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Clinical Application of Risk Assessment in the Treatment-Planning Process

NCJ Number
189552
Journal
International Journal of Offender Therapy and Comparative Criminology Volume: 45 Issue: 4 Dated: August 2001 Pages: 421-435
Author(s)
Marianne J. Moran; Michael G. Sweda; M. Richard Fragala; Julie Sasscer-Burgos
Date Published
August 2001
Length
15 pages
Annotation
This article describes the application of risk assessment to clinical practice in a maximum-security forensic hospital, the Clifton T. Perkins Hospital Center (CTPHC) in Maryland.
Abstract
Most individuals at the hospital have been adjudicated as not criminally responsible for violent felonies and thus are suited for risk assessment due to their histories of serious mental illness and serious violence. The risk assessment process at CTPHC began in 1994 and has rapidly evolved with the expanding literature on prediction of dangerousness. Clinicians have gradually moved away from offering numerically based probabilistic statements to a more categorical probabilistic approach in which they might describe the individual as being at low, moderate, or high risk for recidivism. They use two instruments, as well as relevant data for special populations such as arsonists and sex offenders. The risk assessments aid decisions regarding movement to more or less restrictive settings in the hospital or the community, help inform treatment, and provide a tool for vertical integration of services as the individual moves toward less restrictive settings. The clinical application of risk assessments aids identification of risk management strategies based on specific risk factors that can be treated or managed, the identification of the longitudinal course of illness, the clarification of diagnosis, assistance in the development of insight, the identification of community forensic needs, and the allocation of limited resources based on need. The analysis concludes that although prediction may be the primary goal of risk assessment, the clinical applications may be equally useful, particularly from the offender’s perspective. 55 references