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Assessing Risk and Prioritizing Referral for Self-Harm: When and Why is my Judgement Different from Yours?

Cahill, Shanna and Rakow, Tim (2011) 'Assessing Risk and Prioritizing Referral for Self-Harm: When and Why is my Judgement Different from Yours?' Clinical Psychology & Psychotherapy. ISSN 10633995

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Abstract

This study investigated individual differences in the use of risk factors when making risk assessments for self-harm. Clinical judgement analysis using 35 hypothetical case scenarios was used to determine how case characteristics influence risk assessment for self-harm by mental health professionals. Seven practitioners made four risk/priority assessment judgements for each case, and individual models of judgement for risk and priority were constructed by regressing ten case variables onto these sets of judgements. All but two of the variables (potential risk factors) examined were related to risk and/or priority judgements. Risk assessors applied cues to make assessments consistently – broadly consistent with practice guidelines – though precise cue application varied between professionals. The findings demonstrate: the potential for ambiguity in risk assessment: terms such as “low” or “high” risk had variable interpretation; and that it can be important to specify whether risk is to be assessed for the initiation, continuation, re-occurrence, or escalation of an event or condition. The study shows the importance of clear practice guidelines (not all risk factors were used as might be anticipated from practice guidelines), and illustrates how clinical judgement analysis can be used to understand and enhance the reliability of professional judgement.

Item Type: Article
Uncontrolled Keywords: Risk Assessment; Self-harm; Clinical Judgement Analysis; Practice Guidelines
Subjects: B Philosophy. Psychology. Religion > BF Psychology
Divisions: Faculty of Science and Health > Psychology, Department of
Depositing User: Jim Jamieson
Date Deposited: 25 Nov 2011 13:22
Last Modified: 06 Jul 2012 10:27
URI: http://repository.essex.ac.uk/id/eprint/1604

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