Risk Assessment is Not the Same as Case Formulation

We would like to start with a story. Picture a courthouse in a struggling industrial town in Connecticut. The adult probation department is situated in the basement of this courthouse. We are beginning training with a new cohort of probation officers, teaching them how to incorporate forensic CBT techniques into their work. To start, one of the officers describes a current case and reviews the available assessment information. A quick review of the risk assessment reveals this is a high-risk case; a major area of concern is antisocial companions. We ask the officer to explain how friends and companions specifically influence criminal behavior for this justice-involved client (JIC). We get crickets! We ask, what role did friends play in the most recent offense? Again, an awkward silence permeates the room. While the officer certainly knows that antisocial companions is a risk factor for reoffending, she has not explored the nature of the JIC’s relationships and discussed with the JIC the specific role of companions in his offense history and daily routines. Unfortunately, this is a common training scenario when we begin.

In earlier blogs, we discussed some of the advantages of case planning from a risk-reduction perspective. One of the key challenges in operating from a risk perspective is answering a critical question, Where do mental health symptoms fit when working with justice-involved adolescents and adults?

There is an interesting contradiction in the scientific research of justice-involved clients (JICs) as it relates to mental health. First, JICs tend to have a relatively high prevalence of mental health problems. Second, mental health symptoms among JICs are actually weakly related to criminality (i.e., poor predictors of recidivism). Although there are certainly individual cases in which a JIC’s mental health symptoms directly influenced their offending behavior, these are infrequent occurrences. For the majority of cases, criminal risk domains (discussed in our previous blogs) and not mental health symptoms drive criminal behavior. This concept is particularly important in terms of intervention.

In our previous blog, we described the importance of risk reduction and the Central Eight risk domains. In this blog, we present some elements of risk models that often go unnoticed by practitioners. We believe these features of criminal risk, when applied thoughtfully, powerfully enhance supervision and case management practices. Here is how we think about risk in our work with justice-involved clients (JICs).

What works and doesn’t work when using Cognitive-behavioral therapy (CBT)?  This is something the authors, Raymond Chip Tafrate, PhD, Damon Mitchell, PhD, & David J. Simourd, PhD, of this blog series have spent a long time studying and have put all they’ve learned in the book: CBT with Justice-Involved Clients: Interventions for antisocial and self-destructive behaviors.  We thought our subscribers would be interested in a blog series on this content, knowing so many use or refer their clients to this type of treatment.  Therefore, we are pleased to announce this blog series on Adapting CBT for Justice-Involved Clients.

Let’s face it, much of what occurs in criminal justice is negative. Justice-involved clients (JICs) commit crimes that challenge our sense of right and wrong and safety in the world. They also might resist supervision and intervention that is mandated to them by the courts. These and other issues can create a negative bias against JICs and their ability to improve themselves. Additionally, the contemporary models of rehabilitation are based on risk reduction and risk models that get a bad rap. It can be common for community corrections officers and case managers to be reluctant to embrace a risk reduction perspective with JICs because it is viewed as intrinsically pessimistic and deficit-driven. Practitioners often say that working from a risk framework emphasizes client failures and problems, and the assessment process is simply a matter of adding up the number of risks a client has amassed. By extension, intervention is seen as establishing a set of avoidance goals based on those factors such as stay away from criminal companions and stop smoking pot. The reality is that risk-based models, when used effectively, offer a constructive perspective on client functioning, much more than just a checklist of JICs’ shortcomings. A shift towards a different, more multifaceted way of thinking about risk is often required to make these models useful for practitioners. We also suggest that risk models are the strategic heart of effective community corrections work.