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Managing Clinical Risk
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Violence and self-injury cause anxiety, misery and physical and psychological damage to service users, their carers, the practitioners who look after them, and in some cases, the public at large. In some correctional and mental health settings, violence and self-injury are an all too common feature of the experience of care. Practitioners, service users, and commissioners have a shared interest in working together effectively to prevent violence and self-injury and to maintain an environment in which potential for harm is understood and sympathetically managed. Much has been written about clinical risk assessment in correctional, psychiatric, and community settings with individuals who harm others as well as themselves. However, much less is known about the process of converting the findings of a risk assessment into effectively managed clinical risk. Managing clinical risk on the basis of sound assessment and formulation provides the main focus of this book. The specific objectives of this proposed book are as follows. Firstly to provide practitioners with a comprehensive guide to the current state of risk assessment practice in the UK in relation to risk of harm to others and to oneself. Secondly to describe UK and international research and practice in clinical risk management and how it ties in with best practice in risk assessment, and finally to make recommendations for best practice in each of the areas covered. The book is concerned particularly with the assessment and management of risk by practitioners in forensic -- psychiatric and correctional -- settings although its findings are likely to be of interest to those working in community settings also, especially with forensic clients. The contributors bring to this book a wide range of knowledge and experience in thinking about risk in respect of violence and self-injury, of conducting risk management in real world correctional, mental health, and community settings, and of working with clients with a label of high risk and making everyday practice reflect best practice. It will be essential reading for qualified and trainee clinical psychiatrists and psychologists, forensic psychologists, criminal justice social workers and probation officers, and nursing staff working in correctional and mental health settings and in the community with service users who present a risk of harm to others or to themselves.
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Table of Contents

Part 1: The need for change 1. Violence risk assessment: from prediction to understanding - or from what? to why?, David J. Cooke and Christine Michie Part 2: Key areas of practice: 2. Violence risk assessment and management: putting structured professional judgement into practice, Kevin S. Douglas, Adam J.E. Blanchard and Melissa C. Hendry 3. Working with complicated cases: mental disorder and violence, Lorraine Johnstone 4. Managing the risk posed by personality-disordered sex offenders in the community, Katharine Russell and Rajan Darjee 5. Suicide and self-harm: clinical risk assessment and management using a structured professional judgement approach, Caroline Logan 6. Pathological firesetting by adults, John L. Taylor and Ian Thorne 7. Risk management: beyond the individual, David J. Cooke and Lorraine Johnstone Part 3: Key client groups: 8. Risk assessment and management with clients with cognitive impairment, Suzanne O'Rourke 9. Making delinquency prevention work with children and adolescents, Corine de Ruiter and Leena K. Augimeri 10. Working with women: towards a more gender-sensitive violence risk assessment, Vivienne de Vogel and Michiel de Vries Robbe 11. Clinical risk assessment and mangement with military personnel and veterans: the tip of a camouflaged iceberg, John Marham Part 4: Key practice skills 12. Risk assessment: specialist interviewing skills for forensic practitioners, Caroline Logan 13. Protective factors for violence risk: bringing balance to risk assessment and management, Michiel de Vries Robbe and Vivienne de Vogel Postscript: 14. Future directions in clinical risk assessment and management, Caroline Logan and Lorraine Johnstone, Afterword by Stephen Hart.

About the Author

Lorraine Johnstone is employed as Lead Consultant Clinical Forensic Psychologist in a forensic mental health service for children and adolescents. She also holds honorary position as Research Fellow at the Cente for the Study of Violence, Glasgow Caledonian University. Caroline Logan is a Consultant Forensic Clinical Psychologist in the NHS and an Honorary Research Fellow at the University of Manchester.

Reviews

Assessment and management of risk of harm is a serious undertaking, that requires informed and defensible decision-making. Clinicians who wish to access the very best of current knowledge and practice would be well advised to read this book. The topic is subject to incisive critical appraisal by internationally renowned academics and practitioners. Importantly, this book will not leave clinicians wondering what to do with the information: the directions for good practice are clear and workable. The editors are to be congratulated. Mary McMurran, Professor of Personality Disorder Research, University of Nottingham, UK. This book is an ideal complement to the recent edited Routledge text on risk assessment by Randy Otto and Kevin Douglas. Like its companion, this new, and much-needed work has excellent coherence. The editors, both of whom have highly developed connections to leading clinicians, researchers, and administrators,across the world, themselves have contributed fully a third of the content. This means that the book has an evenness and sustained depth so often lacking in ventures of this kind. Essentially, the book helps clinicians of various stripes to offer "structured clinical guidance". The book does a remarkable job of bringing together what we have learned over the past two decades or more about assessing violence and related risks and then telling readers what they need to know about constructing interventions and even institutions that will work. This is well designed book that deserves to be on the desk, not the shelf, of all serious mental health, forensic,and correctional practitioners. Well done! Chris Webster, Professor Emeritus, Psychiatry, University of Toronto; Professor Emeritus, Psychology, Simon Fraser University, Canada.

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