Comprehensive Violence & Risk Assessment: Key Concepts & Tools

Violence

defined as the actual, attempted, or threatened infliction of bodily harm (including serious psychological harm).

Bodily harm

means harm that 'substantially interferes with the health or well-being' of a person.

Serious psychological harm

includes acts such as stalking, unlawful confinement, and extortion.

Elements of violence

requires 5 elements: An act (including threats), Some degree of intention, Potential to cause harm, Physical or serious psychological harm, Impact on another person.

Mens rea

the legal term for 'guilty mind' associated with intentionality.

Barefoot v. Estelle

(1983) allowed clinicians to testify about future dangerousness.

Predictions of future violence

were highly inaccurate prior to Barefoot.

Modern VRA

focuses on structured risk assessment rather than categorical predictions.

Risk assessment questions

asks: Risk for what outcome? How high? What variables contribute?

Unstructured Professional Judgment (UPJ)

is not evidence-based.

Weakness of UPJ

is low inter-rater reliability.

Structured Professional Judgment (SPJ)

is guided by scientific evidence and professional standards.

HCR-20

the most widely used SPJ tool internationally.

Actuarial methods

rely primarily on static variables.

Major actuarial tools

are the VRAG-R and STATIC-99R.

HCR-20 components

stands for: Historical, Clinical, Risk Management.

Historical factors

include past violence, antisociality, personality disorder, substance use, and violent attitudes.

Clinical factors

include Insight, Violent Ideation/Intent, Major Mental Disorder Symptoms, Instability, Treatment Response.

Risk management items

include Professional Services, Living Situation, Personal Support, Treatment/Supervision Response, Stress/Coping.

SPJ products

results in four products: risk formulation, violence scenarios, management plan, and final opinion.

Numerical risk estimate

SPJ does not generate a numerical risk estimate.

JVRAP purpose

determines risk level, relevant situations, risk/protective factors, interventions, and degree of monitoring/containment.

Historical factors in JVRAP

are those that occurred more than 3 months ago.

Dynamic factors

are changeable and can increase or decrease risk.

Protective factors

include coping capacities that reduce or eliminate risk potential.

Best predictor of future violence

is prior violent acts.

High lifelong risk indicators

Patterns beginning in pre-school years and continuing over time signal high lifelong risk.

Statistical predictors

The BEST statistical predictors of repetitive antisocial behavior include: Prior arrests (especially ≥ 5 before age 16), Poor parental supervision, Affiliation with delinquent peers.

Duty to Protect

established by Tarasoff v. Regents.

Duty to Protect actions

may involve warning the potential victim, notifying authorities, or increasing patient containment.

NY's Mental Health Law

MHL 9.46 expands reporting obligations.

Targeted school violence

is not random; it is planned.

poses

The primary goal of school threat assessment is to determine if a student poses a threat, not just makes one.

behavior

Targeted attacks follow an understandable and detectable pattern of thinking and behavior.

Progression of targeted violence

Ideation, Plan development, Obtaining means, Possible rehearsal, Attack.

days to years

This timeline ranges from days to years.

violent thoughts

Increased risk occurs when a student tends to think about or act on violent thoughts.

loss

Key situational stressors include bullying, humiliation, loss of relationships, and perceived loss of status.

non-violent alternatives

The setting should be assessed for messages that violence is an acceptable strategy versus non-violent alternatives.

report

Common finding from school shootings: other students knew about attack plans but did not report.

duty

Threat assessment must include consideration of target safety and potential duty to protect.

multiple sources

Threat assessment requires a skeptical, inquisitive mindset with continuous review and cross-validation across multiple sources.

facts

Risk assessments should focus on 'behaviorally relevant ____,' not traits or profiles.

community agencies

Integrated assessment requires combining data from mental health, juvenile justice, school, family, and _______.

20%

Less than _____ of school shooters made direct threats before the attack.

grudge/grievance

Does the student have motives, goals, or a significant ________ toward a specific target?

terrorism

Any evidence of atypical interest in school attacks, weapons, mass violence, or _________?

attack sites

Indicators of pathway behaviors include planning, acquiring weapons, practicing, and observing attack sites.

capacity

Assess whether the student has the capacity and means to commit violence.

attack risk

Presence of hopelessness or desperation increases both suicide and attack risk.

responsible adult

Crucial question: Does the student have a trusting relationship with at least one responsible adult?

firearms

Examples: early aggression (< age 6), exposure to DV, abuse, sexually aggressive behavior, use of firearms in threatening manner.

discipline

Examples: poverty, parental felony conviction, substance dependence, poor supervision, harsh or ineffective discipline.

weapons

Examples: repeated discipline problems, academic failure, high crime area, easy access to weapons.

