Behavioral Sciences and the Law

Behav. Sci. Law 33: 39–55 (2015)

Published online 23 January 2015 in Wiley Online Library
(wileyonlinelibrary.com) DOI: 10.1002/bsl.2156

An Examination of Violence Risk

Communication in Practice Using a Structured
Professional Judgment Framework
Jennifer E. Storey*, Kelly A. Watt‡ and Stephen D. Hart§,¶

The increased use of violence risk assessment tools in professional practice has sparked
the development of best-practice guidelines for communicating about violence risk.
The present study examined 166 pre-sentence reports, authored by clinicians and pro-
bation officers, to determine the extent to which they are consistent with those guide-
lines. We examined the frequency with which reports contained information about
five topics: the presence of risk factors; the relevance of risk factors; scenarios of future
violence; recommended management strategies; and summary risk judgments. Analy-
ses revealed that the topics addressed most frequently in reports were the presence of
risk factors and recommended management strategies, but none of the five topics was
addressed consistently, completely, or clearly in reports. This was especially the case
for probation reports. The findings highlight the need to improve practice through
better implementation of guidelines for risk communication. Also needed is research
on the extent to which information in risk communications is comprehended,
accepted, and used by various stakeholder groups. Copyright # 2015 John Wiley &
Sons, Ltd.

The importance of violence risk assessment is evidenced by the growing demand and,
in many countries (e.g., UK, USA, Sweden), legislative requirements for violence risk
assessments to be conducted (Elbogen, 2002; Skeem & Monahan, 2011). Violence risk
assessment is now conducted in healthcare, criminal justice, social service, and cor-
porate settings worldwide (Douglas, Hart, Webster, & Belfrage, 2013). Further, fail-
ure to conduct comprehensive violence risk assessments can result in increased
exposure to liability with respect to tort law, statutory law, or professional standards
of practice in many nations. The substantial advances in research and practice re-
lated to violence risk assessment suggest that the demand for such assessments will
only increase over time.
Two primary methods of structuring violence risk assessment have been the focus of
research and development (Hart, 2001): actuarial risk assessment, in which informa-
tion is weighted and combined according to fixed and explicit rules; and structured
professional judgment (SPJ), in which information is weighted and combined accord-
ing to both guidelines and professional discretion. Both forms of assessment can be

*Correspondence to: Jennifer E. Storey, Department of Social Sciences, Section for Criminology, Mid Sweden
University, Holmgatan 10, Sundsvall, Sweden, 851 70. E-mail: jennifer.storey@miun.se
‡
ProActive ReSolutions Inc., Vancouver, BC Canada
§
Department of Psychology, Simon Fraser University, Burnaby, Canada
¶
Faculty of Psychology, University of Bergen, Norway

Copyright # 2015 John Wiley & Sons, Ltd.

40 J. E. Storey et al.

further subdivided based on the degree of structure imposed on various aspects of the
assessment process (e.g., Skeem & Monahan, 2011). A range of actuarial and SPJ risk
assessment tools are used internationally – in fact, it is estimated that over 120 tools
have been developed (Singh & Fazel, 2010).
More recently, attention has turned from the development and evaluation of
violence risk assessment tools to discussion of how best to communicate the findings
of violence risk assessments – that is, the issue of risk communication (Elbogen,
2002; Heilbrun, Dvoskin, Hart, & McNiel, 1999a; Hilton, Carter, Harris, & Sharpe,
2008; Hilton, Harris, Rawson, & Beach, 2005). Many commentators have pointed
out that good risk communication is crucial for laying the foundation for expert legal
opinion, improving risk reduction, and managing liability, and have presented best-
practice guidelines to help ensure accurate, effective, and ethical risk communication
in criminal and civil proceedings (e.g., Boer, Hart, Kropp, & Webster 1997; Grisso,
2010; Hart et al., 2003; Heilbrun, 2001; Heilbrun et al., 1999a; Melton, Petrila,
Poythress, & Slobogin, 1997). Although there is no clear consensus among these
commentators concerning exactly how risk should be communicated, it seems there
is some broad agreement that at least four general topics can or should be addressed
in oral or written risk communications, depending on the context in which the violence
risk assessment is conducted. The first topic concerns the risk factors present in the
case. This basic descriptive information is arguably the most important to include in
every report, insofar as it establishes a foundation for all subsequent opinions, recom-
mendations, and decisions. The second topic is the functional relevance of risk factors
that are present. This information highlights the (putative) importance of certain risk
factors with respect to opinions, recommendations, and decisions. The third topic is
the nature or level of risk posed. This information concerns the possible nature, seri-
ousness, imminence, or likelihood of future violence. It may be presented in quantita-
tive (e.g., probabilistic) or narrative format. The fourth and final topic relates to
recommendations on how best to manage any risks posed.
Compared with the extensive research on the reliability and validity of structured
risk assessment tools (e.g., Hanson & Morton-Bourgon, 2009; Singh, Grann, & Fazel,
2011), research on risk communication is limited. Furthermore, much of what has
been published has focused on the specific issue of people’s comprehension of and
preference for quantitative estimates of violence risk (e.g., Monahan et al., 2002;
Scurich & John, 2012), or preferences for communicating overall judgments
concerning level of risk (Kwartner, Lyons, & Boccaccini, 2006). Only a few studies
have examined how evaluators communicate about violence risk on a day-to-day basis,
the extent to which their practices are consistent with existing guidelines, or the prefer-
ences of various stakeholder groups with respect to risk communications more
generally. For example, Heilbrun and his colleagues examined the violence risk com-
munication preferences of mental health professionals. In several studies, they found
that professionals valued most highly information about the presence of risk factors
and management recommendations, although they also rated information about risk
level to be valuable (Heilbrun, Philipson, Berman, & Warren, 1999b; Heilbrun,
O’Neill, Strohman, Bowman, & Philipson, 2000; Heilbrun, O’Neill, Stevens,
Strohman, Bowman, & Lo, 2004). The studies by Heilbrun and colleagues found
relatively few differences between various professions, although psychologists tended
to value more types of information. Similar findings were reported by Grann and
Pallvik (2002), who also compared the risk communication practices of professional

