Forensic psychology: Part 4: Chapter 14: Assessing offender populations

by Lynn Stewart, Ph.D., C.Psych.^{Footnote 1}

• The value of the actuarial risk measures in the community is to identify those offenders who need concentrated attention, whereas measures of dynamic risk point to problems associated with failure on release that should form the basis of an intervention strategy.
• Assessments in the community should evaluate specific problems affecting relapse among specific kinds of offenders (Quinsey & Walker, 1992)
• Assessments of dynamic risk factors indicates that need level changes over time. Results of reassessment are more predictive of success in the community than initial assessments. These facts point to the requirement that community based psychological assessments should be ongoing and must reflect change in offenders' circumstances and coping ability.
• Assessments in the community must be part of an assessment and intervention strategy continuum. Community based psychological assessments must consider previous treatment and behaviour during incarceration and provide a clear link to treatment and supervision planning in the community.
• Risk management in the community is likely to be most effective when intensive supervision of higher risk cases is married to clinical services. Recent outcome studies of the intensive supervision projects indicate that intensive supervision alone does not decrease recidivism (Petersilia & Turner, 1993).
• Assessments completed in the community must provide an assessment of risk and recommendations for effective management of risk. Such risk assessments should be presented with due consideration to standards of professional practice outlined in chapters in this manual.
• Clinicians should provide a systematic way of evaluating treatment on an individual case basis. The effect of treatment should be assessed against concrete and measurable objectives and reevaluated on a regular basis.
• Community correctional psychologists must be prepared to work within the ethical guidelines specified for a correctional or high risk clientele. This means clearly stating the limits of confidentiality to the offender before beginning assessments and treatment. Sharing of information applying a RP approach is not limited to assessment of imminent danger to a specified individual but includes sharing any information that is important to effective risk management.
• The guidelines should apply equally to CSC staff psychologists and to psychologists contracting with the Service. Request for contract proposals developed by contract managers in CSC must dearly specify these requirements and standards of professional practice.

CSC has only recently (1990) placed staff correctional psychologists in the community. The role of these psychologists varies depending on the requirements of the parole district where they work. For example, in some geographically compact districts, the psychologist may provide direct service (assessment and treatment) to offenders on conditional release. In larger areas where there is a greater number of offenders and they are more dispersed, psychologists provide a wider resource by functioning as consultants principally involved in designing, implementing and coordinating programming, evaluating treatment interventions and delivering staff training. The training may involve facilitating courses on issues related to effective supervision such as, for example, the CSC initiatives on Sex Offender Management or the Intensive Family Violence training or specific training of case management specialists who sometimes deliver programs under the clinical supervision of psychologists.

Whatever the service delivery model adopted by the community correctional psychologists, all services provided fall under the following areas: 1) assessment and evaluation of clients' needs; 2) clinical intervention to reduce psychopathology and symptoms of serious mental disorder; 3) clinical intervention to support rehabilitation goals by helping offenders to increase their level of self management; 4) clinical intervention to support humanitarian goals of crisis intervention; 5) consultation with and training of staff to enhance their skills in the management of offenders; and 6) program planing, development and evaluation. Psychological services are provided in all the above areas to support the ultimate goal — increased public safety. The preeminent goal of all correctional psychological intervention is to prevent or reduce harm to the community, the offenders and their families (see Shah, 1993; Hargreaves and Shumway, 1989). Blackburn (1993b) suggests that in general terms, correctional treatment can properly be characterized as more akin to remedial education than to treatment as understood in traditional clinical psychology. Offenders are assisted in learning alternative ways to manage their problems without reoffending.

