Question

Give an example of a clinical judgment of an offender. Contrast with an actuarial judgment.

Answer 1

• Through the utilisation of clinical experience when making judgements about the risk of violence posed by an individual, the clinician can assess emotional state throughout the interview. For example, emotional traits such as lack of empathy and anger and physiological and behavioural traits such as chanting, flared nostrils, flushed face and clenching of the jaw and hands are among the indicators of violence that may not be detected through the use of actuarial tools alone in the offender.
• The use of both actuarial tools and of structured risk assessment instruments in conjunction with clinical interviews has therefore been judged to be most effective.
• The use of structured clinical judgement has been seen as a step towards more accurate decision making practice, with this approach being based upon combining empirically established risk factors with clinical judgement.This method of violence risk assessment is considered advantageous as the clinician is given some level of flexibility and discretion.
• In common with clinical judgement, however, actuarial tools are limited when used alone. Within true actuarial assessments, no clinical judgement is present but instead strict, uniform rules and decision making criteria are adhered to. It is largely considered that due to the statistical improvement in inter-rater reliability, that actuarial assessments of violence risk are superior to clinical judgements.