Youth violence: assessment and treatment planning in primary practice.

High-profile and tragic massmurder events committed by teens periodically push youth violence into the national spotlight. Although the high-profile events are uncommon, homicide is still a leading cause of death among youth ages 10 to 24 years in the United States, and 10% of all serious violent crimes do involve a juvenile offender.1,2 With regard to any homicide, and especially those committed by youths or with youths as victims, we are left wondering if there are ways to prevent these horrible acts. Due to enhanced awareness of youth violence, primary care providers may be asked to predict violence potential or to recommend treatments to reduce future violence risks. This article provides the primary care provider with strategies to assess youth violence, understand its causes, and manage at-risk youth. Because performing a violence risk assessment can feel overwhelming and can entail inconsistencies and biases,3 this article also attempts to demonstrate a relatively systematic approach for clinicians. TYPES OF VIOLENCE One way to characterize violence is to think of the “hot or cold” analogy. “Cold” violence would be premeditated or planned and is often predatory or related to conduct disorder. “Hot” violence would be impulsive rather than premeditated and is often situational or relationship-driven. BeYouth Violence: Assessment and Treatment Planning in Primary Practice