Domestic Violence Domestic Violence Knowledge Sharing Knowledge Sharing

ForumForum

Lethbridge, ABLethbridge, AB

March 24, 2011March 24, 2011

Southern Alberta

Forensic PsychiatryServices (SAFPS)

Southern Alberta

Forensic Psychiatry

Centre (SAFPC)

Forensic AdolescentProgram

(FAP)

Calgary DiversionServices

Forensic AssessmentOutpatient

Service(FAOS)

Who Do We Serve?Who Do We Serve?

Target population is adults and adolescents who Target population is adults and adolescents who are:are:

12 years of age or older12 years of age or older In conflict with the lawIn conflict with the law Thought to have mental problemsThought to have mental problems Legally mandated for assessment or Legally mandated for assessment or

treatment for mental health or treatment for mental health or behavioural problems behavioural problems

What Do We Do?What Do We Do?

Assessment for the courtsAssessment for the courts Fitness To Stand TrialFitness To Stand Trial Not Criminally Responsible due to Not Criminally Responsible due to

Mental Disorder (NCRMD)Mental Disorder (NCRMD) Risk AssessmentRisk Assessment TreatmentTreatment

What is a Risk/Threat?What is a Risk/Threat?

the potential that a chosen action or the potential that a chosen action or activity (including the choice of activity (including the choice of inaction) will lead to an undesirable inaction) will lead to an undesirable outcome outcome

Complex – incorporates notions of Complex – incorporates notions of nature, severity, frequency, nature, severity, frequency, imminence, and likelihoodimminence, and likelihood

Contextual – depends on Contextual – depends on circumstances!circumstances!

What is Violence?What is Violence?

The actual, attempted, or threatened The actual, attempted, or threatened physical harm to another personphysical harm to another person

Diverse – includes many actsDiverse – includes many acts Intentional – deliberate or recklessIntentional – deliberate or reckless Non-consensual – unwanted by the Non-consensual – unwanted by the

victim victim

What is AssessmentWhat is Assessment

In the mental health profession, In the mental health profession, assessment is the process of assessment is the process of gathering information for the use in gathering information for the use in making decisions.making decisions.

Include: interviews, psychological Include: interviews, psychological testing, review of records, collateral testing, review of records, collateral informantsinformants

Risk AssessmentRisk Assessment

Is the process of gathering Is the process of gathering information about people to make information about people to make decisions regarding their risk of decisions regarding their risk of perpetrating/offending.perpetrating/offending.

The primary decision to be made is The primary decision to be made is preventative, that is, a determination preventative, that is, a determination of what steps should be taken to of what steps should be taken to minimize any risks posed by the minimize any risks posed by the individual.individual.

Risk Assessment cont…Risk Assessment cont…

Mental health professionals use two Mental health professionals use two basic approachesbasic approaches

Actuarial decision makingActuarial decision making Professional judgementProfessional judgement

Actuarial Risk AssessmentActuarial Risk Assessment

Are designed not to measure anything but Are designed not to measure anything but solely to predict the future.solely to predict the future.

Typically, they are highly optimized to predict Typically, they are highly optimized to predict a specific outcome in a specific population a specific outcome in a specific population over a specific period of time.over a specific period of time.

The items used in such tools are usually The items used in such tools are usually selected empirically (on the basis of their selected empirically (on the basis of their association with the outcome in past association with the outcome in past research).research).

The items are weighted and combined The items are weighted and combined according to some algorithm to yield a according to some algorithm to yield a decision. decision.

Professional JudgementProfessional Judgement

Has evolved over the years into what Has evolved over the years into what is now called structured professional is now called structured professional judgement or guided clinical judgement or guided clinical judgement.judgement.

Decision-making is assisted by Decision-making is assisted by guidelines that have been developed guidelines that have been developed to reflect the “state of the discipline” to reflect the “state of the discipline” with respect to empirical knowledge with respect to empirical knowledge and professional practice. and professional practice.

