Effects of a Violence Prevention Intervention Therapeutic Meeting With Aggression in Forensic Psychiatric Inpatient Care: Protocol for an Observational Study.

Background: Aggression and violence are prevalent in forensic psychiatric inpatient care. These behaviors significantly impact treatment outcomes, create challenging work environments for staff, and strain relationships between patients and caregivers. Managing such behaviors poses a formidable challenge that necessitates innovative approaches and evidence-based interventions. The Therapeutic Meeting with Aggression (TERMA) model is a staff training program designed to equip staff with strategies to de-escalate patient aggression, thus reducing violence and increasing patients' and staffs' perceived safety.

Objective: The aim of this project is to evaluate the violence prevention model TERMA regarding perceived safety by patients and staff and adverse events within forensic psychiatric inpatient care. In addition, the project will investigate whether the organizational culture affects the implementation of the TERMA model.

Methods: The project includes an observational study with a before and after design. Implementation of the TERMA model consists of an 8-seminar staff training program. Data sources include questionnaires, medical records, and registries. Quantitative data will be analyzed using descriptive and comparative statistics. To analyze changes between measurements, dependent sample 2-tailed t tests will be used for normally distributed data, and the Wilcoxon signed-rank test will be applied when normality is not met. The project will also include qualitative interview studies, which are planned to be analyzed using qualitative inductive content analysis.

Results: Participant enrollment began in July 2023 and was concluded by the end of 2024. Data collection and analysis of quantitative data are expected to be completed by early 2026, after which the study findings will be submitted for publication in peer-reviewed scientific journals. Collection of qualitative data is scheduled for the second half of 2025 and 2026.

Conclusions: This study can add valuable knowledge about the effects of the violence prevention model TERMA.