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Active Assailant Strategies Using Vehicles

April 24th, 2017 Comments off

truck

Active shooter and lethal assailant strategies are becoming the next possible trend in favored terrorist tactics against soft target locations. The horrific attack last year along the beachfront in Nice, France at the Bastille Day celebratory fireworks that killed 84 and wounded dozens more has provided a demonstration of an easy means of lethal attack to others. Smaller scale but similar attacks have now happened on a college campus at Ohio State and most recently in London. I think this is just the beginning of a new trend for mass killing with a tool that is readily available to anyone – a vehicle. The initial reports on the incident in Nice stating that is was a ‘lone wolf’ scenario were not accurate. It was well planned and premeditated as cell phone records, computer data, and other intelligence sources indicated. Multiple suspects were arrested, suspected of being accomplices in the planning stages. The scariest dynamic of this incident and the others that have followed, however, is the sheer simplicity of the weapon of choice. Yes, the Nice attacker Mohamed Bouhlel did have a firearm, but that was not the primary killing instrument used. A heavily loaded truck can be quite a destructive force. A very disturbing precedent has been set, and it is being copied on perhaps a smaller scale with normal sized vehicles.

Besides guns and IEDs, we now have to worry about vehicular attacks at places where people gather. Make no mistake; the effectiveness and ease of these attacks will inspire others with evil intentions without the means to acquire guns or explosives. This attack method brings into question how to secure large gatherings of people for holiday and sporting events, outdoor public celebrations, or even large lines of people waiting to enter crowded venues. The list is endless and presents a security challenge that is not easily met. The permanent types of vehicular barriers (bollards, heavy planters, and rising wedge/delta type barriers) typically seen around buildings to stop onrushing vehicles are great, and that may have to become more of the norm in security-conscious construction. However, what can be done about temporary gatherings or conditions that would present the same vulnerability? The temporary tools that come to mind are:

  • The moveable jersey barriers that are used in highway construction projects and Embassy complexes around the world (multiple layers of them would have to be used to stop a large truck)
  • Arranging large parked trucks for protection
  • Devices to destroy tires of any on-rushing vehicles – outside of the barriers
  • Roadblocks surrounding an event and concentric perimeter zones checking credentials and each visitors’ purpose
  • Closing off roads surrounding an event. (if the scale of the event warrants)

None of these are guarantees, but if used creatively and perhaps in layers or combinations they might afford some protection, if not a deterrent. Then there will always be the question about cost and ‘do we really need this’ type of thinking. This will haunt security professionals for quite some time. For example, what will become the standard for large sports venues regarding this type of threat as the crowds gather for entry? I think about it when I am standing in those lines with my family. I wish I had more answers. Tactics will always change, and we will have to be innovative enough to react accordingly and even try to foresee what we really don’t want to.

For more information about our consulting services – check out our website at www.afimacglobal.com.

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Active Shooter Attacks – Universities are Soft Targets

February 15th, 2017 Comments off

Historically, active shooter assaults have been driven by motivations of revenge, jealousy, fear or anger. Some have involved domestic relationships that have gone wrong resulting in violent events in the workplace. Many have been a result of disgruntled employees reaching an irrational point of frustration or former employees not being able to get past being terminated. However, now, on the heels of the Paris and Nice attacks in France, the Pulse nightclub in Orlando, and the Ohio State University attack last year, we should ask another question. Will this type of orchestrated active shooter/deadly assault on ‘soft targets’ continue in our communities, and more specifically on college campuses? In my opinion – this is very likely.

Symbolic government, business, and public infrastructure targets have taken steps to increase security and think about terrorist threat preparation and monitoring. This is great and needs to continue but what about easier targets of equal value in the eyes of attackers. Often these attackers just want to lash out at the perceived evil of western society and what better place to do so than where young people are being educated during a very impressionable period in their lives. Whether religiously motivated, or anti-capitalist motivated, there does not seem to be a lack of terrorist groups, or radicalized individual supporters, that want to attack our way of living and believing. College campuses offer open environments, events with large crowds, and masses of students out on the grounds between classes, with security or campus police departments often being understaffed. Universities and colleges are easy targets that would warrant a significant amount of media attention. No one wants to think about this but we must.

For another perspective on this topic, check out the article in this link:

graphWhy Do Terrorists Target Colleges and Universities?

