Valuing Structured Professional Judgment: Predictive Validity, Decision-making, and the Clinical-Actuarial Conflict

Forensic psychologists commonly utilize unstructured clinical judgment in aggregating clinical and forensic information in forming opinions. Unstructured clinical judgment is prone to evaluator bias and suboptimal levels of inter-rater reliability. This article proposes Structured Professional Judgment (SPJ) methods as a potential remedy. Following a review of canonical forensic assessment models, the prevalence of bias in forensic judgments, and inter-rater agreement in criminal responsibility (CR) determinations, this article presents a SPJ model for CR evaluations translated from violence risk assessment methodology. A systematic user-friendly methodology is described, applying procedural checklists, application of a mental state at time of the offense (MSO) model using structured data collection methods, aggregation of empirical evidence guidelines, and post-hoc hypothesis testing using the Analysis of Competing Hypotheses (ACH). A case study describes application of the procedural and CR decision model in a complex homicide case. The model demonstrates the power and efficacy of the application of SPJ to forensic decision-making and is relevant to other types of forensic assessment (e.g., competency to stand trial, post-acquittal release decision-making).

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Predictive Validity of Personality-Related Career Decision-Making Difficulties

PsycEXTRA Dataset ◽

10.1037/e622312010-001 ◽

2010 ◽

Author(s):

Itamar Gati ◽

Achinoam Fischer ◽

Lisa Asulin-Peretz

Keyword(s):

Decision Making ◽

Predictive Validity ◽

Career Decision ◽

Career Decision Making

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Structured Professional Judgment to Assist the Evaluation and Safety Planning of Suicide Risk: The Risk of Suicide Protocol (RoSP)

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.607120 ◽

2021 ◽

Vol 12 ◽

Author(s):

Nicola S. Gray ◽

Ann John ◽

Aimee McKinnon ◽

Stephanie Raybould ◽

James Knowles ◽

...

Keyword(s):

Mental Health ◽

Mental Health Services ◽

Health Services ◽

Clinical Evaluation ◽

Suicide Risk ◽

Professional Judgment ◽

Health Board ◽

Safety Planning ◽

Nice Guidelines ◽

Structured Professional Judgment

Background: The Risk of Suicide Protocol (RoSP) is a structured professional judgment (SPJ) scheme designed in line with NICE guidelines to improve clinicians' ability to evaluate and manage suicide risk.Aims: This study aimed to evaluate the efficacy of RoSP in two settings: (1) unexpected deaths of people in the community who were known to mental health services; and (2) an inpatient hospital specializing in the assessment and treatment of patients with personality disorder.Method: In Study 1, information from a database of unexpected deaths (N = 68) within an NHS health board was used to complete a RoSP assessment (blind to cause of death) and information from the Coroner's Court was used to assign people to suicide vs. natural causes/accidental death. In Study 2, patients (N = 62) were assessed on the RoSP upon admission to hospital and their self-injurious behaviors were recorded over the first 3 months of admission.Results: (1) Evaluations using RoSP were highly reliable in both samples (ICCs 0.93–0.98); (2) professional judgment based on the RoSP was predictive of completed suicide in the community sample (AUC = 0.83) and; (3) was predictive of both suicide attempts (AUC = 0.81) and all self-injurious behaviors (AUC = 0.80) for the inpatient sample.Conclusion: RoSP is a reliable and valid instrument for the structured clinical evaluation of suicide risk for use in inpatient psychiatric services and in community mental health services. RoSP's efficacy is comparable to well-established structured professional judgment instruments designed to predict other risk behavior (e.g., HCR-20 and the prediction of violence). The use of RoSP for the clinical evaluation of suicide risk and safety-planning provides a structure for meeting NICE guidelines for suicide prevention and is now evidence-based.

