In community based mental health workers, does an open-label four session communication skills programme change the rate of client or patient aggression experienced by the health care workers?"

Four one hour, weekly group sessions providing education communication skills. These sessions are completely scripted. All demonstrations will be filmed and available on DVD. For the purposes of this trial, the intervention will be delivered by CG and NS (psychiatrist and psychologist). However, the intervention is designed to be delivered by lay people. The sessions will be delivered over a period of four weeks. Session one: basic skills. You are seen as a professional member of team. Appearance (Neat, clean). Avoid distractions (gum, texting, phone calls to voice message). Non verbal: pleasant, smiling, appropriate variation. Gaining a working relationship. Follow their interests. Task listening neutral topics. Describing tasks – what I'm going to do, where I am. Gaining agreement from client it is “OK” to do this. Session two: Self care. Working with people with disabilities can be stressful. Difference between friendship and caregiving. Need to always consider clients best interests. No exploitation Keeping conversations secret. Not gossiping. When to break secrecy (around risks). Keeping your family life secret. Dealing with emotions. Talking to supervisor or in supervision group. Sleep, diet, exercise Relaxation. – session finishes with practising relaxation. Session three: Difficulties with working. Caregiving can require we say “no” or do things that are quite private. Dealing with intimate tasks. Reinforce need to describe and get agreement. Respectful, friendly, non judgemental. “Let's get this right” Exposure, privacy. Task – practising agreement to clean hands. Saying “no”. Specific issue. How it affects me and how it affects client. Getting agreement forward. Session four – warnings things will go wrong. You can't help anyone if you are not safe yourself. Reading non verbal clues discomfort. Reacting... verbally and non verbally. Agitation – talking down. When to leave, Who to call.