 

 

An attack at a college or university will be difficult to stop and very effective if not planned for, both regarding anticipated emergency response and tapping resources for preventive intelligence gathering. Social media is often used for communication and planning by those who set out to conduct such attacks, so we need to be paying attention and use the expertise available to monitor and analyze such data. Social media is probably a college student’s most frequently used communication channel, and they are very free with what they post – good or bad.

There has already been some success using proactive intelligence for prevention purposes. However, we need to open the door a little wider. It is one of our better defenses, along with having a solid response plan. Colleges and universities should have people dedicated to social media monitoring through geofencing around campuses. This may be a topic I will expand upon in the future.

Develop an active shooter response plan for your facility or campus! Check out our website for assistance at www.afimacglobal.com

 

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The Role Unarmed Security Officers Can Play in Response to Active Shooter Attacks

January 23rd, 2017 Comments off

I write pretty frequently about workplace violence preparedness and response, and specific response guidelines for active shooter situations. Most of the training that addresses this topic centers on immediate notification procedures, occupant reaction guidelines, evacuation recommendations, and assisting armed police who come to deal with the assailant. There is often an assumption that unarmed security officers are incapable of doing anything to help in the response plan because they cannot neutralize the attacker without being armed. While it is true we should not expect them to put themselves in harm’s way to seek out and attempt to stop the assailant; there are in fact many functions that the unarmed security officer can perform just before, or after, they evacuate themselves.

In a proactive/preventive vein, they can remain diligent in their daily post observations and be alert for security breaches and any red flag behavior that might indicate an internal problem with a particular individual. Just reporting an observation of out of character behavior, or overly aggressive exchanges with others could be enough to start the preliminary investigative effort, which might uncover a more serious problem brewing. Often they get to know the employees well enough to notice behavioral indicators, and usually have a keener eye for such behaviors than do co-workers who might not notice, or might not want to report it if they do.

In the active shooter response plan, there is a lot more that they can and should be expected, and depended upon, to do.  They are typically going to be one of the first ones to receive the panicked call from an employee/witness that an armed assault has occurred. They then are going to have to begin the entire notification chain that launches the specific response/evacuation plan. They will have to be trained to handle this responsibility correctly, and quickly because seconds matter once this lethal event begins. They are going to have to know the entire response plan and everyone’s role in it. They are likely going to become a conduit of communication between facility management and the responding police throughout the duration of the incident. This will eventually be from the designated Emergency Communications Center (established in any response plan). Once primary notification responsibilities have been satisfied, and the evacuation has begun, the unarmed officers should evacuate along with everyone else, but they will have other duties related to the evacuation and assisting with the police response. These duties could include any of the following:

  • Report to designated locations to assist the first police officers on the scene with gaining access into the building if it is typically secured with badge access
  • Assisting for a limited time with those evacuating
  • Reporting to the designated Emergency Communications Center to help with:
    • Monitoring of incoming phone calls related to the incident
    • CCTV monitoring to see if they can spot the location or progress of the shooter
    • Being a communication liaison with the responding police
  • Assisting with treatment of the wounded who have been able to make it out of the facility but still need first aid treatment until professional/public EMS arrives
  • Helping with the accountability of employees who have evacuated the building
  • Staffing evacuation assembly points (if they have been designated in the response plan)
  • Keeping others from entering or re-entering the facility

These are just some of the duties that these officers can be assisting with so that the armed police can focus on the difficult task of searching for, and neutralizing the assailant(s).

For more information, see How Unarmed Security Officers Can Respond to Active Killer Situations
What you can do for your organization’s security personnel is train them in understanding, accepting and performing these roles, within your active shooter response plan. Make sure they realize that they play a significant role in it! For further information on Active Shooter Response Planning, check out our website for assistance at www.afimacglobal.com.

 

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Active Shooter – Recognizing the Signs

October 18th, 2016 Comments off

With the volume of workplace shootings that continue in our businesses and schools, it is nice to hear a true success story.

photo

Armed Student Talked Out of School Shooting by Counselor
The student reportedly had a list of teachers and a police officer at the school he was going to shoot.

