Assessment of Multiple Risk Outcomes, Strengths, and Change with the START:AV: A Short-Term Prospective Study with Adolescent Offenders

Abstract

The Short-Term Assessment of Risk and Treatability: Adolescent Version (START:AV; Nicholls, Viljoen, Cruise, Desmarais, & Webster, 2010; Viljoen, Cruise, Nicholls, Desmarais, & Webster, in preparation) is a clinical guide designed to assist in the assessment and management of adolescents’ risk for adverse events (e.g., violence, general offending, suicide, victimization). In this initial validation study, START:AV assessments were conducted on 90 adolescent offenders (62 male, 28 female), who were prospectively followed for a 3-month period. START:AV assessments had good to excellent inter-rater reliability and strong concurrent validity with Structured Assessment of Violence Risk in Youth assessments (SAVRY; Borum, Bartel, & Forth, 2006). START:AV risk estimates and Vulnerability total scores predicted multiple adverse outcomes, including violence towards others, offending, victimization, suicidal ideation, and substance abuse. In addition, Strength total scores inversely predicted violence, offending, and street drug use. During the 3-month follow-up, risk estimates changed in at least one domain for 92% of youth, and 27% of youth showed reliable changes in Strength and/or Vulnerability total scores (reliable change index, 90% confidence interval; Jacobsen & Truax, 1991). While these findings are promising, a strong need exists for further research on the START:AV, the measurement of change, and on the role of strengths in risk assessment and treatment-planning.

Changes in J-SOAP-II and SAVRY Scores Over the Course of Residential, Cognitive-Behavioral Treatment for Adolescent Sexual Offending

“…Second, similar to other studies (see Viljoen, Mordell, & Beneteau, 2012, for a summary), official records were used to measure reoffending. This approach may fail to detect some sexual offenses (Fleming, Jory, & Burton, 2002).…”

“…To examine this, we used reliable change indices (RCIs) to estimate reliable or true change after taking into account measurement error (Jacobson & Truax, 1991). Although many scholars recommend increased use of RCIs (Duff, 2012; Marsden et al, 2011; Stein, Luppa, Brähler, König, & Riedel-Heller, 2010; Wise, 2004), as of yet, few studies have been conducted examining RCIs in the context of violence risk assessment (i.e., Draycott, Kirkpatrick, & Askari, 2012; Kroner & Yessine, 2013; Viljoen, Beneteau, et al, 2012). …”

A screening mechanism to recognize and support at-risk Aboriginal children

“…Some children completed the ACHWM more than once. Because the average time between assessments exceeded one year, and the mental health of youth is dynamic, 19 we included the repeat assessments in this paper. One case was excluded because the participant completed the survey twice within three months.…”

Measurement of Change in Dynamic Factors Using the START: AV

“…Refocusing the aims of risk assessment from prediction to management (Heilbrun, 1997) encourages assessors to consider dynamic factors, which can change over time in response to interventions (Douglas & Kropp, 2002; Douglas & Skeem, 2005; Viljoen et al, 2012). Indeed, risk fluctuates over time, even within individuals identified as high risk (Douglas & Skeem, 2005).…”

“…The body of research examining dynamic factors in youth is growing (see Childs et al, 2014; Lodewijks, de Ruiter, & Doreleijers, 2010; Penney, Lee, & Moretti, 2010; Randolph, 2004; Shepherd, Luebbers, & Ogloff, 2014; van der Put et al, 2010; Viljoen et al, 2012; Vincent, Perrault, Guy & Gershenson, 2012; Schmidt et al, 2011). Overall, findings converge to highlight the relevance of dynamic factors to assessment and management of risk in youth.…”