June 2-4, 2015
Assessment of Juvenile Sexual Risk
Part V.
The Assessment Report
Phil Rich, Ed.D., LICSW
Specialized Consultation and Training
www.philrich.net
phil@philrich.net
413-687-7098
Phil Rich © 2015
Report Quality
• Evaluation reports require a set of technical skills, including
essential writing skills such as spelling, punctuation, and
grammar, as well as a professional vocabulary.
• Beyond basic writing skills, the evaluator must have skills in
expository writing in order to ensure that complex information
and ideas are described and explained to the reader.
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Report Quality
• An eye for detail and a focused approach is required in order
to ensure not just comprehensive reports…
… but reports that are coherent and internally consistent and
move steadily towards their conclusion without providing
contradictory or inconsistent information, or failing to include
important information.
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Report Quality
• Every report should thus be written as though someone will
read it.
• Better still, every report should be written as though someone
is going to cross examine the evaluator in open court on what
he or she has written.
• In fact, one of the very best ways for evaluators and clinicians
to prepare for giving testimony is to ensure the quality,
accuracy, and completeness of their reports.
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Creating a Report Format
• Report outlines, or what has to be said and in what order,
provide a useful means by which to organize reports and
create a “shell” to later fill in with detailed information.
• The creation of an organized and structured report format, or
template, is an invaluable tool to help writers both structure
and sequence what they have to say and when they say it.
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Creating a Report Format
• Standardized headings and sub-headings represents more
than just the structure and sequence of the report.
• They also describe and embody the content of the
comprehensive assessment.
• Standard report formats ensure that evaluators within the
same practice or within the same organization follow the
same practice and model in completing reports.
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Relationship Among Report Sections
• Each section of a report focuses upon and fully captures one
aspect of the content required by the overall report.
• Each section should be capable of being read, to some
degree, as a “stand alone” section that can be read and
understood independently of other sections that comprise the
larger report.
• At the same time, all sections must relate to and are interrelated with every other section.
• The report as a whole consists of the totality of information
captured in individual sections.
• Information contained in any one section must therefore
supplement, complement, and remain consistent with
information in other sections.
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Relationship Among Report Sections
• This may mean that there is some redundancy built into the
format, as different sections may contain shades of the same
information.
• One thing to avoid, however, is the wholesale repetition of the
same information in different sections of the same report…
… although the cut-and-paste function makes it tempting to
do this.
• Rather than simply repeating the same information over
again, the writer can briefly describe the information and note
that more detail has already been presented or will be later in
the report.
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Completeness
• Ensuring a well sequenced, consistent, and coherent
narrative requires that the evaluator organize information and
content within each section so that it is both complete and
provided in the right order.
• There should be no gaps in information, such as describing
the child’s early life from ages 3-6, for instance, and then
jumping to his or her life from age 9-14.
• Similarly, if information is given about the history of one
parent then it should also include information about the other
parent.
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Completeness
• Family mental health history should provide details about the
mental health and functioning of siblings, as well as parents,
and perhaps other important extended family members as
well.
• If information is not available, the writer should highlight that
information is missing and describe why, so that is it clear that
it is not simply the failure of the writer to include the
information.
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Sequencing
• Information must be provided in a logical and well paced
manner, and thus in the “right” order.
• Information and ideas must be presented in a sequence in
which similar information is grouped together, within the same
paragraph for instance.
• For example, the writer should finish describing the history of
the mother before going on to describe the father’s history.
• The writer should not jump to the father’s history and then
come back and tell us something more about the mother,
although there are exceptions of course.
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Bullet Points and Checklists
• Bullet points can be used to organize and outline each
section, serving as markers for more detailed information to
be added later.
• They can also later be moved into the “right” sequence,
effectively creating an outline for each section in terms of both
required content and sequence.
• Written narrative – the story telling – can then be added to
each outlined point and the bullet points eventually removed
so that the result is a paragraph and not simply a list of
bulleted points.
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Bullet Points and Checklists
• Checklists can serve a useful and summarizing function,
quickly highlighting some aspect of the case before adding
further written detail.
• The checklist may also serve as an organizing tool for the
evaluator, ensuring that adequate and complete information is
provided.
• For instance, a checklist may be used to an element of the
child’s behavioral history, following which details are provided
in the written narrative…
Youth has a history of:
outpatient care
inpatient care
residential care
foster care
other
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Anchor Dates and Ages
• Provide the reader with reminders of certain items at strategic
points throughout the report, such as the dates of certain
events or the youth’s age at key points during his or her life.
• Periodically describing the youth’s age throughout the report
also serves as anchor point so the reader can get a sense of
the unfolding sequence of events in the youth’s life.
• This includes the youth’s age at the time of treatment
episodes, the occurrence of important family events, when
psychological evaluations were administered, etc., as well as
his or her age at the time of behavioral problems.
• Periodically remind the reader of important events and
circumstances that surrounded the youth’s behavior.
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Ensuring Consistency
• Consistency is important.