There has been a much-needed public outcry about what can be done to stop such senseless violence. The above link provides a story of courage and demonstrates the result of non-violent confrontation management training that clearly prepared this school counselor to react and diffuse/de-escalate the situation. It also underscores the importance of inter-office discrete communication during emergency conditions so that law enforcement responders can be alerted. Employers with staff such as counselors, social workers, customer service reps, and other similar positions could be exposed to similar conditions and should take a lesson from this incident. They need to evaluate what training they offer these people and if it prepares them for such a situation.

As with other forms of workplace or criminal violence, there is no one magic solution to preventing an active shooter incident. That is why I have called this society’s challenge in the past. What causes a person to become an active shooter and indiscriminately take the lives of random innocent targets? Is the solution more gun control? Is it better cooperation between the mental health community and law enforcement to spot potential threats?  Is it more censoring and regulation of the video game industry? Does home/family values need realignment?

I believe the premise for reducing these occurrences involves significant progress in all of these areas.

  • The gun control debate has to find an actionable middle ground. Gun enthusiast organizations would have everyone possess high capacity automatic assault weapons standing on the second amendment right to bear arms. Meanwhile, liberal, anti-gun proponents would take guns of any type away from everyone. Does the average civilian need a fully or semi-automatic high capacity weapon(s) for self-defense? No, but citizens should be able to purchase and license a handgun or shotgun for personal or home defense with adequate and required annual training and shooting practice. Politically, we have to find a happy medium on this issue.
  • Does the mental health care profession owe it to their communities to work with law enforcement when a patient’s behavior displays an apparent propensity towards violence? Yes, and they should be legally allowed to get the police involved in whatever capacity will have some dissuasive effect on the person. At least the police could begin a case file and start having a conversation with the individual.
  • Does the video game industry need to take a careful look at themselves and perhaps have stricter regulations regarding the production and release of video games in which killing and extreme violence is rewarded? Yes. I know it is a game, but it contributes to the devaluing of life, the de-sensitization of violence and death, and the blurring of the lines between lawful social conduct and fantasy.
  • Home and family values. The old fashioned way of learning right from wrong. Do we remember what they even are? Technology is wonderful and powerful. Until children totally lose the social skills to talk to each other in order to work out problems. Misguided children become adults with adult problems. Lacking coping skills anchored in values, they look for someone to ‘text an answer to them’, or they escape to act out fantasy solutions, like in the games they

We do these horrible things to each other. We can do better than this. Even if we have just one small conversation, one small compromise, one small act of tolerance, kindness, or understanding at a time.

Check out AFIMAC’s active shooter video at www.imac-training.com. It offers some real world active shooter survival tips for individuals and solid workplace violence incident planning advice for organizations.

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Nice, France Attack: A new security challenge

July 25th, 2016 Comments off

In last month’s blog, I wrote about active shooter strategies being the next possible trend in favored terrorist tactics against soft target locations. The horrific attack along the beachfront in Nice, France at the Bastille Day celebratory fireworks that killed 84 and wounded dozens more has been more thoroughly investigated. The initial reports of this being a ‘lone wolf’ scenario were not accurate. It was well planned and premeditated as cell phone records, computer data, and other intelligence sources are indicating. Five suspects have been arrested since, suspected of being accomplices in the planning stages. The scariest dynamic of this incident, however, is the sheer simplicity of the weapon of choice. Yes, Mohamed Bouhlel did have a firearm, but that was not the primary killing instrument used. A heavily loaded truck can be quite a destructive force. That now sets a very disturbing precedent.

Besides guns and IEDs, we now have to worry about heavily loaded trucks. Make no mistake; the effectiveness of this attack will inspire others with evil intentions without the means to acquire guns or explosives. This attack now brings into question how to secure large gatherings of people for holiday and sporting events, outdoor public celebrations, or even large lines of people waiting to enter crowded venues. The list is endless and presents a security challenge that is not easily met. The permanent types of vehicular barriers (bollards, heavy planters, and rising wedge type barriers) typically seen around buildings to stop onrushing vehicles are great but what can be done about temporary gatherings or conditions that would present the same vulnerability? The temporary tools that come to mind are:

  • The moveable jersey barriers that are used in highway construction projects
  • Arranging large parked vehicles for protection
  • Roadblocks surrounding an event
  • Devices to destroy tires of any on-rushing vehicles

None of these are guarantees but if used creatively and perhaps in layers or perimeters might afford some protection, if not a deterrent. Then there will always be the question about cost and ‘do we really need this’ type thinking. This will haunt security professionals for quite some time. For example, what will they do at the Olympics in Rio for any last minute changes regarding this type of possible threat? I wish I had all of the answers. Tactics will always change, and we have to be innovative enough to react accordingly and even try to foresee what we really don’t want to.