Although in the broadest sense the goals of correctional psychologists in both institutions and the community are similar, the issues they address, and therefore the focus of their efforts, may be quite distinct. Many problems facing practitioners in the delivery of service are intrinsic to the treatment setting. For example, in the community, psychologists and case managers do not normally deal with such institutional issues as good order and security. They are, however, faced with the disconcerting problem of offenders' immediate access to potential victims. Offenders who appear motivated to address criminogenic factors while incarcerated may no longer comply with their correctional treatment plan when released for several reasons. They may feel that their obligations are over once they are in the community. Since they are no longer presenting a case to a case management team or parole board for release, they are often more interested in dealing with immediate practical issues related to adjusting to life in the community such as family reintegration, employment, etc. which they feel are more urgent than program participation. Lack of transportation and financial resources provide additional problems or excuses for non compliance. Family disjunction and lack of employment or adequate housing are immediate stressors in the community that institutionalized offenders may temporarily elude. The impact of struggling with community readjustment may be greater for inmates who have been incarcerated for long terms.

Over the last years public awareness of the correctional enterprise has increased and as a consequence, correctional policy has become more politically sensitized (Ekstedt & Griffiths, 1988). Community correctional staff are particularly susceptible to public reaction to sensational incidents. The impact on community corrections is often direct and immediate. Some communities are under more scrutiny than others and this affects case managers who may be reluctant to grant offenders they supervise much latitude and it increases the stress on high profile latitude offenders whose releases capture media attention.

Despite the additional challenges in the community, there is evidence that supplying correctional programs in a community setting where the new skills are most meaningfully applied is more appropriate and, on average, more effective than programming delivered while the offenders are incarcerated. Shah emphasizes that research generally reports only modest levels of cross-setting consistencies in behaviour (1993) and others have found that treatment effects do not easily generalize across settings (Braukrnann & Wolff, 1987; Rice, Quinsey & Houghton, 1990). Recent data favours the results of community based programs over institutionally based programs (Andrews, Zinger, Hoge, Gendreau, Cullen, 1990; Izzo & Ross, 1990; Lipsey, 1990). However, decision makers are unwilling to release high risk offenders without evidence of program participation. What is more, institutional programs which help offenders develop coping skills provide a useful preparation for community programming. At the very least, the success of institutional programs is enhanced by follow-through in the community (Zigler & Hall, 1987). Evidence from the substance abuse treatment literature (Marlatt & Gordon, 1985) and the literature on treatment of sex offenders (Pithers,1990) emphasizes the key role of skill and knowledge maintenance and follow up in reducing the risk of relapse.

Psychological assessment in the community differs in emphasis from assessments traditionally required in the institution. Institutional assessments have been most concerned about predictive accuracy, that is, providing information on relative risk to reoffend that can guide decision makers in evaluating parole suitability. The primary purpose of assessments in the community, however, must be to guide the management of risk in order to reduce or prevent recidivism. Factors which best anchor risk prediction are static and, by definition, unchangeable (Harris, Rice & Quinsey, 1993). For example, tombstone data on age of offender at release, age at first offense and the extent and versatility of the offense history are reliably associated with risk to reoffend. Although these variables are useful for community psychologists to consider in so far as they identify higher risk offenders who will require the most intensive service, community practitioners are principally concerned with identifying dynamic risk factors that can be modified through clinical or supervision interventions.

The assessment of risk level is the first among several components of community risk management. A well conducted risk assessment must be accompanied by the linking of the risk assessment to appropriate interventions, the sharing of information between clinical staff and case management supervisors, and by close monitoring of the offenders' activities in the community. Perhaps the most distinctive feature of community correctional psychology, as opposed to institutionally based correctional psychology, is the degree to which a multidisciplinary team effort is key to effective clinical and case management intervention.

The type of psychological assessment conducted and the assessment techniques selected, in the community as in the institution, will be dictated by the nature of the referral question. However, this paper proposes that applying the Relapse Prevention (RP) model as a framework, along with adherence to the Risk, Need and Responsivity principles of effective correctional treatment as described and championed by Andrews (1989), provide a sound theoretical basis for the assessment and treatment of offenders released in the community.