Copyright # 2015 John Wiley & Sons, Ltd. Behav. Sci. Law 33: 39–55 (2015)
DOI: 10.1002/bsl
 Violence risk communication 41

groups, finding that psychologists communicated about varied aspects of violence risk
most often. Storey, Campbell, and Hart (2013) examined the preferences of judges,
as they commented on violence risk assessment reports they received. Judges identified
a number of preferences, including that evaluators identify and describe the violence
risk assessment instruments they employ, how conclusions are reached, and the prob-
ability and severity of reoffense, including the worst-case scenario of reoffense.
In the present study, we attempt to build on previous research by investigating the risk
communication practices in a sample of pre-sentence reports for convicted sexual
offenders authored by clinicians (psychologists and psychiatrists) and probation officers.
We rated the extent to which each of these reports communicated information in a manner
consistent with the best-practice guidelines set out in the Risk for Sexual Violence Protocol
(RSVP; Hart et al., 2003), which are an expanded version of those originally presented in
the Sexual Violence Risk-20 (SVR-20; Boer et al., 1997). We also examined differences
between the reports authored by clinicians and probation officers.

METHOD
Cases

All reports concerned sex offenders referred to a forensic psychiatric outpatient clinic in
British Columbia, Canada, for evaluation. Under section 721 of the Criminal Code of
Canada, once an accused has pled guilty to or been found guilty of an offence, a court
may request a report to assist in sentencing. Pre-sentence reports typically include
information concerning, inter alia, any risks for general criminality, violence, or sexual
violence posed by an offender.
We gathered a sample of 166 pre-sentence reports concerning 122 offenders that
were written by 57 different professionals over a period of 9 years. Of the 166 reports,
100 were authored by clinicians: 88 reports were written by one of 13 psychologists,
and 12 reports were written by one of eight psychiatrists. Each clinician wrote between
one and 28 reports. The remaining 66 reports were authored by one of 36 probation
officers. Each probation officer wrote between one and six reports.
The 122 offenders were all adult males convicted of at least one sexual offence against
another person and referred to a forensic psychiatric outpatient clinical for evaluation. Mul-
tiple reports were written about 42 offenders; 41 of the offenders were the subject of two re-
ports (typically one clinical and one probation) and one offender was the subject of three
reports (one clinical and two probation). The inclusion of multiple reports per offender does
not pose a problem, as the units of analysis in the study were reports rather than offenders.
To identify reports for inclusion in the study, we reviewed the files of all sex of-
fenders seen at the clinic between 1998 and 2007. We included all pre-sentence reports
concerning adult male sex offenders; we excluded reports written for other clinical or
legal issues, as well as pre-sentence reports concerning youth or adult females
convicted of sexual offenses. Reports written before 1998 were excluded, as they pre-
dated publication of the best-practice guidelines first summarized in the SVR-20 and
subsequently expanded in the RSVP. Reports written in 2008 or later were excluded,
as they were submitted after the start of data collection. Some of the reports concerned
offenders included in a study by Jackson (2007).

Copyright # 2015 John Wiley & Sons, Ltd. Behav. Sci. Law 33: 39–55 (2015)
DOI: 10.1002/bsl
42 J. E. Storey et al.

Only a minority of reports (n = 28, 17%) documented the use of structured violence
risk assessment tools by the evaluators; all of them concerned evaluations that took
place in 2000 or later. Of evaluators who used structured violence risk assessment tools,
most used one tool (n = 16), although one evaluator used four different tools. Both
actuarial and SPJ tools were used by evaluators, including the Static-99 (Hanson &
Thornton, 2000; n = 7); the RSVP (Hart et al., 2003; n = 7); the SVR-20 (Boer et al.,
1997; n = 4); the Sex Offender Need Assessment Rating (SONAR; Hanson & Harris,
2000; n = 2); the Evaluation for Dangerousness of Sexual Offenders (Bays &
Freemen-Longo, 1995; n = 2); the Sex Offender Risk Appraisal Guide (SORAG;
Quinsey, Harris, Rice, & Cormier, 2006; n = 1); and the Sex Offender Risk Assessment
guide (SORA; Atkinson, Kropp, Laws, & Hart, 1996; n = 1).
Ethical approval for the study was obtained from the clinic and from Simon Fraser
University prior to the start of data collection.

