Using safety planning for aggressive behavior in youth: Applications to intensive treatment settings

Abstract

Aggression is an especially thorny symptom in the field of child mental health, cutting across a variety of psychiatric diagnoses and one of the most common reasons for referral for services. Associated with a variety of affects (anger, irritability, agitation, hostility), it is nonetheless poorly defined. Some writers distinguish “adaptive aggression” (benefit from an evolutionary standpoint) from “maladaptive aggression,” which is characteristic of those with psychiatric or neurological conditions. A discussion of the specifics of the concept is beyond the scope here, because ultimately it is the aggression that is fueled by angry affect that is the variety we are most often trying to manage in behavioral health settings and that contributes to extensive disruption in family, school, and community environments. Connor et al. (2019) call this variety impulsive aggression and define it as reactive and overt, and out of proportion to environmental precipitants. They also note that it is indicative of disorder severity. This is a useful description of the variety occurring most frequently in clinical contexts.