SPJ Cont…SPJ Cont…

The guidelines attempt to define the risk The guidelines attempt to define the risk being considered, discuss necessary being considered, discuss necessary qualifications for conducting the qualifications for conducting the assessment, recommend what information assessment, recommend what information should be considered as part of the should be considered as part of the evaluation and how it should be gathered, evaluation and how it should be gathered, and indentify a set of core risk factors that and indentify a set of core risk factors that according to the scientific and professional according to the scientific and professional literature should be considered as part of literature should be considered as part of any reasonably comprehensive assessment.any reasonably comprehensive assessment.

SPJ Cont..SPJ Cont..

Such guidelines help to improve the Such guidelines help to improve the consistency and usefulness of decisions.consistency and usefulness of decisions.

The core assumption behind structured The core assumption behind structured professional judgement assessments is professional judgement assessments is that good prevention is based on that good prevention is based on planning, not on prediction.planning, not on prediction.

Planning reflects practical wisdom Planning reflects practical wisdom rather than abstract knowledge of rather than abstract knowledge of technical skillstechnical skills

The advantage is that planning doesn’t The advantage is that planning doesn’t assume a single “possible future” assume a single “possible future”

General ProceduresGeneral Procedures

Gather information (purpose, history, Gather information (purpose, history, behaviours) behaviours)

Consider relevance of risk factors Consider relevance of risk factors (motivators, disinhibitors, (motivators, disinhibitors, destabilizers)destabilizers)

Consider scenarios of violenceConsider scenarios of violence Develop case management strategies Develop case management strategies

(monitoring, supervision, tx, risk (monitoring, supervision, tx, risk management)management)

Document summary judgementsDocument summary judgements

What is a Static Factor?What is a Static Factor?

Something that that can not be Something that that can not be changed changed

Natural hair colourNatural hair colour Eye colourEye colour HistoryHistory SexSex Criminal recordCriminal record

What is a Dynamic Factor?What is a Dynamic Factor?

Something that can change over Something that can change over time and as result change a person’s time and as result change a person’s riskrisk

RelationshipsRelationships EmploymentEmployment Substance useSubstance use Suicidal/homicidal ideationSuicidal/homicidal ideation Mental health Mental health

Factors Predictive of Future ViolenceFactors Predictive of Future Violence

Actuarial instruments as well as Actuarial instruments as well as clinical assessments consider a clinical assessments consider a number of factors in their assessment number of factors in their assessment of risk potential magnitude, of risk potential magnitude, imminence and frequency. Research imminence and frequency. Research has indicated that the following has indicated that the following factors have predictive value:factors have predictive value:

Base RatesBase Rates

refers to the frequency of violence in a refers to the frequency of violence in a given population given population

one of the most highly predictive one of the most highly predictive actuarial factors actuarial factors

does not relate specifically to mental does not relate specifically to mental disorder disorder

can "over-predict" (e.g.,. can can "over-predict" (e.g.,. can incorrectly identify some offenders as incorrectly identify some offenders as potential killers) potential killers)

Demographic FactorsDemographic Factors

men more highly represented in criminal men more highly represented in criminal and violent populations (though not and violent populations (though not necessarily in psychiatric areas) necessarily in psychiatric areas)

age: crime (especially violent) tends to age: crime (especially violent) tends to occur more in younger than in older men occur more in younger than in older men

unemployment: low socioeconomic status, unemployment: low socioeconomic status, low educational achievement correlate with low educational achievement correlate with violence violence

race and ethnicity: although these can be race and ethnicity: although these can be factors, they tend to dissipate when the factors, they tend to dissipate when the other factors taken into account statistically other factors taken into account statistically

Past History of ViolencePast History of Violence

violent history: one of most powerful violent history: one of most powerful indicators of future violence potential indicators of future violence potential

nature of the violence: always nature of the violence: always important to consider (e.g.,. types of important to consider (e.g.,. types of victims, environmental and victims, environmental and contextual issues, etc) contextual issues, etc)

