ABSTRACT
This chapter reviews some of the factors that are commonly accepted to have some predictive value in violent acts, many of which are well rehearsed in the literature, and to understand them in the context of the patient's history and the clinical presentation, through both conscious and unconscious communication. Risk is often described in terms of an event outcome, such as the likelihood of a violent act, but there are numerous risk-influencing decisions that need to be taken by the clinician before this end point. The chapter addresses the issue of containment, both for individual clinicians and for organizations. The clinical approach, on the other hand, is seen as informal and not amenable to quantitative assessment, and it leaves the power with the clinicians. The truism "the best predictor of the future is the past" clearly has some basis in clinical reality. It also has a strong basis in a formal or informal actuarial approach.
