Christopher D. Webster's research while affiliated with Simon Fraser University and other places

Publications (70)

Chapter
This chapter provides a succinct review of the literature demonstrating that the general mental health literature has largely integrated the principles of positive psychology and that the importance of including strengths is firmly entrenched in mental health as standard, evidence‐based practice. It considers the importance of integrating strength‐...
Presentation
While virtual health has gained popularity and increased in usage amongst the general population, its application in the domain of forensic mental health services and judicial processes has historically been rare, and remains a sparsely researched topic. The current study evaluates the experiences of patients and key stakeholders with virtual heari...
Book
Full-text available
Česká adaptace: „SVR 20 V2 Manual for Version 2 of the Sexual Violence Risk–20: Structured professional judgment guidelines for assessing and managing risk of sexual violence“ od autorů: Douglas P. Boer, Stephen D. Hart,P. Randall Kropp , Christopher D. Webster. Boer, D. P., Hart, S. D., Kropp, P. R., & Webster, C. D. (2017). Manual for Version 2...
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Background Identification of the risk factors underlying impulsivity related to violent acts is an essential component of risk assessment and management to reduce violent offending. Aims Our aim was to develop a clinically useful measure for assessing impulsivity related to violence. Our research questions were which items in the newly developed m...
Article
We analyze relevant aspects in the history of forensic mental health services in the Toronto area, which offers a well-documented historical record for contextualizing current public debates and controversies. Spanning the late 18th century to the present, we trace the development of common and statute law, and service responses in the forensic and...
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The HCR-20 Version 3 (HCR-20(V3)) was published in 2013, after several years of development and revision work. It replaces Version 2, published in 1997, on which there have been more than 200 disseminations based on more than 33,000 cases across 25 countries. This article explains (1) why a revision was necessary, (2) the steps we took in the revis...
Book
This expanded and updated new edition reflects the growing importance of the structured professional judgement approach to violence risk assessment and management. It offers comprehensive guidance on decision-making in cases where future violence is a potential issue. Includes discussion of interventions based on newly developed instruments. Covers...
Article
Findings from violence risk assessment prediction-outcome studies suggest that there is no overall 'standout' scheme. This paper aims to highlight that even greater attention is now required on intervention-focused research. Recent advances in the development of structured professional judgement schemes, such as the Historical, Clinical, Risk Manag...
Chapter
In this chapter, the authors focus on just one issue: How is some degree of consistency to be brought to bear in the conduct of these assessments? In short supply, though, are ideas on how best (i) to teach the use of these devices to individual practitioners (many of whom may view such ?standardizations? as being too simplistic and, therefore, sup...
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The HCR-20 is widely used to assess risk of violence among patients with schizophrenia. Further understanding of the accuracy and changes over time in C and R scores is needed. Using prospectively collected data on 248 men with schizophrenia, the present study found that the HCR-20 significantly predicted aggressive behavior over 24 months. The H,...
Article
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The field of violence risk assessment has matured considerably, possibly advancing beyond its own adolescence. At this point in the field's evolution, it is more important than ever for the development of any new device to be accompanied by a strong rationale and the capacity to provide a unique contribution. With this issue in mind, we first take...
Article
Structured professional judgement risk management schemes such as the Historical, Clinical, Risk Management - 20 (HCR-20) can be described as clinical guidelines produced by a collaborative process between mental health clinicians and researchers. The purpose is to provide clinicians with a framework to guide interventions designed to manage specif...
Article
From flipping the coin to seeing both its sides - Volume 7 Issue 2 - Christopher D. Webster
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Current best practice guidelines recommend clinicians consider clients’ strengths as well as their deficits (APA, 2006; Department of Health, 2007). The Short-Term Assessment of Risk and Treatability (START) is one of the few structured professional judgment (SPJ) measures that facilitate this balanced approach to assessment and treatment planning....
Article
A description is offered of how colleagues in a variety of mental health disciplines were helped to implement a structured professional judgment (SPJ) risk assessment guide, the HCR-20 (Webster, Douglas, Eaves, & Hart, 199712. Webster , C. D. , Douglas , K. , Eaves , D. and Hart , S. D. 1997. HCR-20: Assessing Risk for Violence, Version 2, Burn...
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Forty years ago in this journal, Jay Haley wrote an article entitled ‘‘How to Fail as a Psychotherapist." In his article, he outlined the "daily dozen" of what could be construed as sub-optimal psychotherapy practices (e.g., "Insist that the problem which brought the patient into therapy is not important"; "Insist that only years of therapy will re...