Procedure

Coding Consistency with Best-practice Guidelines

Reports were coded by one of three trained, masters- or doctoral-level graduate

students in forensic psychology to determine the extent to which they were consistent
with the best-practice guidelines set out in the RSVP.
The RSVP is a set of SPJ guidelines for comprehensive, management-oriented sexual
violence risk assessment developed on the basis of systematic review of the scientific and
professional literature. It is an updated and expanded version of the SVR-20. Although
the RSVP is most often used as a tool to structure the process of (i.e., conduct) sexual
violence risk assessment, in this paper we used it as a checklist for best practice with respect
to risk communication; this decision was based primarily on the absence of an alternative
checklist. Discussions of the reliability and validity of the RSVP as a risk assessment
tool, as well as more general discussions of the relative merit of SPJ versus actuarial
methods of risk assessment are beyond the scope of this paper, but may be found
elsewhere (e.g., Hart & Boer, 2010; Hart & Logan, 2011; Otto & Douglas, 2010).
According to the best-practice guidelines set out in the RSVP, sexual violence risk
assessments should comprise and discuss or document six steps: information gather-
ing; the presence of risk factors; the relevance of risk factors; scenarios of future sexual
violence; management recommendations; and summary judgments of risk. In the cur-
rent study, we examined the extent to which each report documented the last five steps;
we did not include the first step, as all 166 reports listed the information on which the
assessment was based. Note that the five steps in the RSVP administration procedure
that we reviewed correspond to the four broad topics identified in the introduction to
this article, although the RSVP breaks down communication about the nature or level
of risks posed into two separate steps, namely, scenarios of future violence (a narrative
description of the nature of risks posed) and summary risk judgments (categorical
statement of risk level). (The parallels between the RSVP administration steps and the
general topics discussed by others is not a coincidence, of course; the RSVP was based
on a systematic review of the literature, which included the best-practice recommenda-
tions for violence risk communication made by others.) In the following, we discuss the
five steps of the RSVP administration procedure coded by researchers in more detail:

Copyright # 2015 John Wiley & Sons, Ltd. Behav. Sci. Law 33: 39–55 (2015)
DOI: 10.1002/bsl
 Violence risk communication 43

• Presence of risk factors. The RSVP includes 22 basic risk factors, grouped into five
domains (Table 1). Raters coded the extent to which reports documented the
presence of each basic risk factor using a three-point scale: “concrete,” if the report
contained a clear statement about the presence, possible or partial presence, absence,
or lack of information concerning the risk factor (e.g., “the offender has no prior
history of sexual violence” or “the offender has a history of substance abuse”); “men-
tion,” if the report made reference to the risk factor but did not clearly state whether
or not it was present (e.g., “the offender attended a sex offender treatment program
prior to the current offence,” a statement that does not clarify whether this informa-
tion was viewed as enhancing or reducing risk); and “absent,” if the report made no
reference to the risk factor.
• Relevance of risk factors. Next, raters coded the extent to which reports
documented the relevance of each basic risk factor using a similar three-point scale.
Relevance was defined, per the RSVP, as functional relevance with respect to the
nature of the risks posed by the offender or the management of those risks. When risk
factors were coded as “concrete,” raters then coded whether they were identified as
being “criminogenic” (i.e., risk-enhancing), “protective” (i.e., risk reducing), or
“neutral” (i.e., present but of little functional relevance).

Table 1. Number and percentage (%) of reports in which Risk for Sexual Violence Protocol (RSVP) risk
factors were concretely identified and mentioned

Concrete Mention

Clinical Probation Clinical Probation

RSVP n n (%) n n (%)

Sexual violence history 66 11 (17%) 21 16 (24%)

1. Chronicity of sexual violence 43 5 (8%) 15 14 (21%)
2. Diversity of sexual violence 20 1 (2%) 7 1 (2%)
3. Escalation of sexual violence 20 2 (3%) 3 0 (0%)
4. Physical coercion in sexual violence 27 1 (2%) 3 2 (3%)
5. Psychological coercion in sexual violence 36 4 (7%) 4 3 (5%)
Psychological adjustment 95 23 (35%) 56 56 (84%)
6. Extreme minimization or denial of sexual violence 77 10 (15%) 16 50 (76%)
7. Attitudes that support or condone sexual violence 38 2 (3%) 13 12 (18%)
8. Problems with self-awareness 53 7 (11%) 29 19 (29%)
9. Problems with stress or coping 39 4 (7%) 28 22 (33%)
10. Problems resulting from child abuse 49 8 (12%) 17 43 (65%)
Mental disorder 97 27 (41%) 36 53 (80%)
11. Sexual deviance 67 3 (5%) 11 35 (53%)
12. Psychopathic personality disorder 47 0 (0%) 7 0 (0%)
13. Major mental illness 74 7 (11%) 18 26 (39%)
14. Problems with substance use 78 17 (26%) 13 40 (61%)
15. Violent or suicidal ideation 31 1 (2%) 18 12 (18%)
Social adjustment 85 15 (23%) 48 57 (86%)
16. Problems with intimate relationships 58 6 (9%) 29 53 (80%)
17. Problems with non-intimate relationships 55 2 (3%) 20 36 (55%)
18. Problems with employment 59 6 (9%) 29 54 (82%)
19. Non-sexual criminality 47 4 (7%) 16 38 (58%)
Manageability 81 13 (20%) 31 47 (71%)
20. Problems with planning 16 0 (0%) 13 6 (9%)
21. Problems with treatment 61 7 (11%) 21 44 (67%)
22. Problem with supervision 38 4 (7%) 14 32 (49%)

n = 100 for clinicians so the percentage is not reported. Domain values indicate the percentage of cases in
which at least one risk factor was identified.

Copyright # 2015 John Wiley & Sons, Ltd. Behav. Sci. Law 33: 39–55 (2015)
DOI: 10.1002/bsl
44 J. E. Storey et al.