Pithers has voiced his concern that RP is becoming a catch-all phrase that is sometimes indiscriminately applied. He observes that applying the term but not rigorously adopting the methods threatens to dilute the integrity and effectiveness of the approach. He is not suggesting as Marlaat has that RP should only be regarded as an adjunct to a multifaceted treatment program. Rather, he encourages the delivery of treatment to the sex offender population he works with within a RP framework, that is, with a view as to how risk factors contribute to reoffending. This paper supports the idea that relapse prevention which originated out of the treatment of substance abusers (Marlatt & Gordon, 1985) and was later adapted to the treatment of sex offenders by Pithers (1990) and Marques (1988), need not be applied only as a structured follow-up to an intensive specialized treatment program but can also be usefully applied in the community as a unifying framework for formulating correctional intervention strategies for the general offender population.

The internal or treatment component of the RP model identifies the idiosyncratic precipitates of offending and trains the offender in various self management techniques to cope with these high risk factors. Treatment providers involved in delivering RP to high risk groups quickly became aware that relying on the offender's motivation and compliance in self management was not an adequate means of reducing community risk. The external supervision component of the RP model was therefore developed by Pithers et al. to supplement the internal, self management component. Although self-management techniques can be taught in an institutional based program, the external supervision component is really only relevant to a community setting. It is composed of several supervision strategies that include: encouraging the development of a network of individuals known to the offender who are supportive of prosocial change and who will assist the offender in anticipating potential high risk situations and slips or lapses into the offence cycle; case managers' monitoring and intervention based on knowledge of signs of imminent relapse; and close collaboration between treatment specialists and supervision staff. Some treatment settings have been able to effectively bring in additional community resources such as the specialized police squads, particularly the sexual assault squad and the domestic response squads, which apparently have contributed to the program by providing additional monitoring and information on offenders without compromising the cooperation of the program participants (for example, the community sex offender program in the Regina parole area includes the sexual assault squad in their monthly case conferences). Self management techniques and supervision strategies developed by Pithers and colleagues have been applied to the management of sex offenders, however, a similar approach can be used in counselling offenders engaged in other high risk or compulsive behaviours such as assaultiveness, firesetting, substance abuse, among others.

The Risk, Need and Responsivity principles of effective treatment are compatible with the RP model. In brief, the Risk principle recommends that the highest level of service be reserved for offenders at higher risk to reoffend; minimal levels of service, low intensity interventions or no intervention are recommended for the lower risk cases. The goal of supervision or of any intervention is, in Andrews' words, "to reduce the risk of high risk offenders to a lower risk category and keep the low risk cases low risk." There is adequate literature to suggest that reserving intensive service for high risk cases is a cost effective strategy that most effectively reduces recidivism. Several outcome studies have demonstrated that intensive intervention with low risk offenders may not only be ineffective, but, more alarmingly, it can actually increase recidivism (Andrews, Bonta and Hoge, 1990). Unfortunately, because low risk offenders are often more compliant and easier to deal with in a treatment context than high risk offenders, they may be over-represented in treatment programs. Recently, we implemented a more formal psychological service referral process in the Ontario Region when we realized that an unacceptably high portion of the budget was allotted to support long term counselling for lower risk offenders. Although recidivism rates for higher risk offenders post treatment may well be greater than for lower risk groups, there is consistent evidence that the relative improvement is more likely to be significant for the higher risk group. The exceptions to the principle may be the highest risk groups where treatment outcome studies to data have not been encouraging. Nevertheless, Andrews encourages even closer adherence to the Risk/Need principles in post release planning for this group which includes the closest possible supervision and open communication between all members involved with the release plan.

The Need principle specifies that interventions should normally be geared only to identified criminogenic needs, needs that an analysis of the offense(s) points to as being relevant. Andrews recommends that all assessments minimally address the "Big Four" factors which are generally associated with criminal conduct: antisocial attitudes, antisocial peers, antisocial personality and antisocial history. More specific factors may be common to particular offender groups. For example, in Pithers, Kashima, Cumming, Beal, and Buells' (1988) study of sex offenders they found that 94% of rapists reported experiencing anger and frustration just prior to their offenses. A module teaching the appropriate expression of anger, then, is an essential component of a treatment program for rapists. This is not true of child molesters. If correctional psychologists are adhering to the Need principle, clients reporting vague emotional complaints should not be counselled unless the emotional distress can be demonstrated to be related to the offenders' criminal behaviour (an exception to this would be to provide the offender with crisis counselling consistent with humanitarian goals). Indeed, there is evidence that "neurotic misery" may be a factor that inhibits criminal behaviour, providing a motivation for the unhappy offender to address problems associated with his criminality.

