONS

Event Threshold

Event Horizon
4/13/2015
© Nicoletti-Flater Associates
The probability of a violent
incident from an insider
should be low.
4/13/2015
© Nicoletti-Flater Associates
ALGORITHM ANALYSIS

35 Incidents Between 1/13/12 &
12/27/12




57% of the attackers were insiders
63% of the attackers broadcast a
perceived injustice
71% of the victims initially targeted were
the focus of the perceived injustice
74% of the attackers entered through the
main entrance
4/13/2015
© Nicoletti-Flater Associates
ALGORITHM ANALYSIS (con’t)






71% of the
49% of the
17% of the
34% of the
37% of the
minutes
63% of the
minutes
4/13/2015
attackers just walked in
attackers committed suicide
attackers were killed
attackers were arrested
attacks were over in under 5
attacks were over in under 15
© Nicoletti-Flater Associates
ALGORITHM ANALYSIS (con’t)
Location of the Attacks





51% of the attacks occurred in the workplace
17% of the attacks occurred in a school
17% of the attacks occurred in a public place
6% of the attacks occurred in a religious
establishment
9% of the attacks occurred either in the
victim’s or the offender’s residence
4/13/2015
© Nicoletti-Flater Associates
EVENT THRESHOLD ACTIONS
Identification of The Event
Threshold Behaviors
4/13/2015
© Nicoletti-Flater Associates
Avengers always have a
progression.
4/13/2015
© Nicoletti-Flater Associates
HOW DO YOU GO FROM POINT A TO
POINT Z?
4/13/2015
© Nicoletti-Flater Associates
HOW DO YOU GO FROM POINT A TO
POINT Z?
4/13/2015
© Nicoletti-Flater Associates
HOW DO YOU GO FROM POINT A TO
POINT Z?
4/13/2015
© Nicoletti-Flater Associates
HOW DO YOU GO FROM POINT A TO
POINT Z?
4/13/2015
© Nicoletti-Flater Associates
DEVELOPMENT OF AN AVENGER






Perceived Injustice
Feeling Victimized
Externalization of Responsibility
Development of a Grudge
Obsessed with Avenging
Avenging Action
4/13/2015
© Nicoletti-Flater Associates
Avengers always
broadcast ahead of time.
4/13/2015
© Nicoletti-Flater Associates
HOW DO THEY
BROADCAST IT?
4/13/2015
© Nicoletti-Flater Associates
HOW DO THEY BROADCAST IT?
Insiders broadcast directly to
their targets.
 Outsiders triangulate their
broadcasts.

4/13/2015
© Nicoletti-Flater Associates
4/13/2015
© Nicoletti-Flater Associates
4/13/2015
© Nicoletti-Flater Associates
4/13/2015
© Nicoletti-Flater Associates
BEHAVIORAL CODING OPTIONS:
• Normal Behaviors
• Boundary Probing Behaviors
• Attack Related Behaviors
• Attack Behaviors
4/13/2015
© Nicoletti-Flater Associates
NORMAL BEHAVIORS

Must be defined according to:





The specific environment
The individual
The event
In reality, “normal behaviors” refer to
behaviors that are accepted and
tolerated.
There cannot be any universal definition
of “normal behaviors.”
4/13/2015
© Nicoletti-Flater Associates
BOUNDARY PROBING


Involves pushing rules, regulations and
tolerance levels.
The purpose is to determine how much
he/she can get away with.
4/13/2015
© Nicoletti-Flater Associates
IMPORTANT ISSUE
If you allow a boundary
probe to occur without a
disrupter, then by default
that behavior becomes
normal.
4/13/2015
© Nicoletti-Flater Associates
ATTACK RELATED BEHAVIORS

Desensitization Behaviors (threat
making – direct, veiled,
conditional)



In Vivo
Virtual
Dehumanization Behaviors


4/13/2015
In Vivo
Virtual
© Nicoletti-Flater Associates
ATTACK RELATED BEHAVIORS



Skill Set Building
Development of an Armament
Inventory
Development of an Attack Plan
4/13/2015
© Nicoletti-Flater Associates
ATTACK RELATED BEHAVIORS

Threatening Verbalizations

Threatening Behaviors

Personal Space Violations
4/13/2015
© Nicoletti-Flater Associates
ATTACK BEHAVIORS
People
 Property

4/13/2015
© Nicoletti-Flater Associates
ACTIVATION OF
COUNTERMEASURES
Always Interrupt / Disrupt
the Behavior
4/13/2015
© Nicoletti-Flater Associates
BOUNDARY PROBING AND
ATTACK RELATED BEHAVIORS
INCREASE WHEN THERE ARE
NO TREES (DETERRENTS)
4/13/2015
© Nicoletti-Flater Associates
TREES CATEGORIES
(Disrupters)
CATEGORY I
QUESTIONING
CATEGORY II
CONFRONTING
CATEGORY III
CONSEQUENCES
4/13/2015
© Nicoletti-Flater Associates
INDIVIDUAL REACTIONS TO TREES
WHEN A TREE IS PLACED AFTER A
PRACTICE SESSION THE INDIVIDUAL
HAS A CHOICE TO EITHER
BACK OFF
OR
CLIMB OVER IT
4/13/2015
© Nicoletti-Flater Associates
PREDICTING FUTURE VIOLENCE
The best predictor of future
behavior is not past behavior
but post-intervention behavior.
4/13/2015
© Nicoletti-Flater Associates
INTERPRETING LACK OF
COMPLIANCE
If the concerning behaviors
continue after an intervention,
then two possible hypotheses
have been generated:
1.
2.
The individual is choosing to disregard rules
when it suits him/her.
The individual does not have the capacity to
control his/her actions.
4/13/2015
© Nicoletti-Flater Associates
IMPORTANT CONSIDERATION
Once an individual has engaged in an
attack-related behavior, he/she should
always remain on the radar detector,
even if the behavior appears to have
stabilized.
4/13/2015
© Nicoletti-Flater Associates
EVENT HORIZON
CONSIDERATIONS
4/13/2015
© Nicoletti-Flater Associates
Always Proactively Train
for an Event Horizon
4/13/2015
© Nicoletti-Flater Associates
RESPONSE STRATEGIES (Initiate At
The Event Horizon)


Activation of Delay Systems/Target
Hardening
Internal Notification




Hi-Tech
Hi-Touch
External Notification
Activation of Survival Strategies
4/13/2015
© Nicoletti-Flater Associates
STRATEGIC RESPONSES:
PERSONAL SURVIVAL STRATEGIES
WHEN VIOLENCE IS OCCURRING:
GET OUT
HIDE OUT – Saferoom/Concealment
FAKE OUT – Play Dead
TAKE OUT – Active Resistance
4/13/2015
© Nicoletti-Flater Associates
AFTERMATH
4/13/2015
© Nicoletti-Flater Associates
THERE WILL BE AN
AFTERMATH AND YOU
MUST DEAL WITH IT.
4/13/2015
© Nicoletti-Flater Associates
THE SIZE OF THE
PSYCHOLOGICAL
FOOTPRINT WILL EXCEED
THE SIZE OF THE
MEDICAL FOOTPRINT
© Nicoletti-Flater Associates
AFTERMATH ISSUES



Physical Clean Up
Psychological Clean Up
Business Reactivation
4/13/2015
© Nicoletti-Flater Associates