Risk Assessment Principles and Practices

Risk Assessment: Principles and Practices

• Risk assessment is a systematic process collecting information to evaluate the likelihood of harm to self or others. This data comes from interviews, collateral information, reports, and risk measures.

Components of Risk Assessment

• Risk Prediction: Identifying factors increasing future violent potential. Aims to predict future criminal or violent acts.
• Risk Management: Developing interventions to reduce future violence. This focuses on treatments and conditions to manage risk.

Goals of Risk Assessment

• The overall aim of risk prediction and management is to prevent future violence by identifying factors that increase risk and implementing treatments to reduce risk.
• Balancing individual rights and public safety.

Practical Concerns in Risk Assessment

• Base Rates: Frequency of violence in a population. Over-prediction of violence is a concern, leading to false positives.
• Decision Errors: Correctly predicting/predicting accurately. Risks of false positives (incorrect prediction of reoffending) and false negatives (incorrect prediction of no reoffending).
• Clinical Judgment Errors: Humans make errors in judgment. Be aware of heuristics (mental shortcuts) that lead to biases. Types of biases include illusory correlation, confirmation bias, fundamental attribution error, representativeness heuristic, and clinician gender bias.
• Empirical Support: Limited empirical support might exist for clinicians' judgments in risk assessments. The AUC (area under the curve) statistic for violent recidivism is approximately 0.62 compared to 0.80 for structured instruments like the VRAG-Revised.
• Research Challenges: Risk assessment research faces methodological problems. The gap between risk assessment assumptions and reality must be minimized. Incomplete consideration of risk factors and variability in their measurement is also a concern.

Contexts of Risk Assessment

• Civil: Hospitals, child protection, immigration, schools, workplace, duty to warn.
• Criminal: Pre-trial, sentencing, and release stages of the criminal justice system. Police may issue warnings for released offenders deemed likely to reoffend.

Ways to Measure Risk

• Actuarial Risk Assessment: Empirically derived risk factors statistically combined to predict reoffending. Primarily uses static risk factors. Examples include Static-99 and the newer Static-99R, the Level of Service Inventory-Revised, Violence Risk Appraisal Guide-Revised, Classification of Violence Risk, the Ontario Domestic Assault Risk Assessment, the Sex Offender Risk Appraisal Guide, Static-2002, the Minnesota Sex Offender Screening Tool.
• Structured Professional Judgment: A predetermined list of risk factors, guided by professional judgment, to assess risk level. Examples include the HCR-20 (assessing historical, clinical, and risk management profile).

Risk Assessment Philosophies

• Actuarial methods are considered superior to unstructured clinical judgment methods.
• Use research-supported actuarial and structured instruments. The choice depends on the specific context and goals.
• Risk assessment approaches are continuously improving, evolving from unstructured to integrated management with an emphasis on treatment targets.

Risk Factors

• Risk Factors: Measurable features for predicting the likelihood of specific behaviors, like violence or criminal activity.
  • Static: Historical, cannot be changed. Examples include childhood maltreatment and past offending.
  • Dynamic: Fluctuate, can potentially be changed through intervention. Examples include substance use and mental health issues.
• Examples of Empirically Supported Risk Factors: Psychopathy, young age, criminal/violent history, antisocial behavior onset in childhood, alcohol abuse, history of childhood maltreatment, and intimacy deficits.

Categories of Risk Factors

• Historical: Childhood maltreatment, prior offending, supervision failures, age of onset.
• Clinical: Substance use, mental health issues, “threat/control override” symptoms.
• Contextual: Factors like access to weapons, easy access to victims (lack of empirical support).
• Dispositional: Current age, personality disorders, specific personality traits.

Important Considerations

• Interaction of Risk Factors: Different factors interact and affect each other.
• Coffee Can Study: Important to understand that effective risk assessments are based on valid evidence-based instruments.

Protective Factors

• Protective Factors: Mitigate the likelihood of negative outcomes. They highlight factors contributing to positive outcomes, even given multiple risk factors. Prosocial involvement, strong social support, positive social orientation, intelligence, and more.

Specific Types of Risk Assessment

• Spousal Assault/Intimate Partner Violence
• Sexual Violence
• Women Offenders
• Young Offenders
• Workplace Violence
• Indigenous Offenders
• Threat-Based Risk Assessment: ASSESS (Attitudes, Capacity, Thresholds Crossed, Intent, Other's reactions, Non-compliance)

Ethical Practice in Risk Evaluations

• Specialized training, best practices, ethical considerations (e.g., Avoiding bias, maintaining confidentiality, duty of care), limitations of expert testimony and transparency.

RNR Principles & Risk Reduction

• Risk, Needs, Responsivity (RNR) Approach: More effective treatment for psychopathy than empathy-based approaches.
• Needs: targets criminogenic needs (e.g., substance abuse) for effective intervention.
• Responsivity: matching target intervention to offender learning style, motivation, skills, and strengths.
• Risk: tailoring intervention level (intensity) to match offender risk level.