For more information- check out our website at www.afimacglobal.com.

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Arming Your Employees Against Active Shooters – Making a Bad Situation Worse!

February 24th, 2016 Comments off

There is always debate after a tragic school or workplace active shooter incident over employees wanting to take their protection into their own hands. Yes, certain states have laws which allow employees to have their firearms with them if they have completed the necessary background checks and training, and have acquired the required permits. On the other hand, companies and other organizations should have workplace violence policies which prohibit their employees from bringing guns on property, even locked in their car in the parking lot. So where should prudent workplace violence policies draw the line?

Practically speaking, an employee would very rarely be in a realistic position to safely and effectively employ a weapon in an actual active shooter situation. There are some harsh realities about firing a personal weapon accurately in a tense ‘combat’ situation. The average citizen cannot effectively engage a hostile shooter under the typical active shooter ‘combat’ conditions without hurting any innocent bystanders or co-workers, or getting themselves killed. They don’t have the necessary training or the mindset. There are also further dangers created by the armed employee attempting to take protective action.

Let’s think about some of these realities and further dangers. You can shape your own opinion.

  • Do all private citizens/employees engage in sufficient combat shooting training to prepare themselves for the adrenalin rush, fear, tunnel vision, panic and confusion which will characterize an active shooter rampage? This type of defensive shooting is even a challenge for law enforcement patrol officers who do such training.
  • What liabilities exist for the company and the defending employee, if they engage a personal weapon defensively but miss and hit an innocent person nearby?
  • If the weapon is going to be defensively used in an active shooter incident, it would have to be in a position to be reached quickly, not in a locked car in the parking lot. Thus, the weapon would have to be in the building to be employed practically. This however, represents a more significant risk on a daily basis for the business under normal conditions. What if another type of workplace violence incident, or crime, is perpetrated simply because others know about that personal weapon in the workplace? (And others will know about its presence)
  • You certainly would not want an employee who was safely evacuated during an active shooter incident to get their gun from their locked vehicle and re-enter the facility to hunt the shooter down.
  • How are the responding police officers, who already have limited information about the suspect(s), know that your armed employee is not the active shooter?
  • Personally, if I was the employee who could not get out and had to hide out, I would like to have my 9mm with me, if I did have to fight for my life, rather than makeshift weapons. However, I also feel confident in my training and level of shooting experience with my law enforcement and protective operations background. Still, the weapon wouldn’t do me much good if it wasn’t in my desk or close-by.

Companies and organizations need to develop proactive weapon restrictions as part of their workplace violence prevention policy.  Granted, that the policy has to take into account the local and state laws relative to each of their facilities. I also think that the employer has the duty, for the safety of their workplace, to keep the weapons out of the building and, if possible, off of property. Having them locked in the car in the parking lot is still debatable.

An active shooter response plan should be part of this workplace violence policy. The active shooter response plan should dictate that the first reaction priority is to get out of the building during such an incident. The second response option, if you are trapped, is to hide quietly in a safe, locked and barricaded place. Only as a last resort should you engage the shooter in a fight for your life. Granted, at that point having a weapon would be useful.  However, not everyone would have that discipline to stick to the policy and get out first and not try to play hero, potentially making matters worse for the responding police.

It is essential that you consider these practical concerns when formulating your active shooter response plan as part of your larger workplace violence prevention plan.

Check out our workplace violence and active shooter response training courses.

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Active Shooter Response – Responsibility to Have a Plan

January 21st, 2016 Comments off

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Will your building occupants know what to do if an active shooter is loose in your facility hallways or on your campus? Will they all know that the event is happening, thus giving them some chance to react? Do they know what the appropriate reaction should be? Most people’s instincts are to run from danger but they must be given guidelines for doing so in an active shooter situation that won’t put them in even greater danger. What if they are trapped in an area by the shooter? What will they do then? What can they expect from responding police?