• Scenarios of future violence. Next, raters coded whether reports discussed the
risks posed by the offender, something that may be crucial for legal decision-
making and offender management. Specifically, researchers coded, using a two-
point scale (yes vs. no), whether reports identified scenarios of future violence or
the components of such scenarios, including the nature, severity, imminence,
frequency/duration, and likelihood of any future sexual violence. These facets of risk
were defined as per the RSVP.
• Management recommendations. Raters then coded whether reports contained
specific recommendations for risk management. Specifically, raters coded the
number of risk management recommendations made in the following categories of
management strategies: “monitoring” (i.e., strategies aimed at evaluating changes
in risk or risk factors over time); “treatment” (i.e., efforts to improve deficits in the
offender’s psychosocial adjustment); “supervision” (i.e., attempts to impose controls
or restrict the offender’s freedom to prevent sexual violence); and “victim safety
planning” (i.e. efforts to increase the static and dynamic security of potential
victims). These types of management strategies were defined as per the RSVP.
• Summary risk judgments. Finally, raters coded, using a two-point scale (yes vs.
no), whether reports contained explicit statements regarding the level of risk in the
case, either in terms of the absolute or relative likelihood of future violence (e.g.,
“above average,” “high risk” compared with a reference sample of sex offenders) or
in terms of case prioritization (e.g., “moderate priority,” or “poses a high risk” with-
out mention of a reference group).

Data Analysis

We summarized the frequency with which clinical and probation reports were consis-
tent with the best-practice guidelines from the RSVP, and compared professional type
and other aspects of the reports using Fisher’s exact and t-tests.

RESULTS

As the RSVP was published in 2003, we first conducted a set of exploratory analyses to
determine whether reports differed systematically pre- and post-2003. We did this to
determine whether the publication of the RSVP changed the reporting practices of
clinicians and probation officers. We thought this unlikely, for two reasons. First, the
RSVP did not establish new guidelines, but simply summarized the opinions of others
as they existed in the literature. Secondly, the RSVP was not formally implemented in
the agencies that employed the clinicians and probation officers who wrote the reports
we reviewed.
The results (Table 2) revealed no evidence of increasing consistency with best
practices over time; indeed, if anything, the opposite was true. Prior to 2003 reports
included more “concrete” identification of risk factors and relevance, fewer risk factors
were “mentioned”, components of scenario planning were more often included in
reports, and more management recommendations and summary risk judgments were
made. We speculate that this may have been due to formal training in actuarial risk
assessment methods among some clinicians and most probation officers after 2003.

Copyright # 2015 John Wiley & Sons, Ltd. Behav. Sci. Law 33: 39–55 (2015)
DOI: 10.1002/bsl
 Violence risk communication 45

Table 2. Comparison of risk communication practices pre- and post-2003 for clinical reports and probation
reports

RSVP steps Pre-2003 Post-2003

M (SD) M (SD) t df p d

Clinical reports
Presence of risk factors Concrete 12.52 (3.65) 8.02 (5.04) 5.12 96 < 0.001 1.02
Mention 2.02 (1.95) 4.74 (3.06) 5.36 96 < 0.001 1.06
Relevance of risk factors Concrete 6.80 (4.16) 6.98 (5.14) 0.18 96 0.855 0.04
Mention 0.16 (0.53) 0.29 (0.71) 1.00 96 0.321 0.21
Scenarios of future violence Nature 0.36 (0.48) 0.24 (0.43) 1.26 96 0.210 0.26
Frequency/duration 0.04 (0.19) 0 (0) 1.23 96 0.220 0.30
Imminence 0.29 (0.46) 0.10 (0.30) 2.36 96 0.020 0.50
Severity 0.05 (0.23) 0.10 (0.30) 0.79 96 0.433 0.19
Likelihood 0.77 (0.43) 0.05 (0.22) 10.03 96 < 0.001 2.11
Management recommendations 4.39 (1.94) 3.50 (2.36) 2.05 96 0.043 0.41
Summary risk judgments 1.65 (1.68) .68 (1.15) 2.95 81 0.004 0.67

Probation reports
Presence of risk factors Concrete 3.33 (3.87) 1.46 (1.83) 2.61 63 0.011 0.62
Mention 6.53 (3.96) 8.24 (3.61) 1.57 63 0.121 0.45
Relevance of risk factors Concrete 2.40 (3.72) 0.68 (1.32) 2.78 63 0.007 0.62
Mention 0 (0) 0.02 (0.14) 0.55 63 0.588 0.20
Scenarios of future violence Nature 0 (0) 0.02 (0.14) 0.55 63 0.588 0.20
Frequency/duration 0 (0) 0 (0)
Imminence 0 (0) 0 (0)
Severity 0 (0) 0 (0)
Likelihood 0.07 (0.26) 0 (0) 1.86 63 0.067 0.38
Management recommendations 6.13 (2.50) 4.61 (1.97) 2.46 62 0.017 0.68
Summary risk judgments 2 (0) 2 (0)

RSVP, Risk for Sexual Violence Protocol.

In any event, as there was no evidence that publication of the RSVP impacted the find-
ings, we do not discuss this further.

