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Forensic mental health professionals often ask how effective risk assessments are. However, if the results are not clearly communicated to the specific audience, they lose their significance.
In her presentation for the International Forensic Psychiatry Lecture Series, Dr. Ilvy Goossens discussed her research on effective forensic risk communication strategies.
“Communication matters, but it didn’t matter as much as I thought it would, to be very honest,” she said. “There’s a big role to play for the type of offence, bias, personal experience, and so on. So our writing [of risk assessment opinions] might have to be a little bit more adaptive to context. Like many things in psychology, one size really does not fit all.”
Risk Road Map
Dr. Goossens noted that structured risk assessments are more effective than unstructured clinical judgments.
However, the assessment is only the first stage on the risk road map.
- Risk assessments first relied on unstructured clinical judgments, then on statistical models alone to predict risk. Later, combining clinical judgment with evidence-based risk factors created the structured professional judgment approach, shifting the focus from risk prediction to risk management and reduction.
- Implementation has been inconsistent worldwide, with about half of assessors using structured risk assessments. A study co-authored by Dr. Goossens demonstrated that targeting training to assessors with large networks who already do good work can triple the spread of best practices.
- Intervention through a risk–needs–responsivity model provides the most intensive monitoring and services to the people with the highest risk.
- Risk communication is the way the assessment results are organized and presented to various people (for example, courts, the person charged, the person harmed, families). If not done effectively, the assessment can lose its meaning.
Risk Communication Formats
There are four main ways to communicate an opinion.
Categorical
Categorical ways of writing about risk use ratings of low, moderate, or high. For example:
“Riley obtained a score of 6 on the DVRAT [a fictional tool used in Dr. Goossens’s research]. This places Riley at [high versus low] risk to get charged with another offence against their partner within an average of 5 years.”
Numerical
There are many ways of conveying numerical risk (for example, percentage, frequency, relative risk ratio, absolute risk). This summary and Dr. Goossens’s studies use frequencies and percentages as examples.
Percentages show how many people with similar scores or situations are charged.
“Riley received a score of 6 on the DVRAT. Previous research found that 53% of offenders with a similar score are charged with another offence against their partner within an average of 5 years.”
Risk Formulation
Also called case formulation or narrative risk communication, risk formulation integrates case information into a personalized framework to understand an individual’s history of violence. It combines various factors — such as personality, mental state, and environment — to create a narrative that helps anticipate and manage future risk. It informs risk reduction strategies and treatment plans tailored to the individual. For example:
“Riley Smith’s recurrent pattern of relationship instability, together with indications of prior verbal abuse and the recent escalation to physical abuse are cause for concern. Alcohol and shatter use may have intensified Riley’s sensitivity in relationships — allowing the abuse to escalate. Riley was not that honest about past relationship problems and the extent of substance use — indicating a lack of insight into the seriousness of risk.
“Notable risk factors include alcohol use disorder, lack of insight, unemployment, the presence of prior assaults on partners, and the lack of a supportive network of friends and family. Given the apparent lack of insight and lack of social support, it seems unlikely that Riley would voluntarily comply with suggestions to reduce the risk factors (e.g., substance use, interpersonal skills, employment).”
Hybrid
Hybrid risk communication combines two or more of these styles.
Research Findings
Systematic Review
Dr. Goossens’s large-scale systematic review examined how different risk communication formats influence understanding and decision-making.
She found that almost half of individuals preferred and used categorical risk communication. About 1 in 3 preferred a risk formulation, and about 1 in 4 preferred hybrid risk communication.
A 2013 study found that defence-retained evaluators were less likely than prosecution-retained evaluators to use categorical communication. A 2014 study found that judges valued categorical communication more for high-risk than low-risk cases.
However, the format either did not have any effect on understanding and decision-making, or it depended on factors such as the participants’ preconceptions about specific offences (for example, risk communication format mattered less in sexual offending cases), numeracy, and race, as well as the risk level and outcome examined (for example, release from hospital or sentencing).
Vignette Studies
In two vignette studies, Dr. Goossens worked with people who experienced or perpetrated intimate partner violence (IPV) and examined how lived experience and personal attitudes toward IPV may affect how individuals understand and reason with their own risk information.
The first study showed that individuals judged the high-risk people who perpetrated IPV as riskier, especially in the hybrid format. High-risk messages were seen as more important — most notably in non-numerical formats. Overall understanding was high but varied by risk level, format, numeracy, gender, and attitudes toward IPV.
In the second study, participants’ own victimization history influenced risk perception and legal decision-making, while prior perpetration affected legal and personal decisions. Adding attitudinal factors explained variance and, in some cases, outweighed the significance of personal experience. Being female was linked to most outcomes (for example, risk perception, legal decision-making, and decision-making around safety planning), suggesting that the female experience may reflect victimization history and its effect on risk perception and decision-making. While preliminary, the findings suggest that considering personal experience and attitudes could help bridge the gap between risk perception and decision-making.
For more details, watch the recording of Dr. Goossens’s May 8, 2025, International Forensic Psychiatry Lecture Series presentation, “Decoding Risk: Effective Communication Strategies in Forensic Risk Assessment,” on our website.
Written by Virginia St-Denis and approved by Dr. Ilvy Goossens.
