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A wide variety of psychological assessments may be ordered by the court to assist in making decisions involving legal matters. A psychologist may be called on to help determine whether a defendant is competent to stand trial or was insane at the time of the offense. These evaluations usually consist of a clinical interview and psychological testing. In all forensic evaluations, the final decision is made by the court (judge or jury), not by the psychologist or expert witness. Of the different types of forensic mental health evaluations, the most frequently requested are violence risk assessments, competency to stand trial evaluations, and insanity evaluations.

Violence Risk Assessment

Frequently, criminal courts call on mental health professionals to evaluate the dangerousness of violent and sex offenders. The main goal of these evaluations is to determine the likelihood that an individual will commit violent crimes, either now or in the future. Since violent behavior is not all that common, prediction can often lead to an extremely elevated number of false positives. A false positive mistakenly identifies someone as a future risk when in fact they are not. This may result in offenders being inappropriately incarcerated or denied release from prison.

Certain characteristics, such as the nature and seriousness of the crime, arrest and conviction history, and substance abuse, have been related to predicting the probability that an offender will commit a new violent crime. The idea that mental health professionals can predict future violence is very controversial. Should an offender be released once he or she has served time? Several studies indicate that such predictions can be made, although the accuracy is debatable. Up until the early 1980s, it was believed that these predictions were accurate some of the time, whereas others argued that the prediction of dangerousness was near to impossible. However, recent literature suggests that in certain situations, clinicians can indeed accurately predict dangerousness.

Clinical and Statistical Prediction

There are two general approaches to violence risk assessment: clinical and statistical. Using the clinical method, the clinician forms an impression about the offender by focusing on clinical symptoms based on an offender's criminal history and the results of psychological test data. Clinicians are also needed to understand the personality structure of the individual, the factors that led to past violent behaviors, and how these factors might influence future violent acts. The mental health professional must be able to describe, using clinical analysis, why the offender did what he or she did and under what circumstances he or she is likely to repeat it. Of the different assessment tools available, the most subjective are clinical judgements. As a result, a clinical interview alone cannot be used to make an accurate prediction.

In contrast to clinical prediction, statistical tools are based on empirical research that establishes which individuals, because of certain factors, are at relatively higher risk. When statistics are applied to a violent population (i.e., prison inmates), better predictions can be made. Modern research suggests that predicting future violence can be improved over chance by the use of statistical methods.

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