How Do You Prepare Violence Risk Assessment Opinions for High-Stakes Courtroom Scrutiny as a Forensic Psychologist Across Diverse Forensic Settings?

The field of forensic psychology has made a concerted effort to move away from relying exclusively on clinical judgment when making predictions about future violence, as unstructured approaches historically produced inaccurate predictions. Two primary structured approaches now dominate the field: the actuarial approach and Structured Professional Judgment (SPJ).

Actuarial assessment tools are structured instruments that approach violence risk in a mechanical or automated way. These tools select risk factors based on their statistical relationship to a specific event within a development sample, combining them via an algorithm to create a total score. The primary benefit of an actuarial approach is the removal of human judgment biases from the clinical decision-making process. However, they come with significant drawbacks, including a failure to consider individual context or situations and a lack of structure for identifying necessary interventions.

Conversely, SPJ provides an evidence-based framework within which the evaluator can exercise clinical discretion. SPJ tools, such as the HCR-20 Version 3, the SAVRY for youth, or the SARA-V3 for intimate partner violence, require evaluators to consider the frequency, severity, trajectory, and relevance of specific risk factors. Research indicates that decisions made using SPJ tools have a demonstrated ability to accurately forecast violence risk while maintaining consistent ratings between evaluators. Unlike actuarial tools, SPJ frameworks help develop individualized risk management plans tailored to a person's history and current acuity.

A high-quality risk assessment must go beyond a simple list of risk factors; it requires a risk formulation. Formulation is conceptualized as an organizational framework for producing a narrative description that explains the underlying mechanisms of harmful behavior and proposes theories and directions for intervention.

In practice, many forensic psychologists utilize the "P" models (e.g., predisposing, precipitating, perpetuating, and protective factors) to structure their formulations. These frameworks help the court better understand why specific presenting problems have arisen, rather than merely observing the outcome of the offending behavior. A successful formulation should be future-focused, moving from assessing vulnerability to informing clinical interventions and treatment plans. Formulations should provide a detailed account of the individual that explains their current level of risk and its implications for future proceedings.

To withstand high-stakes courtroom scrutiny, an opinion should incorporate dynamic risk factors, which reflect changes over time and are often the focus of treatment. Examples include peer relationships, substance use, and impulse control. Evidence suggests that measures capturing dynamic clinical variables, such as the HCR-20 V3 Clinical scale or the Short-Term Assessment of Risk and Treatability (START), demonstrate incremental predictive validity beyond static factors like age or criminal history.

Forensic psychologists can further enhance their opinions by using additional psychometric instruments. The MMPI-2-RF, for instance, has shown utility in assessing dynamic personality factors and externalizing behaviors that overlap with constructs evaluated in sexual violence risk assessments. While not a risk assessment tool in itself, the MMPI-2-RF can provide valuable information about current psychiatric symptoms that may not be adequately captured by other instruments. In the courtroom, relying on multiple data sources is a prudent strategy for making high-stakes clinical decisions.

One of the most significant threats to the quality of forensic testimony is adversarial allegiance. Research indicates that forensic evaluators' reporting and interpretation styles often align with the side that retained them. For example, in sexually violent predator cases using the Static-99R, defense-retained evaluators were more likely to endorse practices conveying the lowest possible risk and the highest level of uncertainty. Conversely, prosecution-retained evaluators tended to use normative samples that suggested the highest levels of risk.

To maintain objectivity, forensic psychologists must explicitly consider the degree to which their decisions may be shaped by their adversarial affiliation. One essential practice is the inclusion of confidence intervals in reports, which provides risk estimates that acknowledge the inherent error in the prediction model. Transparency in how the "index offense" contributed to the overall judgment of risk is also recommended to fully inform the decision-making process.

The usefulness of a risk evaluation depends largely on how well the results are communicated to the trier of fact, such as a judge or jury. Jurors generally tend to defer to expert opinions, but the format of risk data significantly impacts their perception.

Research suggests that when risk data is not anchored by an absolute recidivism estimate, jurors significantly overestimate the likelihood of future violence. If an expert only provides an ordinal category (e.g., "medium risk") or discusses only the necessary interventions, perceptions of risk are highest. Therefore, clinicians are advised to use a hybrid approach, testifying about risk using multiple data formats, including numerical estimates, rank-ordered categorical "bins," and a comprehensive risk management plan.

While base rate examples are often used to simplify information, some studies suggest they may not always impact risk perceptions in the presence of clear numerical data. However, mentioning the population base rate for violent offending is still considered a required component of balanced testimony. Experts should avoid apparent precision that might mislead the court, as the predictive validity of specific numbers is often debated.

A critical area of scrutiny involves the use of the Psychopathy Checklist-Revised (PCL-R) in capital cases. A group of experts has issued a statement of concern, concluding that the PCL-R cannot precisely or accurately predict an individual's risk for serious institutional violence in high-security facilities. Meta-analyses show that the association between PCL-R scores and serious physical harm in prisons is negligible.

Furthermore, labeling a defendant a "psychopath" has a substantial prejudicial impact, potentially making jurors more inclined to support the death penalty. Because interrater reliability for PCL-R scores can drift significantly in adversarial proceedings, with prosecution-retained experts often reporting higher scores, the tool may lack the probative value necessary for high-stakes decisions, such as capital sentencing. Psychologists must be wary of using tools developed for one purpose (e.g., measuring traits) for a different objective (e.g., predicting institutional violence).

The goal of forensic risk assessment is to facilitate communication between agencies and provide a common language for the courts to discuss risk and intervention. Even when representing one side in the courtroom, forensic psychologists have a moral obligation to present data that is both understandable and comprehensive enough to assist the court in rendering a just decision. By combining structured methodologies, acknowledging the limitations of their predictions, and focusing on dynamic risk management, forensic psychologists can provide high-quality opinions that withstand the intense scrutiny of the legal system.

Training

• Violence Risk Assessment Certificate
• Evaluations for High Stakes Sentencing: Capital and Juvenile Murder Cases
• Evaluation of Mental State at the Time of the Offense (Insanity/Criminal Responsibility)
• Foundations of Violence Risk Assessment and Management
• Assessing Psychopathy using the Hare Scales (PCL-R and PCL-SV)
• Advanced Issues in the Assessment of Risk for Violence: Formulation

Blog Posts

• An Introduction to Violence Risk Assessments
• New Fordham Risk Screening Tool May Be Able to Accurately Identify Patients In Need Of A Full Violence Risk Assessment - CONCEPT Professional Training
• Adversarial Allegiance Appears Evident in Static-99R Score Reporting and Interpretation
• What Are the Roles and Responsibilities of the Forensic Psychologist?