Department of Psychology, Simon Fraser University.
Law Hum Behav. 2018 Jun;42(3):181-214. doi: 10.1037/lhb0000280. Epub 2018 Apr 12.
Although it is widely believed that risk assessment tools can help manage risk of violence and offending, it is unclear what evidence exists to support this view. As such, we conducted a systematic review and narrative synthesis. To identify studies, we searched 13 databases, reviewed reference lists, and contacted experts. Through this review, we identified 73 published and unpublished studies (N = 31,551 psychiatric patients and offenders, N = 10,002 professionals) that examined either professionals' risk management efforts following the use of a tool, or rates of violence or offending following the implementation of a tool. These studies included a variety of populations (e.g., adults, adolescents), tools, and study designs. The primary findings were as follows: (a) despite some promising findings, professionals do not consistently adhere to tools or apply them to guide their risk management efforts; (b) following the use of a tool, match to the risk principle is moderate and match to the needs principle is limited, as many needs remained unaddressed; (c) there is insufficient evidence to conclude that tools directly reduce violence or reoffending, as findings are mixed; and (d) tools appear to have a more beneficial impact on risk management when agencies use careful implementation procedures and provide staff with training and guidelines related to risk management. In sum, although risk assessment tools may be an important starting point, they do not guarantee effective treatment or risk management. However, certain strategies may bolster their utility. (PsycINFO Database Record
虽然人们普遍认为风险评估工具可以帮助管理暴力和犯罪风险,但目前尚不清楚有哪些证据支持这种观点。因此,我们进行了系统的回顾和叙述性综合。为了识别研究,我们搜索了 13 个数据库,查阅了参考文献,并联系了专家。通过这项审查,我们确定了 73 项已发表和未发表的研究(N=31551 名精神科患者和罪犯,N=10002 名专业人员),这些研究考察了使用工具后专业人员的风险管理工作,或实施工具后暴力或犯罪的发生率。这些研究包括各种人群(例如,成年人、青少年)、工具和研究设计。主要发现如下:(a)尽管有一些有希望的发现,但专业人员并不始终坚持使用工具或应用工具来指导他们的风险管理工作;(b)使用工具后,与风险原则的匹配是中等的,与需求原则的匹配是有限的,因为许多需求仍未得到满足;(c)没有足够的证据表明工具可以直接减少暴力或再犯罪,因为研究结果参差不齐;(d)当机构采用谨慎的实施程序并为员工提供与风险管理相关的培训和指导时,工具对风险管理的影响似乎更有益。总之,尽管风险评估工具可能是一个重要的起点,但它们并不能保证有效的治疗或风险管理。然而,某些策略可能会增强它们的效用。