Clinical or unstructured assessment

Essentially, unstructured assessment involves interviewing people and trying to get an understanding of how they behave, and why. From this, one tries to make a judgement about how likely it is they will reoffend.

Unstructured assessments may be based not only on interviews, but also consideration of psychological test results, staff information, the individual’s history, etc. The assumption is that professionals have skills based on years of experience and can apply these to predicting future behaviour.

There are four main flaws in this approach:
  1. Accuracy is not related to clinical experience (some people actually get worse with experience, because they make snap judgements based on too little information!).
  2. Any one professional’s experience is not comprehensive; professionals differ in the types and amounts of experience they have had. For example, few forensic psychologists have any experience of assessing psychological trauma; and this means they will not recognize cases in which an offender's depth of emotional expression has been affected by traumatic experiences (very common in such cases). This can result in a person being regarded as psychopathic rather than traumatised.
  3. Clinicians have often used hunch and private views presented as professional opinion. Some have even used risk factors the wrong way round. For example, in one study clinicians tended to rate offenders with lower IQs as being more dangerous, when the reverse was actually true. If you doubt this, ask yourself whether you would rather be in a dispute with a highly intelligent psychopath, or a very stupid one.
  4. Acts of violence (including sexual violence) are very situationally-determined; we can’t predict what situations a person will encounter, and we rarely observe people in situations which are relevant. For example, we may know that someone will become enraged if his mother is insulted, but how do we know whether he will ever meet anyone who is unwise enough to do this?
On top of these problems, there are some practical ones:

Unstructured assessment is very labour intensive, as a great deal of time is required to conduct it properly.
It is very inaccurate: in terms of predicting reconviction, most research studies suggest that it is about as accurate as tossing a coin. Tossing a coin is a great deal cheaper.

Some of the most important published studies are:

Meehl (1954), Quinsey and Maguire (1986), Hanson and Bussière (1998), Hanson and Morton-Bourgon (2004, 2005, 2008)

To sum up, there may be many reasons for conducting a clinical assessment of someone, but risk assessment is not one of them. The whole approach is much too subjective, and allows for personal prejudices or ignorance to affect professional judgement. For example, it is commonplace in probation reports to see that sex offenders against children within the family described as a danger to all children. In fact, intrafamilial sex offenders have the lowest rate reconviction of any type of sex offender, and many pose little risk to anyone outside the family. Their level of risk is generally low, but the moral panic associated with any offences against children ensures that they are usually assessed as being high risk in unstructured assessments.
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