Forensic Psychology Practice Ltd, Birmingham, UK.
Centre for Applied Psychology, University of Birmingham, Birmingham, UK.
Curr Psychiatry Rep. 2018 May 19;20(6):43. doi: 10.1007/s11920-018-0904-0.
Case formulations (CF) have been the cornerstone of effective practice in clinical psychology since the 1950s and now form one of the core competencies in clinical and forensic assessment. The use of CFs within forensic settings is becoming more relevant when working with offenders who have experienced significant trauma, suffered from personality disorder, and have displayed sexually abusive behavior. Furthermore, most North American and European jurisdictions insist that expert witnesses adopt an idiosyncratic approach to risk assessment and consider the characteristics of the individual as part of a wider formulation of the problem behavior. This article focuses specifically on CF incorporating risk assessment procedures of sexual offenders.
While empirical support for the use of risk analysis and formulation in managing offending behavior generally, and sexual offending behavior in particular, is limited, there is mounting evidence to suggest that CF can improve understanding of an individual's problem sexual behaviors. We argue that by integrating risk formulations into the CF provides a conceptually robust link between the etiologically development of the problem sexual behavior and effective assessment and risk management of sexual offenders. As forensic treatment programs increasingly moved toward strength-based approaches, in keeping with the Risk-Need-Responsivity principles Andrews and Bonta (2004), and the Good Lives Model Ward and Stewart (Prof Psychol Res Pract 34:353-60, 2003) of offender rehabilitation, the use of CFs in the assessment, treatment, and management of sexual offenders is indispensable. We present an etiological framework for understanding risk in an individual sexual offender by integrating a case formulation model to include the use of (static, stable, and acute) actuarial and clinical risk assessment measures as well as protective risk factors, referred to as the CAse Formulation Incorporating Risk Assessment (CAFIRA) model.
自 20 世纪 50 年代以来，个案概念化（CF）一直是临床心理学实践的基石，现在它构成了临床和法医评估的核心能力之一。当与经历过重大创伤、患有人格障碍和表现出性虐待行为的罪犯合作时，在法医环境中使用 CF 变得更加相关。此外，大多数北美和欧洲司法管辖区坚持要求专家证人采用独特的风险评估方法，并将个人特征视为问题行为更广泛概念化的一部分。本文特别关注纳入性犯罪者风险评估程序的 CF。
虽然风险分析和个案概念化在管理犯罪行为，特别是性犯罪行为方面的应用得到了有限的实证支持，但越来越多的证据表明，CF 可以提高对个人问题性行为的理解。我们认为，将风险概念化纳入 CF 可以在问题性行为的病因发展与性犯罪者的有效评估和风险管理之间建立概念上的强大联系。随着法医治疗计划越来越倾向于基于优势的方法，以符合风险-需求-反应性原则安德鲁和邦塔（2004 年）和良好生活模式沃德和斯图尔特（专业心理研究与实践 34:353-60,2003 年）的罪犯康复，CF 在性犯罪者的评估、治疗和管理中的应用是不可或缺的。我们通过整合个案概念化模型来呈现一种理解个体性犯罪者风险的病因框架，包括使用（静态、稳定和急性）计量风险评估和临床风险评估措施以及保护风险因素，称为纳入风险评估的个案概念化（CAFIRA）模型。
