720 Violence Risk Assessment PDF

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Violence Risk Assessment Mike Davison, Psy.D. What is Risk Assessment? Forensic risk assessment is concerned with calculating how likely it is that antisocial behavior or criminal offending will occur. This question is most commonly posed when an individual has recently been found guilty of a crime, as authorities need to know how to appropriately deal with the individual. Psychologists, social workers or legal professionals conduct these assessments, and they form an important part of decisions regarding what kind of prison is most appropriate for an offender (e.g., maximum security), whether to release an offender (e.g., to parole), and what factors need to be targeted by interventions. This fact-sheet is intended to aid those who deal with offenders by reviewing recent literature in the field, including tools used to assess risk, and risk factors for offending. Research on Assessment Tools Methods for assessing probability of future violence A. Traditional Clinical Judgment: unguided, intuitive B. Actuarial Determination: Statistical C. Structured Clinical Judgment: guided by research- selected factors

Pros and Cons of Methods for assessing probability of future violence A. Traditional Clinical Judgment: unguided, intuitive 1. pro: individually specific 2. con: low reliability and validity B. Actuarial Determination: Statistical 1. pro: statistical formulas are generally more reliable and valid than clinical judgment; specific probability over specific no. of years, likelihood of false positives and false negatives. 2. con: only applicable to certain well-defined populations with a highenough base rate of violent acts C. Structured Clinical Judgment:

guided by research-selected factors

1. pro: can be applied to a specific individual in certain relevant contexts, with moderate or better reliability and validity, depending on stability of important factors

2. con: cannot give statistically accurate information such as probability of recidivism in a specific number of years, or likelihood of false positives and false negatives. Selecting Appropriate Method for unique clinical case A.

Salient factors in choosing proper method

For example, military members are not included in any significant number in samples upon which actuarial methods have been developed Specific Instruments The most commonly used actuarial instruments include: Violent Risk Appraisal Guide (VRAG), Sex Offender Risk Appraisal Guide (SORAG), Level of Service Inventory – Revised (LSI-R), STATIC-99/ STATIC2002, Static 99R The most commonly used structured clinical instruments include: Psychopathy Checklist – Revised (PCLR), HCR-20 (Historical, Clinical, Risk-20), Sexual Violence Risk -20 (SVR-20), Structured Assessment of Violence Risk in Youth (SAVRY). Research on Potential Risk Factors Research dedicated to this topic has identified several universal risk factors, and some risk factors that are crime specific. Good risk assessment tools will tap into some or all of these empirically validated risk factors, and also consider protective factors that reduce the risk of offending. Note that the more risk factors that apply to an individual the more likely he or she is to offend. Because we cannot predict the future, it is advised that individuals refrain from saying that an individual will re-offend. Risk factors are often divided into two categories; static and dynamic. Static Factors Offender characteristics that are predictive of re-offending but cannot be changed are considered static. These include: 

Psychopathy. Psychopathy is a personality disorder characterized by behavioral problems such as cruelty to people and animals from a young age, and emotional deficits such as a lack of empathy. It is typically diagnosed by administering the PCL-R. It is highly researched, and arguably the single greatest predictor of criminal behavior.

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Adult criminal history, pre-adult history of antisocial behavior

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Family criminality, poor family rearing practices and structure, low socio-economic status

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Age, gender, low intellectual functioning

Dynamic Factors Characteristics of an offender that can be changed are considered dynamic. These are factors that should be primarily addressed by interventions, and include: 

Deviant companions, interpersonal conflict

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Criminogenic needs (antisocial cognitions, values and behaviors), personal distress and anxiety

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Low social achievement, substance abuse

Crime-specific Factors In addition to their scores on risk assessment scales, adult, juvenile, sexual and mentally disordered offenders have uniquely important risk factors. The primary risk factors most highly correlated with reoffending are listed for each type of offender below: 

Adult offenders: identification and socialization with other offenders, antisocial personality (Psychopathy), criminogenic needs.

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Adult sexual offenders: General self-regulation problems, violation of conditional release.

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Young offenders: Age at first offence, age at first contact with the law, non-severe pathology, psychopathy.

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Young sexual offenders: Non-Caucasian, psychopathy, victim of sexual abuse, deviant sexuality, more than one victim, out-of-home placement.

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Mentally disordered offenders: Adult criminal history, juvenile delinquency.

Conclusion Risk assessment will always be a predictive judgment and as such there will be errors in judgment. However, as those who deal with forensic populations, it is our duty to use up-to-date empirically based methods to make predictions that are as accurate as possible. Quick summary: 

Risk assessment asks: how likely is it that an individual will commit a crime?