Article
Within the conceptual framework of the scientist-practitioner model, this paper describes how the science of risk assessment has progressed to a point where it can be of definite assistance to clinicians. Similarly, clinicians can be of marked help to researchers as they play a role in concept definition and as they design and carry out studies to...
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Best Practice in Managing Risk is a recent Department of Health publication which provides a framework for mental health professionals working with service users to assess risk. It underpins risk assessment with principles of good practice for all mental health settings and provides a list of guides offering structure to risk management. We conside...
Article
Although it is generally presumed that there will be an association between the levels of security at which clients are held in a forensic hospital and the formal ratings of violence risk ascribed to them, such a relationship is seldom demonstrated. One measure in this study was the security level of 218 inpatients held in a German forensic hospita...
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Schizophrenia is associated with an elevated risk for violence. The response has been to incarcerate people with schizophrenia and to increase the number of forensic beds. Most of these beds are filled by men with schizophrenic disorders with long histories of offending and of treatment in general psychiatry. Outcome from forensic, as compared to g...
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This article presents reasons for undertaking “The Comparative Study of the Prevention of Crime and Violence by Mentally Ill Persons” and reasons for decisions regarding the study design and choice of measures. A brief portrait of the forensic patients that have been recruited is also presented. Community treatment programs could offer long-term co...
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The Short-Term Assessment of Risk and Treatability (START) is a new structured professional judgment scheme intended to inform multiple risk domains relevant to everyday psychiatric clinical practice (e.g. risk to others, suicide, self-harm, self-neglect, substance abuse, unauthorized leave, and victimization). The article describes the processes i...
Article
A new assessment scheme--the Short-Term Assessment of Risk and Treatability (START)--presents a workable method for assessing risks to self and others encountered in mentally and personality disordered clients. This study aimed to demonstrate (a) prevalence and severity of risk behaviors measured by the START, (b) psychometric properties of START,...
Article
Numerous studies have identified various historical factors strongly associated with violent behaviour in psychiatric patients. We comment herein on some practical reasons for difficulty in obtaining the background documentation necessary for risk assessment.
Article
Over the past quarter-century, Canadian researchers, clinical practitioners, and policy specialists have made several notable contributions to the broad field of violence risk assessment and management. In part, these contributions have been fostered by major changes in law over this period; in part, they have been spurred by findings from large-sc...
Article
Purpose of review: The identification of those who may be at increased risk of exhibiting violence is one of the highest-profile tasks of mental health professionals. Risk assessment is a rapidly developing field, and a number of instruments have been proposed for facilitating this task. Recent findings: This article summarizes the main development...
Article
The HCR-20 has gained considerable acceptance by mental health, forensic, and criminal justice professionals since its initial publication only seven and a half years ago. Scientific evidence has gradually accrued to show that the guide can be used reliably and validly. Yet the scheme is sometimes misapplied. It is important that HCR-20 item defini...
Article
Much energy has been expended over recent years in debating the relative merits of actuarial versus clinical approaches to violence risk prediction. Although it has gradually become apparent that scores based on more or less static factors obtainable from the record do indeed associate with outcome violence over years of follow-up, there is no reas...
Article
In this chapter, the authors focus on risk assessment as it relates to violence. The authors begin with a brief examination of some conceptual issues surrounding the study of violence and its prevalence in Canadian society. Next, a review of a few of the junctures within the Canadian legal context where risk assessments occur and some of the method...
Article
The wide majority of formally published research studies in child and youth care depend upon carefully defined behaviour and generally accepted statistical procedures. There can be no quarrel with this approach. Yet when data are extracted from files retrospectively it can be surprisingly difficult to achieve good inter-coder agreement. And even wh...
Article
Recently colleagues of ours discoursed on the topic of treatment effectiveness as it relates to persons with serious mental and personality disorder (Harris & Rice, 1997). They introduced their piece by pointing out that, although they had never encountered a fully effective intervention programme, they would in all likelihood recognize one such if...
Article
The Historical, Clinical, and Risk Management (HCR-20) violence risk assessment scheme was coded in a sample of 75 Canadian male, federally sentenced, maximum-security offenders. The concurrent validity of the HCR-20 was assessed through comparison to other risk instruments and to the presence of several past indexes of violent and antisocial behav...
Article
An inmate who has spent the last five years incarcerated for aggravated sexual assault comes before a parole board asking to be considered for release. A person suffering from schizophrenia murdered his parents and was found not guilty by reason of insanity and now, some years later, stands before a release review board. A 14-year-old girl allegedl...
