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Risk Assessment Approaches

Violence risk assessment is relevant to the field of law and psychology because it occurs at numerous junctures in the legal system, and it is one of the key areas of research and clinical practice in forensic psychology. This entry reviews two primary approaches to risk assessment: unstructured and structured. The former approach, sometimes also called clinical prediction or judgment, imposes no rules on the decision-making process, whereas the latter approach does. Two primary approaches to structured risk assessment include (1) actuarial and (2) structured professional judgment (SPJ). Although both structured approaches impose rules in terms of which risk factors are considered and defined, actuarial risk assessment uses an algorithm to combine risk factors into a final decision, whereas SPJ does not. This entry will describe these approaches, along with their attendant strengths and weaknesses.

The Relevance and Context of Risk Assessment

Risk assessment informs decisions about future violence. In numerous legal and clinical practice areas, such decisions are required by statute, professional ethics, or common law. For instance, in most jurisdictions, a person must pose, inter alia, a risk of harm to others (or to self) to be involuntarily civilly committed. The release of prisoners from institutional to community placement is typically contingent on whether they constitute an undue risk to public safety. Risk assessment is the basis for decision making in these situations. Depending on jurisdiction in the United States, psychologists and other mental health professionals have common law and ethical duties to protect third parties from the violence posed by their patients. Correspondingly, risk assessment is used to determine whether a sexual offender will be subjected to postsentence involuntary commitment under sexual predator laws. Analogous “indeterminate sentencing” provisions exist in non-U.S. jurisdictions as well, for example, Canada and the United Kingdom. As such, risk assessment plays a pivotal role in balancing public safety with constitutionally protected rights and freedoms such as liberty.

Approaches to Risk Assessment

Contemporary approaches to risk assessment have been heavily influenced by Paul Meehl's distinction between actuarial and clinical prediction. The former refers to decision-making procedures that involve the formal combination of variables or pieces of information, by way of equations or other algorithmic processes, to reach a decision. The latter is defined by a lack of such rules. In contemporary risk assessment, approaches may be generally classified as structured and unstructured. As described below, unstructured risk assessment is, in essence, the clinical prediction to which Paul Meehl referred. Structured risk assessment includes actuarial prediction as well as a more recent approach termed structured professional judgment.

Unstructured Risk Assessment

Conventionally, unstructured clinical judgment is the most common approach to appraising an individual's risk for violence. By definition, it is based primarily on professional opinion, intuition, and clinical experience. Assessors have absolute discretion in terms of selecting risk factors to consider, how to conceptualize them, how to synthesize case material, and how to interpret this information to render decisions. As such, this method is inherently informal and subjective. Although clinical judgment is a routine and necessary component within many clinical decision-making contexts, the defining feature of clinical judgment in terms of prediction is the lack of rules to integrate case information. Although this permits flexibility, ostensible widespread applicability, and relevance to the individual patient, there are numerous problems with this approach.

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