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Gray AL, Viljoen JL. Violence and Suicidal/Nonsuicidal Self-Injury Among Adolescents Undergoing Residential Treatment: An Examination of the Predictive Validity of the SAVRY, START:AV, and VRS-YV. CRIMINAL JUSTICE AND BEHAVIOR 2023; 50:931-952. [PMID: 37323998 PMCID: PMC10265301 DOI: 10.1177/00938548231165531] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Using a retrospective study design, predictive validity of the Structured Assessment of Violence Risk in Youth, Short-Term Assessment of Risk and Treatability: Adolescent Version (START: AV), and the Violence Risk Scale-Youth Version (VRS-YV) was examined among 87 adolescents referred to a residential treatment program. With few exceptions, moderate to high accuracy was achieved for the three measures in predicting violence and suicidal/nonsuicidal self-injury occurring during the adolescents' time in treatment. Accuracy of the measures peaked within 90 days for violence and gradually increased over the 180-day follow-up for suicidal/nonsuicidal self-injury. Dynamic factors were more predictive of repeated events involving violence relative to static/historical factors, whereas only factors from the START: AV were predictive of repeated events involving suicidal/nonsuicidal self-injury. These results emphasize the need for further examining the risk of adverse outcomes beyond violence among adolescents.
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De Beuf TLF, de Vogel V, Broers NJ, de Ruiter C. Prospective Field Validation of the START:AV in a Dutch Secure Youth Care Sample. Assessment 2023; 30:633-650. [PMID: 34907790 PMCID: PMC9999285 DOI: 10.1177/10731911211063228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The Short-Term Assessment of Risk and Treatability: Adolescent Version (START:AV) is a risk assessment instrument for adolescents that estimates the risk of multiple adverse outcomes. Prior research into its predictive validity is limited to a handful of studies conducted with the START:AV pilot version and often by the instrument's developers. The present study examines the START:AV's field validity in a secure youth care sample in the Netherlands. Using a prospective design, we investigated whether the total scores, lifetime history, and the final risk judgments of 106 START:AVs predicted inpatient incidents during a 4-month follow-up. Final risk judgments and lifetime history predicted multiple adverse outcomes, including physical aggression, institutional violations, substance use, self-injury, and victimization. The predictive validity of the total scores was significant only for physical aggression and institutional violations. Hence, the short-term predictive validity of the START:AV for inpatient incidents in a residential youth care setting was partially demonstrated and the START:AV final risk judgments can be used to guide treatment planning and decision-making regarding furlough or discharge in this setting.
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Affiliation(s)
- Tamara L. F. De Beuf
- Ottho Gerhard Heldring Institution, Zetten, The Netherlands
- Maastricht University, The Netherlands
- Tamara L. F. De Beuf, Herbert Hooverplein 10, 3000 Leuven, Belgium.
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Kasal A, Táborská R, Juríková L, Grabenhofer-Eggerth A, Pichler M, Gruber B, Tomášková H, Niederkrotenthaler T. Facilitators and barriers to implementation of suicide prevention interventions: Scoping review. Glob Ment Health (Camb) 2023; 10:e15. [PMID: 37854412 PMCID: PMC10579684 DOI: 10.1017/gmh.2023.9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 01/12/2023] [Accepted: 03/06/2023] [Indexed: 03/14/2023] Open
Abstract
We know that suicide is preventable, yet hundreds of thousands of people still die due to suicide every year. Many interventions were proven to be effective, and dozens of others showed promising results. However, translating these interventions into new settings brings several challenges. One of the crucial obstacles to success is not anticipating possible barriers to implementation nor enhancing possible benefits of factors facilitating the implementation. While we witnessed great support for suicide prevention activities globally in the past years, implementation barriers and facilitating factors are yet to be comprehensively mapped to help implementation activities worldwide. This scoping review maps current knowledge on facilitators and barriers to the implementation of suicide prevention interventions while using the Consolidated Framework for Implementation Research (CFIR) for classification. We included 64 studies. Barriers and facilitators were most commonly identified in the outer setting CFIR domain, namely in the sub-domain of patient needs and resources, which refers to the way in which these needs and resources are reflected by the reviewed interventions. The second most saturated CFIR domain for facilitators was intervention characteristics, where relative advantage, adaptability and cost of intervention sub-domains were equally represented. These sub-domains refer mostly to how the intervention is perceived by key stakeholders, to what extent it can be tailored to the implementation context and how much it costs. While intervention characteristics domain was the second most common also for barriers, the complexity sub-domain referring to high perceived difficulty of implementation was the most frequently represented. With reference to the results, we recommend adapting interventions to the needs of the target groups. Furthermore, carefully selecting the intervention to suit the target context concerning their adaptability, costs and complexity is vital for a successful implementation. Further implications for practice and research are discussed.
