Although rewarding, working in the health and social services can be very demanding, often dangerous.

Whether you work in child protection, nursing, residential care, GP services, outreach youth work, substance misuse services, mental health services, and so on, the personal and professional risks are similar.

Statistics on violence against social service and health staff are not collated nationally in the UK and since most violent crimes against health and social care workers go unreported it is difficult to get a true measure of the problem.

What we do know is that public sector employees face all kinds of danger almost every day of their working lives and sometimes that danger is life threatening. In fact, according to the British Crime Survey for 2003-2005 health and social care professionals have the fifth most dangerous occupations in the UK.

When you choose to make a career in the social and health services you accept that you will be working with the most vulnerable, at times most unpredictable, of service users. Working in high risk situations is indeed part and parcel of the job, a view shared by the British Association of Social Workers and the Social Care Association.

Risk is inherent in the work and to manage this employers often emphasise prevention and de-escalation methods and techniques alongside associated policies and procedures covering issues such as violence to staff and lone working.

However there are some situations that arise which are not covered in the training manual. These are the situations when workers come face to face with service users behaving in such a way that violence feels inevitable. They are the most critical, and sometimes fatal.

When policies and procedures seem inadequate, when the mobile phone and safety equipment have little use, when help is not immediately available and when the situation has gone beyond the normal safe practice approaches, what then?

Facing “rage” from another person or group is a very traumatic experience, and the feelings of helplessness can be overwhelming.

Normal violence and aggression courses do not adequately prepare people for dealing with behaviour that has gone beyond reason, to cope with the emerging fear whilst at the same time thinking through how best to respond.

It is these training deficits that Dr Iain Bourne’s uniquely theatrical Violence: Difficult Disturbing, Dangerous Behaviour Course addresses

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"This course is excellent. If only more were so engaging and interesting. It provides a strategy for dealing with extreme situations and gives confidence to handle these. We raved about it at work.

I would recommend it "

DB, Fife Council (April 08)