Article
Evaluations of risk were conducted for 162 Canadian mentally disordered criminal defendants through the assembly of actuarial data, scores from special-to-purpose psychometric instruments, and scaled global predictions of dangerousness to others by clinicians and nonclinical raters. Violent conduct by participants was tracked across legal and medic...
Article
Extends a previous study (R. J. Menzies et al; see record 1985-19087-001) on clinical predictions of violence using the Dangerous Behavior Rating Scheme by increasing follow-up interval from 2 to 6 yrs and supplying new data on prediction-outcome correlations for multidiscipline assessors. 162 accused persons from the original study who had been re...
Article
Discusses reviews by J. Monahan (1981) and by R. K. Otto (see record 1992-29580-001 ) of the accuracy of dichotomous (yes/no) violence predictions, which reported rates of false positive errors that were calculated using conceptually and mathematically dissimilar methods. It is concluded that investigators who report the results of studies based on...
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The impulsivity scale from the Personality Research Form (PRF), the control/impulsiveness scale from the Multidimensional Personality questionnaire (MPQ), and the restraint scale from the Guilford-Zimmerman Temperament Survey (GZTS) were each subjected to exploratory factor analysis in a sample of 252 normal adults. The replicability of the derived...
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In this article we report on a survey that was organized to expand knowledge across a range of medicolegal issues and pragmatic applications. We wanted to provide forensic professionals with an opportunity to express their views on these various forensic trends, and on their relevance for expert identities, statuses and activities across a broad sp...
Article
Although mental health workers have long played an active and influential role in the provision of services to youth court, they have, as yet, devoted little effort to establishing standards to guide their procedures. As a result, numerous problems arise which to some extent threaten the credibility of youth court workers. The authors draw upon exa...
Article
This article is concerned with psychiatric recommendations for treatment at the Metropolitan Toronto Forensic Service (METFORS), a clinical assessment agency providing both 1-day and 30-day evaluations of criminal defendants in Toronto, Canada. Analysis of both psychiatric reports and quantitative research instruments demonstrated the saliency of t...
Article
The research literature on the treatability of forensic patients is sparse and fragmented. Employing available studies, we argue for a radical rethinking of treatability within the criminal justice system as a complex predictive task that tests the very limits of clinical competence. Issues that must be addressed in examining treatment needs of men...
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Clinical judgments on the treatability and prognosis of mentally disordered offeenders (MDO) may strongly influence legal dispositions and the availability of treatment resources. This study examined 1,238 discharge summaries for MDOs referred for court assessments. Psychiatrists evidenced marked variability in how often they recommended treatment...
Chapter
This chapter addresses a number of medicolegal, ethical, and policy issues associated with the clinical prediction of dangerousness. A review of the major studies in the area of prediction research is undertaken, and it is concluded that an abundance of methodological concerns (including the low base rates of violence, the situational character of...
Article
Developed and tested a psychometric instrument sensitive to several facets of dangerous behavior (personality, situational, facilitating, global estimate, and rater confidence in judgment factors) among forensic patients. Two trained nonclinical raters used the scale in assessing the dangerousness of 210 patients interviewed in a pretrial forensic...
Article
Describes a study investigating relationships between mental illness and violence in persons referred to a forensic clinic from the criminal courts for pretrial assessment. Three levels of analysis were of interest: (1) whether mentally ill patients had been more violent than others prior to their arrest; (2) whether clinicians perceived a positive...

Citations

... The role of the forensic psychiatrist is to describe to the courts the basis for the evidence that the expert offers. Most are familiar with the modern use of risk assessments, not actuarial check lists but structured professional judgments formed with judgment support frameworks De Vries Robbè et al., 2011;Kennedy, 2001;Müller-Isberner et al., 2007;Webster et al., 1997Webster et al., , 2006. ...
... Whatever the reason, there is no doubt that many people shift back and forth between mental health and criminal justice systems. Menzies and Webster (1987) followed up 571 accused persons admitted to a brief assessment unit for a pretrial psychiatric assessment 2 years later. In that time, 349 individuals (61%) received a total of 663 terms of imprisonment, 281 (49%) received a total of 592 psychiatric admissions, and 141 patients (25%) spent time in both prison and a hospital. ...