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Affiliation(s)
- Alexandr Kasal
- Department of Public Mental Health, National Institute of Mental Health, Klecany, Czech Republic
- Faculty of Social Sciences, Charles University, Prague, Czech Republic
| | - Roksana Táborská
- Department of Public Mental Health, National Institute of Mental Health, Klecany, Czech Republic
| | - Laura Juríková
- Department of Public Mental Health, National Institute of Mental Health, Klecany, Czech Republic
- Department of Psychology, Faculty of Arts, Charles University, Prague, Czech Republic
| | | | - Michaela Pichler
- Department of Psychosocial Health, Gesundheit Österreich GmbH, Wien, Austria
| | - Beate Gruber
- Department of Psychosocial Health, Gesundheit Österreich GmbH, Wien, Austria
| | - Hana Tomášková
- Department of Public Mental Health, National Institute of Mental Health, Klecany, Czech Republic
- Department of Psychology, Faculty of Arts, Charles University, Prague, Czech Republic
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De Beuf TLF, de Ruiter C, Edens JF, de Vogel V. Taking "the boss" into the real world: Field interrater reliability of the Short-Term Assessment of Risk and Treatability: Adolescent Version. BEHAVIORAL SCIENCES & THE LAW 2021; 39:123-144. [PMID: 33569848 PMCID: PMC7986435 DOI: 10.1002/bsl.2503] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 10/30/2020] [Accepted: 11/20/2020] [Indexed: 06/12/2023]
Abstract
There is emerging evidence that the performance of risk assessment instruments is weaker when used for clinical decision-making than for research purposes. For instance, research has found lower agreement between evaluators when the risk assessments are conducted during routine practice. We examined the field interrater reliability of the Short-Term Assessment of Risk and Treatability: Adolescent Version (START:AV). Clinicians in a Dutch secure youth care facility completed START:AV assessments as part of the treatment routine. Consistent with previous literature, interrater reliability of the items and total scores was lower than previously reported in non-field studies. Nevertheless, moderate to good interrater reliability was found for final risk judgments on most adverse outcomes. Field studies provide insights into the actual performance of structured risk assessment in real-world settings, exposing factors that affect reliability. This information is relevant for those who wish to implement structured risk assessment with a level of reliability that is defensible considering the high stakes.