Merely depending on common sense assumptions when considering these questions is not a good response plan. Absent of a well thought out and thoroughly communicated plan, your organization is subject to occupants doing things that might make bad conditions worse. You have an ethical and legal responsibility to maintain some level of preparedness. Furthermore, you cannot depend on a very low probability of an occurrence as a defense. The human cost, if it ever does take place, demands a response plan!  No facility where such a tragedy has happened ever considered itself a likely place for it to occur!

These tragic events are now happening with even more frequency. Also, the recent incidents in San Bernardino, CA and Paris, France brings into play the possibility that this could become a terrorist’s preferred method of attack, regardless of their motivation or group sponsorship. It has become increasingly evident that organizations/businesses/schools/universities need an active shooter response plan. Specifically one that is tailored for the security circumstances at their facilities. There is no ‘one size fits all’ solution. Granted, the response plan from one organization or institution to another may have some common reaction guidelines but the specific response protocols for each will be quite different.

In a prior piece I wrote that there are typically three response choices for facility occupants to rely upon:

  • get out – exit the danger area immediately if possible
  • hide out – lock and barricade silently in place if escape is not possible due to the location of the shooter
  • take out – mass attack the shooter if you’re cornered and your hide out option becomes a sudden fight for your life

To be practical and effective a tailored active shooter response plan has to take into account several factors including, but not limited to:

  • The type of facility in question – school, office building, retail store, factory, sports complex, secured facility, etc.
  • The presence of public occupants as well as employees
  • The environment in which the facility is located – city, suburban, rural, remote, etc.
    • This may dictate the time it will take for law enforcement response
  • The type of communication/notification system available – how will everyone in your facility know that such an event is taking place?
    • Don’t just pull the fire alarm as this may generate some less than advisable responses
  • The occupants’ capabilities to evacuate and knowledge of where to go – considering age/physical abilities/facility operations/etc.
  • Emergency responder tactics and expectations

The variations of how “get out / hide out / take out” is applied and which of the response options are selected under what conditions will be influenced by these and other factors.  Accounting for these factors in a specific response plan, and giving example circumstances during training will help to prepare each occupant to know what they should be doing.

Finally, the response plan must be tested and rehearsed. Include the local emergency responders in the refinement of your plan. Lessons learned from other incidents that have occurred, and from your own rehearsals, can be used to further modify and tailor your active shooter response plan; the one that might become part of your legal defense and your clear conscience. Arm people with the knowledge that will give them a chance to survive. It’s the right thing to do.

For more detailed training regarding active shooter response guidelines see our free course at www.imac-training.com

 

 

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Active Shooter – Post Incident Information Release

October 20th, 2015 Comments off

By now everyone in America, Canada and much of the world knows what happened on October 1, 2015 at Umpqua Community College in Roseburg, Oregon. Unfortunately we also know the name of the shooter and that becomes part of the problem. Yes, we should learn from these incidents by studying what preceded them and what, if any, possible predictive signs could have been spotted. We should also learn from the tactics used in the incident so that we can prepare first responders for future events. But, do we all really have to know the name of the offender if they were killed in the incident? Might this feed the misguided notions of potential assailants who are troubled and may be seeking equal notoriety? I know the media feels that we need to know, but do we really? Yes, we need to know what happened and what we can learn from it, but knowing ‘who’ is a double-edged sword.

I applaud the responding law enforcement officers in this case because they did not release any names. Authorities did not publicly identify the shooter, but anonymous law enforcement officials told multiple news organizations that he was 26-year-old “unnamed”. “Unnamed” had neighbors who told CBS News that he was a bit of a loner and kept to himself.

As CBS News and the Guardian reported, a blog apparently linked to “unnamed” showed an interest in mass shootings, including the shooting in Virginia this August that left two journalists dead. One blog post stated, “I have noticed that so many people like [the shooter] are alone and unknown, yet when they spill a little blood, the whole world knows who they are. A man who was known by no one, is now known by everyone. His face splashed across every screen, his name across the lips of every person on the planet, all in the course of one day. Seems like the more people you kill, the more you’re in the limelight.” That suggests a desire for fame, which experts feel is quite common among mass shooters.

So why exactly do we need to know their names? Yes, as individuals and organizations, we need to know how to react to these dangerous incidents. Yes, we need to know the value of reporting red flag behavior if observed, or read about. But why offer the enticing notoriety that might provide motivation for future tragedies. In my opinion – we shouldn’t!

For more information on how to react in an actual active shooter event check out AFIMAC’s free online course at http://www.imac-training.com.