• Reports should not, for instance, say that someone was age 5
at one point and later report he or she was age 6, or report
that someone has a half-brother and later refer to the same
brother as a step-brother.
• Double check uncertain information and, if necessary, refer
back to the original source of the information, even if this
means an additional phone call.
• If information is reported differently in different reports
available to the evaluator it is the evaluator’s responsibility to
get the accurate information and not simply pass on an error
or just ignore it.
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Ensuring Accuracy
• If, even after checking and double checking, the evaluator is
still not sure of the information, then this should be noted in
the report itself.
• It is the evaluator’s responsibility to do his or her best to
gather and report information is correct.
• Information that may be questionable, even if presented in a
previous document or reported by an informant, should be
double checked.
• The evaluator cannot and should not assume that information
contained in prior records is accurate as it may not be, and
often is not.
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Ensuring Accuracy
• Where there is doubt for any reason, and certainly
inconsistency in previous records, the evaluator should take
pains to ensure that he or she has the correct information.
• The evaluator otherwise risks simply passing along incorrect,
inconsistent, or inadequate information, not only weakening
the evaluation but actively adding to an inaccurate or
inadequate record.
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Safeguarding Accuracy
• The evaluator should not use definitive statements in
assessments and report writing, unless he or she definitively
knows that the statement is an accurate representation of the
facts.
• Statements about what the youth did or did not do should only
be made if the evaluator is reasonably sure that the behavior
did or did not occur as described.
• It is acceptable for the evaluator to make clinical speculations
in the written report, as long as the evaluator makes clear that
this is his or her clinical opinion, based upon facts, details,
circumstances, statements, and other factors.
• However, evaluators should avoid broad speculation and
sweeping statements.
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Safeguarding Accuracy
• Assessment and other professional reports should not
over-report, assume, assign guilt or responsibility, or
definitively make statements that are unproven or unverified.
• On a related note, it is the evaluator’s job to gather and
evaluate information, but not to pass judgment or conclude
guilt or innocence.
• It is important that the evaluator maintain a non-judgmental
and impartial style and “voice,” and present data both
accurately and objectively.
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Guidelines for Ensuring Accuracy and Clarity
• The evaluation report may be heavily scrutinized at a later
point.
• The very best bet for the evaluator is to assume it will be
heavily scrutinized.
• The evaluator is well advised to ensure the accuracy of the
report and that due care was taken in stating fact,
speculation, and case formulation, clearly distinguishing
between fact and speculation.
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Guidelines for Ensuring Accuracy and Clarity
o Ensure that the report is internally consistently and free from
internal contradiction.
o Do not speculate, without making clear that this is
speculation.
o Provide evidence or support for speculative statements.
o Do not make definitive statements unless you know they are
correct.
o Qualify uncertain statements.
o Cite the source of information.
o Use quotation marks to make clear that you are using the
actual words of a particular informant.
o Use terms such as “alleged” and “reported” when you are
reporting unsubstantiated facts.
o Avoid overly broad and sweeping statements.
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Protecting Confidential and Sensitive Information
• It’s clear that the youth’s confidentiality is compromised by
and through the assessment process.
• Nevertheless, even within the forensic context the evaluator
should remain sensitive to issues involving the youth’s privacy
and protect it whenever possible.
• The evaluator should also remain cognizant of the fact that
the report will also probably contain information about other
persons that is equally confidential and sensitive.
• This will certainly include information and details about the
victims of sexually abusive behavior.
• The names of victims should not be disclosed, and initials or
other identifying information used instead.
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Protecting Confidential and Sensitive Information
• It may be important that, even when consent is given for
dissemination or review, some information is redacted from
copies of some distributed reports.
• However, the right to confidentiality belongs to the client and
not the clinician, and, in the case of juveniles, the legal
guardian.
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The Final Report
• The evaluation report should be complete and explain the
process and purpose of the evaluation,
• identify sources of information, note any weaknesses in the
evaluation, and take care to highlight important information.
• In the written evaluation, the evaluator should…
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The Final Report
 State the purpose of the evaluation.
 Document all records reviewed and informants
interviewed.
 Note unavailable records and informants not available for
interview.
 Note any limitations on the assessment, including lack of
collateral or supporting information that may affect the
ability to make informed judgments about the juvenile, the
reported offenses, or the risk for future sexual offending.
 Describe that consent was given for the evaluation, and
that any limitations to confidentiality were explained to the
juvenile and legal guardian.
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Considerations in Completing the Report
 Ensure that non-family victims are not identified by name.
 Ensure a non-judgmental and impartial style, and that all
data presented are both objective and accurate.
 Avoid making speculative statements, except when stating
clinical formulations and when ample evidence exists to
adequately support the hypotheses of the formulation.
 Be clear when expressing speculation rather than fact.
 Document any denial of offenses that the juvenile may
make, as well as his or her explanation, if any, for false
allegations.
 Form assessments of future risk only when adequate
information is available upon which to base the risk
assessment.
