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The Short-Term Assessment of Risk and Treatability (START): A prospective sudy of inpatient behavior

Gray, Nicola Susan ORCID: https://orcid.org/0000-0003-3849-8118, Benson, Richard, Craig, Rebecca L., Davies, Huw, Fitzgerald, Suzanne, Huckle, Phillip, Maggs, Richard, Taylor, John, Trueman, Marianne, Williams, Tegwyn and Snowden, Robert Jefferson ORCID: https://orcid.org/0000-0001-9900-480X 2011. The Short-Term Assessment of Risk and Treatability (START): A prospective sudy of inpatient behavior. International Journal of Forensic Mental Health 10 (4) , pp. 305-313. 10.1080/14999013.2011.631692

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Abstract

Structured professional judgment guides (SPJs) have gained acceptance for the prediction of future violence. We conducted a prospective study of 44 psychiatric inpatients with a variety of mental health problems to test whether the Short-Term Assessment of Risk and Treatability (START; Webster, Martin, Brink, Nicholls, & Middleton, 2004) was able to predict a range of problem behaviors. We obtained outcome behaviors from the nursing record for a period of up to 6 months after the assessment. For all types of behavior tested (violence to others, self-harm, self-neglect, and being victimized), the clinical judgment of risk based on the START was a good predictor. However, the actuarial scores on the Strength and Risk scales of the START were only useful for the prediction of violence. The results provide a strong evidence base for the use of START to predict a range of problem behaviors, and confirms that the START should be used as an adjunct to clinical decision making and not with a blind adherence to the actuarial scores. The difference in efficacy between START used in an actuarial manner and as a SPJ suggests that schemes using other items may prove more effective in guiding the clinician to assess and managing these risks.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Psychology
Subjects: B Philosophy. Psychology. Religion > BF Psychology
H Social Sciences > HV Social pathology. Social and public welfare
Publisher: Taylor & Francis
ISSN: 1499-9013
Last Modified: 20 Oct 2022 09:15
URI: https://orca.cardiff.ac.uk/id/eprint/31164

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