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Assessment of Risk and Need

Assessment of Risk and Need. Douglas B. Marlowe, J.D., Ph.D. National Association of Drug Court Professionals. Exigent Risk. History of violence or dangerousness Records check Interview collaterals GAIN-Q Behavioral Health Scale; TCU Hostility Scale

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Assessment of Risk and Need

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  1. Assessment of Risk and Need Douglas B. Marlowe, J.D., Ph.D. National Association of Drug Court Professionals

  2. Exigent Risk • History of violence or dangerousness • Records check • Interview collaterals • GAIN-Q Behavioral Health Scale; TCU Hostility Scale • Substance abuse and psychosis, combat-related PTSD, mania or frontal brain injury • Mental status assessment or psychiatric history • Any substance abuse screen (CAGE, DAST, AUDIT, etc.) • Psychopathy • PCL-R

  3. Risk of Dangerousness Tools • COMPAS Violence Scale • Violence Risk Appraisal Guide (VRAG) • Sex Offender Risk Appraisal Guide (SORAG) • Historical-Clinical-Risk 20 (HCR-20) • Classification of Violence Risk (COVR) • Static-99

  4. Prognostic Risk ~ Any validated recidivism risk tool

  5. Prognostic Risk • ~ Any validated recidivism risk tool • Prior criminal history • Current age < 25 years • Delinquent onset < 16 years • Substance abuse onset < 14 years • Prior rehabilitation failures • Antisocial Personality • Criminal values • Familial history of crime or addiction • Criminal associations • Instability (chronic homelessness, unemployment)

  6. Recidivism Risk Tools Level of Service Inventory-Revised (LSI-R) Wisconsin Risk and Need Assessment Scale (WRN) Risk and Needs Triage (RANT) Correctional Offender Management Profiling for Alternative Sanctions (COMPAS) Ohio Risk Assessment System – Community Supervision Tool (ORAS-CST) Post Conviction Risk Assessment (PCRA)

  7. Criminogenic Needs • Substance Dependence or Addiction • Triggered binge response • Cravings or compulsions • Withdrawal symptoms

  8. DSM-5 Criteria Substance Use Disorder- 2 in 12 months • Often taken in larger amounts than anticipated • Persistent desire or unsuccessful efforts to quit • Great deal of time obtaining or using the substance • Cravings • Failure to fulfill major role obligations • Persistent social or interpersonal problems • Important activities given up • Recurrent use in physically hazardous situations • Persistent physical or psychological problems • Tolerance • Withdrawal } Must be causal Mild = 2 to 3 Moderate = 4 to 5 Severe ≥ 6

  9. DSM-5 Criteria Substance Use Disorder- 2 in 12 months • Often taken in larger amounts than anticipated (i.e. binges) • Persistent desire or unsuccessful efforts to quit • Great deal of time obtaining or using the substance • Cravings • Failure to fulfill major role obligations • Persistent social or interpersonal problems • Important activities given up • Recurrent use in physically hazardous situations • Persistent physical or psychological problems • Tolerance • Withdrawal } Must be causal Mild = 2 to 3 Moderate = 4 to 5 Severe ≥ 6

  10. DSM-5 Criteria Substance Use Disorder- 2 in 12 months • Often taken in larger amounts than anticipated (i.e. binges) • Persistent desire or unsuccessful efforts to quit • Great deal of time obtaining or using the substance • Cravings • Failure to fulfill major role obligations • Persistent social or interpersonal problems • Important activities given up • Recurrent use in physically hazardous situations • Persistent physical or psychological problems • Tolerance • Withdrawal } Must be causal Mild = 2 to 3 Moderate = 4 to 5 Severe ≥ 6

  11. DSM-5 Criteria Substance Use Disorder- 2 in 12 months • Often taken in larger amounts than anticipated (i.e. binges) • Persistent desire or unsuccessful efforts to quit • Great deal of time obtaining or using the substance • Cravings • Failure to fulfill major role obligations • Persistent social or interpersonal problems • Important activities given up • Recurrent use in physically hazardous situations • Persistent physical or psychological problems • Tolerance • Withdrawal } Must be causal Mild = 2 to 3 Moderate = 4 to 5 Severe ≥ 6

  12. DSM-5 Criteria Substance Use Disorder- 2 in 12 months • Often taken in larger amounts than anticipated (i.e. binges) • Persistent desire or unsuccessful efforts to quit • Great deal of time obtaining or using the substance • Cravings • Failure to fulfill major role obligations • Persistent social or interpersonal problems • Important activities given up • Recurrent use in physically hazardous situations • Persistent physical or psychological problems • Tolerance • Withdrawal } Must be causal Mild = 2 to 3 Moderate = 4 to 5 Severe ≥ 6

  13. Criminogenic Need Tools Substance Dependence &Abuse Diagnostic Tools • Global Appraisal of Individual Needs (GAIN) • Structured Clinical Interview for the DSM-IV (SCID) • Psychiatric Research Interview for Substance and Mental Disorders (PRISM) • Diagnostic Interview Schedule (DIS) • Texas Christian University (TCU) Drug Dependence Screen-II • Drug Abuse Screening Test (DAST-20)

  14. Criminogenic Need Tools (cont.) • Mental Illness • Brief Jail Mental Health Screen (BJMHS) • GAIN-Q, GAIN-SS, ASI Psychiatric, etc. • Severe Functional Impairment • Low IQ, disinhibition • Lack of employable skills • Poor daily living skills (ADLs)

  15. LSI-R • Third Generation (3G) tool • Meta-analyses: mean r = .36 • compared to .27 for 2G tools, and .10 for 1G judgments • Kelly & Welsh (2008): • N= 276 male drug offenders released from special prison • Return to custody within approximately 15 months • Total Score predicted return to custody: r = .25; r2 = .08. • Drug & Alcohol Score also predicted return to custody: r = .16; r2 = .04

  16. LSI-R (cont.) • Lowenkamp & Latessa (2002): • Predictive validity highly variable across different programs and populations • Holsinger et al (2006): • Not predictive for Native Americans • Whiteacre (2006): • Higher false positives and false negatives for African-Americans

  17. LSI-R (cont.) • Fass et al. (2008): • Total Score significantly predicted rearrest within 1 year • AUC = .60; r2 = .03 • Higher false positives for African-Americans

  18. COMPAS • Fourth Generation (4G) tool • Fass et al. (2008): • 276 males released from halfway houses in NJ • Not significantly predictive of re-arrest within 1 year • AUC = .53 • Significantly higher false positives and false negatives for African-Americans

  19. COMPAS (cont.) • Brennan et al. (2009) • Northpointe (test developers) • 2,328 probationers, both male and female • Rearrests within ~ 1 to 5 years • All but three scales predicted felony recidivism (AUC = .70 in combination) • Recidivism Risk Index predicted felony recidivism (AUC = .70) • Equivalent prediction by gender, race and ethnicity

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