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.

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 a powerful statement made by Dr. Ed Latessa while speaking about what works and doesn’t work in reducing recidivism at the OCCA conference in May of 2018. Of course, you need referees in a game and metaphorically when running a community corrections program. We must play by and enforce the rules, but coaches win games and make their players successful. Community corrections does need staff that “blow the whistle” when clients go out of bounds, give appropriate consequences and redirection, but that alone only keeps people in bounds during the game, it doesn’t teach them how to improve their skills and improve long term. In my experience, Dr. Latessa is dead on.  Staff naturally gravitate towards being the rule enforcer rather than the encourager. Getting staff to take on coach as their primary role is something that can’t just be trained, it must be immersed in the daily culture of the program.