Section 3: Assessment
2 Hours

Lecture Topic TOPIC: ASSESSMENT

Approaches to Assessing Risk

Now that we have reviewed some of the potential risk factors for sexually abusive youth, let’s talk about some of the processes by which risk assessments are conducted. Broadly speaking, there are three primary approaches.85

Use SlideUse Slide #47: Risk Assessment Approaches

Unstructured Clinical Judgment

The first approach is sometimes referred to as “unstructured clinical judgment.” Essentially, with this approach, the assessor relies on his or her experience and clinical intuition when assigning a level of risk—such as low, moderate, or high—to a specific youth. Some might consider this approach to making risk determinations to be similar to using one’s “gut instinct.”

You won’t be surprised to hear that research reveals that the predictive accuracy of unstructured clinical judgment is not nearly as good as a risk assessment that carefully considers factors consistently found to be related to recidivism86 —and in some instances, it may be no better than the flip of a coin.

Empirically–Guided

Another approach to risk assessment is commonly known as an “empirically guided” strategy. In this instance, the assessor considers a range of risk factors that are found in the empirical literature to be related to recidivism. It is believed that if more risk factors are present in the youth being assessed, the risk for recidivism is greater. The empirically–guided approach often includes the use of a structured assessment tool to review the same set of variables from case to case, although some assessors may consider a combination of other factors from the professional literature in addition to—or sometimes in lieu of—an assessment instrument. Regardless, the judgment about level of risk is generally left to the evaluator.

The predictive accuracy of empirically–guided assessments tends to be better than that of an unstructured clinical judgment87 —perhaps because this method is more grounded in research. However, there remains room for improvement.

Actuarial

Currently, the favored approach to risk assessment—at least for adult sex offenders—is the “actuarial” method, because it is found to be better at predicting recidivism than either the unstructured or empirically–guided approaches.88 The actuarial approach is a statistical calculation about an expectancy for a certain outcome, such as sexual recidivism. Car, health, and life insurance premiums are typically established by actuarial approaches—whereby individuals are rated on a fixed set of factors known to be related to certain outcomes (either better outcomes or poorer outcomes), and are subsequently assigned to a specific risk category. Evaluator discretion is not part of the decision.

With the actuarial method, a person’s score on the risk assessment tool is associated with specific recidivism rates of a large sample of offenders who were tracked for a specified period of time. It is presumed that an individual who has the same score as the reference group of offenders may have a similar level of risk as that group of offenders.

Keep in mind that actuarial risk assessment tools are far from perfect, and should not be considered to be a “magic bullet,” so to speak. Several issues should be considered when using them:89

Use SlideUse Slide #48: Limitations of Actuarials

Nonetheless, actuarial tools can be very helpful as one important source of information—but again, multiple sources are better when conducting assessments. Relying on a single tool limits the quantity and quality of the data that you will have and, as a result, will limit your ability to make the most informed decisions.

Risk Assessment Tools for Juvenile Sex Offenders

As we’ve discussed, a considerable challenge for professionals who work with juvenile sex offenders has been the absence of a validated tool for assessing recidivism risk specifically for these youth. This is in sharp contrast to where we are with adult sex offenders. In fact, there are several empirically–validated actuarial and empirically–guided tools designed to assess recidivism risk with adult sex offenders, but these tools are not designed for use with sexually abusive youth.90

Use SlideUse Slide #49: Promising Tools for Juveniles

At present, there are no true actuarial risk assessment tools for juvenile sex offenders, but there are two very promising risk assessment measures that are empirically–guided: The Juvenile Sex Offender Assessment Protocol–II (J–SOAP–II)91 and the Estimate of Risk of Adolescent Sexual Offense Recidivism (ERASOR).92

J–SOAP–II

The J–SOAP–II is used to assess by both non–clinicians and clinicians, provided that they have had adequate training. It is designed to assess short term risk of juvenile males between 12 and 18 years of age. The items explore static, or unchangeable, factors as well as dynamic, or changeable, factors.

Use SlideUse Slide #50: J–SOAP–II Subscales

There are 28 items on the J–SOAP–II, falling into one of four subscales:

Recognizing that circumstances can change over time, and that these changes may impact risk or intervention needs, the tool’s developers recommend that users re–assess youth at least every six months, or more often if there are known changes in the youth or his circumstances.

ERASOR

Similar to the J–SOAP–II, the ERASOR is a relatively short–term (less than one year) risk assessment tool for juveniles between the ages of 12 and 18, and which includes both static and dynamic risk factors.

Use SlideUse Slide #51: ERASOR Domains

The ERASOR has 25 items across 5 relatively self–explanatory domains:

The ERASOR, too, is recommended to be used as a repeated risk assessment in order to capture changes that occur over time.

Again, both of these measures are considered to be empirically–guided approaches to risk assessment. The items in these tools are based on the factors that research seems to suggest are related to sexual recidivism among juveniles who commit sex offenses.

Many people have asked whether or not the J–SOAP–II or the ERASOR have official scores that place a youth into either a low, moderate, or high risk category, similar to the way that adult actuarial risk assessment tools have these “cut off” scores. Right now, the answer is “no.” Remember, they are considered “empirically guided” assessments, not true actuarial tools. But, even though neither of the tools have these “cut–off” scores yet, and even though there aren’t any “scores” for these tools that are linked with recidivism rates of reference groups of youth, research suggests that these tools do have considerable promise. And there is a growing body of research supporting the reliability and validity of these measures. That’s better than the alternative—using a tool with no research support at all, right?

Remember, a significant strength of these tools is that they include dynamic, or changeable, risk factors, which makes them very useful for intervention planning and to make adjustments to case management plans over time based on reassessments.

The J–SOAP–II and the ERASOR are relatively easy to use, but of course, specialized training is important. Our training today is by no means designed to make you an expert on these tools! Our goal is simply to let you know that these tools are very promising, and through the references that are included in your materials, you can learn more about them.

Use SlideUse Slide #52: Programs Using J–SOAP–II or ERASOR
Use SlideUse Slide #53: Conclusion

And as you can see, a substantial number of juvenile sex offender programs across the country have begun to incorporate one or both of these tools into their practices.

Conclusion

We’ve now highlighted some of the key issues related to assessing risk with youthful sex offenders. And in fact, we’ve discussed quite a bit about assessing these youth overall. So before we move into the next topic, let’s take just a moment to review what we’ve covered about assessment.

Before we conclude this section, does anyone have any questions about the material we covered?

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