Exam 10: Predicting Violent Behaviour and Risk Assessment

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Answers will vary but should include some of the following from the text: Unstructured clinical judgments are relatively weak predictors of future violence; one reason for this is that they are based on clinical prediction for which feedback is not always available; it is hard to gauge the longer term outcomes with this approach. Traditional assessment tools and techniques are used in sessions to render a decision. The more distinctions in behaviours, rather than just generic categories of violence, the better prediction might become. Actuarial techniques outperform unstructured clinical judgments; they calculate estimates of risk factors based on large samples of data on individuals whose background and behaviour can be statistically compared. This method is nomothetic in that it is based on groups and quantitative. For this reason, it may not do well with less common cases for which there is less archived data. The Violence Risk Appraisal Guide is an example of an actuarial instrument. Both structured and unstructured clinical judgments, on the other hand, are more qualitative and idiographic-that is, they are based on individual's behaviour and subjective judgments of inherent risks. Structured professional judgments (SPJ) were developed to address the limitations of both the earlier approaches; they are designed to combine the accuracy of actuarial methods with the flexibility of a clinical approach; SPJ use instruments like the Historical Clinical Risk Management Scheme and the Short-Term Assessment of Risk and Treatability. Research comparing actuarial and structured professional methods have had mixed results, both have methodological strengths and weaknesses.