ABSTRACT
A great deal has been written about clinical risk assessment in correctional, forensic psychiatric, and community settings with individuals who harm others as well as themselves. Indeed, this book is founded on a considerable amount of that research and guidance. Practitioners now have the means to identify reliably a range of factors known to correlate directly — and indirectly — with adverse outcomes, such as violence or suicide (see Otto and Douglas, 2010). In addition to specific risk assessment protocols such as the HCR-20 (Webster, Douglas, Eaves, and Hart, 1997), forensic practitioners, by virtue of their core training, are able to access a range of meaningful heuristics in order to guide their daily pursuit of harm prevention or minimization. However, the process of converting the findings of a risk assessment into effectively and demonstrably managed clinical risk for individual clients is not straightforward. Spelling out that process has been a key objective of this book. We have endeavoured to do this by addressing two important issues in the context of discussing adverse outcomes — or risks — of different kinds (e.g., violence, sexual violence) in different populations (e.g., women, young people): the structured professional judgement (SPJ) approach to clinical risk assessment and management, which emphasizes risk formulation as the essential bridge between the risk assessment and risk management tasks. If nothing else, readers should take from this book the importance, or at least the relevance, of these tasks in their work with harmful clients. In this chapter, we summarize the main points made by each of the contributors to the book as they relate to these key processes and offer suggestions for future directions in both clinical practice and research.
