Violence Risk Assessment: Using Structured Clinical Guides Professionally

Abstract

The HCR-20 has gained considerable acceptance by mental health, forensic, and criminal justice professionals since its initial publication only seven and a half years ago. Scientific evidence has gradually accrued to show that the guide can be used reliably and validly. Yet the scheme is sometimes misapplied. It is important that HCR-20 item definitions be kept anchored to the text to prevent “drift” that the guide be seen as a vehicle to promote discussion among colleagues rather than being viewed as capable of offering violence risk estimates that necessarily approach full accuracy; that would-be users should receive practice in coding case examples; and that, as urged in the basic manual, clinicians and researchers make all possible effort to avoid omitting items. The paper offers suggestions about conceptual and research work that needs to be completed in the future and offers one concrete example of a project in progress.