Predicting future behavior is almost impossible to do, yet mental health professionals are asked to do this when the need arises. This need is to determine how likely it is that an individual will display violent behavior if released into the general population of society. This is usually done through assessment of the individual along with some secondary data review. There are three main categories of dangerousness risk assessment that forensic psychologist rely on. According to Ackerman (2011) they are clinical, actuarial, and anamnestic.
In clinical assessments a trained professional uses subjectiveness and intuition combined with a review of professional literature associated with recidivism in similar case studies (Ackerman, 2011). There are no two clinical assessments that are alike, which is a strength with this type of assessment but it lacks empirical evidence and can be called “unstructured professional opinion”. Actuarial assessments connect relationships between outcomes with measurable variables. Actuarial is based on empirical data and is therefore standardized against similar groups. This can help the mental health professional predict risk in a more accurate way. The actuarial assessment tool still requires clinical judgment however (Ackerman, 2011). An anamnestic assessment examines the individuals past violent behavior along with patterns, common precipitating factors, and antecedents (Ackerman, 2011). After this evaluation is complete protective measures can be determined and informed right action can take place.
There are four aspects of predicting dangerousness that can make things difficult for clinicians are; 1) definitional problems 2) the amount of useful research 3) unconscious and conscious judgment errors and biases and 4) political consequences of an erroneous prediction (Melton et al., 2007). The definitional problem includes what definition the court you are performing the assessment has for dangerousness. Some courts have a very low level of danger in their definition and you may risk sending someone away that is not at high risk for re-offending in a violent manner. The personal biases are something that you have to be on a constant look out for. If you have an aversion to sex offenders it would not be wise to assess this population since you may be persuaded by your unconscious biases. The amount of research available can impede on a clinical assessment procedure. Especially if the individual being assessed does not fall into a researched population. Lastly the political consequences that can occur if the individual is not at risk and you assess him/her as high risk and vice versa. This can be detrimental to your reputation so it is a must that you get extensive training and be honest about your strengths and weaknesses.
History of Assessment Procedure
Violence touches the lives of many in our society. When people are victimized by violent crime, the general public assumes that the victim could have been spared if the perpetrator had been identified as potentially dangerous by mental health professionals, yet the prediction of dangerousness remains an inexact science and depends upon many complex factors (Pinard, Pagini, 2001). In the late 19th century the problem of predicting dangerousness came into question and researchers started assessing dangerousness. Criminologist Cesare Lombroso along with some of his colleagues developed the Theory of Ativism, this theorized that a dangerous individual could be identified by their facial features alone (Ackerman, 2011). Lombroso argued that violent humans were throwbacks to more primitive humans and would therefore have some of the facial characteristics and should be detained based on this premise alone. This was disproven as further discoveries were made in assessing dangerousness.
Risk assessment involves estimating the probability of a future event based on past indicators and variables usually compared with others that have had similar circumstances (Hanson, 2009). Until the late 1980’s risk assessments were denoted as “unstructured professional opinion” and professionals were wrong more often than they were right and a lot considered that assessing dangerousness was a doomed process and should be abandoned (Hanson, 2009). Currently risk assessment has gained popularity thanks to the introduction of some useful assessment tools that have been recently developed.
Explained the legal standards used for this evaluation.
Before 1966 relatively little attention was paid to how well clinicians assessed risk (Dolan, Doyle, 2000), this is when Baxgtrom v. Herald (1966) changed the guidelines for dangerousness assessment. With this landmark case 966 patients that were deemed dangerous were removed from maximum security prison and released into society or placed in a lower security setting. Of these individuals that were once held on dangerousness risk 20% had re-offended after they were released. This forced clinicians to relook at the way that they were assessing for dangerousness.
Assessing dangerousness does not occur as often as we may think it does. Forensic assessments that are usually conducted are Competency to Stand Trial and Competency for Sentencing. Dangerousness assessments are usually conducted with sex offenders and can also be conducted with individuals charged with interpersonal relationship violence.
