An audit of the quality of HCR-20 violence risk assessments in a low secure service

Sen, Piyal; Lindsey, Simone; Chatterjee, Nilanjan; Rama-Iyer, Rajesh; Picchioni, Marco

doi:10.1017/s1742646415000096

Cited by 6 publications

(8 citation statements)

References 24 publications

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“…We have also demonstrated that knowledge diffusion can be accelerated by providing continuing education to the most influential individuals in professional networks. It is yet unclear how effective risk assessment training is; Previous studies have indicated that even short education sessions are effective in improving risk assessment practices (Gough, Richardson, & Weeks, 2015;McNeil et al, 2008;Reynolds & Miles, 2009;Sen, Lindsey, Chatterjee, Rama-Iyer, & Picchioni, 2015). For example, a 5-hour workshop on the management of risk of violence and suicide significantly improved psychiatrists' ability to identify risk and protective factors (McNeil et al, 2008;Teo et al, 2012).…”

Section: Discussionmentioning

confidence: 99%

Is Knowledge Contagious? Diffusion of Violence-Risk-Reporting Practices Across Clinicians’ Professional Networks

Charette

Goossens

Seto

et al. 2021

Clinical Psychological Science

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The knowledge–practice gap remains a challenge in many fields. Health research has shown that professional networks influence various aspects of patient care, including diffusion of innovative practices. In the current study, we examined the potential utility of professional networks to spread the use of violence-risk-assessment tools in forensic psychiatric settings. A total of 6,664 reports, written by 708 clinicians, were used to examine the effect of clinicians’ use of risk-assessment tools on subsequent reports by other clinicians with whom they share patients. Results show that professional networks serve as an important channel for the spread of assessment practices. Simulation of a continuing education program showed that targeting more influential clinicians in the network could be 3 times more efficient at disseminating best practices than randomly training clinicians. Decision-makers may consider using professional networks to identify and train influential clinicians to maximize diffusion of the use of risk-assessment instruments.

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Section: Discussionmentioning

confidence: 99%

Is Knowledge Contagious? Diffusion of Violence-Risk-Reporting Practices Across Clinicians’ Professional Networks

Charette

Goossens

Seto

et al. 2021

Clinical Psychological Science

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“…(1) Adherence will vary per START:AV feature. In line with Sen et al's (2015) finding that rationales were only provided in 40% of the HCR-20s, it is hypothesized that adherence scores for features that require reflection and written arguments will be lower than features that only require checking off boxes.…”

Section: Hypothesesmentioning

confidence: 99%

“…More recently, Sen et al (2015) adjusted the CAI-V (McNiel et al, 2011) to assess adherence of completed HCR-20 forms to the instrument's instructions. With the resulting "HCR-20 quality assessment guide", the authors identified shortcomings in the HCR-20s completed within their service.…”

Section: Participant Responsivenessmentioning

confidence: 99%

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Adherence to Structured Risk Assessment Guidelines: Development and Preliminary Evaluation of an Adherence Scale for the START:AV

Beuf

Vogel

Ruiter

2020

Journal of Forensic Psychology Research and Practice

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Risk assessment instruments are widely used to predict risk of adverse outcomes, such as violence or victimization, and to allocate resources for managing these risks among individuals involved in criminal justice and forensic mental health services. For risk assessment instruments to reach their full potential, they must be implemented with fidelity. A lack of information on administration fidelity hinders transparency about the implementation quality, as well as the interpretation of negative or inconclusive findings from predictive validity studies. The present study focuses on adherence, a dimension of fidelity. Adherence denotes the extent to which the risk assessment is completed according to the instrument's guidelines. We developed an adherence measure, tailored to the Short-Term Assessment of Risk and Treatability: Adolescent Version (START:AV), an evidence-based risk assessment instrument for adolescents. With the START:AV Adherence Rating Scale, we explored the degree to which 11 key features of the instrument were adhered to in 306 START:AVs forms, completed by 17 different evaluators in a Dutch residential youth care facility over a two-year period. Good to excellent interrater reliability was found for all adherence items. We identified differences in adherence scores on the various START:AV features, as well as significant improvement in adherence for those who attended a START:AV refresher workshop. Outcomes of risk assessment instruments potentially impact decision-making, for example, whether a youth's secure placement should be extended. Therefore, we recommend fidelity monitoring to ensure the risk assessment practice was delivered as intended.

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“…whether or not to grant area leave, how to best progress patients to other wards, and how to safely manage discharge). We have ourselves observed considerable variation in how different units have approached this task, and some research has highlighted weaknesses in servicelevel implementation (Sen et al 2015;Gough et al 2015).…”

Section: Introductionmentioning

confidence: 99%

Practicalities of HCR-20 implementation within secure psychiatric services

Beazley¹,

Carter²,

Stewart³

et al. 2017

j psych intensive care

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The HCR-20 is established as the de-facto tool for the assessment of violence risk within forensic psychiatric services. Although much has been written about the value of the tool, less has been written about the practicalities of achieving meaningful completion of HCR-20 assessments at a service level. The present paper seeks to review recommendations within the literature and also those based upon the authors' own experiences in HCR-20 implementation, reviewing a number of the common issues and barriers encountered within the development of a strategic, service-level, approach to completion of the HCR-20. Possible solutions to these problems are also considered. We conclude that although there is not necessarily a single approach that is right for every service, certain principles need to be followed to ensure high quality assessments. Further, we develop a number of 'good practice points' which will be useful for services considering this issue on a strategic level, as well as commissioners evaluating the quality of HCR-20 completion within services.

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An audit of the quality of HCR-20 violence risk assessments in a low secure service

Cited by 6 publications

References 24 publications

Is Knowledge Contagious? Diffusion of Violence-Risk-Reporting Practices Across Clinicians’ Professional Networks

Is Knowledge Contagious? Diffusion of Violence-Risk-Reporting Practices Across Clinicians’ Professional Networks

Adherence to Structured Risk Assessment Guidelines: Development and Preliminary Evaluation of an Adherence Scale for the START:AV

Practicalities of HCR-20 implementation within secure psychiatric services

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