Presence of Risk Factors

On average, risk factors were concretely identified in 47% of clinical reports and 7% of
probation reports, and mentioned in an additional 16% of clinical reports and 37% of
probation reports. The mean number of items concretely identified per report was
greater for clinical reports (M = 10.66, SD = 4.82) than for probation reports
(M = 1.86, SD = 2.54) [t(164) = 13.62, p < 0.001, d = 2.28]. Conversely, the mean
number of items mentioned in clinical reports (M = 3.15, SD = 2.80) was lower than
the mean in probation reports (M = 7.95, SD = 3.80) [t(164) = 9.36, p < 0.001,
d = 1.44].
There was substantial variation in the frequency with which risk factors were com-
municated about (Table 1). From the table, several patterns are evident. First, risk
factors related to previous sexual offending (i.e., sexual violence history domain) were,
on average, the least frequently discussed. Secondly, each risk factor was concretely
identified in clinical reports more frequently than mentioned, yet in probation reports
this pattern was reversed in all but four cases. Thirdly, probation reports never
concretely identified or mentioned three of the 22 risk factors. Further, in three proba-
tion reports, none of the 22 RSVP risk factors were discussed.

Copyright # 2015 John Wiley & Sons, Ltd. Behav. Sci. Law 33: 39–55 (2015)
DOI: 10.1002/bsl
46 J. E. Storey et al.

Table 3. Mean number of RSVP risk factors concretely identified and mentioned in reports by RSVP
domain

Concrete Mention

M (SD) M (SD)
t d t d
RSVP domain Clinical Probation Clinical Probation

Sexual violence history 1.49 (1.48) 0.23 (0.55) 6.63* 1.13 0.30 (0.64) 0.29 (0.58) 0.12 0.02
Psychological adjustment 2.68 (1.44) 0.56 (0.96) 10.53* 1.73 0.92 (0.98) 2.12 (1.34) 6.66* 1.02
Mental disorder 3.01 (1.40) 0.50 (0.69) 13.56* 2.27 0.62 (1.05) 1.65 (1.17) 5.91* .93
Social adjustment 2.25 (1.35) 0.33 (0.69) 10.64* 1.79 0.88 (1.12) 2.68 (1.31) 9.45* 1.48
Manageability 1.23 (0.83) 0.24 (0.56) 8.51* 1.40 0.43 (0.70) 1.21 (0.92) 6.21* .95

RSVP, Risk for Sexual Violence Protocol. df = 164.

*p < 0.001.

Table 3 displays the mean difference in the number of risk factors in each domain
identified in clinical and probation reports. Clinical reports concretely identified risk
factors significantly more often than did probation reports across all domains. Further,
with the exception of the Sexual Violence History domain, which was again the least
frequently discussed, probation reports were more likely to Mention risk factors.

Relevance of Risk Factors

On average, the relevance of risk factors was concretely identified in 31% of clinical
reports and 5% of probation reports, and mentioned in a further 1% of clinical reports
and 1% of probation reports. The mean number of items concretely identified per
report was greater for clinical (M = 6.91, SD = 4.57) than for probation reports
(M = 1.06, SD = 2.20) [t(164) = 9.68, p < 0.001, d = 1.63]. The mean number of items
mentioned per report was higher for clinical (M = 0.21, SD = 0.61) than for probation
reports (M = 0.02, SD = 0.02) [t(164) = 2.57, p < 0.011, d = 0.44].
Given the low number of probation reports that discussed the relevance of risk
factors, further analyses were conducted only for clinical reports. On average, risk
factors were identified as criminogenic in 16% of reports, protective in 13% of reports,
and neutral in 3% of reports. The mean number of items identified as criminogenic per
report was 3.47 (SD = 3.22, range 0–14), the mean for protective items was 2.75
(SD = 2.99, range 0–13), and 0.69 for neutral items (SD = 1.88, range 0–10). The
mean number of items identified in each RSVP domain is shown in Table 4. From
the results it is evident that criminogenic and protective factors were discussed most
commonly and at a similar rate, while neutral factors were the least discussed.

Scenarios of Future Violence

Various facets of risk were discussed in reports, but no scenarios of future violence were
identified. Fisher’s exact tests revealed large differences in the frequency with which the
clinical and probation reports discussed several components of violence risk: nature,
31% versus 2% (n = 1), p < 0.001; frequency/duration, 2% versus 0%, p = 0.518; immi-
nence, 21% versus 0%, p < 0.001; severity, 7% versus 0%, p = 0.043; and likelihood,
47% versus 2% (n = 1), p < 0.001.

Copyright # 2015 John Wiley & Sons, Ltd. Behav. Sci. Law 33: 39–55 (2015)
DOI: 10.1002/bsl
 Violence risk communication 47

Table 4. Mean number of risk factors identified in reports as criminogenic, protective, and neutral by RSVP
domain

RSVP domains

Sexual violence Psychosocial Mental Social

history adjustment disorder adjustment Manageability

M (SD) Range M (SD) Range M (SD) Range M (SD) Range M (SD) Range

Criminogenic 0.41 (0.68) 0–3 1.15 (1.17) 0–5 0.85 (0.91) 0–3 0.67 (1.02) 0–4 0.39 (0.65) 0–3
Protective 0.43 (0.93) 0–5 0.38 (0.72) 0–3 0.75 (1.12) 0–4 0.72 (1.04) 0–4 0.47 (0.67) 0–2
Neutral 0.14 (0.55) 0–3 0.14 (0.47) 0–3 0.24 (0.74) 0–4 0.12 (0.50) 0–3 0.05 (0.26) 0–2

RSVP, Risk for Sexual Violence Protocol.

