The assessment and management of violence in forensic populations

Abstract

The identification and management of individuals with a perceived high risk of future violence is of great priority for mental health professionals and the criminal justice system. The overall aim of this thesis is to examine the validity of the assessment and treatment of violence in forensic populations with a specific focus on the contribution of dynamic risk factors in predicting recidivism. Chapter One presents a conceptual literature review which provides an overview of the development of violence risk assessment approaches, and examines the predictive validity of dynamic factors in predicting violent recidivism. The review demonstrates the ability of dynamic risk factors in predicting future community and institutional violence. Chapter Two provides a critique of the HCR-20 Risk Assessment Scheme and highlights that despite some apparent shortcomings of the HCR-20, the instrument remains the best known and best researched, empirically based guide to violence risk assessment. In Chapter Three a prospective research study examines the predictive validity of the HCR-20 Risk Assessment Scheme in a UK sample of patients under the care of a community forensic mental health service. The study aimed to examine the ability of the HCR-20 total scores and individual sub scale scores to predict future acts of violence. The study demonstrates that the historical factors of the HCR-20 are highly predictive of future re-offending within this population and also highlights the importance of the clinical scale in predicting future violent acts. This work adds to current knowledge and understanding of the risk assessment and management process in UK samples. A case study is presented in chapter Four which evaluates the impact of the ETS programme on the cognitive deficits identified in a violent adult male offender (client A) serving a sentence at HMP Birmingham. By Mariam Azam-Zangane