Substance AbuseSubstance Abuse

drugs and alcohol are major contributors to drugs and alcohol are major contributors to violence amongst both mentally disordered violence amongst both mentally disordered and non-mentally disordered offenders and non-mentally disordered offenders

prevalence of substance abuse in mentally prevalence of substance abuse in mentally disordered offender tends to be higher than in disordered offender tends to be higher than in general (non-incarcerated) population general (non-incarcerated) population

substance abuse is important risk factor in substance abuse is important risk factor in psychotic individuals psychotic individuals

doubles the lifetime risk of violence among doubles the lifetime risk of violence among the severely mentally disordered, particularly the severely mentally disordered, particularly if substance abuse had early onset if substance abuse had early onset

Psychiatric DiagnosisPsychiatric Diagnosis

earlier research linked violence with earlier research linked violence with schizophrenic patients in particular schizophrenic patients in particular but later studies have been more but later studies have been more equivocal about this equivocal about this

much more relevant to look at much more relevant to look at psychiatric psychiatric symptomssymptoms as opposed to as opposed to diagnosis: diagnosis:

Antisocial Personality DisordersAntisocial Personality Disorders

characterized by persistent disregard for characterized by persistent disregard for and violation of the rights of others and violation of the rights of others

begins in childhood begins in childhood higher prevalence of it in severely higher prevalence of it in severely

mentally ill population and in prison mentally ill population and in prison population (50-70%) population (50-70%)

strong association with substance abuse strong association with substance abuse strong predictor of criminal recidivism, strong predictor of criminal recidivism,

particularly violent recidivism, and particularly violent recidivism, and especially in women especially in women

PsychopathyPsychopathy often overlaps with Antisocial Personality often overlaps with Antisocial Personality

Disorder (APD) Disorder (APD) characterized by combination of traits characterized by combination of traits

from APD and Narcissistic Personality from APD and Narcissistic Personality Disorder: self-centredness, egocentricity, Disorder: self-centredness, egocentricity, lack of empathy, etc. lack of empathy, etc.

degree of psychopathy measured degree of psychopathy measured effectively by Hare's Psychopathy effectively by Hare's Psychopathy Checklist-Revised (PCL-R) Checklist-Revised (PCL-R)

high scores on PCL-R consistently correlate high scores on PCL-R consistently correlate with violence in incarcerated offenders with violence in incarcerated offenders and forensic patients and forensic patients

Organic Disorders and Learning Organic Disorders and Learning Disorders (influence of)Disorders (influence of)

presence increases the risk of violence presence increases the risk of violence elderly neurologically impaired responsible elderly neurologically impaired responsible

for disproportionately high number of for disproportionately high number of violent incidents in health care facilities violent incidents in health care facilities

Attention Deficit/Hyperactivity Disorder Attention Deficit/Hyperactivity Disorder ( ADHD):( ADHD):- persistent pattern of inattention or - persistent pattern of inattention or hyperactivity-impulsivityhyperactivity-impulsivity- in childhood, is more frequent and severe - in childhood, is more frequent and severe than comparable behaviour of other than comparable behaviour of other children at similar stages of developmentchildren at similar stages of development

Attachment, Mental Disorder and Attachment, Mental Disorder and CriminalityCriminality

children learn about relationships through children learn about relationships through complex interruption with their caregivers complex interruption with their caregivers

early disruption of this attachment can lead early disruption of this attachment can lead to later psychopathology, mental disorders to later psychopathology, mental disorders and criminality in some individuals and criminality in some individuals

fertile ground for research into relationship fertile ground for research into relationship between abuse/neglect and later violence: between abuse/neglect and later violence:

it may well be that prison environments tend it may well be that prison environments tend to replicate or reflect lack of care that some to replicate or reflect lack of care that some offenders may have experienced as children offenders may have experienced as children

Who can use the assessments?Who can use the assessments?