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Use actuarial or structured clinical judgment

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DO NOT use unstructured clinical judgment.

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Static factors are things like age that cannot be changed

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Dynamic factors can be treated

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Crime-specific risk factors also need to be considered, as do culture, context, referral question.

Also consider how to communicate results. What it expected of you – for example, are you making treatment recommendations? Small sample of Violence Risk Assessment Tools

Risk Category

Adult Instruments

Level of Service Inventory (LSI-R) General Risk

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General Recidivism

General Statistical Information on Recidivism (GSIR)

Child/Youth Instruments Youth Level of Service Inventory (YLSI) Early Assessment Risk for Boys (EARL-20B) *for children

Early Assessment Risk for Girls (EARL-21G) *for children

Workplace Risk Assessment (WRA-20) Workplace Risk

Employee Risk Assessment (ERA-20)

Spousal Violence Risk

Spousal Assault Risk Assessment Guide (SARA)

Hare Psychopathy Checklist Revised (PCL-R) Violent Risk

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Violent Recidivism

Sexual Risk

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Historical Clinical Risk -20 (HCR-20)

Hare Psychopathy Checklist, Revised Youth Version (PCL-R: YV)

Structured Assessment of Violent Risk Appraisal Guide Violence Risk for Youth (SAVRY) (VRAG)

Sex Offender Risk Appraisal Guide (SORAG)

Estimate of Risk of Adolescent Sexual Offence Recidivism

Sexual Violence Risk-20 (SVR-20) Rapid Risk Assessment for Sex Offence Recidivism (RRASOR) (ERASOR) Sexual Recidivism

STATIC-99/ STATIC 2002 Minnesota Sex Offender Screening Tool - Revised (MnSORT-R) Sex Offender Needs Assessment Rating (SONAR)

Actuarial Risk Assessment Instruments: VRAG (Violent Risk Appraisal Guide) Quinsey, Harris, Rice, Cormier (1998) This instrument contains a 12-item actuarial scale which has been widely used to predict risk of violence within a specific time frame following release in violent, mentally disordered offenders. Developed at Penetanguishene Mental Health Centre, the tool uses the clinical record, particularly the psycho-social history component, as a basis for scoring as opposed to interview or questionnaires. The Hare PCL-R (Psychopathy Checklist -Revised) score is incorporated into the VRAG calculations of risk. The VRAG is not available as a stand-alone commercially available scheme but the current version is detailed in the text Violent Offenders, Appraising and Managing Risk (p.237) by Quinsey et al. Violent Offenders, Appraising and Managing Risk can obtained from: APA Order Department PO Box 92984 Washington, DC, 20090-2984 phone: 1-800-374-2721 SORAG (Sex Offender Risk Appraisal Guide) Quinsey, Harris, Rice, Cormier, 1998 Also developed at Penetanguishene Mental Health Centre, this 14 item instrument is a modification of the VRAG and is used to assess the risk of violent and sexual recidivism of

previously convicted sex offenders within a specific period of release. It also uses the clinical record as a basis for scoring and incorporates the PCL-R scores. The VRAG is not available as a stand-alone commercially available test but the current version is detailed in the text Violent Offenders, Appraising and Managing Risk (p.241) by Quinsey et al. Violent Offenders, Appraising and Managing Risk can obtained from: APA Order Department PO Box 92984 Washington, DC, 20090-2984 phone: 1-800-374-2721 PSYCHOPATHY CHECKLIST - Revised (PCL-R) Hare, 1991 & 2002 Even though it was not originally designed as a risk assessment device, the Hare PCL-R has gradually come to be used to assess likely future recidivism and violent offending. It is a 20-item rating scale, scored on the basis of both semi-structured interview and collateral information. It has been validated for use in adult male correctional and forensic psychiatric samples. Over recent years, research has shown that it is a relatively good predictor of violence across diverse populations. Hare PCL-R scores are incorporated into a number of subsequently developed risk assessment tools and guides. The Hare PCL-R can be obtained from: Multi-Health Systems Inc. 3770 Victoria Park Avenue Toronto, Ontario M4H 3M6 Tel: 800-456-3003 (US) 800-268-6011 (Canada) E-mail: [email protected] PSYCHOPATHY CHECKLIST - SCREENING VERSION (PCL-SV) (Hart, Cox, Hare, 1995) This is a 12-item abbreviated tool designed to screen for the possible presence of psychopathy. Based on a subset of the original 12 Hare PCL-R items,it is particularly well suited for community samples. The PC-SV can be obtained from: Multi-Health Systems Inc. 3770 Victoria Park Avenue Toronto, Ontario M4H 3M6 Tel: 800-456-3003 (US) 800-268-6011 (Canada) E-mail: [email protected]