Typical Instruments Used During the Assessment
The Historical Clinical Risk Scheme (HCR-20) is a structured tool that looks at the past, present and future to predict dangerousness (Ackerman, 2011). This tool The ten historical factors look at past behaviors concerning previous violence, age of first violent act, relationship instability, employment problems, substance use problems, major mental illness, psychopathy, early maladjustment, personality disorders, and prior supervision failure (Ackerman, 2011). The five clinical items look at the correlations between violent behaviors and dynamic correlations (Ackerman, 2011). The HCR-20 has done extremely well in studies, in a 1999 study researchers found that individuals that scored above the median scores were 6 to 13 times more likely to offend again 2 years after initial discharge (Ackerman, 2011). This tool was developed for use in correctional settings and should be done in conjunction with another tool.
The Violence Risk Appraisal Guide (VRAG) was developed in 1993 and was standardized on a group of 600 males that were in maximum security hospital settings for violent behaviors. The VRAG identifies 50 predictor variables and a series of regression models identify 12 static factors that covers a variety of life situations, behaviors and characteristics (Ackerman, 2011). This measure has performed well in studies for predicting violence in high-risk offenders. The VRAG is conducted in conjunction with the Psychopathy Checklist-Revised (PCL-R) and must be conducted together because it is a part of the diagnostic criteria.
The Psychopathy Checklist-Revised (PCL-R) is the most widely used instrument of its kind; it is considered the gold standard of violence risk measurements (Ackerman, 2011). It is used in conjunction with the VRAG. The PCL-R assesses 20 traits that range from callousness and lack of empathy to criminal versatility. This measure requires lots of training on behalf of the forensic professional.
Impact of the Assessment on Individuals Being Examined
According to The Sentencing Project (2004) there are more non-violent offenders in prisons than there are violent offenders. The statistics state that 7.9% of offenders had been convicted of violent offenses in federal prisons and 52.4% were incarcerated for violent offenses in state prisons (Bureau of Justice Statistics, 2011). Among these violent offenders there are those that have committed murder, sexual assault, physical assault, intimate partner violence, armed robbery, and many other offenses. The population of violent offenders may seem large, but it is indeed a small population; however it is one that can put the community at a high risk if allowed to re-enter society without assessing them for dangerousness.
The Future of Assessing Dangerousness
Assessing dangerousness has come a long way in the past 30 years and we should be excited that it is has progressed as far as it has. We now have assessments that have done quite well in studies. Now that we have produced some instruments that predict future violence with good accuracy, it is time to enhance these assessments and start looking at underserved groups. The LGBT community has little to no studies conducted with them and the risk of future violence. With the current civil rights movements taking place around the world, and the explosion of same sex couples we need to ensure that this group can be assessed effectively. Women are also an underrepresented group. Since most assessments were standardized on male offenders, it would be wise for an assessment to be developed and standardized with the female offender population. Women like the LGBT community have been all but overlooked when it pertains to violence assessment. It has been a general notion that men tend to be more violent than women and thusly it has been thought that assessing females for dangerousness would be a waste of time. With the shift that society is seeing and the rise of female offenders this should be a fair warning that an effective assessment will be needed in the near future. The LGBT community has become more visible and with more visibility the issues that were once hidden come to surface.
References
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The Sentencing Project (2004) The federal prison population: a statistical analysis, retrieved on July 8, 2011 from http://www.sentencingproject.org/doc/publications/inc_federalprisonpop.pdf
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Ullrich S., Yang M., Coid J., Zhang T., Sizmur S., Roberts C., Farrington D. P., Rogers C., (2009) Gender differences in structured risk assessments: comparing the accuracy of five instruments, Consulting and Clinical Psychology, vol 77, no 2, p 337-348
United States Bureau of Justice Statistics, (2009) Prisoners in 2009, Office of Justice Programs, Washington D.C.
West, Heather; Sabol, William (2010). "Prisoners in 2009". Bureau of Justice Statistics. http://bjs.ojp.usdoj.gov/content/pub/pdf/p09.pdf.
