Most violence risk assessment tools have been validated predominantly in males. In this multicenter study, the Historical, Clinical, Risk Management–20 (HCR-20), Historical, Clinical, Risk Management–20 Version 3 (HCR-20V3), Female Additional Manual (FAM), Short-Term Assessment of Risk and Treatability (START), Structured Assessment of Protective Factors for violence risk (SAPROF), and Psychopathy Checklist–Revised (PCL-R) were coded on file information of 78 female forensic psychiatric patients discharged between 1993 and 2012 with a mean follow-up period of 11.8 years from one of four Dutch forensic psychiatric hospitals. Notable was the high rate of mortality (17.9%) and readmission to psychiatric settings (11.5%) after discharge. Official reconviction data could be retrieved from the Ministry of Justice and Security for 71 women. Twenty-four women (33.8%) were reconvicted after discharge, including 13 for violent offenses (18.3%). Overall, predictive validity was moderate for all types of recidivism, but low for violence. The START Vulnerability scores, HCR-20V3, and FAM showed the highest predictive accuracy for all recidivism. With respect to violent recidivism, only the START Vulnerability scores and the Clinical scale of the HCR-20V3 demonstrated significant predictive accuracy.
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The task of risk assessment is a central feature of probation work and a core activity of probation officers. Risk assessment forms the basis for subsequent interventions and management of offenders so that the likelihood of reoffending is reduced. A primary difficulty for probation workers is the ability to predict the risk of probation violations which could facilitate prevention. The main objective of the present study was to investigate the value of the 61-item Dutch diagnostic and risk assessment tool Recidivism Assessment Scales (RISc) with respect to predicting probation supervision violations of male probationers (N = 14,363). Because all RISc assessments included in the study were completed before the start of the supervision period, they could not have been influenced by behavior of the offenders or other circumstances during this period. It was found that the predictive accuracy of the RISc, with regard to supervision violation, was supported. All RISc subscales and the total score significantly predicted probation supervision violation. The AUC demonstrating the strength of the relationship of the RISc total score (AUC = .70) is satisfactory. Logistic regression analyses resulted in a fitting model, demonstrating that a selection of only 17 items from the total of 61 RISc items was sufficient to predict probation violation while preserving predictive accuracy (AUC = .73). For one of the possible cut-off sum scores used to select groups at high risk for probation violation, it was shown that is possible to double the percentage of correctly identified future violators when compared to the base rate of probation violation.
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The increased use of instruments for assessing risks and needs in probation should lead to intervention plans that meet the criteria for effective practice. An analysis of 300 intervention plans from the Dutch probation service showed that the match between the assessed criminogenic needs and the goals and interventions in the intervention plan is fairly low. It was also found that the so-called risk principle is not fully applied by probation officers. In addition, personal goals that the offender values are often not taken fully into account. Finally, the intervention plans have a strong focus on improving human capital, while improving social capital and basic needs often is not part of the intervention plans, even if they were assessed as dynamic criminogenic needs.
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Risk assessment plays an important role in forensic mental health care. The way the conclusions of those risk assessments are communicated varies considerably across instruments. In an effort to make them more comparable, Hanson, R. K., Bourgon, G., McGrath, R., Kroner, D. D., Amora, D. A., Thomas, S. S., & Tavarez, L. P. [2017. A five-level risk and needs system: Maximizing assessment results in corrections through the development of a common language. The Council of State Governments Justice Center. https:// csgjusticecenter.org/wp-content/uploads/2017/01/A-Five-Level-Risk-and-Needs-system_Report.pdf] developed the Five-Level Risk and Needs System, placing the conclusions of different instruments along five theoretically meaningful levels. The current study explores a Five-Level Risk and Needs system for violent recidivism to which the numerical codings of the HCR-20 Version 2 and its successor, the HCR-20V3 are calibrated, using a combined sample from six previous studies for the HCR-20 Version 2 (n = 411 males with a violent index offence) and a pilot sample for the HCR-20V3 (n = 66 males with a violent index offence). Baselines for the five levels were defined by a combination of theoretical (e.g. expert meetings) and empirical (e.g. literature review) considerations. The calibration of the HCR-20 Version 2 was able to detect four levels, from a combined level I/II to an adjusted level V. The provisional calibration of the HCR-20V3 showed a substantial overlap with the HCR-20 Version 2, with each level boundary having a 2-point difference. Implications for practice and future research are discussed.
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In this thesis several studies are presented that have targeted decision making about case management plans in probation. In a case management plan probation officers describe the goals and interventions that should help offenders stop reoffending, and the specific measures necessary to reduce acute risks of recidivism and harm. Such a plan is embedded in a judicial framework, a sanction or advice about the sanction in which these interventions and measures should be executed. The topic of this thesis is the use of structured decision support, and the question is if this can improve decision making about case management plans in probation and subsequently improve the effectiveness of offender supervision. In this chapter we first sketch why structured decision making was introduced in the Dutch probation services. Next we describe the instrument for risk and needs assessment as well as the procedure to develop case management plans that are used by the Dutch probation services and that are investigated in this thesis. Then we describe the setting of the studies and the research questions, and we conclude with an overview of this thesis.