... There is little empirical doubt that ADHD is a risk factor for antisocial behavior, including earlier onset, greater variety, and more severe delinquency (e.g., Lichtenst ein et al., 2012;Sibley et al., 2011;Von Polier et al., 2012). When viewed through a transdiagnostic developmental psychopathology lens, it is unsurprising that not only the diagnosis of ADHD (van der Put et al., 2016), but also higher levels of the traits thought to underlie the externalizing spectrum (e.g., impulsivity), are similarly associated with criminal recidivism (Lichtenst ein et al., 2012;Moffitt et al., 2002;Weizmann-Henelius et al., 2019). Much less clear, is whether stimulants-which appear to be efficacious for ADHD symptoms (including behavioral problems and impulsivity; Pringshei m et al., 2015)-can reduce criminal behaviors both for those with and without a formal diagnosis. ...
... In diesem Kontext kann, nicht zuletzt um keine potenziellen beziehungsrelevanten Aspekte zu übersehen, auf Structured-Professional-Judgement-Instrumente, wie die z. B. HCR-20 V3 (Douglas et al. 2013) betreffs Gewaltrisiko, das TRAP-18 (Guldimann und Meloy 2020) betreffs terroristischer Handlungen oder bezüglich häuslicher Gewalt das SARA (Kropp et al. 1999;dt. Version Gaunerdorfer et al. 2011) zurückgegriffen werden. ...
... For instance, a more general assessment of threat can be performed with the Danger Assessment (DA)(Campbell, 1995). For a more targeted assessment the Spousal Assault Risk Assessment Guide (SARA)(Kropp et al., 1995(Kropp et al., , 1999 is the most used. For a more specific assessment of obsessive search for intimacy risk, Stalking Assessment and Management (SAM)(Kropp et al., 2008) is currently one of the best instrument available.Frontiers in Psychology | www.frontiersin.org ...
... Risk assessment instruments included the Historical Clinical Risk-20 (HCR-20) [37] and Sexual Violence Risk-20 [38]. We chose these as they are the most common risk assessment instruments used in clinical settings in Norway. ...
... Structured Professional Judgment tools provide evidence-based guidelines or frameworks that incorporate systemization and consistency while allowing for flexibility in incorporating case-specific and contextual factors. They contain actuarial elements, but based on the recognition that risk is dynamic and sensitive to changing conditions, Structured Professional Judgment tools allow for overrides of actuarial measures when there is sufficient justification based on clinical or policy factors (Doyle and Dolan 2002;Webster, Haque, and Hucker 2013;De Bortoli and Dolan 2015;De Bortoli et al. 2016). In this way, clinical judgments are intended to "serve as check on algorithms that cannot possibly take into account the nuances of the case and the particularities related to context" (Bosk and Feely 2020, 663). ...
... instruments with respect to comprehensiveness (i.e., the degree to which these tools capture the breadth of possible relevant risk factors). A critique of applying tools developed for common violence risk assessments for general violence (e.g., the Historical Clinical Risk Management-20 Version 3 (HCR-20 V3 ; Douglas et al., 2013) to violent extremism is both the lack of specific risk factors at the individual level (e.g., "us versus them" mentality, ideological commitments; Borum, 2015) and the lack of consideration for factors existing at higher levels (e.g., group factors, such as group influence and control; Lloyd & Dean, 2015). Each of these tools recognize the importance of the group-level factors for risk but cover these areas to varying degrees (for a comparison of the MLG and Violence Extremist Risk Assessment (VERA; Pressman 2009)/VERA-2 in this regard, see Hart et al., 2017; for an overview of the ERG-22+, see Lloyd & Dean, 2015; for an overview of the TRAP-18, see Meloy, 2018). ...
... Sleep quality monitoring may also have a part to play in risk assessment in secure care, though such a move would require adjustment to current protocols. At present, sleep quality is not a dedicated item in many of the instruments used to assess risk in forensic patients (for example: the Short Term Assessment of Risk and Treatability (Webster et al., 2004); the Broset Violence Checklist (Almvik et al., 2000); the Dynamic Appraisal of Situational Aggression (Ogloff & Daffern, 2006) or the HCR-20 V3 (Douglas et al., 2014). ...
... It has produced a longstanding, wide consensus within both the legal and mental health communities that mental health professionals are unimpressive in their ability to predict dangerousness (Cocozza & Steadman, 1976; Monahan, 1981 ). This consensus is perhaps overly broad, given the considerable methodological problems with these studies (Webster & Menzies, 1987), recent evidence about limited clinical accuracy (Lidz, Mulvey, & Gardner, 1993), and some progress on identifying more accurate predictors (). There can still be little argument, however, about the statement that clinicians have only very limited ability to predict that someone is dangerous to others. ...