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Implementation of the START:AV in a secure adolescent service

Marilyn A. Sher (Principal Forensic and Clinical Psychologist, based at Psychology Department, St Andrews Healthcare, Northampton, UK)
E. Gralton (Consultant Forensic Psychiatrist, based at Adolescent Service, St Andrews Healthcare, Northampton, UK)

The Journal of Forensic Practice

ISSN: 2050-8794

Article publication date: 5 August 2014

Abstract

Purpose

The purpose of this paper is to establish gaps in training, involve staff in the implementation process by incorporating their views on what is helpful and what can be improved, as well as provide information that might be helpful to other sites who are considering implementing the START:AV.

Design/methodology/approach

The current study is the first to examine a START:AV implementation and survey a multi-disciplinary team on their views about implementation in a medium secure service for adolescents in the UK. The survey was adapted from the one used by Collins et al. (2008). Once surveys were received the qualitative information was collated to explore themes, and frequency analysis was undertaken on the quantitative information.

Findings

The staff survey on the implementation of the START:AV highlighted a number of strengths and challenges. There was significant support for the START:AV in relation to it being a dynamic assessment to measure change, that focuses equally on strengths and vulnerabilities, making the process individualised. Users of the START:AV reported that the process of rating the START:AV as a team improved communication, teamwork, generated discussion and improved the detailed understanding of the patient being rated. Staff felt it was generally straightforward to use in terms of strengths and vulnerability ratings, but some difficulties emerged regarding making finer distinctions in ratings as well as completing risk formulations, highlighting further training needs. There was also some confusion about differentiating between certain strengths and vulnerabilities, leading to “double ratings”. Other difficulties highlighted centred on time and increasing workload.

Research limitations/implications

The main limitation of the study relates to the low response rate to the survey (31 per cent).

Practical implications

Recommendations for implementation and evaluation of new risk assessment procedures are made.

Originality/value

The current study is the first to examine a START:AV implementation and survey a multi-disciplinary team on their views about implementation in a medium secure service for adolescents in the UK.

Keywords

Citation

A. Sher, M. and Gralton, E. (2014), "Implementation of the START:AV in a secure adolescent service", The Journal of Forensic Practice, Vol. 16 No. 3, pp. 184-193. https://doi.org/10.1108/JFP-04-2013-0021

Publisher

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Emerald Group Publishing Limited

Copyright © 2014, Emerald Group Publishing Limited