Structured Approaches to Violence Risk Assessment: A Critical Review

Abstract

This article critically reviews the theory, methodology, and empirical evidence pertaining to the various approaches employed by mental health professionals in expert testimony regarding the probability of future violence for people within the jurisprudence system. Many professionals rely on unstructured clinical assessment, which allows the evaluator to fully capitalize on their clinical experience but is vulnerable to cognitive and situational biases that negatively affect the validity and reliability of the evaluation. In contrast, actuarial assessment involves statistical estimation of violence risk based on certain combinations of criminogenic variables derived from prospective analysis of recidivism in various offender groups. Structured professional judgment relies on professional expertise with a structured checklist application, and thus attempts to minimize the limitations of unstructured clinical and actuarial assessment while retaining the strengths of each. Although an improvement on unstructured assessment, structured applications have significant limitations, highlighting the importance of a multimethod approach to violence risk assessment. [ Psychiatr Ann . 2017;47(9):454–459.]