New Study Finds the CARE Equal to Existing Violence Risk Tools With the Added Benefit of a Risk Management Plan

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Traditional risk tools, such as the PCL, SAVRY, and Earl-20B have demonstrated that they can significantly improve prediction of risk of dangerousness above that of clinical judgment. A new preliminary study that compares the PCL-YV, SAVRY, and CARE indicates that the CARE is equal to the SAVRY and PCL-YV in validity and reliability, but the CARE also has a risk management plan. The CARE has a wider range of age applicability and can be used with male and female youth from ages 2 to 19.

A new study (Seifert, 2004) has found that youth violence risk tools, CARE, PCL-YV, and SAVRY, are all significantly correlated with past and future violence. They appear to be promising tools for making judgments about a youth's risk of future violence and assist in providing treatment where needed. They are also significantly correlated with each other, demonstrating that they all measure the same or similar constructs. This study has also shown that early childhood abuse, neglect, exposure to violence and attachment problems are important factors contributing to the development of violence in youth and adults. Therefore, prevention efforts will include early family interventions.

Assessment of risk of future violence and sexual offending is an important area of forensic evaluations. Many evaluators have traditionally used clinical judgement to assess risk of future dangerousness. However, research has demonstrated that unaided clinical judgment of the risk of future violence/sexual offenses is no better than chance (r = .10). Because of this statistically and clinically based risk tools were developed.

The first generation of risk tools were actuarial tools using the 3 or 4 static items most highly correlated with the behavior in question, such as the RRASOR (Hanson). The second generation of tools included clinically and statistically determined items, such as the PCL (Hare) and the LSI(Andrews). The third generation of risk tools used guided clinical assessments that were clinically and statistically derived, such as the SAVRY (Borum) and the EARL-20B (Augimeri). These tools do not have a statistically derived scoring systems, but do include resiliency factors. The SAVRY can be used for teens, while the EARL-20B & G are for 7 to 12 year olds. The fourth generation of tools included those that used clinically and statistically derived items, a statistically derived scoring system, static and dynamic factors, and a risk management tool, such as the CARE and the RME (Seifert, 2003). Using a clinically and statistically derived tool will guide treatment decisions and can prevent future violence. The CARE and RME show significant promise as risk assessment and management tools.

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Kathryn Seifert
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