Encyclopedia of Psychology and Law

helping professionals to assess aspects of risk other than

likelihood (i.e., nature, severity, imminence, frequency)

as well as to develop risk management strategies.

Interrater Reliability.Research indicates that judg-

ments regarding the lifetime presence of risk factors

and overall risk can be made with good interrater reli-

ability. The interrater reliability of judgments regard-

ing recent change has not been evaluated.

Predictive Validity.Research has provided good sup-

port for the use of the SVR–20 in sexual violence risk

assessment. Individual studies and meta-analyses have

demonstrated that the SVR–20 predicts sexually vio-

lent recidivism about as well as, and in some cases bet-

ter than, commonly used actuarial tests. In studies that

compared evaluators’ overall judgments of risk with

simple linear combinations of risk factors, typically,

overall judgments have better predictive validity.

Recommendations

In the authors’ experience, most assessors find that the

inclusion of a locally normed actuarial risk assessment

test alongside the SVR–20 allows for a more compre-

hensive appraisal of risk, and we support this practice.

There is no convergence of opinion as to what is the

best practice in this area; however, it is clear to most

clinicians that the use of a single instrument is not nec-

essarily the best manner in which to protect the public

from future offending and that a more comprehensive

and conservative approach is warranted.

Douglas P. Boer and Stephen D. Hart

See alsoForensic Assessment; Hare Psychopathy

Checklist–Revised (2nd edition) (PCL–R); Rapid Risk

Assessment for Sexual Offense Recidivism (RRASOR); Risk

Assessment Approaches; Sex Offender Needs Assessment

Rating (SONAR); Sex Offender Risk Appraisal Guide

(SORAG); STATIC–99 and STATIC–2002 Instruments

Further Readings

Boer, D. P. (2006). Sexual offender risk assessment

strategies: Is there a convergence of opinion yet? Sexual

Offender Treatment, 1,1–4.

Boer, D. P., Hart, S. D., Kropp, P. R., & Webster, C. D.

(1997). Manual for the Sexual Violence Risk–20:

Professional guidelines for assessing risk of sexual

violence.Vancouver, Canada: The Mental Health, Law,

and Policy Institute, Simon Fraser University.

SHORT-TERMASSESSMENT OF

RISK ANDTREATABILITY (START)

The Short-Term Assessment of Risk and Treatability

(START) is a concise clinical guide for the dynamic

assessment of short-term (i.e., weeks to months) risk

for violence (to self and others) and treatability. START

guides the assessor toward an integrated, balanced

opinion to evaluate the client’s risk across seven

domains: violence to others, suicide, self-harm, self-

neglect, unauthorized absence, substance use, and risk

of being victimized. This structured professional guide

is intended to inform clinical interventions and index

therapeutic improvements or relapses.

START represents a refinement in the risk assess-

ment field, in that it comprises dynamic variables that

are responsive to treatment and management efforts and

because each of the 20 items is scored both as a vulner-

ability and as a strength, from 0 (no evident risk or

strength) to 2 (high risk or strength). It also allows for

the recording of historical and case-specific factors.

Once the 20 items are coded, the assessor completes a

summary judgment of risk (low, moderate, or high) on

the seven domains (i.e., violence to others, suicide, etc.);

other client-specific risks may also be added. A poten-

tially useful aspect of START is that it facilitates the

identification, recording, and communication of individ-

ually determined “critical” vulnerability items, “key”

strengths, and “signature risks” (i.e., early but reliable,

unique, and invariant signals of impending relapse and

elevation in risk) deemed to be especially relevant to the

particular client’s functioning, responsivity to treatment,

and the likelihood of adverse outcomes.

START is devoted to the systematic assessment of

the strengths and vulnerabilities of the individual client

with the ultimate goal of enhancing mental health func-

tioning and preventing adverse events. It is intended to

assist in day-to-day monitoring, treatment planning,

and risk communication. Repeated administrations are

a convenient method of tracking changes in mental

health status, vulnerabilities, strengths, and violence

potential (against self/others). START is anticipated to

be an effective means of reducing the cycling of men-

tally disordered persons through the civil psychiatric

and criminal justice systems. It was developed for use

with adults with mental, personality, and substance-

related disorders, with relevance to correctional, civil,

and forensic clients in the community and institutional

settings. This new scheme is particularly applicable to

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