Professionals in a variety of disciplines Professionals in a variety of disciplines Expertise in conducting assessmentsExpertise in conducting assessments Expertise in the area of violence, spousal Expertise in the area of violence, spousal

assault, sexual violence.assault, sexual violence. Expertise in mental disordersExpertise in mental disorders Proper training in the risk assessment Proper training in the risk assessment

tooltool Refer to the User Qualifications in the Refer to the User Qualifications in the

risk assessment manual risk assessment manual

Actuarial Risk Assessment ToolsActuarial Risk Assessment Tools

Violent Risk Appraisal Guide (VRAG)Violent Risk Appraisal Guide (VRAG)Quinsey, Harris, Rice, Cormier (1998)Quinsey, Harris, Rice, Cormier (1998)

This instrument contains a 12-item actuarial This instrument contains a 12-item actuarial scale which has been widely used to predict scale which has been widely used to predict risk of violence within a specific time frame risk of violence within a specific time frame following release in violent, mentally following release in violent, mentally disordered offenders. Developed at disordered offenders. Developed at Penetanguishene Mental Health Centre, the Penetanguishene Mental Health Centre, the tool uses the clinical record, particularly the tool uses the clinical record, particularly the psycho-social history component, as a basis psycho-social history component, as a basis for scoring as opposed to interview or for scoring as opposed to interview or questionnaires. The Hare PCL-R (Psychopathy questionnaires. The Hare PCL-R (Psychopathy Checklist -Revised) score is incorporated into Checklist -Revised) score is incorporated into the VRAG calculations of risk. the VRAG calculations of risk.

-24 to -8 = low risk, -7 to 13 = medium risk, 14 to 32 = high risk-24 to -8 = low risk, -7 to 13 = medium risk, 14 to 32 = high risk

Psychopathy Checklist - Revised (PCL-R)Psychopathy Checklist - Revised (PCL-R)Hare, 1991Hare, 1991 & & 20022002

Even though it was not originally designed as Even though it was not originally designed as a risk assessment device, the Hare PCL-R has a risk assessment device, the Hare PCL-R has gradually come to be used to assess likely gradually come to be used to assess likely future recidivism and violent offending. It is future recidivism and violent offending. It is a 20-item rating scale, scored on the basis of a 20-item rating scale, scored on the basis of both semi-structured interview and collateral both semi-structured interview and collateral information. It has been validated for use in information. It has been validated for use in adult male correctional and forensic adult male correctional and forensic psychiatric samples. Over recent years, psychiatric samples. Over recent years, research has shown that it is a relatively research has shown that it is a relatively good predictor of violence across diverse good predictor of violence across diverse populations. Hare PCL-R scores are populations. Hare PCL-R scores are incorporated into a number of subsequently incorporated into a number of subsequently developed risk assessment tools and guides. developed risk assessment tools and guides.

Level of Service Inventory – Revised (LSI-R)Level of Service Inventory – Revised (LSI-R)Andrews & Bonta, 1995Andrews & Bonta, 1995

This is a 54-item rating scale used to This is a 54-item rating scale used to assess the likelihood of general assess the likelihood of general recidivism among adult offenders. It recidivism among adult offenders. It is designed to measure attributes of is designed to measure attributes of offenders and their situations in offenders and their situations in relation to level of supervision and relation to level of supervision and treatment decisions. It has been treatment decisions. It has been validated for use with adult male and validated for use with adult male and female correctional offenders. female correctional offenders.

Static-99/Static-2002Static-99/Static-2002Hanson & Thornton, 1999 and 2002Hanson & Thornton, 1999 and 2002

Developed subsequently to the Developed subsequently to the RRASOR, the original 10-item STATIC-RRASOR, the original 10-item STATIC-99 was designed to assess the long-99 was designed to assess the long-term potential for sexual recidivism term potential for sexual recidivism among adult male sex offenders. It among adult male sex offenders. It incorporates RRASOR factors. A incorporates RRASOR factors. A revised version, STATIC-2002, has so revised version, STATIC-2002, has so far been used predominately within far been used predominately within the correctional system. the correctional system.

