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

Gray, Nicola Susan, Benson, Richard, Craig, Rebecca L., Davies, Huw, Fitzgerald, Suzanne, Huckle, Phillip, Maggs, Richard, Taylor, John, Trueman, Marianne, Williams, Tegwyn and Snowden, Robert Jefferson 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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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: 23 Oct 2017 12:37

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