Management Recommendations1

On average, clinical and probation reports recommended 6.38 (SD = 4.10, range 0–20)
and 14.02 (SD = 5.17, range 1–27) management strategies, respectively [t(163)
= 10.53, p < 0.001, d = 1.64]. A total of 18 clinical reports and 52 (80%) probation re-
ports recommended monitoring strategies with an average of 0.33 (SD = 0.82) and 1.55
(SD = 1.26) strategies, respectively [t(163) = 7.56, p < 0.001, d = 1.15]. A total of 95
clinical and 63 (97%) probation reports recommended treatment strategies, with an av-
erage of 3.32 (SD = 2.19) and 4.49 (SD = 2.10) strategies, respectively [t(163) = 3.42,
p = 0.001, d = 0.55]. A total of 83 clinical and 63 (97%) probation reports recom-
mended supervision strategies, with an average of 2.64 (SD = 2.36) and 6.89
(SD = 3.29) strategies, respectively [t(163) = 9.66, p < 0.001, d = 1.48]. A total of six
clinical and 45(68%) probation reports recommended victim safety planning stra-
tegies, with an average of 0.09 (SD = 0.40) and 1.08 (SD = 0.96) strategies, respectively
[t(163) = 9.14, p < 0.001, d = 1.35].
Further examination of the types of treatment strategies recommended revealed that
generally, in earlier reports (primarily those before 2000), clinicians were making more
generic treatment recommendations. These recommendations largely consisted of
recommending the offender take part in a sex offender treatment program. In more re-
cent years, however, both probation and clinical reports included more case-specific
recommendations (e.g., psychological treatment, assessment). In fact, there was no
longer a statistical difference in the number of treatment strategies recommended by
each professional group.

Summary Risk Judgments

The level of sexual violence risk posed by the offender was discussed in 85 clinical
reports and three probation reports (5%). Only 14 clinical reports indicated the level
of general violence risk posed, and no such ratings were made in probation reports.
Reports that included summary judgments used the following categories to describe
the level of risk posed by the offenders: low, low-moderate, moderate, moderate-high,
and high.

1
Information was missing in one case because the prosecution and defense submitted joint recommenda-
tions for conditions, so the probation report did not include any management recommendations.

Copyright # 2015 John Wiley & Sons, Ltd. Behav. Sci. Law 33: 39–55 (2015)
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48 J. E. Storey et al.

DISCUSSION

This study is the second to examine how different professional groups communicate
violence risk in practice and the first to use best-practice guidelines as outlined in a
validated structured assessment tool to do so. The study was strengthened by the fact
that it included a detailed examination of recommended risk communication practices,
from a large sample, taken from actual practice, spanning almost a decade. In addition,
a large percentage of the reports described the same offender, suggesting that differ-
ences identified between professionals were unlikely the result of diversity among
offenders. The results revealed a gap between recommended and actual practice.
Few evaluators used any violence risk assessment tool. Evaluators also failed to docu-
ment or concretely discuss risk factors. The gap between recommended and actual
practice was even more pronounced when advanced steps related to risk assessment
and communication recommended in the RSVP were examined, such as the relevance
of risk factors and scenarios of future violence. Differences were evident by professional
type, with clinicians more often identifying risk factors and probation officers more
often identifying management strategies. However, both groups showed gaps in risk
communication across the five areas examined.

Presence of Risk Factors

In examining the communication of risk factors, both encouraging and problematic

findings emerged. It is encouraging that, in a number of reports, empirically validated
risk factors were concretely identified or mentioned. For instance, for RSVP domains,
more than half of the clinical reports concretely identified at least one risk factor, and
individual risk factors were concretely identified in up to three-quarters of reports.
What was problematic was that there was little completeness or clarity in risk commu-
nication practices.
First, problems with completeness were evident whereby very few reports included a
discussion of risk factors. As previously noted, the RSVP was used as a best-practice
guideline herein, and there was no expectation that the tool be used or that every aspect
of the tool be included in every report. However, many of the risk factors examined are
risk factors that, for the purpose of a pre-sentence report for a male sex offender, would
be expected to be routinely present and relevant and therefore concretely identified or
mentioned. For instance, few clinical or probation reports discussed risk factors related
to prior sexual offending. Consideration of an offender’s history of sexual violence is
important not only when identifying risk factors, but also to inform each subsequent
step of the violence risk assessment. For instance, evaluating the diversity of sexual
violence (item 2) will inform the number and type of plausible scenarios of future
sexual offending. Evaluating the escalation of sexual violence (item 3) will inform the
summary judgment made about the severity of future sexual violence. Therefore, the
consistent lack of such information would lead to incomplete evaluations.
Secondly, problems with clarity were evidenced by the large number of risk factors
that were mentioned. Problems with clarity were particularly pronounced in probation
reports, where risk factors were mentioned more often than concretely identified. Sim-
ply mentioning a risk factor is problematic because the recipient of the evaluation does
not know if the risk factor is present, possibly or partially present, or absent for the

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DOI: 10.1002/bsl
 Violence risk communication 49

offender. Further, as discussed in the following section, simply mentioning risk factors
provides no clarity as to whether the risk factor is relevant to future violence risk or in
need of risk management.