Our office recently reviewed an inappropriate referral th.at did not tie treatment recommendations to criminogenic need. An offender serving three years for trafficking was released with a condition to participate in marital or relationship counselling because he had fathered six children by six different women. A brief interview revealed no evidence of abuse in these relationships. He was not supporting the women or the children so he was not trafficking to earn money for them. In fact, though his attitude toward parenthood was unconventional, perhaps, irresponsible, it was not criminogenic. As a result of the assessment, the psychologist recommended that the condition to attend marital counselling be lifted.

It is worth emphasizing that adherence to the Need principle requires that the intervention should be geared to specific aspects of the criminogenic need area that are relevant to the risk to reoffend. Andrews illustrates this point by arguing that if the criminogenic factor involves an inability to keep a job, keeping a job should be targeted (and issues of reliability, attitudes toward authority, etc.), not getting a job (and issues of trades training, resume writing, etc.). The assessment, then, should provide a needs analysis that is detailed enough that the most critical aspects of the need are highlighted. Furthermore, identification of the specific need and the provision of an appropriate intervention to address it must be tied to a long term correctional plan. Failure to provide continuity in the provision of programming may decrease its effectiveness or worse. An early review of the effectiveness of prison education programs conducted by Glaser (1964) showed that offenders with extensive records who had participated in short term prison education programs were associated with higher than average post release failure. The author attributes this result in part to offenders' frustration because of the setting of unrealistic expectations on release. Addressing offenders' needs must be tied to the sort of continuity of service and on-going assessment and reanalysis throughout the sentence that is required by CSC's Correctional Strategy.

One problem in predicting potential for future criminal behaviour is the difficulty in factoring in situational stressors which offenders will face on release. Anti-social behaviour, as formulated by a functional analysis, is the outcome of an interaction between relatively stable personality variables, the changing environmental context in which the behaviour occurs and the individual's interpretation of his circumstances. Until quite recently, there have been no formal means of assessing and re-assessing on-going changes in offenders' circumstances that are related to community adjustment and to recidivism.

Adherence to the Risk and Need principles outlined above incorporates the assessment of dynamic risk factors (sometimes termed "needs" or criminogenic factors) with static risk factors which are the basis of actuarial based risk measures, to provide an evaluation of current risk status that is sensitive to changes in the offender's circumstances.

Well-validated instruments like the Level of Supervision Inventory (ISI) and, in federal corrections, the Community Risk Needs Management Scale (Motiuk & Porporino, 1989) have identified general precursors of criminal conduct. These are: criminal associates, anti-social attitude, poor job skills, family/ marital problems, behavioural/emotional problems, substance abuse, and problems in community function.

The Community Risk Needs Management Scale, implemented in the community nationally in 1989, has been shown to add significant predictive information on parole success to that provided by instruments like the Nuffield Scale (General Statistical Information on Recidivism, 1982) alone. The original field test of the measure demonstrated that released offenders whose need level was assessed by their parole officers as high were more likely to become supervision failures than those whose need level was low, even if their offense histories did not indicate that they were high risk. What is more, need reassessments were found to better predict later outcome than the original intake assessments. This is critical information for individuals working with offenders in the community because having a valid means of identifying and assessing criminogenic needs allows them to target the most relevant areas for clinical and case management intervention - something that knowledge of the static risk factors cannot provide.

The latest version of the Community Risk Needs Management Scale piloted in Ontario Region (the Community Offender Management System [COMS]) not only requires the case manager to set the need level for a general need domain, but probing indicator questions point to specific behaviours within a need domain that should be targeted.

