Staff's perception of adolescent aggressive behaviour in four European forensic units: A qualitative interview study

Background: Aggressive behaviour among patients is extremely common in forensic adolescent psychiatry compromising the safety of the treatment milieu and posing a treatment challenge to the staff. The staff's perception of aggression is likely to contribute to the aggression management practices among disturbed adolescents. Aims: To examine staff's perceptions of adolescent aggressive behaviour and factors contributing it. Methods: Qualitative interviews were conducted in four adolescent forensic units in four European countries. Data was analysed using qualitative content analysis. Findings: Aggressive behaviour was perceived to be verbal and physical in nature with various levels of severity. Several factors were perceived to contribute to aggressive acts, including adolescents' early life experiences. Participants mainly shared perceptions of adolescent aggressive behaviour in the four units studied. Conclusions: The study provides new international knowledge about how staff perceive adolescent aggressive behaviour in the forensic setting. The shared understanding of adolescents' aggressive behaviour enables the implementation of safe, ethically sound and more consistent aggression management in clinical forensic practice. Reduced occurrence of aggression may improve the therapeutic milieu of the unit and may strengthen the staff's occupational health.