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Example Outline, by Section
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
Explanatory, Demographic, and Descriptive Information
Presentation and Response to the Assessment Process
Treatment and Placement History
Family History
Psychosocial History
Psychological Functioning
History of Sexually Abusive/Troubled Behavior
Sexual Behavior Risk and Needs Assessment
Risk for Sexual Re-offense
Diagnosis
Summary and Case Formulation
Recommendations
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Example Outline, by Sub-Section
1. Explanatory, Demographic, and Descriptive Information
a. Identifying Information
 Age, gender, height/weight, race/ethnicity, religion, IQ, grade, important other
characteristics
b. Presenting Problem/Reason for Evaluation
c. Informants to the Evaluation
d. Documents Reviewed for this Evaluation
e. Legal Guardianship and Custody
f. Legal Status
g. State Agency Involvement
h. Sexual Offender Registry
2. Presentation and Response to the Assessment Process
a. Mental Status Exam
b. Youth’s Level of Participation, Engagement, and Response to
Assessment Process
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Example Outline, by Sub-Section
3. Treatment and Placement History
a.
b.
c.
d.
Placement History/Treatment Type
Treatment and Diagnostic History
Relevant Medical History
Medication History and Current Medication
4. Family History
a. Current Family Arrangement
b. General Family History
• Parent Histories
• Sibling Histories
c. Family Relationships
d. Family Mental Health/Substance Abuse
e. Family Strengths and Vulnerabilities
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Example Outline, by Sub-Section
5. Psychosocial History
a.
b.
c.
d.
e.
f.
g.
h.
i.
j.
Early Developmental Experiences (ages 0-4)
History of Adverse Childhood Experiences/Trauma
History of Behavioral Problems
History of Substance Use/Abuse
Academic History/School Behaviors
Social/Relational Development
Prior Psychological Assessments
Psychiatric Assessment
Youth Assets and Strengths
Sexual Development and Non-Offending/Non-Abusive Sexual
Interests and Behaviors
6. Psychological Functioning
a. History/Recent Psychiatric Evaluation
b. History/Recent Psychological Testing
c. Cognitive Functioning
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Example Outline, by Sub-Section
7. History of Sexually Abusive/Troubled Behavior
a. Description of the Sexually Abusive or Problematic Behavior
b. Youth’s Description of Sexually Abusive/Problematic Behavior
c. Family Perspective Regarding Sexually Abusive/Problematic Behavior
d. Prior Sexual Behavior Risk Assessment
8. Sexual Behavior Risk and Needs Assessment
a.Boilerplate Text: Understanding Assessments of Risk and Need
9. Risk for Sexual Re-offense
a. Estimated Risk Level
b. Prominent Static Individual, Situational, and Contextual Risk Factors
c. Prominent Dynamic Individual, Situational, and Contextual Risk
Factors
d. Acute Stressors
e. Protective Factors/Mitigators of Risk
f. Summary of Risk Assessment
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Example Outline, by Sub-Section
10. Diagnosis
11. Summary and Case Formulation
12. Treatment Considerations and Recommendations
a.
b.
c.
d.
Principles of Risk, Need, and Responsivity: Boilerplate
Treatment Goals and Interventions
Individualized Treatment/Case Management Recommendations
Level of Recommended Supervision
Signature/Credential/Date
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Case Formulation
• In addition to summarizing the case, formulation should
also describe:
 The motivations of the youth, and hypothesized reasons
behind the youth’s behavior and thinking patterns.
 Past and present factors that influence and shape the
youth’s thinking, attitudes, behaviors, and interactions.
 Why the youth engaged in sexually abusive behavior in the
first place.
 The prognosis, if things go unchanged, including risk for
sexual recidivism.
 Central issues or problems for the youth, and the
treatment problem to be addressed and resolved.
 Interventions that might be useful or will be used to attack
the problem and bring about change.
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Wrapping
Up
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Last Words
• There is a great deal at stake for the subject of the report.
• The young person’s future may rotate in some way around
the report, the information it includes, the conclusions it
reaches, and the recommendations it may make.
• The evaluator must recognize the powerful and sensitive
nature of the assessment report, and thus exercise caution
and sensitivity in undertaking and completing the report.
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Last Words
• Finally, the written report represents the culmination of the
comprehensive assessment of risk.
• Its conclusions should be transparent to the reader who must
understand, through the process of reading the evaluation,
how the evaluator arrived at his or her conclusions.
• Of importance is the evaluator’s ability not simply to provide
information, but also to assume a neutral stance…
…reflected in a risk assessment that reports and concludes
as objectively as possible.
• It is thus important for the evaluator to focus as much as
possible on protective factors, strengths, and assets, as on
risk factors, vulnerabilities, and deficits.
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Last Words
• In part, the evaluator must understand the forces that
have shaped and driven the young person’s sexually abusive
behavior.
• Of equal importance, the evaluator must also assess the
young person based on his or her acts of sexually abusive
and other troubled behavior…
… without writing a deficit-based report that focuses only on
the youth’s weaknesses and his or her potential to harm
others.
• It is the job of the evaluator to evaluate, but not judge.
• The position that the evaluator takes is locked into the report.
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