Risk Assessment: Concepts and Components

Risk Assessment: Concepts and Components

• Risk assessment is a systematic process to determine the likelihood of harm to self or others.
• Information is gathered from various sources (interviews, collateral info, reports, risk measures).
• Risk prediction identifies factors associated with future violent/criminal acts.
• Risk management develops interventions to decrease future violence.
• The ultimate goal is risk prevention, achieved by identifying risk factors and designing treatments to reduce recidivism.
• Balancing individual rights with public safety is a practical concern.

Risk Assessment: Practical Concerns

• Base rates: Frequency of violence in a population. Overprediction of violence can lead to false positives.
• Decision errors: Concerns about accuracy of predictions; false positives and false negatives are possible.
• Clinical judgment errors: Human biases (heuristics) can affect clinical decisions (illusory correlation, confirmation bias, fundamental attribution error, representativeness heuristic, gender bias). Limited empirical support for clinical judgments exists.
  • Areas of judgment have low AUC scores, suggesting room for improvement. Example, clinical judgment scores (AUC = 0.62) vs. tools like the Violence Risk Appraisal Guide (VRAG, AUC = 0.80)
• Research challenges: Methodological errors, gaps between assumptions and reality, limited number of risk factors, and variability in risk variable definitions and measurement.

Risk Assessment: Measurement Approaches

• Actuarial risk assessment: Method relies on statistically-validated risk factors (e.g., Static-99).
  • Primarily static risk factors (those that do not change).
  • Generally superior to unstructured clinical judgment.
  • Examples of actuarial instruments: Static-99, VSAG, Minnesota Sex Offender Screening Tool
• Structured professional judgment: Method incorporates research-derived risk factors, prioritizing professional judgment (e.g., HCR-20).
• Example HCR-20 assesses 20 risk factors across offender's history, clinical profile, and management factors.
• Actuarial methods are generally preferred over unstructured clinical judgement for effectiveness.

Risk Factors: Types and Examples

• Static risk factors: Historical, unchanging (e.g., criminal history, age of onset, childhood maltreatment).
• Dynamic risk factors: Changeable, acute (e.g., substance use, mental health status, social supports).
• Empirically supported risk factors: Psychopathy, young age, criminal history, early onset antisocial behavior, alcohol abuse, childhood trauma, intimacy deficits

Risk Assessment Contexts

• Civil contexts: Hospitals, child protection, immigration, schools, workplace, duty to warn.
• Criminal contexts: Pre-trial, sentencing, and release stages.

Specific Risk Assessment Types

• Threat-based risk assessment: Assesses attitudes (A), capacity (C), thresholds crossed (T), intent (I), other's reactions (O), and non-compliance with interventions (N).
• Spousal assault/intimate partner violence, Sexual violence, Women offenders, Young offenders, Workplace violence, Indigenous offenders

Risk Reduction Principles (RNR)

• Risk: Matching intervention level to offender’s risk level.
• Needs: Addressing criminogenic needs (e.g., substance abuse) through intervention.
• Responsivity: Tailoring intervention to the offender's learning style, motivation, and abilities.
• RNR approach is superior to empathy-based treatments for psychopathy.

Ethical Considerations

• Specialized training and best practices.
• Ethical issues (e.g., guilt, minimizing harm)
• Confidentiality, duty of care, limitations (expert testimony, objectivity), transparency

Protective Factors

• Protective factors can mitigate risk, helping individuals having many risk factors from becoming violent.
• Protective factors include prosocial involvement, strong social support, positive social orientation, and intelligence.