In:
British Journal of Psychiatry, Royal College of Psychiatrists, Vol. 202, No. 5 ( 2013-05), p. 365-371
Abstract:
Forensic psychiatry aims to reduce recidivism and makes use of risk
assessment tools to achieve this goal. Various studies have reported on the predictive qualities of these instruments, but it remains unclear
whether their use is associated with actual prevention of recidivism in clinical care. Aims To test whether an intervention combining risk assessment and shared care
planning is associated with a reduction in violent and criminal behaviour. Method A cluster randomised controlled trial (Netherlands Trial Register number
NTR1042) was conducted in three outpatient forensic psychiatric clinics. The intervention comprised risk assessment with the Short Term Assessment
of Risk and Treatability (START) and a shared care planning protocol formulated according to shared decision-making principles. The control
group received usual care. The outcome consisted of the proportion of clients with violent or criminal incidents at follow-up. Results In total 58 case managers and 632 of their clients were included, in the
intervention group ( n =310), 65% received the
intervention at least on ce. Findings showed a general treatment effect
(22% of clients with an incident at baseline v. 15% at
follow-up, P 〈 0.01) but no significant difference
between the two treatment conditions (odds ratio (OR)=1.46, 95% CI 0.89-2.44, P = 0.15). Conclusions Although risk assessment is common practice in forensic psychiatry, our
results indicate that the primary goal of preventing recidivism was not reached through risk assessment embedded in shared decision-making.
Type of Medium:
Online Resource
ISSN:
0007-1250
,
1472-1465
DOI:
10.1192/bjp.bp.112.113043
Language:
English
Publisher:
Royal College of Psychiatrists
Publication Date:
2013
detail.hit.zdb_id:
2021500-9
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