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Active Shooter Response Planning

July 24th, 2015 Comments off

With every news flash of a workplace active shooter incident, now almost monthly, it becomes increasingly evident that organizations/businesses/schools need an Active Shooter Response Plan. Furthermore, this is not a one size fits all challenge. Granted, the plan from one organization or institution to another may have some common reaction guidelines. Most of the active shooter response videos and training courses available promote a variation of the ‘run/hide/fight’ responses. However, the way your employees/occupants apply these concepts in an actual incident needs to be specific to the uniqueness of your facility.

Yes, in fact there are only three response choices for facility occupants to rely upon:

  • get out – exit immediately if possible
  • hide out – lock and barricade quietly in place if escape is not possible
  • take out – mass attack the shooter if you’re cornered and fight for your life

However to be practical and effective, tailored active shooter response protocols have to take into account several factors such as:

  • The type of facility in question –school, mall, office, factory, sports complex, etc.
  • The environment in which the facility is located –city, suburban, rural, remote, etc.
  • The type of communication system available – public address system, mass texting or email, audible warning, etc.
  • The occupants’ capabilities –employees or non-employees, age, physical abilities, etc.
  • Emergency responder availability/response time
  • Public occupants vs. employees only

These are just to name a few.

Other factors will influence the variations of how ‘get out/hide out/take out’ is applied and which of these response options are selected under what conditions. Having a generic plan which defines the three basic options is only the beginning. Accounting for the uniqueness of your facility and giving example circumstances to prepare each occupant to know specifically how they should react in a situation is the key to developing an effective active shooter response plan.

Then the plan must be tested and rehearsed. Include the local emergency responders in the refinement of your plan. Lessons learned from other incidents that have occurred, and from your own rehearsals, can be used to further modify and tailor your active shooter response plan; the one that might become part of your legal defense and your clear conscience. Facility management has a legal and moral responsibility to have an active shooter response plan that is practical and will give people a chance to survive. It’s the right thing to do.

For more detailed training regarding active shooter response guidelines see our course at www.imac-training.com.

High Risk Employee Terminations – Not Always Obvious

May 22nd, 2015 Comments off

There are two types of terminations that should be considered high risk. One is when aggressive behavior violates workplace violence policies or elevates to an unacceptable level and the person has to be terminated due to that behavior. The other kind can sneak up on you and many workplace violence prevention programs do not address it. With this type, the person has displayed continuously deteriorating work performance, in spite of corrective counseling, and this leads to a termination requirement. What makes this situation high risk is that the underlying cause(s) for the deteriorating work performance can also contribute towards that person’s potential to react violently during the termination itself. Their termination can cause an extreme sense of desperation at a time when they are the most volatile.

Most good workplace violence prevention programs will have educated the workforce, especially supervisors, to recognize the dangerous individual behaviors leading to the first type of high risk termination. The unacceptably aggressive behavior is the reason for the termination. It is therefore reasonable to expect some element of risk with the termination event itself, and precautions are often taken.

The second type may not contain the same aggressive behavioral indicators. However, in some of these cases, there will be indications of stress induced aggressiveness which should then serve as a red flag. Human resource personnel and the corporate security team should work together and involve third party clinical professionals to evaluate the underlying causes for the performance drop in otherwise good employees seemingly under stress. Those causes could indicate that if termination becomes necessary, precautions should be taken during the process. They can discuss with the individual what is going on in their life. They can also assess how those factors might affect the person’s response to the possible loss of their employment (often the last straw.)

Violence is typically a process, not an isolated event. The violence process usually has behavioral red flags along the way and this is what thorough workplace violence training often outlines. But the ‘under the radar’ cases that I have just described are especially dangerous because they lack those aggressive behavioral indicators. Therefore, your termination process protocols should not only address the obvious high risk terminations, but they should also account for those where there has been a dramatic drop off in performance so substantial and out of character that it results in the need for termination. Perhaps the real reasons for that performance drop off are so personally severe and so devastating, they could also represent a danger for a violent reaction to the loss of employment. Not realizing the desperation that this person faces until the time of the actual termination may be too little, too late. The job may have been all they had left to depend on!  They are now focusing on your company as the evil force that took away the one last thing that was important to them.

For more information regarding safely conducting the termination process for all types of high risk cases, check out the courses at www.imac-training.com.

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