The Construction and Preliminary Validation of the Client Violence Questionnaire

Background and Purpose: Client violence is a problem that affects social workers at various types of workplaces (e.g., Ringstad. 2005; Macdonald & Sirotich , 2005), however, the measurement tools used to study such violence have suffered from methodological shortcomings, either by being developed for other types and contexts of violence, such as intimate violence (e.g., using a modified version of the CTS-2, Ringstad. 2005) or using instruments that are somewhat related but do not measure violence directly, such as The Confidence in Coping with Patient Aggression Instrument (Gately &.Stabb, 2005). Furthermore, whereas client violence has been studied to some extent over the world, and especially in the US, in Israel no such study has been reported over the last 20 years. The purpose of the current study was to systematically develop a measurement instrument that will be based on the actual workplace experience of social workers in Israel, thus carrying relevance and accurately representing the major forms such violence may take.

Methods: The development of the Client Violence Questionnaire was carried out in 3 stages. In the first stage, 38 social workers from various municipal social services in northern and central Israel, who experienced client violence over the last year were purposefully selected and interviewed using an in-depth qualitative interview, probing for various experiences of client violence directed at them over the last year, the different forms violence has taken, their experiences, thoughts, expectations, and the interaction that took place between them and the violent client. In the second stage, the interviews were transcribed and content-analyzed. For the purpose of developing the measurement, the descriptions of the incidents of violence were thematically analyzed, yielding four distinct forms of violence used against social workers: Verbal aggression, threats, aggression towards property, and physical violence. In the third stage, based on the contents of the interviews, 32 items, describing specific behaviors, were developed, representing the four different content areas identified earlier. Those items were scored in terms of relevance and uni-dimensionality by a group of 10 expert judges, retaining the 12 most relevant items. The overall inter-rater reliability for the final scale was 0.86, and the average score of relevance was 6.2 on a 1-7 Likert-like scale.

Conclusions and Implications: Violence against social workers has plagued the profession in Israel from its inception. However, over the years no systematic attempts have been carried in order to understand the phenomena and fight it. One of the hindrances to the conduct of systematic studies is the lack of a relevant and appropriate measurement tool. The current study is a first step towards this purpose.