Relevance of Risk Factors

Two encouraging findings emerged with regard to the identification of risk factor rele-
vance, as well as one problematic finding. First, reports were more likely to include risk
factors concretely identified as relevant as opposed to mentioned, indicating clarity in
discussing relevance. Secondly, in most reports, evaluators made a sensible and infor-
mative distinction between the relevance of risk factors as criminogenic or protective.
This is also a promising finding given the recent focus on the importance of considering
protective factors as part of a comprehensive approach to assess and manage violence
risk (de Ruiter & Nicholls, 2011; de Vogel, de Ruiter, Bouman, & de Vries Robbé,
2009; Hart, 2008; Ullrich & Coid, 2011). Attending to protective factors can be bene-
ficial because they can reduce the over-prediction of risk, increase fairness in the
criminal justice system, improve therapeutic treatment, and assist with management
strategy development, planning, and implementation (Borum, Bartel, & Forth, 2006;
de Ruiter & Nicholls, 2011; Gagliardi, Lovell, Peterson, & Jemelka, 2004; Rogers,
2000).
The problematic finding was that even fewer reports included a discussion of the rel-
evance of risk factors compared to their presence. The goal of violence risk assessment
is prevention, and prevention is achieved by managing risk factors that are functionally
related (i.e., relevant) to an offender’s risk of future violence (Hart & Logan, 2011).
Thus, it is vital that reports concretely identify risk factors that require management.
Further, indicating relevance has been identified as a core competency in forensic
mental health practice (Hart, Sturmey, Logan, & McMurran, 2011). Thus, although
the quality of the relevance discussed was promising, the quantity of discussion was
inadequate for a comprehensive assessment and for what is required of forensic mental
health professionals.

Scenarios of Future Violence

Identifying scenarios for future violence in the SPJ approach has evaluators speak to the
five facets of risk by considering whether future violence is likely to resemble past
violence, escalate, de-escalate, or change substantially in nature in some other way.
Facets of risk for future violence were discussed only in a minority of cases. It is possi-
ble, however, that the substantial amount of information required to develop such
scenarios was not always available to evaluators. The least discussed components were
the frequency/duration and severity of future violence. Both components are critical
because they inform the level and type of violence risk posed and the management
required. For example, identifying whether risk is chronic or time-limited will indicate
the duration of offender management and victim safety planning required. Similarly,
identifying whether severe (e.g., homicide) or less severe (e.g., threat) violence may
occur will indicate whether restrictive management strategies such as victim relocation
are appropriate. In addition to being part of a comprehensive assessment, research
shows that judges desire such information (Storey et al., 2013).

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50 J. E. Storey et al.

Management Recommendations

The vast majority of pre-sentence reports included management recommendations.

This was promising and particularly true of probation reports, as over two-thirds of
reports recommended at least one strategy in each of the four categories examined. It
was problematic, however, that clinical reports did not recommend equally diverse or
numerous strategies. Probation reports consistently recommended significantly more
management strategies than did clinical reports, and more often recommended at least
one strategy per category. This finding is notable and problematic given the recom-
mended process of violence risk assessment and the types of professionals examined.
With respect to the recommended process of violence risk assessment, management
strategies should be developed based on risk factors identified as relevant to future
violence and scenarios of future violence. Both groups rarely identified the relevance
of risk factors and never identified scenarios of future violence. Probation reports, in
particular, tended to move directly from identifying risk factors to recommending risk
management strategies. These practices are problematic as they provide little informa-
tion for decision-makers to consider when determining what risk management
strategies to implement. Further, they suggest that the management strategies recom-
mended may not be adequately tailored to the risk posed in a given case. It was also
notable that clinical reports rarely recommended monitoring or victim safety planning
strategies. This is problematic because it suggests that evaluators were not considering
all possible management strategies that might be critical to preventing future violence.
Evaluators should provide comprehensive and complete assessments, and a failure to
both assess and manage risk falls short of this.
With respect to the types of professionals examined, given the role of probation
officers (i.e., supervising the management of the offender in the community) we would
expect them to provide more detailed management plans generally. Having said that,
we did not anticipate this difference to arise for treatment-related strategies, given the
familiarity that clinicians have with treatment and the possibility that they would
administer such treatment. As such, we examined the types of treatment strategies
suggested in more detail. The findings of this analysis were positive as they indicated
that over time clinicians increased the number of treatment recommendations made
and, furthermore, their recommendations were more tailored to the case at hand.

Summary Risk Judgments

Most clinical reports included summary risk judgments, which is encouraging, partic-
ularly given the lower frequencies found in previous research (Grann & Pallvik, 2002;
Heilbrun et al., 1999b). Providing risk judgments was uncommon in probation reports.
This finding is problematic because providing a summary risk judgment can help to
communicate the level of intervention needed for the recipient of the evaluation. As
such, providing a summary risk judgment could assist probation officers in justifying
their management recommendations.

Clinical Versus Probation Reports

Overall, clinical reports identified risk factors more often than did probation reports,
possibly owing to the extensive training that the clinicians have received in relation to

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DOI: 10.1002/bsl
 Violence risk communication 51

the risk factors for sexual violence. The strength of probation reports was in
recommending risk management strategies, likely because the professional duties of
probation officers focus more strongly on managing offender risk. In general, however,
problems existed across all the areas examined for both groups. The most commonly
missing elements of risk communication for both groups were the more advanced ones,
such as the relevance of risk factors and scenarios of future violence. Perhaps most
concerning was the lack of fundamental elements of violence risk assessment and com-
munication, including a lack of completeness and clarity when discussing the presence
of risk factors. This may have been the result of the infrequent use of structured risk as-
sessment tools. This is particularly concerning because for years it has been widely rec-
ognized that structured methods of violence risk assessment are superior to
unstructured professional judgment, both generally and for sexual violence (Hanson
& Morton-Bourgon, 2009; Mossman, 1994). Moreover, the inadequacy of unstruc-
tured professional judgment was identified almost two decades before the first report
in the present sample was written (Monahan, 1981).