For example, within the Employment domain, unstable job history and unreliability on the job correlate with failure on release after a 6 month follow up, while poor interpersonal skills on the job and physical or learning disability did not (Motiuk & Brown, 1993). Evidence that need level at the time of reassessment better reflects actual risk status confirms that these needs or risk factors are dynamic which should give practitioners confidence that interventions to lower specific need levels can in principle, improve risk management. Indeed, this is the basic assumption behind CSC's Correctional Strategy.

• The value of the actuarial risk measures in the community is to identify those offenders who need concentrated attention, whereas measures of dynamic risk point to problems associated with failure on release that should form the basis of an intervention strategy.
• Assessments in the community should evaluate specific problems affecting relapse among specific kinds of offenders (Quinsey & Walker, 1992)
• Assessments of dynamic risk factors indicates that need level changes over time. Results of reassessment are more predictive of success in the community. These facts point to the requirement that community based psychological assessments should be ongoing and must reflect change in offenders' circumstances and coping ability.
• Assessment in the community must be part of an assessment and intervention strategy continuum. Community based psychological assessments consider previous treatment and behaviour during incarceration and provide a clear link to treatment and supervision planning in the community.
• Risk management in the community is likely to be most effective when intensive supervision of higher risk cases is married to clinical services.
• Recent outcome studies of the intensive supervision projects indicate that intensive supervision alone does not decrease recidivism (Petersilla & Turner, 1993).

If both dynamic and static risk levels can be assessed well by case management officers with the benefit of the latest in risk assessment tools, what is the additional information that the clinician can provide in an assessment that is worth the additional costs to a correctional service?

Pithers has recently reformulated his analysis of the precursors to sexual offender. This analysis can explain general criminal behaviour as well. He discusses three types of precursors: predisposing risk factors, precipitating risk factors and perpetuating risk factors.

With their knowledge of developmental psychology, psychologists can offer insights into the life history and personality traits of offenders that predispose them to criminal acting out. These factors, such as previous abuse as a child and chaotic family environment are typically referred to as the predisposing risk factors.

Through their clinical training, psychologists can provide an analysis of the specific dynamic conditions such as emotional mismanagement, low impulse control, excessive sexual arousal to deviant stimuli, substance abuse and the offenders' construal of the environmental events that precede their offending. These are referred to as precipitating risk factors.

Finally, with a combination of knowledge of both predisposing and precipitating risk factors and knowledge of community resources, referral sources, and a background in the literature that Don Andrews refers to as the "psychology of criminal conduct," psychologists can assist community case managers in planning and monitoring intervention strategies that reduce the perpetuating risk factors and as a consequence, enhance community safety. Perpetuating risk factors maintain and support antisocial lifestyles and criminal behaviour, for example, cognitive distortions, antisocial values, association with antisocial peer groups and poor or inadequate supervision.

Andrews cites the importance of consideration of the additional principles of Responsivity and Professional discretion, both of which suggest a role for clinicians. The principle of Professional discretion gives due consideration to ethically, individualized appropriateness and cost effectiveness of treatment when treating an offender or referring an offender to treatment. According to the Responsivity principle, the most successful correctional intervention must be sensitive to the suitability of a given treatment option for the individual offender. The clinician takes into account such factors as cognitive style, interpersonal maturity, intellectual level, degree of psychopathology, level of motivation and anxiety as well as gender issues and cultural issues in matching the offender to appropriate treatment. For example, there is preliminary evidence that RP with sex offenders who are "career criminals" (and, by extension, RP with career criminals, in general) is not as effective as with offenders whose criminal pattern is not so entrenched. The career criminals' antisocial attitudes and impulsivity are not compatible with learning self management strategies. The impulsive nature of the criminal pattern makes it difficult for clinicians and case managers to intervene to curtail antecedents to crime because the offence so quickly follows the immediate precursors. The attitudes and criminal associates which support this life style are chronic and attenuate any motivation for change. In these cases, the RP framework assists in identifying the problems of impulsivity, criminal values and criminal associates as criminogenic risk factors but effective clinicians would not rely on the self management component of RP.

