Taking Stock and Taking Steps: The Case for an Adolescent Version of the Short-Term Assessment of Risk and Treatability

Abstract

The field of violence risk assessment has matured considerably, possibly advancing beyond its own adolescence. At this point in the field's evolution, it is more important than ever for the development of any new device to be accompanied by a strong rationale and the capacity to provide a unique contribution. With this issue in mind, we first take stock of the field of adolescent risk assessment in order to describe the rapid progress that this field has made, as well as the gaps that led us to adapt the Short-Term Assessment of Risk and Treatability (START; Webster, Martin, Brink, Nicholls, & Desmarais, 2009) for use with adolescents. We view the Short-Term Assessment of Risk and Treatability: Adolescent Version (START:AV; Nicholls, Viljoen, Cruise, Desmarais, & Webster, 2010; Viljoen, Cruise, Nicholls, Desmarais, & Webster, in progress) as complementing other risk measures in four primary ways: 1) rather than focusing solely on violence risk, it examines broader adverse outcomes to which some adolescents are vulnerable (including self-harm, suicide, victimization, substance abuse, unauthorized leave, self-neglect, general offending); 2) it places a balanced emphasis on adolescents’ strengths and vulnerabilities; 3) it focuses on dynamic factors that are relevant to short-term assessment, risk management, and treatment planning; and 4) it is designed for both mental health and justice populations.

We describe the developmentally-informed approach we took in the adaptation of the START for adolescents, and outline future steps for the continuing validation and refinement of the START:AV.

Keywords:

• risk assessment
• strengths
• dynamic
• violence
• victimization
• self-harm
• suicide
• substance abuse

Acknowledgments

J. L. Viljoen's work on this project was supported by a Michael Smith Foundation for Health Research Career Investigator Award and a grant from the British Columbia Mental Health and Addictions Research Network. T. L. Nicholls’s work is supported by a Michael Smith Foundation for Health Research Career Investigator Award and a Canadian Institutes of Health Research New Investigator Award. S. L. Desmarais's work on this project was supported by the National Institute on Drug Abuse (P30DA028807, PI: Roger H. Peters). The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies. The authors would like to thank Taryn Urquhart for her assistance with final edits.

Notes

To derive this estimate, we conducted a search of violence risk assessment in PsychInfo and Medline using the following terms (violence or offend* or offense* or offence*) and risk and assessment.