PSYCHOPATHY CHECKLIST - YOUTH VERSION (PCL-Y) (Forth, Kossen, Hare, 1996) This 20-item scale was designed specifically for use with adolescents to assess psychopathic features. It has been validates for use in both male and female populations between the ages of 12 and 17. Contact Information: Dr. A. Forth or Multi-Health Systems Inc. 3770 Victoria Park Avenue Toronto, Ontario M4H 3M6 Tel: 800-456-3003 (US) 800-268-6011 (Canada) E-mail: [email protected] LEVEL OF SERVICE INVENTORY - Revised (LSI-R) Andrews & Bonta, 1995 This is a 54-item rating scale used to assess the likelihood of general recidivism among adult offenders. It is designed to measure attributes of offenders and their situations in relation to level of supervision and treatment decisions. It has been validated for use with adult male and female correctional offenders. LSR-R (general) LSI-R (computerized version) Multi-Health Systems Inc. 3770 Victoria Park Avenue Toronto, Ontario M4H 3M6 Tel: 800-456-3003 (US) 800-268-6011 (Canada) E-mail: [email protected]

YOUTH LEVEL OF SERVICE INVENTORY/CASE MANAGEMENT STRATEGY (YLSI) This 43-item instrument was designed to measure risk, need, and responsivity factors in adolescents who have had contact with the justice system. It has been validated for use

with both males and females between the ages of 12 and 17 and uses file information, selfreport and collateral report information, and as well as results of other formal assessments.

The YSLI can be obtained from: Multi-Health Systems Inc. 3770 Victoria Park Avenue Toronto, Ontario M4H 3M6 Tel: 800-456-3003 (US) 800-268-6011 (Canada) E-mail: [email protected]

RRASOR (Rapid Risk Assessment for Sex Offence Recidivism) Hanson, 1997 This is a brief, 4-item screening instrument for risk of sexual offender recidivism among males who have been convicted of at least one sexual offence. It relies on information obtained in files and has been tested extensively on forensic populations. For more detail. Contact Information: Dr. R.K. Hanson Senior Research Officer 11th Floor, 340 Laurier Ave. West Ottawa, ON K1A 0P8 STATIC-99/STATIC-2002 Hanson & Thornton, 1999 and 2002 Developed subsequently to the RRASOR, the original 10-item STATIC-99 was designed to assess the long-term potential for sexual recidivism among adult male sex offenders. It incorporates RRASOR factors. A revised version, STATIC-2002, is currently in development. Again, it has so far been used predominately within the correctional system. Contact Information: Dr. R.K. Hanson Senior Research Officer 11th Floor, 340 Laurier Ave. West Ottawa, ON K1A 0P8 SEX OFFENDER NEEDS ASSESSMENT RATING (SONAR) Hanson & Harris, 2000 This 9 item scale is designed to measure change in risk level for sexual offenders. It includes 5 stable factors and 4 acute factors. For more detail.

Contact: Dr. R.K. Hanson Senior Research Officer 11th Floor, 340 Laurier Avenue West Ottawa, Ontario, Canada K1A 0P8 MINNESOTA SEX OFFENDER SCREENING TOOL - Revised (MnSORT-r) Epperson, Kaul, & Hasselton, 1998 This is a sexual violence risk assessment tool that is used to predict sexual recidivism in rapists and intra-familial child molesters. It uses 16 static and dynamic variables to distinguish three levels of risk category. For more details VIOLENCE RISK ASSESSMENT SCALE (VRS) – Experimental Version 1 Wong and Gordon, 1996 This scheme was designed to assess the risk of violent recidivism for incarcerated offenders. It consists of 6 static and 23 dynamic factors, includes a section designed to measure changes in risk level as a result of treatment Contact: Dr. Steve Wong Department of Psychology and Research Regional Psychiatric Centre (Prairies) Box 9243 Saskatoon, Saskatchewan, Canada S7K 3X5

Structured Clinical Guides: Spousal Assault Risk Assessment Guide (SARA) Kropp, Hart, Webster, & Eaves, 1995 This is a a 20 item set of risk factors for use in the assessment of spousal assault. It can be used to help gauge risk of future violence in men arrested for spousal assault. To order the SARA contact: Multi-Health Systems Inc. 3770 Victoria Park Avenue Toronto, Ontario M4H 3M6 Tel: 800-456-3003 (US) 800-268-6011 (Canada) Website: www.mhs.com

