for Violence
Dr Lorraine Johnstone
Consultant Clinical Forensic Psychologist
Honorary Research Fellow
Accredited Risk Assessor
Lorraine.Johnstone@ggc.scot.nhs.uk
Perspectives
RESEARC
H
PRACTITIO ORGANISATI
NER ONAL
What is Risk Assessment?
Offender Background
Offence Analysis
Risk Factors
Protective Factors
Risk Scenarios
Risk Management
•Drive
•Disinhibit
•Destabilise Scenarios
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Risk Assessment: Approaches
PREDICTIVE
VALIDITY
Unstructured Clinical Judgement
Unstructur
ed
Clinical
Judgement
Unstructured Clinical Judgement
“…relies on an
informal, ‘in the head,’
impressionistic,
subjective conclusion,
reached (somehow)
by a human clinical
judge”
Grove and Meehl
ACTUARIA SCJ
L
PREDICTIVE
VALIDITY
Methodologies
Assessing Risk for
Violence
A Framework for
Practice
David Farrington
Darrick Jolliffe
Lorraine Johnstone
RMA Scotland
Aims and objectives
CHARACTERISE AND QUANTIFY THE
EVIDENCE
PREDICTIVE
VALIDITY
Method
Overall ES
Inclusion Criteria
Prospective
Males N= 50 or
more
Search Terms and Strategy
145
31
Results: Overall ES
Device N AUC Lower CI Upper
CI
GSIR 4 0.73 0.68 0.79
OGRS 4 0.71 0.66 0.75
HCR-20 13 0.70 0.66 0.74
PCL 18 0.69 0.66 0.73
VRAG 18 0.69 0.67 0.72
LSI-R 7 0.64 0.63 0.66
From the Group to the
Individual....
Illustration
Violence Risk Assessment
Guide
VRAG Variables - 1
VRAG CATEGORY
Probability of Violent Reconviction after Two Years
1.0
95% CI Individual
0.8
Probability
0.6
95% CI Group
0.4
0.2
95% CI Group
95% CI Individual
0.0
-20 -10 0 10 20
VRAG
“The ARAIs cannot be used to estimate
an individual’s risk for future violence
with any reasonable degree of certainty
and should be used with great caution
or not at all.”
•Drive
•Disinhibit
•Destabilise Scenarios
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METHOD: DESIGN
Standards and Principles
1. User Manual
2. Specified User Qualifications, Competencies
and Skills
3. Accessible Training
4. Ease of Use
5. Uses a Comprehensive Information Source
6. Appropriate Administration Time
7. Social History
8. Offence Analysis
9. Appropriate Number of Risk Factors
10. Appropriate Emphasis on Static Factors
Standards and Principles
11. Appropriate Emphasis on Dynamic Risk
Factors
12. Well Defined Risk Factors
13. Ease of Scoring/Rating Procedures
14. Describes and Identifies Protective Factors
Standard 21 18 20 18
s
(Max =
22)
Which tool is best?
But.....Organisational Issues
Expertise
Time intensive
High Cost
On-going
Training
Labour &
Intensive Development
2004
MWC Inquiry Senior Management
Directive to develop
RA policy
Legislative and Policy
Drivers
2006
2 Dedicated Posts
Aims
1) to have at least a preliminary
formulation of the person’s risk
available to inform management;
2) Risk assessment
Limited Information used to inform HCR-20
Preliminary formulation
Re-formulation
Re-formulation
Implementation
Back to before...