Although it is widely believed that risk assessment tools can help manage risk of violence and offending, it is unclear what evidence exists to support this view. As such, we conducted a systematic review and narrative synthesis. To identify studies, we searched 13 databases, reviewed reference lists, and contacted experts. Through this review, we identified 73 published and unpublished studies (N = 31,551 psychiatric patients and offenders, N = 10,002 professionals) that examined either professionals' risk management efforts following the use of a tool, or rates of violence or offending following the implementation of a tool. These studies included a variety of populations (e.g., adults, adolescents), tools, and study designs. The primary findings were as follows: (a) despite some promising findings, professionals do not consistently adhere to tools or apply them to guide their risk management efforts; (b) following the use of a tool, match to the risk principle is moderate and match to the needs principle is limited, as many needs remained unaddressed; (c) there is insufficient evidence to conclude that tools directly reduce violence or reoffending, as findings are mixed; and (d) tools appear to have a more beneficial impact on risk management when agencies use careful implementation procedures and provide staff with training and guidelines related to risk management. In sum, although risk assessment tools may be an important starting point, they do not guarantee effective treatment or risk management. However, certain strategies may bolster their utility. (PsycINFO Database Record

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Indigenous people and the courts have emphasized that it is important to examine whether scores from violence risk assessment tools are valid and appropriate for Indigenous youth. However, studies are scarce. Therefore, we examined the predictive validity of youth probation officers’ Structured Assessment of Violence Risk in Youth (SAVRY) ratings for 744 Canadian youth, including 299 Indigenous youth (219 male, 80 female), and 445 Caucasian youth (357 male, 88 female) in a prospective field study. The SAVRY summary risk ratings and risk total scores significantly predicted violent and any reoffending for Indigenous female and male youth with medium effect sizes. Relatively few significant differences in the predictive validity emerged for Indigenous and Caucasian youth. However, Historical, Protective, and Risk Total scores predicted any recidivism better for Caucasian males than Indigenous males. Also, Indigenous youth scored significantly higher on all risk domains than Caucasian youth. Opposite to predictions, the rates of false positives were higher for Caucasian youth than for Indigenous youth. Based on the results, the SAVRY appears to be a reasonable tool to use for assessing risk in Indigenous youth. However, assessors should take steps to ensure that they use the SAVRY in a culturally appropriate manner, such as considering cultural factors in case formulations and treatment planning as the SAVRY does not ground assessments in an understanding of factors such as colonialism. In addition, future research should examine culturally salient risk factors (e.g., discrimination) and examine potential causes of higher risk scores in Indigenous youth, particularly the role of both past and present-day colonialism.

Even when probation officers use risk assessment tools, many of their clients' needs remain unaddressed. As such, we examined whether the implementation of the Structured Assessment of Violence Risk in Youth (SAVRY) and a structured case planning form resulted in better case plans as compared to prior practices (i.e., a non-validated local tool and an unstructured plan). Our sample comprised 216 adolescents on probation who were matched via propensity scores. Adolescents in the SAVRY/Structured Plan condition had significantly better case plans than those in the pre-implementation condition. Specifically, following implementation, adolescents' high need domains were more likely to be targeted in plans. Plans also scored higher on other quality indicators (e.g., level of detail). These improvements appeared to be due primarily to the structured plan rather than the SAVRY. Overall, our findings highlight that, just as structure can improve risk assessments, so too might structure improve case plans.

The funders had no role in the study design, data collection, data analysis, or manuscript composition. We thank Shanna Li and Julia Schillaci-Ventura for data entry and editing and Dr. Matthew Sigal for statistical assistance with the ggplot2 package in R. Jodi L. Viljoen designed the study, wrote the protocol, conducted analyses, and wrote the manuscript. Lee M. Vargen, Dana M. Cochrane, Melissa R. Jonnson, Ilvy Goossens, and Sanam Monjazeb extracted data from the studies, conducted analyses, and contributed to the final manuscript. Also, Lee M. Vargen and Dana M. Cochrane conducted the systematic searches.

Even though risk assessment tools are often intended to inform case planning, they do not provide much direct guidance. As such, we developed an intervention-planning tool called the Adolescent Risk Reduction and Resilient Outcomes Work-Plan (ARROW) to accompany the Structured Assessment of Violence Risk in Youth. The ARROW includes a decision support system, guide, and training, and is one of the first tools of its kind. To evaluate the ARROW, we conducted two studies: (a) a vignette study with 178 professionals and (b) a field study with 320 propensity-score matched adolescents. Most professionals (>98%) rated the ARROW as useful. Moreover, compared with (a) unstructured plans and (b) a simple form, ARROW plans were more likely to include supported interventions, adhere to best practices, and integrate culturally tailored approaches for Indigenous adolescents. Formulations also showed improvements. However, further research is needed on strategies to bridge risk assessment and risk management.