Instead, psychologists may recommend a more profitable referral to a program teaching problem solving, and challenging antisocial beliefs (such as cognitive living skills), and the external supervision component of the model would be emphasized, that is, measures would be put in place to ensure vigilant monitoring (e.g., curfew checks, urinalysis, increased reporting) and delivery of highly structured programs.

Considerable work has been conducted on the matching of treatment to conceptual level and interpersonal maturity (Andrews, Bonta & Hoge 1990; Jesness, 1988). Outcome studies have tended to demonstrate that offenders assessed as having a higher conceptual level and maturity can benefit most from less structured programming and more flexible, non directive supervision. Offenders who have a low conceptual level and low interpersonal maturity do best with highly structured programs and a very directive counselling style. Highly anxious clients are normally unsuitable for group therapy settings particularly if the group is confrontational and intensive (Annis, 1988).

Psychologists who are aware of the literature on responsivity and the related literature on treatability are in a position to advise case managers on methods of enhancing offenders' motivation for self change. According to Blackburn (1993b), conditions of program delivery are at least as important to outcome as the specific techniques applied. A common ingredient of successful programs is treatment staff who are warm but directive and are able to set limits and challenge egocentric beliefs and antisocial values. Andrews has also emphasized the critical role of interpersonal "chemistry" between offender and therapist. Soliciting the offender's participation in the identification of treatment priorities is both good ethical practice and may also enhance motivation for change. Evaluation of the COMS has recently shown that the case managers' assessment of the offenders' motivation for change on five of seven need domains significantly correlated with success on conditional release (Motiuk & Brown, 1993). The premise of motivational interviewing is that through careful questioning, the clinician can help the client come to recognize which behaviours are self defeating and maladaptive and should be modified (Proshasta and diClementi, 1986). There is evidence that when working with younger offenders, involvement of a family member in even one counselling session improves compliance and reduces recidivism. Finally, critical to any useful psychological assessment must be an evaluation of whether there is evidence of any change in attitude and values and improvement in skills and coping abilities that are acquired through previous and current treatment.

There is increased pressure in the community to move from a reliance on the "full psychological assessment" to more specific requests for reports that answer questions related to treatment needs of offenders, progress in treatment, risk assessment and recommendations on supervision strategies that would improve risk management. The previous heavy reliance on the "stand alone report" had meant that in the community the psychological service budget was largely allotted to assessment and not to treatment. For most offender groups, with the exception perhaps of sex offenders, this paralleled the way psychological services were allocated in the institutions. Several factors have influenced a change away from routine requests for full assessments in the community: 1) the high costs of contracted psychological assessments; 2) the National Parole Board's increasing recourse to additional conditions that mandate treatment; and 3) a recent improvement in the extent and quality of the information available on offender files which makes a full work up redundant. In the Ontario Region, the comprehensive sexual behaviour assessment completed through the Millhaven Reception Unit in Kingston, Ontario is an excellent example. The Intake Assessment, when implemented nationally, will be a further extension of this trend toward thorough assessment for the general offender population.

Although assessment of treatment needs is probably the most common assessment referral question in the community, there are still occasions when the case manger requests clinical guidance because of a change in the status of the offender's case. Reports may be requested, for example, in cases where an application is submitted for Full Parole or cases where an offender has been suspended and the case manager seeks the clinician's opinion on whether the offender can be safely returned to the community following a violation of his release conditions or evidence of deteriorating behaviour and, if so, under what conditions. In addition, there are offenders who transfer into the community with very little background information on file and may therefore require a more elaborate assessment. The following outlines a model for the two categories of reports that are most often requested in the community: (i) the assessment of treatment needs and progress note; and (ii) the full psychological assessment.

As a general principle, it is worthwhile to keep in mind Weiner's (1987) recommendation that all forensic psychological reports be dear (avoid jargon), relevant (focus on the question) and informative (provide information that is not already known).

The limits of confidentiality must be outlined with the offender prior to beginning the first assessment interview. The offender needs to understand that working within the relapse prevention model limits the extent of confidentiality that can be guaranteed. Although some personal information may not be discussed with the case manager, the offender is informed that the clinician and the case manager will work together very closely and that all information relevant to risk to the community will be shared with the parole staff. In order to make it very dear to the offender the nature of the relationship between case management and treatment, it may be advisable, where possible to conduct the initial interview with the offender in the presence of his/her parole officer.

