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Welcome to Issue 19(2). We are very pleased to begin this issue with two invited papers. The first is by Geoff Dean and Graeme Pettet. This is a timely conceptual piece looking at structured professional judgement approaches to terrorist/extremist risk assessment, exploring how best to deal with subjectivity. The paper carefully considers both the conceptual and methodological issues with this approach, and how best it can be utilised with terrorism risk considerations. They skilfully present how a quantified tool can be utilised at both operational and national level. Following a similar theme of aggression is the invited paper by Verstegen and colleagues. This is another excellent paper, looking carefully at inpatient violence in a Dutch forensic psychiatric hospital. Here the authors focus, amongst others, on the traumatic experiences for victims and witnesses. They successfully provide more insight into patterns of violent behaviour, allowing greater consideration of preventive measures. They utilise a sizeable sample, and as such are able to draw some significant conclusions. Ultimately, they illustrate a range of important differences between groups of forensic inpatients in frequency and type of inpatient violent behaviour, and which offers great applicability to those practitioners working in the field.
In keeping with the focus on aggression, the paper is then followed by Sher and colleagues, presenting an excellent validation study on the START:AV. They explore the validity and reliability of the START:AV, looking at an adolescent sample. They succinctly argue the relevance of this tool when working with adolescents in hospital settings, further reinforced by their findings of significant relationships between strength and vulnerability scores. They introduce very well the notion and importance of protective factors, and when looking at risk issues; as such they make a valued addition to this important field. Continuing with aggression risk assessment, and progressing to examining adults, Geoffrey Dickens and Laura O’Shea then explore the use of the HCR-20 from the views of clinicians working in a mental health setting. Using a cross-sectional design, they observe that historical and clinical items were felt to be most relevant to clinicians, with a recent history of violence being regarded as more relevant for risk formulation. They note that, overall, it is recent violence that appears to be regarded as the most important, followed by clinical items. The authors argue well that there is a risk some clinicians can over-value historical items, and that the importance of recent violence is worthy of further consideration.
Moving towards the impact on staff is a paper by Chandler and colleagues. Here they explore burnout in clinicians, and when working with forensic clients in the community who have personality disorder. They note that levels of burnout are higher in those who work with a forensic community sample, compared to non-forensic. They summarise effectively strategies for managing clinician burnout, including developing resilience, using humour, team coherence, use of breaks and developing personal strategies for releasing stress. As such, it is a timely piece that offers strategies of support to the clinician working in this challenging field. A thought-provoking paper follows by Jamie Walton and Simon Duff, and where they have conducted a small-scale study examining the experiences of five individuals who were assessed as having a sexual preference for children. They examine thematically the experiences of this group and note three recurring themes: “internal battle”, “I’m always going to have these thoughts” and “there’s no help out there”. An overall identification was that the participants felt their sexual preference was relatively enduring, and as such, this paper argues for a creative approach to manage such individuals.
This issue is completed with a paper by Carol Bond and Emma Whiteside, reviewing serious incidents of violent disruption within the national young persons’ prison estate. They carefully consider the function and factors which influence such disruption using a sample of 21 young people, using thematic analysis. They noted a number of themes linked to disruption, including “attitude and propensity for violence”, “perceptions and intolerance of others”, “consequences of violent behaviour”, “the physical environment”, “previous indicators” and “protective factors”. Importantly they argue a range of key implications to assist in reducing such disruption.