Clinicians' Perceptions of Which Factors Increase or Decrease the Risk of Violence Among Forensic Out-patients

Abstract

There is a debate in the academic community about which approach to the assessment of risk for violence is preferable. A vital aspect of this debate is evaluating the relative merits of clinical decision-making. However, clinical decision-making in violence risk assessment is understudied. The present study investigated if and how clinicians perceived that the absence and presence of dynamic factors affected the individual-specific risk for violence in forensic out-patients. The Structured Outcome Assessment and Community Risk Monitoring (SORM) instrument was administered by 35 clinicians to 51 different patients, yielding a total of 103 unique clinician-patient encounters. The clinicians' emphasized the following factors: lack of insight, lack of treatment motivation, psychiatric institutional treatment, professional support contacts, and substance misuse. Least weight was given to physical health care, children, occupational training and employment services, partner, and impaired daily functioning. The results suggest that clinicians considered violence risk and protective factors anchored in empirical research. Clinicians preferred clinical factors before non-clinical factors. Also, clinicians put more weight on individual than on contextual factors and more weight on risk factors than on protective factors.