The relapse prevention model provides a framework for a functional analysis of the case. Assessments that provide test results without an analysis of why the offender offended or recommendations for effective risk reduction would fail to meet the standards of professional practice.

i) Assessment of treatment needs
Rice et al. (1990) have developed a structured approach derived from Gottfredson (1984) to establish measurable treatment objectives for inmates of a secure psychiatric facility. In their Program Development Evaluation (PDE), program outcome is measured against objectives and the periodic assessments are regarded as a form of cybernetic feedback loop where adjustments are made to treatment delivery based on identification of "errors," i.e., evidence that a given objective had not been met through a particular treatment strategy. As a means to diagnose change, the authors developed the Patient Problem Survey which assessed patients' adjustment in the institution and in the community.

The rationale for the assessment report required in the community in the Ontario Region is similar to the Penetang PDE. The template for psychological assessment of treatment needs in the community was developed for two reasons: 1) to more appropriately allocate program funding; and 2) to provide some kind of structured means of evaluating the impact of contracted counselling on offenders mandated to treatment.

A recent review of the conditions of release for offenders in the Ontario Region found that almost half were being mandated to treatment by NPB. Most of these were being sent by their case managers to contracted psychological services. To control costs and to improve the appropriateness of these referrals, we put in place a process whereby if the offender has a condition specifically to attend psychological services, he is initially referred to the psychologist for an assessment of treatment needs only. Contracted psychologists are required to specify treatment goals within the first three sessions. If they do not believe that psychological counselling is required or that the offender could not benefit from such sessions, a copy of their decision is sent to the NPB and an argument is made is either suspend the offender if the case manager believes that the risk without treatment is not assumable or the condition is stayed. If, however, the assessing psychologist believes that is it worthwhile to begin treatment with the offender he or she must develop the treatment plan and share it with the case manager. Treatment is approved by the contract manager (usually the Area Director) for eight sessions after which a case conference is required before further funding for counselling is approved. A progress note following the same format as the treatment plan is required every four sessions.

We encourage case managers supervising offenders released with a more generic condition "to attend counselling" to first refer them to the core programs run by trained non clinical staff (for example, a substance abuse relapse prevention program or one of the cognitive living skills components) before consideration is given to further treatment with psychologists. Under the new service provision, in general, continued counselling with a psychologist should only occur for the higher risk cases.

The assessment of treatment needs should provide an analysis of risk factors and a road map for treatment and supervision in the community that address these factors. The report outlining treatment needs and treatment objectives should be completed or at least shared with the offender to both to increase his or her cooperation treatment plan and to clarify for him or her the nature of the clinical information that is relayed to the case manager.

Normally, the assessment of treatment needs in the community can be completed in the first 1-3 sessions. Clinicians should be able to justify the identification of concrete treatment objectives by explicitly relating them to the offenders' criminal behaviour. Assessment should focus on those criminogenic areas shown to be related to general recidivism that clinical intervention can address, e.g., employment & education (vocational assessment and counselling), attitude (values and beliefs that are antisocial and procriminal), mental health areas, substance abuse, life skills, family/marital dynamics (especially issues related to family violence).

Treatment objectives should be outlined in such a way that response to treatment can be reassessed at a later date through a progress note. The means by which the evaluation of progress is made should be explicit, e.g., the clinician may have used objective measures, behavioural observation, feedback from case managers, etc. The final section of the report assesses risk level based on various criteria. The criteria are in line with those outlined by Webster and Eaves (1995) in their HCR-20. The HCR combines Historical (actuarial data on the extent of previous violence, as well as information on the extent of psychopathology), Clinical (current assessment of relevant clinical status such as level of insight, degree of antisocial attitudes, evidence of symptoms, emotional stability and degree to which he is responding to treatment) and Risk (how well an individual may manage risk in different contexts, given a specified release plan) variables (see outline in Appendix B). Our template requires the clinician to state on what basis he or she arrived at the current risk assessment. The report follows with recommendations, if any, to the case managers on supervision strategies that may reduce risk. He or she will make a further clinical recommendation to continue in treatment, terminate treatment, or call for a case conference. The initial treatment plan should be followed at regular intervals with a progress note.