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Affiliation(s)
- Tamara L. F. De Beuf
- Research DepartmentOttho Gerhard Heldring InstitutionZettenNetherlands
- Department of Clinical Psychological ScienceMaastricht UniversityMaastrichtNetherlands
| | - Corine de Ruiter
- Department of Clinical Psychological ScienceMaastricht UniversityMaastrichtNetherlands
| | - John F. Edens
- Department of Psychological and Brain SciencesTexas A&M UniversityCollege StationTexasUSA
| | - Vivienne de Vogel
- Research DepartmentDe Forensische ZorgspecialistenUtrechtNetherlands
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Viljoen JL, Vincent GM. Risk assessments for violence and reoffending: Implementation and impact on risk management. CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2020. [DOI: 10.1111/cpsp.12378] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Cheng J, Haag AM, Olver ME. Predictors of Historical Clinical Risk Management-20 Version 3 (HCR-20:V3) summary risk ratings. PSYCHIATRY, PSYCHOLOGY, AND LAW : AN INTERDISCIPLINARY JOURNAL OF THE AUSTRALIAN AND NEW ZEALAND ASSOCIATION OF PSYCHIATRY, PSYCHOLOGY AND LAW 2019; 26:682-692. [PMID: 31984104 PMCID: PMC6762121 DOI: 10.1080/13218719.2019.1618753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
How individual risk factors on structured professional judgement (SPJ) assessment tools translate into SPJ final risk formulations is unclear due to a lack of structured criteria. Understanding pathways to risk formulations is vital, as they serve as intervention targets for risk management. This study examined how Historical Clinical Risk Management-20 Version 3 (HCR-20:V3) raters weighed varied information sources to complete summary risk ratings (SRRs). Four independent raters retrospectively coded an archived sample of 32 inpatients at a Canadian forensic psychiatric hospital. HCR-20:V3 SPJ SRRs were regressed on the 20 individual items and sample covariates to identify unique predictors of risk formulations across each rater. Raters consistently used HCR-20:V3 items and composite subscales for SRRs. Despite strong inter-rater agreement on the SRRs, there were variations across raters regarding which items informed each SRR. Rater-unique biases were also shown to influence SRRs. Implications for forensic practice and risk management are discussed.
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Affiliation(s)
- Jeremy Cheng
- Department of Psychology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Andrew M. Haag
- Alberta Health Services, Edmonton, AB, Canada
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
- Department of Psychology, University of Alberta, Edmonton, AB, Canada
| | - Mark E. Olver
- Department of Psychology, University of Saskatchewan, Saskatoon, SK, Canada
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Sellers BG, Desmarais SL, Hanger MW. Measurement of Change in Dynamic Factors Using the START:AV. JOURNAL OF FORENSIC PSYCHOLOGY RESEARCH AND PRACTICE 2017; 17:198-215. [PMID: 30198010 PMCID: PMC6128294 DOI: 10.1080/24732850.2017.1317560] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Historical approaches to violence risk assessment emphasized prediction of future violence and focused on static or historical risk factors. Consideration of dynamic factors as part of a comprehensive violence risk assessment approach may allow practitioners to better tailor treatment and risk management strategies. Limited research exists on whether risk assessment instruments can detect change in dynamic factors over time. The Short-Term Assessment of Risk and Treatability: Adolescent Version (START:AV) is a relatively new risk assessment instrument that considers both Vulnerabilities and Strengths on factors that are purportedly dynamic in nature. This study examined changes in START:AV factors between initial and follow-up assessments conducted approximately three months later as part of a pilot implementation at three juvenile justice residential facilities in a Southern state. Overall, findings revealed significant item-level changes on several factors, as well as reliable changes in total scores for 28% (reliable change index; 95% confidence interval) of adolescents.
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Singh JP, Desmarais SL, Sellers BG, Hylton T, Tirotti M, Van Dorn RA. From Risk Assessment to Risk Management: Matching Interventions to Adolescent Offenders' Strengths and Vulnerabilities. CHILDREN AND YOUTH SERVICES REVIEW 2014; 47:1-9. [PMID: 25346561 PMCID: PMC4207631 DOI: 10.1016/j.childyouth.2013.09.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Though considerable research has examined the validity of risk assessment tools in predicting adverse outcomes in justice-involved adolescents, the extent to which risk assessments are translated into risk management strategies and, importantly, the association between this link and adverse outcomes has gone largely unexamined. To address these shortcomings, the Risk-Need-Responsivity (RNR) model was used to examine associations between identified strengths and vulnerabilities, interventions, and institutional outcomes for justice-involved youth. Data were collected from risk assessments completed using the Short-Term Assessment of Risk and Treatability: Adolescent Version (START:AV) for 120 adolescent offenders (96 boys and 24 girls). Interventions and outcomes were extracted from institutional records. Mixed evidence of adherence to RNR principles was found. Accordant to the risk principle, adolescent offenders judged to have more strengths had more strength-based interventions in their service plans, though adolescent offenders with more vulnerabilities did not have more interventions targeting their vulnerabilities. With respect to the need and responsivity principles, vulnerabilities and strengths identified as particularly relevant to the individual youth's risk of adverse outcomes were addressed in the service plans about half and a quarter of the time, respectively. Greater adherence to the risk and need principles was found to predict significantly the likelihood of externalizing outcomes. Findings suggest some gaps between risk assessment and risk management and highlight the potential usefulness of strength-based approaches to intervention.