HCR-20, Version 2 (Historical, Clinical, Risk-20) Webster, Douglas, Eaves, & Hart, 1997 Originally made available in 1995, the HCR-20 Structured Guide for the Assessment of Violence Risk was later modified in light of actual clinical experience gained from initial trials. It is intended for use with civil psychiatric, forensic, and criminal justice populations. It consists of 20 items as well as the Hare PCL-R. There are 10 historical variables, 5 clinical variables, and 5 risk management factors. Each item is scored as 0 (not present), 1 (possibly present) or 2 (definitely present) to yield a score out of 40. It includes variables that capture relevant past, present, and future considerations. It can be regarded as an important first step in the risk assessment process. The manual provides information about how and when to conduct violence risk assessments, reviews the research on which the risk factors are based, and suggests key questions which should be addressed when making judgments about risk. The scheme has been tested in all three of the domains for which it was originally intended. Results of various studies which have emanated from it are summarized by K. Douglas periodically. The HCR-20 has been translated into several different languages and is under active examination internationally. Its work is guided, to an extent, by a consortium of researchers and clinicians who make up the RISC-TEAM, a sub-group of the International Association of Forensic Mental Health Services. To order HCR-20: Psychological Assessment Resource, Inc. Telephone: 1-800-331-8378 Website: www.parinc.com SEXUAL VIOLENCE RISK-20 (SVR-20) Boer, Hart, Kropp, & Webster, 1997 This is a 20 item guide for assessing violence risk in sex offenders. Eleven items deal with Psychosocial Adjustment, 7 with Sexual Offences and 2 with Future Plans. Scoring is based on a N(definitely not present), ? (perhaps present), or Y (definitely present) scale with allowance for changes over time. Little is currently known about its effectiveness as a predictive device. Its main current usefulness lies in its ability to help structure clinical assessments. To order SVR-20: Psychological Assessment Resource, Inc Telephone: 1-800-331-8378 Website: www.parinc.com Estimate of Risk of Adolescent Sexual Offence Recidivism (ERASOR) (Worling & Curwen, 2001) This scheme is designed for use with adolescents to determine their risk of sexual reoffence. It uses both static and dynamic factors that are empirically linked to sex offending: Historical sexual assaults; Sexual interests, Attitudes and behaviours; Psychosocial

functioning; Family/Environmental functioning; and Treatment. The guide is available in either hard copy for a nominal fee or in PDF downloadable format:

For information or copy of the guide, contact: Dr. James Worling, C.Psych. Consultant Psychologist/Co-ordinator of Research SAFE-T Program Thistletown Regional Centre 51 Panorama Court Toronto, Ontario, Canada M9V 4L8 tel: 416-326-0664 fax: 416-326-6581 STRUCTURED ASSESSMENT OF VIOLENCE RISK IN YOUTH (SAVRY) Bartel, Borum, & Forth, 1999 This is a violence risk assessment scheme designed to assess risk for violence in adolescents. It consists of 10 historical variables, 8 social/contextual variables, 7 individual/clinical variables and 6 protective variables. To obtain information on the SAVRY: Mental Health, Law and Policy Institute University of South Florida Tampa, FL 33612 Tel: 813-974-7947 Dr. Adelle Forth Dr. Randy Borum Dr. Patick Bartel EARL-20B (Consultation Version) Augimeri, Koegl, Webster & Levene, 1998 This is a 20 item instrument designed to measure risk of violence potential in boys under the age of 12. The items are grouped under the headings of Family, Child, and Responsivity and items are scored on a 0 (not present), 1(possibly present), or 2 (definitely present) basis. Clinicians offer an overall clinical judgment of risk as Low, Moderate or High. The guide was developed through references to the published scientific literature and clinical experience based on large numbers of boys and their families followed over several years. It has been translated into Swedish and a large Swedish prospective study is currently under way.

Contact information: Earlscourt Child and Family Centre 46 St. Clair Gardens Toronto, Ontario, Canada M6E 3V4 Tel. 416-654-8981 E-Mail: [email protected] EARL-21G (Version 1 Consultation edition) Levene, Augimeri, Pepler, Walsh, Webster, Koegl, 2001 Similar in scope and purpose to the EARL-20B, the EARL-21G takes account of the fact that girls often express anti-sociality and aggressiveness in ways that differ from boys. The basic framework is similar to the EARL-20B although some items are labeled and defined differently. Designed for use in girls under 12, the EARL-21G is under test at the Earlscourt Child and Family Centre. Contact information: Earlscourt Child and Family Centre 46 St. Clair Gardens Toronto, Ontario, Canada M...