Content area
Full Text
Introduction
Risk assessment forms an integral part of a clinician’s role in forensic settings. The demand for accurate risk assessment tools is growing and the consequences of inaccurate assessment of risk are significant (Viljoen et al., 2012). The process of risk assessment has developed significantly in the last few years, but with much of the focus being directed upon adult tools and upon the risk of interpersonal violence (Otto and Douglas, 2010). The structured professional judgement (SPJ) model has been widely accepted as an empirically-supported way to approach risk assessment, and that use of an actuarial or SPJ tool is best practice (Heilbrun et al., 2010). The structured assessment of violence risk in youth (SAVRY: Borum et al., 2003) was developed as an assessment of the risk of interpersonal violence in adolescents, drawing on the extensive literature highlighting the factors that place adolescents at greater risk of violence (Borum, 2000). Although evidence suggests good predictive validity for the SAVRY, including in institutional settings (Gammelgård et al., 2008; Olver et al., 2009) there are some ongoing themes in the area of adolescent risk assessment which require consideration.
First, the SAVRY is often used to assess long-term risk, with short-term violence being relatively neglected. Research has shown that a focus on dynamic clinical factors can improve the assessment of violence occurring in the short-term within institutional settings (Grevatt et al., 2004). Despite the emphasis on historical and dynamic risk factors the SAVRY was not designed specifically to assess risk within institutions in the short-term. It has also not been studied extensively in this context, with the Viljoen et al. (2012) study being the first prospective study of the SAVRY in an institutional setting. In terms of assessing risk in a learning disability population, the dynamic risk assessment and management system (DRAMS) explores a number of proximal/dynamic risk variables, such as mood, self-regulation and compliance and was developed for use with offenders who have intellectual disabilities (Lindsay et al., 2004). A unique aspect to its use was the design of a “traffic-light analogy” which allows the tool to be used in collaboration with service users (Lindsay et al., 2004). The DRAMS was later reformulated to consist of ten items, and...