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Examining the Factor Structure of a Risk Assessment Inventory in Young Offenders: FER-R, Risk and Resource Assessment Form

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph19020756 ◽

2022 ◽

Vol 19 (2) ◽

pp. 756

Author(s):

Paula Alarcón ◽

Ricardo Pérez-Luco ◽

Sergio Chesta ◽

Lorena Wenger ◽

Andrés Concha-Salgado ◽

...

Keyword(s):

Construct Validity ◽

Convergent Validity ◽

Resource Assessment ◽

Professional Judgment ◽

Young Offenders ◽

Factorial Validity ◽

Factorial Structure ◽

Divergent Validity ◽

Individualized Intervention ◽

Structured Professional Judgment

The FER-R, Risk and Resource Assessment Form, is a multidimensional inventory of structured professional judgment that assesses criminogenic risks and resources for the design and management of individualized intervention plans with criminally sanctioned adolescents. The aim of this study was to examine the psychometric properties of the FER-R, reviewing its factorial structure to contribute evidence of convergent and discriminant construct validity in a sample of adolescents sentenced for crimes in Chile. For each domain (risks and resources) with its respective facets, a unidimensional bifactor structure (CFA-BF) was obtained, with adequate indices of fit that confirmed its construct validity, while the convergent validity was demonstrated with the YLS/CMI and the divergent validity with two MACI scales. The FER-R adds factorial validity to the evidence of the previously reported predictive validity, making it a robust inventory for the evaluation of young offenders, and a relevant tool to manage differentiated interventions in Chile, with a high potential for use in Latin America. The importance of finding a suitable balance in assessing risks and protective factors is discussed, in order to manage interventions adjusted to the needs of the adolescents to promote their criminal desistance.

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THE VALUE OF PREDICTIVE VALIDITY STUDIES AND THE NEED FOR ‘FIT-FOR-PURPOSE’ DATA TO INFORM POSTSECONDARY ADMISSIONS POLICIES AND DECISION-MAKING IN THE UNITED STATES

EDULEARN18 Proceedings ◽

10.21125/edulearn.2018.0042 ◽

2018 ◽

Author(s):

Stuart Shaw ◽

Carmen Vidal Rodeiro

Keyword(s):

United States ◽

Decision Making ◽

Predictive Validity ◽

The United States ◽

Admissions Policies ◽

Fit For Purpose ◽

Validity Studies

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Teaching and Learning Decision-Making in Child Welfare and Protection Social Work

Decision-Making and Judgment in Child Welfare and Protection ◽

10.1093/oso/9780190059538.003.0013 ◽

2020 ◽

pp. 281-298 ◽

Cited By ~ 1

Author(s):

Brian J. Taylor

Keyword(s):

Risk Factors ◽

Decision Making ◽

Social Work ◽

Child Welfare ◽

Teaching And Learning ◽

Cognitive Learning ◽

Legal Aspects ◽

Professional Judgment ◽

Role Clarity ◽

Learning And Teaching

This chapter begins with reflections on the author’s own “journey into risk and decision-making” during 10 years of practice and 25 years teaching social workers on this topic. Challenges in teaching and learning the knowledge and skills required for professional judgment in child welfare and protection are considered in terms of models of decision-making and models of cognitive learning processes. This is illustrated with aspects of teaching about decision-making on qualifying and post-qualifying social work courses in Northern Ireland, such as relating understandings of professional judgment and decision-making processes to assessment and care planning practice; legal aspects of making reasonable, reasoned decisions; understanding the value of and challenges in using statistical data on risk factors within decision-making; using models of professional judgment to reflect on practice; ensuring role clarity; and developing skills in engaging other professionals in decision processes. The chapter concludes with a discussion of future directions in learning and teaching about professional judgment in child welfare and protection, including (1) the science of decision-making (including use of risk factors), (2) the art of decision-making (including understanding judgment processes using psychosocial rationality concepts), (3) evidencing what works in terms of teaching decision-making, and (4) building a knowledge base to inform teaching.

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