Treatment Evaluation in Forensic Psychiatry. Which One Should Be Used: The Clinical Judgment or the Instrument-based Assessment of Change?

2021 ◽  
pp. 0306624X2110239
Author(s):  
Erwin Schuringa ◽  
Marinus Spreen ◽  
Stefan Bogaerts
Keyword(s):  
Risk Assessment ◽  
Psychiatric Patient ◽  
Clinical Judgment ◽  
Forensic Psychiatry ◽  
Treatment Evaluation ◽  
Behavioral Changes ◽  
Professional Judgment ◽  
Forensic Treatment ◽  
Forensic Psychiatric ◽  
Structured Professional Judgment

In forensic psychiatry, it is common practice to use an unstructured clinical judgment for treatment evaluation. From risk assessment studies, it is known that the unstructured clinical judgment is unreliable and the use of instruments is recommended. This paper aims to explore the clinical judgment of change compared to the calculated change using the Instrument for Forensic Treatment Evaluation (IFTE) in relation to changes in inpatient violence This study shows that the clinical judgment is much more positive about patient’s behavioral changes than the calculated change. And that the calculated change is more in accordance with the change in the occurrence of inpatient violence, suggesting that the calculated change reflects reality closer than the unstructured clinical judgment. Therefore, it is advisable to use the IFTE as a base to make a structured professional judgment of the treatment evaluation of a forensic psychiatric patient.

Assessing Potentially Violent Extremists

2021 ◽  
pp. 639-653
Author(s):  
Lieke Bootsma ◽  
Ellen Harbers
Keyword(s):  
Risk Assessment ◽  
The Netherlands ◽  
Information Gathering ◽  
Professional Judgment ◽  
The Future ◽  
Future Challenges ◽  
Structured Professional Judgment ◽  
National Police ◽  
Do So ◽  
The Way

This chapter describes the way investigative psychologists of the Dutch National Police assess behavior of potentially violent extremists. Investigative psychologists in the Netherlands have adopted structured professional judgment as the best framework to do so. The different phases investigative psychologists go through in practice while assessing the risk of violence for these potential extremists are set out. Specifically, the following steps are explored: intake and triage, information gathering, conducting a behavioral timeline, risk assessment, risk formulation, scenario thinking, and advice. Lastly, the future challenges in this field of operations are discussed.

A Prevention-Based Paradigm for Violence Risk Assessment

2002 ◽  
Vol 29 (5) ◽  
pp. 617-658 ◽  
Author(s):  
Kevin S. Douglas ◽  
P. Randall Kropp
Keyword(s):  
Risk Assessment ◽  
Intervention Strategies ◽  
Professional Judgment ◽  
Violence Risk ◽  
Clinical Prediction ◽  
Violence Risk Assessment ◽  
Validation Procedure ◽  
Actuarial Prediction ◽  
Structured Professional Judgment ◽  
Risk Assessment And Management

The rationale for this article was to outline and describe an emerging model of prevention-based violence risk assessment and management and to discuss attendant clinical and research implications. This model draws on structured professional judgment rather than on actuarial prediction or unstructured clinical prediction. Its purpose is to prevent violence through the assessment of relevant violence risk factors and the application of risk management and intervention strategies that flow directly from these factors. The authors discuss the nature of the clinical tasks that stem from the model as well as a four-step validation procedure required to evaluate it.

Risk Assessment of Stalkers

2002 ◽  
Vol 29 (5) ◽  
pp. 590-616 ◽  
Author(s):  
P. Randall Kropp ◽  
Stephen D. Hart ◽  
David R. Lyon
Keyword(s):  
Risk Assessment ◽  
Professional Judgment ◽  
Violence Risk ◽  
Limited Time ◽  
Violence Risk Assessment ◽  
Basic Principles ◽  
Targeted Violence ◽  
Time Periods ◽  
Structured Professional Judgment ◽  
The Relationship

Risk assessment of stalkers is difficult due to the diversity of stalking-related behaviors and the lack of research. The authors discuss three problems. First, stalking is a form of targeted violence, that is, violence directed at specific people known to the perpetrator. Second, stalking may include acts that are implicitly or indirectly threatening. Third, stalking can persist for many years, even decades. In contrast, most research on violence risk assessment ignores the relationship between victim and perpetrator, defines violence solely in terms of physical harm, and tracks perpetrators for limited time periods. The authors conclude that these problems make it impossible to rely on actuarial approaches when assessing risk for stalking at the present time, although it is possible to use structured professional judgment. They discuss some basic principles that can be used to guide stalking risk assessment within the framework of structured professional judgment.

Validity and Predictive Accuracy of the Structured Assessment of Protective Factors for Violence Risk in Criminal Forensic Evaluations

2016 ◽  
Vol 44 (4) ◽  
pp. 493-510 ◽  
Author(s):  
Milena Abbiati ◽  
Agathe Azzola ◽  
Julie Palix ◽  
Jacques Gasser ◽  
Valerie Moulin
Keyword(s):  
Risk Assessment ◽  
Protective Factors ◽  
Interrater Reliability ◽  
Predictive Accuracy ◽  
Professional Judgment ◽  
Assessment Instruments ◽  
Violence Risk ◽  
Forensic Evaluations ◽  
Recidivism Prediction ◽  
Structured Professional Judgment

Some actuarial and structured professional judgment (SPJ) risk-assessment instruments have already demonstrated their validity and predictive accuracy in expert criminal forensic evaluations. In contrast, little is known about the effectiveness of instruments identifying protective factors in risk of recidivism prediction. The present study was designed to evaluate the validity and predictive accuracy of the Structured Assessment of Protective Factors for Violence Risk (SAPROF) in 94 violent and sexual violent offenders assessed in a Swiss pretrial criminal forensic context. The SAPROF showed good interrater reliability, and was significantly correlated to predominately dynamic instruments but not to predominately actuarial instruments. However, in terms of predictive accuracy, the SAPROF did not perform as well as expected when compared with other instruments and with previous SAPROF accuracy validation studies. These results have implications for the use of the SAPROF in criminal forensic contexts risk assessment.

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