By Stephen D. Hart, P. Randall Kropp, & D. Richard
with Jessica Klaver, Caroline Logan, and Kelly A. Watt
Published jointly by the Mental Health, Law, and Policy Institute of
Simon Fraser University, the Pacific Psychological Assessment Corporation,
and the British Columbia Institute Against Family Violence
The assessment of dangerousness can, itself, be a dangerous undertaking.
Disagreement and acrimony erupt throughout the literature. Despite
evidence showing the improvement of empirically derived assessments
clinical judgments, numerous questions remain: How closely did the
research conditions resemble current practice conditions? How closely
tasks of research subjects match the referral questions of practitioners
today? Armed with the recent research data, can’t clinicians
now go about their assessments more effectively? Or is the fundamental
that some clinicians are less motivated to base their assessments
on what the research tells us?
The predictive validity of many current actuarial methods for assessing
risk of sexual recidivism has already been described (Hanson & Morton-Bourgon,
2004). However, their utility beyond risk classification can be limited,
albeit with some exceptions (Roberts, Doren, & Thornton, 2002; Doren,
2002). Many (e.g. Hart, Laws, & Kropp, 2003) highlight the potential
shortcomings of these methods. Still others (e.g. Beech & Ward, in
press; Zamble & Quinsey, 1997) offer ideas for further refinement
and suggest that static factors are best considered as markers for
underlying dynamic processes.
Ultimately, only one thing is clear: There are many reasons to assess
risk, and many frameworks (clinical and forensic) in which to assess
it. No assessment scheme speaks to every referral question, practice
context, or legal application. In 2000, Serin & Brown developed their “10
Commandments of Risk Assessment”. These are:
1) Thou shalt know thy base-rate
2) Thou shalt use multi-method assessment strategies
3) Thou shalt not confuse shared method variance with increased validity
(i.e. more information does not necessarily increase accuracy)
4) Thou shalt be wary of clinical overrides
5) Thou shalt heed statistical estimates
6) Thou shalt not covet thy neighbor’s data
7) Thou shalt know the limits of thy prediction
8) Thou shalt know thy false positive and false negative rates for specific
9) Thou shalt provide conditional predictions
10) Thou shalt follow an aide-memoire
More recently, Webster, Hucker, & Bloom (2002) have offered five
guidelines for “transcending the actuarial versus clinical polemic
in assessing risk for violence”:
1. Understand the applicable legal framework
2. Make risk assessments evidenced-based
3. Provide an individualized statement of risk
4. Include steps to reduce that risk
5. Compare the individual case with scientific data when possible
The RSVP incorporates many, if not all, of these latter guidelines.
It contributes to comprehensive risk assessment formulations beyond
simple categorization. It is structured to distinguish between the
of risk factors and determination of their relevance to future offending.
While the implicit aim of most risk assessment is the prevention
of further sexual abuse, their design tends to be limited to classification
or a probabilistic statement. The RSVP’s primary and explicit
focus is in prevention, as well as protection of past and future
The RSVP is designed to provide structure to professional judgement.
It is not intended as a revision of the Sexual Violence Risk 20 (SVR-20;
Boer, Hart, Kropp, & Webster, 1998) or the Sex Offender Risk Assessment
(SORA; Atkinson, Kropp, Laws, & Hart, 1996), but has clearly evolved
from both. The authors chose risk factors based on empirical, clinical,
and legal criteria, selecting those associated with the nature, severity,
frequency, imminence, and likelihood of sexual violence. They further
attempted to conceptualize these factors at a basic level in order to
provide clear definitions to help inform risk management decisions. The
authors are clear that the RSVP represents their own opinions and judgments,
and not necessarily those of any professional organization. There are
no restrictions on purchasing the RSVP, but the authors state it “may
be considered a psychological test” (P. 15).
Administration of the RSVP includes six steps:
1. Gathering and evaluating case information (including: gathering
case information regarding the individual’s history of sexual
violence, in multiple domains; using multiple methods from multiple
concerning static and dynamic aspects. Information should be updated
and documented, and its adequacy evaluated.)
2. Establishing the presence of risk factors (including coding some as
provisional, or omitting them due to lack of information)
3. Establishing the relevance of risk factors
4. Establishing risk scenarios (including the questions: “What
is it I’m trying to prevent? What exactly is it I’m worried
the person might do?)