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The HCR-20V3 is a violence risk assessment tool that is widely used in forensic clinical practice for risk management planning. The predictive value of the tool, when used in court for legal decisionmaking, is not yet intensively been studied and questions about legal admissibility may arise. This article aims to provide legal and mental health practitioners with an overview of the strengths and weaknesses of the HCR-20V3 when applied in legal settings. The HCR-20V3 is described and discussed with respect to its psychometric properties for different groups and settings. Issues involving legal admissibility and potential biases when conducting violence risk assessments with the HCR-20V3 are outlined. To explore legal admissibility challenges with respect to the HCR-20V3, we searched case law databases since 2013 from Australia, Canada, Ireland, the Netherlands, New Zealand, the UK, and the USA. In total, we found 546 cases referring to the HCR-20/HCR-20V3. In these cases, the tool was rarely challenged (4.03%), and when challenged, it never resulted in a court decision that the risk assessment was inadmissible. Finally, we provide recommendations for legal practitioners for the cross-examination of risk assessments and recommendations for mental health professionals who conduct risk assessments and report to the court. We conclude with suggestions for future research with the HCR-20V3 to strengthen the evidence base for use of the instrument in legal contexts.
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The relationship between socioeconomic factors and crime is a classic theme in criminological literature. However, the relationship between debt and crime is still unclear, and little is known about the causality of this relationship and the factors that influence it. In addition, effective interventions and guidelines to adequately support offenders with debt are limited. Therefore, this thesis aims to systematically gain more insight into the factors that influence the relationship between debt and crime among probation clients and to contribute to developing tools that probation officers and other forensic social professionals can use to support clients with debt adequately. The relationship between debt and crime was studied by (1) a systematic and scoping literature review (5 studies were included in the systematic review and 24 studies in the scoping review), (2) a client file study including risk assessment data of a sample of 250 Dutch probation clients, (3) a quantitative study including recidivism data of the same sample of 250 Dutch probation clients, (4) interviews with 33 Dutch probation officers and 16 clients, and (5) a multiple case study focusing on working elements in the supervision of individual offenders (5 cases). The results show that debt is prevalent among probation clients, hinders resocialization, and increases recidivism risk. Debt and crime are not only related directly but are also related by a complex interplay of problems in different life domains, such as problems regarding childhood, education and work, and mental and physical health. Notwithstanding the strong relationship between debt and crime, financial assistance for probation clients with debts is limited. As debt is strongly related to problems in other life domains, a systematic collaboration between professionals of different disciplines is necessary to support clients with debt adequately.
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Although studies point to a relationship between debt and crime, there is a limited understanding of their reciprocal relationship and possible mediating risk factors. Moreover, knowledge about the prevalence and scope of debt among offenders is lacking. Therefore, the present study analyzed 250 client files including risk assessment data from the Dutch probation service on the prevalence of debt and possibly related risk factors. The results show that debt is highly prevalent and complex, which underlines the importance of acquiring more knowledge about debt as a potential risk factor for relapse during supervision. It was found that problems with regard to childhood and living situation, education and work/daytime activities, and mental and physical health may be possible underlying risk factors in the relationship between debt and crime. These insights can help professionals adequately support clients with regard to debt in order to prevent recidivism. debt and crime. These insights can help professionals adequately support clients with regard to debt in order to prevent recidivism.
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There is emerging evidence that the performance of risk assessment instruments is weaker when used for clinical decision‐making than for research purposes. For instance, research has found lower agreement between evaluators when the risk assessments are conducted during routine practice. We examined the field interrater reliability of the Short‐Term Assessment of Risk and Treatability: Adolescent Version (START:AV). Clinicians in a Dutch secure youth care facility completed START:AV assessments as part of the treatment routine. Consistent with previous literature, interrater reliability of the items and total scores was lower than previously reported in non‐field studies. Nevertheless, moderate to good interrater reliability was found for final risk judgments on most adverse outcomes. Field studies provide insights into the actual performance of structured risk assessment in real‐world settings, exposing factors that affect reliability. This information is relevant for those who wish to implement structured risk assessment with a level of reliability that is defensible considering the high stakes.
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Background. Violent criminal offenders with personality disorders (PD’s) can cause immense harm, but are often deemed untreatable. This study aimed to conduct a randomized clinical trial to test the effectiveness of long-term psychotherapy for rehabilitating offenders with PDs. Methods. We compared schema therapy (ST), an evidence-based psychotherapy for PDs, to treatment-as-usual (TAU) at eight high-security forensic hospitals in the Netherlands. Patients in both conditions received multiple treatment modalities and differed only in the individual, study-specific therapy they received. One-hundred-three male offenders with antisocial, narcissistic, borderline, or paranoid PDs, or Cluster B PD-not-otherwise specified, were assigned to 3 years of ST or TAU and assessed every 6 months. Primary outcomes were rehabilitation, involving gradual reintegration into the community, and PD symptoms. Results. Patients in both conditions showed moderate to large improvements in outcomes. ST was superior to TAU on both primary outcomes – rehabilitation (i.e. attaining supervised and unsupervised leave) and PD symptoms – and six of nine secondary outcomes, with small to moderate advantages over TAU. ST patients moved more rapidly through rehabilitation (supervised leave, treatment*time: F(5308) = 9.40, p < 0.001; unsupervised leave, treatment*- time: F(5472) = 3.45, p = 0.004), and showed faster improvements on PD scales (treatment*- time: t(1387) = −2.85, p = 0.005). Conclusions. These findings contradict pessimistic views on the treatability of violent offenders with PDs, and support the effectiveness of long-term psychotherapy for rehabilitating these patients, facilitating their re-entry into the community
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