Limitations

Three limitations of this study should be considered. First, we used the RSVP to
operationalize best-practice guidelines for risk communication. The RSVP guidelines
are not universally accepted, of course, and the use of other guidelines or recommen-
dations (e.g., Babchishin & Hanson, 2009; Grann & Pallvik, 2002) may have resulted
in different findings and conclusions.
Secondly, owing to issues around file access and the timing of coding, we were
unable to have multiple raters code the same files and were thus unable to measure
interrater reliability. However, several steps were taken to maximize rater reliability.
First, a structured and comprehensive coding form with clear operational definitions
was used. Secondly, raters were all highly familiar with the tool. Finally, raters had
regular meetings with one another about coding issues.
Thirdly, the reports were authored by two professional groups in a single jurisdiction
during a 10-year period. The current findings may not be generalizable across profes-
sions, jurisdictions, and time.

Implications for Practice

Research and development are crucial to improving practice; however, they are of lim-
ited use if findings are not implemented in practice. Consistent with previous research,
the results revealed a gap between recommended and actual practice in violence risk
assessment and communication. The results have several implications for practice that
may assist in reducing this gap.
First, evaluators should familiarize themselves with existing guidelines and other
education material in the area of violence risk assessment and communication (e.g.,
Grisso, 2010; Hart & Logan, 2011; Heilbrun, 2001; Heilbrun et al., 1999a; McNiel
et al., 2011; Melton et al., 1997). This task would be easier if steps were taken to build
a broad consensus – reflecting the opinions of multiple stakeholder groups, including
diverse professionals, from around the world – regarding best practices in risk
communication.

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DOI: 10.1002/bsl
52 J. E. Storey et al.

Secondly, evaluators should seek out opportunities for advanced training in the areas
of risk assessment and communication. Training should cover multiple kinds of com-
munication (i.e., verbal, written, expert testimony), because effective communication
of violence risk depends, in part, on the mode, the recipient, and the context of the
communication.
Thirdly, pre-sentence reports were used herein as a measure of risk communication;
however, there are issues specifically related to pre-sentence reports that may have
impacted the results and could offer areas for improvement. For example, Bonta,
Bourgon, Jesseman, and Yessine (2005) found that most probation officers were
unhappy with the amount of training they received and the time they had to complete
their pre-sentence reports. Thus, the present results may be a reflection of these deficits
and their correction could lead to improved risk communication (for a review, see
Hilton, Scurich, & Helmus, this issue, pp. 1–18).

Implications for Research

A great deal more research is needed to examine violence risk communication practice.
We believe that three areas of future research are particularly relevant to advancing the
field. First, since the time that the present data were collected, advances have been
made in risk assessment and communication. For instance, in addition to the RSVP,
several other SPJ tools now include guidance and structure related to advanced steps,
such as the relevance of risk factors and scenarios of future violence. In the area or risk
formulation, most recent SPJ tools include a discussion of how to identify and consider
motivators, disinhibitors, and destabilizers. In addition, guidelines about how to evalu-
ate communication regarding risk formulation have recently been developed (Hart
et al., 2011). Future research examining these developments is an important next step.
Secondly, with the dramatic rise in the number of violence risk assessment tools, it
will also be important to examine how evaluators are combining such tools in practice,
particularly when using different assessment approaches in the same case (i.e., SPJ and
actuarial tools). There is little agreement about whether these diverse approaches to vi-
olence risk assessment can be combined in practice. Some professionals argue that if
actuarial risk assessment tools are used correctly, discretion cannot be used when
weighting and combining information (e.g., Meehl, 1998). Others argue that when
using actuarial risk assessment tools, discretion must be used to consider additional
case-specific or dynamic risk factors (e.g., Gottfredson & Moriarty, 2006). As a result
of this debate, there is limited guidance regarding how best to communicate findings.
For instance, it is unclear what professionals should do if they are using multiple tools
that lead them to different conclusions regarding the risk posed by perpetrators and
therefore what they should do to manage this risk. Researching this issue is critically im-
portant to understand how professionals are actually using these tools in practice and
how they are justifying their opinions to others.
Thirdly, future research will also need to examine how risk communication is
interpreted or received to fully assess its quality. Understanding how professionals
are communicating about violence risk is the first step, and understanding the implica-
tions of their communication for action is the next step. For instance, the number of
management strategies recommended may not be as good of a measure of the quality
of risk communication as the understanding of the recipient of the evaluation, the num-
ber of strategies that were implemented, the number of agencies that responded to the

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 Violence risk communication 53

evaluation by implementing strategies, and whether the violence risk that was identified
was ultimately prevented. Future research in this area should therefore begin to
examine the recipients of violence risk assessments and case outcomes.
Developments in the area of violence risk assessment and management have been
exponential in recent decades. To determine if we are fully benefiting from these
advances, we must ensure that they are being implemented in practice. Good risk
communication is an integral part of the assessment process, it can justify opinions,
convey risk and management leading to risk reduction, and protect against liability,
and should therefore be a priority for evaluators.

ACKNOWLEDGEMENTS

The authors wish to thank Jesse Klaver for her assistance with data collection and
coding. Jennifer E. Storey was supported by a Postdoctoral Fellowship from the Social
Sciences and Humanities Research Council of Canada.

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