We have also developed and are piloting the Problem Identification Rating Scale List (PIRS) which we use to assess change in areas related to the criminogenic needs domains outlined in the measure used by the case managers, the COMS. The PIRS is completed by the clinician at the same time as the initial treatment plan and completed again after eight sessions, or on termination, whichever comes first (see Appendix C).

ii) Full psychological assessment
All materials used in the preparation of the report should be outlined at the beginning. This includes reference to all file information, the number and length of interviews, and any additional sources of information.

There are a couple of model interview formats current in corrections that tap the areas of function that are related to adjustment and risk to the community. There is satisfactory evidence that the Psychopathy Checklist provides one of the best means of assessing actual dangerousness. A psychosocial interview that draws on the content areas that are scored on the checklist and a detailed description of the current and any prior offenses are the basis of any comprehensive assessment (see the outline of the a psychosocial interview as developed by Cormier (1992) or the interview associated with the PCL-R).

As a supplement to the background information derived from the above interview, the criminal profile report can help structure the section of the interview that taps the current offense and the offense history. Clinicians will want to elicit as much information as necessary in order to supply an outline of the offense cycle (if one can be identified) and the cognitive, emotional and behavioural components of the offending behaviour.

Interview questions that tap the criminogenic need areas add additional information to the historical data collected from the psychosocial interview and the profile of the offenses. This part of the interview should assess the current status of the offender, in particular his current adjustment to the community, his attitude toward supervision and treatment, the extent of his community support, any improvement or deterioration in his coping abilities or emotional state. The clinician should try to provide an analysis of how the offender's current ability to cope may interact with the environment he will be living in. Finally, the report would assess a risk level, outline the offense precursors and would recommend what controls in addition to treatment could be put in place to assist a prosocial release.

• Assessments completed in the community must provide an assessment of risk and recommendations for effective management of risk. Such risk assessments should be presented with due consideration to standards of professional practice outlined in chapters in this manual.
• Clinicians should provide a systematic way of evaluating treatment on an individual case basis. The effect of treatment should be assessed against concrete and measurable objectives and reevaluated on a regular basis.
• Community correctional psychologists must be prepared to work within the ethical guidelines specified for a correctional or high risk clientele. This means clearly stating the limits of confidentiality to the offender before beginning assessments and treatment. Sharing of information applying a RP approach is not limited to assessment of imminent danger to a specified individual but includes sharing any information that is important to effective risk management.
• The guidelines should apply equally to CSC staff psychologists and to psychologists contracting with the Service. Request for contract proposals developed by contract managers in CSC must clearly specify these requirements and standards of professional practice.

Quinsey and Walker (1993) have argued that community risk management can be improved if psychologists have sound knowledge in several areas: 1) the literature on the prediction of violent behaviour; 2) the literature on the study of decision making and clinical judgement; and 3) the literature on treatment outcome and program evaluation. I would also add, from the point of view of a community correctional psychologist, that the practitioner should have a good knowledge of treatment options in their communities where they practice, their effectiveness and their history of a sound working relationship within a correctional system (for example, treatment and supervision staff should have a clear understanding of the requirements for information sharing). The most recent r" outcome studies offer grounds for optimism that correctional interventions can be effective, particularly with the application of a comprehensive and integrated treatment and supervision plan.

Chapter 14 Appendix A, B, C

Andrews, D., Bonta, B., (St. Hoge, R. (1990). "Classification for effective rehabilitation; Rediscovering psychology," Criminal Justice and Behaviour, 17, 19-52.

Andrews, D.A., Zinger, I, Hoge, R.D., Gendreau, P, Cullen, F.T. (1990). "Does correctional treatment work? A psychologically informed meta-analysis," Criminology, 28, 369-404.

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