5. Development of risk management strategies (including monitoring, treatment,
supervision, and victim safety planning)
6. Summary judgments (including: case prioritization from low/routine
through moderate/elevated to high/urgent, with consideration given to
risk of serious physical harm/need for immediate action and other risks
that may be indicated)
Twenty-two risk factors are presented in five domains: Sexual Violence,
Psychological Adjustment, Mental Disorder, Social Adjustment, and Manageability.
Each factor is given a description with reference to literature that
supports it. No specific protective aspects that might serve to mitigate
risk are offered directly. Although the absence of some factors might
serve a protective function (e.g. problems with intimate relationships),
no discussion is provided on how best to understand the absence of
risk factors. Also excluded is discussion related to the combination
and sexual deviance (Quinsey, Harris, Rice, & Cormier, 1998; Serin,
Mailloux, & Malcolm, 2001). While “treatment problems” are
defined effectively, this factor could benefit from more consideration
of how different treatment strategies apply to certain types of offenders.
Examples might include empathy training for those high in psychopathic
traits, or aversive reconditioning for those whose offending is related
more to antisociality than sexual deviance. Finally, the RSVP does
not discuss the need to anchor assessments in applicable base rate
Without a doubt the RSVP will assist many evaluators in structuring
assessments, refining their formulations, and communicating their findings
in this most important work. It is applicable to diverse situations.
Further, it will assist in the construction of assessment-driven treatment
plans. Its main advantage, beyond its explicit structure and focus on
prevention, lies in its capacity to remind evaluators to consider aspects
they might have forgotten, and to give thought to elements that they
might otherwise not want to consider. Given its price and advantages,
it will benefit anyone interested in risk assessment. It builds on the
SVR-20 without negating it. It is a welcome contribution to the literature.
The RSVP would benefit from additional development in a number of
areas. Discussion of current thought into risk, need, and responsivity
(Andrews & Bonta,
1998) might help evaluators understand the contribution of risk factors
that receive inconsistent support in the literature, and whose role in
an offense may be less direct than others. Inclusion of current thought
into the nature of acute and stable dynamic risk (as “states and
traits”; Beech & Ward, in press) might also be helpful.
Those entering the unenviable world of risk assessment are implicitly
asked to decide amongst a range of competing perspectives in high-stakes
situations. Many have strong opinions about the meaning of research findings.
There is still a dearth of recommendations for reconciling the diversity
of thought in risk assessment. One might wish for a more integrated (but
still structured and explicit) means to understand and communicate risk
of harm for people across the life span. No method fully assists practitioners
in making sense of what is known to this point.
Despite its appeal and comprehensive approach, the RSVP risks continuing
much of the debate it might otherwise have resolved. Section titles
such as “the alleged superiority of actuarial risk assessment
do little to move past an arguably insubstantial debate. One could
argue that the
RSVP itself has not yet been demonstrated to be effective, either.
Its predictive validity and inter-rater reliability remain unknown.
introduction, the authors present their own perspective on the actuarial-versus-clinical
“Despite recent advances in research (or perhaps more accurately,
because of them) there is considerable debate concerning best practices
with respect to sex offender assessment… The optimistic view highlights
the promise of risk assessment. The promise is that risk procedures can
identify the specific or absolute probability that any given offender
will commit another sexual offense… The optimists believe that
such prognoses are stable and accurate, and will assist in making important
decisions about sexual offenders. In contrast, pessimists highlight the
peril. Their primary concern is that mental health professionals who
conduct risk assessments over-rely on methods of unknown or limited value,
pretending a degree of scientific support and precision that has not
been attained… One potential consequence is that important decisions
will be based on professional opinions of questionable value; another
is that decision-makers are encouraged to think about management in very
simplistic terms.” (P. 2)
Ultimately, one might hope that future manuals of this sort will offer
resolution to both promise and peril, and offer greater insight into
how we can best understand those factors whose empirical support is inconsistent.
In the meantime, it is probably not enough to study risk assessment methods
and their development. One should study how the field produces such diversity
of thought. Despite the areas where the RSVP would be aided by further
development, it will benefit those struggling with risk assessment, treatment
planning, and other aspects of reducing the harm of sexual abuse.
Andrews, D.A. & Bonta, J.L. (1998) The Psychology of Criminal
Conduct, Second Edition. Cincinnati: Anderson Publishing.
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