1. Introduction and Overview
Stephen D. Hart, PhD
Introduction and Overview
Violence: New Developments in Risk Assessment, Formulation, and management

2. Risk Assessment: Task Analysis

3. VPD Threat Assessment Course
February 18, 2005
Multiple Goals
Prevent violence
Guide intervention
Improve consistency
Protect patient rights
Minimize professional liability
Sexual Violence

4. Multiple Stakeholders
VPD Threat Assessment Course
February 18, 2005
Multiple Stakeholders
Patients and offenders
Service providers
Administrators
Courts and tribunals
Public
Sexual Violence

5. Multiple Steps Clarify psycholegal issues Gather relevant information
Identify relevant risk factors
Weight and combine risk factors
Determine preferred actions
Optimize risk Communication

6. Risk Assessment as Prediction

7. Actuarial Approach Problem is task complexity
Clinicians don’t have the necessary brainpower
Solution is simplification + automation
Reconceptualize risk assessment as violence prediction
Develop algorithms (ARAIs) for discriminating known groups of violent recidivists versus non-recidivists
Apply algorithms to new cases

8. Multiple Steps Clarify psycholegal issues Gather relevant information
Identify relevant risk factors
Weight and combine risk factors
Determine preferred actions
Optimize risk Communication

9. Problems with ARAI Predictions
Ignore complexity
Ignore causality
Not individualized
Not contextualized
Discourage action

10. Assessing Psychopathy: An Overview of the Hare Scales
31 October 2005
Niels Bohr
“Predicting is very difficult, especially about the future.”
(c) 2005 by Stephen D. Hart

11. Prevention Through Planning

12. Planning Directly guides action Focuses on what should be done
Based on prudence
Goes beyond abstract knowledge and technical skills
Relies on qualitative, narrative reasoning
Uses formulation, rather than formulas

13. Advantages Does not require prediction
Considers what might happen, not what will happen
Does not require certainty
Evaluates action in light of current knowledge
Encourages causal, systemic thinking
Identifies controlling factors

14. Approaches to Planning
Clinical case formulation
Root cause analysis
Scenario planning
Failure modes and effects analysis

15. Assessing Psychopathy: An Overview of the Hare Scales
31 October 2005
Dwight D. Eisenhower
“Plans are nothing; planning is everything.”
(c) 2005 by Stephen D. Hart

16. Conclusions

17. Evidence-Based Decisions
“[T]he conscientious, explicit and judicious use of current best evidence in making decisions”
– David Sackett

18. Evaluating Plans HCR-20 for CONREP 18-19 March 2008
Plausibility
Information anchors should be relevant, comprehensive, and credible
Utility
Plans should be detailed, individualized, and feasible
Reliability
Different evaluators should develop similar plans
Acceptability
Plans should be agreeable to stakeholders
Validity
Properly implemented plans should reduce violence
© 2008 by Stephen D. Hart, PhD

19. Assessing Psychopathy: An Overview of the Hare Scales
31 October 2005
Alan Kay
“The best way to predict the future is to invent it.”
(c) 2005 by Stephen D. Hart

20. Correspondence
Stephen D. Hart, PhD Department of Psychology Simon Fraser University University Drive Burnaby, BC Canada V5A 1S6 Tel: +1 (778)