justify/glorify

Examples: bullying, social isolation, affiliation with delinquent peers, attitudes that justify/glorify violence.

empathy

Examples: TBI, risk-taking, psychotic-like thinking, lack of empathy, alcohol dependence.

potential victims

Examples: inadequate supervision, history of excessive injury to victims, potential victims readily available.

school/hospital/residential placement

Examples: recent aggression despite deterrents, aggression in supervised settings (e.g., school/hospital/residential placement).

problem

Examples: average or above IQ, acknowledges violence as a problem, good response to intervention.

consent

Sexual offending refers to sexual acts committed without consent.

informed consent

When sexual offending involves minors, consent is legally impossible because minors cannot provide informed consent.

physical contact

A sexual offense becomes 'hands-on' when it involves direct physical contact.

pornography

'Hands-off' sexual offenses primarily involve voyeurism, exhibitionism, or pornography.

sexual offenses

Most sexual offenses occur between the offender and someone they know.

cognitive distortions

Sexual offending is strongly associated with distorted thinking known as sexual cognitive distortions.

paraphilia disorder

A paraphilia becomes a disorder when it causes distress, impairment, or harm to another person.

major paraphilic disorders

DSM-5 lists eight major paraphilic disorders; name three: Pedophilic, Exhibitionistic, Voyeuristic, Sexual Sadism, Sexual Masochism, Frotteuristic, Fetishistic, Transvestic.

Pedophilic disorder

Pedophilic disorder involves recurrent sexual interest in a child ≤ age 13.

Sexual sadism disorder

Sexual sadism disorder involves arousal from the suffering of another person.

Sexual masochism

Sexual masochism involves arousal from being harmed/humiliated.

Exhibitionistic disorder

Exhibitionistic disorder involves exposing one's genitals to an unsuspecting person.

Voyeuristic disorder

Voyeuristic disorder involves observing someone naked or engaging in sexual activity.

STATIC-99R

The STATIC-99R is an actuarial tool used to assess risk of male sexual recidivism.

STATIC-99R items

STATIC-99R contains 10 items.

STATIC-99R factors

STATIC-99R assesses only static factors.

STATIC-99R domains

Two primary STATIC-99R domains: 1) sexual offense history, 2) victim characteristics.

risk factor age

Age is included as a risk factor because younger offenders statistically show higher risk.

STATIC-99R treatment needs

STATIC-99R does NOT assess treatment needs or dynamic change.

recidivism rates

Scores correspond to recidivism rates over 5, 10, 15 years.

relapse prevention

Relapse prevention focuses on recognizing personal patterns leading to sexual offending.

relapse cycle

A relapse cycle usually begins with a seemingly innocuous decision.

key elements of relapse prevention

Key elements of relapse prevention: Personal responsibility, Understanding offense cycle, Identifying high-risk situations, Coping skills.

cognitive distortions in relapse

Cognitive distortions must be challenged because they justify or normalize sexual behavior.

relapse prevention plan

Offenders create a relapse prevention plan that includes early warning signs, coping skills, and accountability supports.

polygraph testing

Many relapse prevention programs incorporate polygraph testing to encourage honesty.

domestic violence

Domestic violence is a pattern of coercive control involving physical, psychological, or emotional abuse.

intimate partner violence (IPV)

Intimate partner violence (IPV) includes current or former romantic partners and includes coercive control, threats, and violence.

three-phase cycle of abuse

The three-phase cycle of abuse includes tension building, acute violence, and honeymoon phase.

predictor of future IPV

The strongest predictor of future IPV is past IPV.

risk factors for IPV perpetrators

Risk factors for IPV perpetrators include substance abuse, jealousy, unemployment, and emotional dependence.

victims of IPV

Victims often remain due to fear, financial dependence, children, or concerns about lethal retaliation.

Battered Woman Syndrome (BWS)

Battered Woman Syndrome (BWS) was developed by psychologist Lenore Walker.

learned helplessness

BWS reflects a pattern of learned helplessness after repeated cycles of abuse.

BWS in court

BWS is often used in court to explain delayed reporting, staying with an abuser, or using self-defense force.

cycle of violence in BWS

The cycle of violence associated with BWS includes tension, battering, and contrition ("honeymoon").

perception of helplessness

Learned helplessness emerges when victims perceive no effective actions they can take.

Strength at Home

Strength at Home is an evidence-based IPV intervention originally designed for military veterans.

maladaptive beliefs in Strength at Home

What types of maladaptive beliefs does Strength at Home help participants challenge? Beliefs about gender roles, power, and entitlement.

Strategies to reduce conflict

Strategies that reduce conflict, promote clarity, and prevent emotional escalation.

Family-Only batterer subtype

Violence limited to the home, low antisocial traits, and minimal general criminality.