An evaluation of the understanding risk group programme in inpatient forensic psychological services

Purpose Risk assessment and risk management planning are integral to reducing risk of future violence in forensic settings. Over the past decade, emphasis has been placed on involving service users in this process. Nonetheless, service user knowledge of violence risk assessments such as the Historical-Clinical-Risk Management-20, Version 3 (HCR-20v3) and collaborative risk assessment is often limited. This service evaluation aimed to assess the effectiveness of a pilot Understanding Risk programme, on increasing knowledge of the HCR-20v3 and insight into risk of violence. Design/methodology/approach The methodology used was a within-subjects design, collecting quantitative data before and after intervention. Participants’ beliefs and attitudes supportive of violence, and perceptions of their recovery, were assessed using a semi-structured HCR-20v3 questionnaire, the Maudsley Violence Questionnaire and the Recovery Assessment Scale – Domains and Stages. An HCR-20v3 historical factor checklist was also completed. The final sample ( n = 11) consisted of low and medium secure forensic inpatients. Findings The results of this study indicated that after intervention, participants had significantly greater knowledge of the HCR-20v3 and more positive perceptions of their functional and personal recovery. Significant changes were not observed on the Maudsley Violence Questionnaire total score; however, further analysis indicated significantly lower scores on the “acceptance of violence” subscale after intervention. Practical implications The Understanding Risk programme was associated with positive changes across treatment domains in a small sample of forensic inpatients. Specifically, improvements were observed for increased knowledge of the HCR-20v3, attitudes towards recovery and non-acceptance of violence. It would be of clinical benefit to replicate this study across different levels of security to increase the generalisability of findings. This study shows promise for the efficacy of the Understanding Risk programme among forensic inpatients. Originality/value This service evaluation provides preliminary support for the benefits of educating and involving service users in violence risk assessment.