The Short-Term Assessment of Risk and Treatability (START): A Prospective Study of Inpatient Behavior

摘要

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.View full textDownload full textRelated var addthis_config = { ui_cobrand: "Taylor & Francis Online", services_compact: "citeulike,netvibes,twitter,technorati,delicious,linkedin,facebook,stumbleupon,digg,google,more", pubid: "ra-4dff56cd6bb1830b" }; Add to shortlist Link Permalink http://dx.doi.org/10.1080/14999013.2011.631692