Clinical opinions of structured risk assessments for forensic child protection: The development of a clinically relevant device

Structured risk assessments are well established and outperform unaided judgement in most forensic fields, yet there has been little uptake of structured assessments in Australian forensic child protection. The reasons for such limited uptake are unknown. To address this, this study trained five independent senior clinicians contracted by the Children's Court to use three structured approaches: 1) an Actuarial approach measuring static factors, 2) a Contextual/Dynamic approach measuring dynamic factors and, 3) a combination of the two measures via a proposed risk matrix model. Following training, clinicians applied the approaches to 30 vignettes (based upon actual restoration cases), and their perceptions of the clinical utility of the approaches were measured via questionnaires. Clinician's opinions of the three approaches were generally positive, suggesting that structured risk assessments have clinical utility for forensic child protection cases. Alternative explanations for the limited uptake are discussed. Of the three approaches the Combined was viewed most favourably, followed by the Contextual/Dynamic, and finally Actuarial.