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Affiliation(s)
- Jay P. Singh
- Department of Psychology, University of Konstanz, Konstanz, Germany
- Psychiatric/Psychological Service, Department of Justice, Zurich, Switzerland
- Institute of Health Sciences, Molde University College, Molde, Norway
| | - Sarah L. Desmarais
- Department of Psychology, North Carolina State University, Raleigh, NC, USA
| | - Brian G. Sellers
- Department of Sociology, Anthropology, and Criminology, Eastern Michigan University, Ypsilanti, MI, USA
| | - Tatiana Hylton
- Department of Psychology, University of Florida, Gainesville, FL, USA
| | - Melissa Tirotti
- Department of Community and Family Health, University of South Florida, Tampa, FL, USA
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Underwood LA, Warren KM, Talbott L, Jackson L, Dailey FL. Mental Health Treatment in Juvenile Justice Secure Care Facilities: Practice and Policy Recommendations. JOURNAL OF FORENSIC PSYCHOLOGY PRACTICE 2014. [DOI: 10.1080/15228932.2014.865398] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Viljoen JL, Cruise KR, Nicholls TL, Desmarais SL, Webster C. Taking Stock and Taking Steps: The Case for an Adolescent Version of the Short-Assessment of Risk and Treatability. INTERNATIONAL JOURNAL OF FORENSIC MENTAL HEALTH 2012; 11:135-149. [PMID: 23436982 PMCID: PMC3578698 DOI: 10.1080/14999013.2012.737406] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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; 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.
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Viljoen JL, Beneteau JL, Gulbransen E, Brodersen E, Desmarais SL, Nicholls TL, Cruise KR. Assessment of Multiple Risk Outcomes, Strengths, and Change with the START:AV: A Short-Term Prospective Study with Adolescent Offenders. INTERNATIONAL JOURNAL OF FORENSIC MENTAL HEALTH 2012; 11:165-180. [PMID: 23436983 PMCID: PMC3578709 DOI: 10.1080/14999013.2012.737407] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The Short-Term Assessment of Risk and Treatability: Adolescent Version (START:AV; Nicholls, Viljoen, Cruise, Desmarais, & Webster, 2010; Viljoen, Cruise, Nicholls, Desmarais, & Webster, in preparation) is a clinical guide designed to assist in the assessment and management of adolescents' risk for adverse events (e.g., violence, general offending, suicide, victimization). In this initial validation study, START:AV assessments were conducted on 90 adolescent offenders (62 male, 28 female), who were prospectively followed for a 3-month period. START:AV assessments had good to excellent inter-rater reliability and strong concurrent validity with Structured Assessment of Violence Risk in Youth assessments (SAVRY; Borum, Bartel, & Forth, 2006). START:AV risk estimates and Vulnerability total scores predicted multiple adverse outcomes, including violence towards others, offending, victimization, suicidal ideation, and substance abuse. In addition, Strength total scores inversely predicted violence, offending, and street drug use. During the 3-month follow-up, risk estimates changed in at least one domain for 92% of youth, and 27% of youth showed reliable changes in Strength and/or Vulnerability total scores (reliable change index, 90% confidence interval; Jacobsen & Truax, 1991). While these findings are promising, a strong need exists for further research on the START:AV, the measurement of change, and on the role of strengths in risk assessment and treatment-planning.
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