Number Number Risk Factor Risk Factor Codes Codes ScoreScore 1 1 Young Young Aged 25 or older Aged 25 or older 00 Aged 18 – 24.99 Aged 18 – 24.99 1 1 2 2 Ever lived with lover for at least two years? Ever lived with lover for at least two years? YesYes 0 0

No No 1 1 3 3 Index non-sexual violence - Any Convictions? Index non-sexual violence - Any Convictions? NoNo 00

YesYes 1 1 4 4 Prior non-sexual violence - Any Convictions? Prior non-sexual violence - Any Convictions? No No 00

YesYes 11 5 5 Prior Sex Offences Prior Sex Offences Charges ConvictionsCharges Convictions

None None None None 0 0 1-2 1-2 1 1 1 1 3-5 3-5 2-3 2-3 226 + 6 + 4+ 4+ 3 3

6 6 Prior sentencing dates (excluding index) Prior sentencing dates (excluding index) 3 or less3 or less 0 0 4 or more 4 or more 1 1

7 7 Any convictions for non-contact sex offences Any convictions for non-contact sex offences No No 00YesYes 11

8 8 Any Unrelated Victims Any Unrelated Victims NoNo 0 0 YesYes 1 1

9 9 Any Stranger Victims Any Stranger Victims NoNo 0 0 YesYes 1 1

10 10 Any Male Victims Any Male Victims No No 00YesYes 1 1

Add up scores from individual risk factors for Total ScoreAdd up scores from individual risk factors for Total Score 0-1 = low risk, 2-3 = moderate-low, 4-5 = moderate-high, 6+ = high0-1 = low risk, 2-3 = moderate-low, 4-5 = moderate-high, 6+ = high

Structural Clinical GuidesStructural Clinical Guides

Sexual Violence Risk-20 (SVR-20)Sexual Violence Risk-20 (SVR-20)Boer, Hart, Kropp, & Webster, 1997Boer, Hart, Kropp, & Webster, 1997

This is a 20 item guide for assessing This is a 20 item guide for assessing violence risk in sex offenders. Eleven violence risk in sex offenders. Eleven items deal with Psychosocial Adjustment, items deal with Psychosocial Adjustment, 7 with Sexual Offences and 2 with Future 7 with Sexual Offences and 2 with Future Plans. Scoring is based on a N (definitely Plans. Scoring is based on a N (definitely not present), ? (perhaps present), or Y not present), ? (perhaps present), or Y (definitely present) scale with allowance (definitely present) scale with allowance for changes over time. Little is currently for changes over time. Little is currently known about its effectiveness as a known about its effectiveness as a predictive device. Its main current predictive device. Its main current usefulness lies in its ability to help usefulness lies in its ability to help structure clinical assessments. structure clinical assessments.

Structured Assessment of Violence Risk in Youth Structured Assessment of Violence Risk in Youth (SAVRY)(SAVRY)

Bartel, Borum, & Forth, 1999Bartel, Borum, & Forth, 1999

This is a violence risk assessment This is a violence risk assessment scheme designed to assess risk for scheme designed to assess risk for violence in adolescents. It consists of violence in adolescents. It consists of 10 historical variables, 8 10 historical variables, 8 social/contextual variables, 7 social/contextual variables, 7 individual/clinical variables and 6 individual/clinical variables and 6 protective variables. protective variables.

HCR-20HCR-20Webster, Douglas, Eaves, & Hart, 1997Webster, Douglas, Eaves, & Hart, 1997

Consists of 20 items. There are 10 Consists of 20 items. There are 10 historical variables, 5 clinical historical variables, 5 clinical variables, and 5 risk management variables, and 5 risk management factors.  Each item is scored as 0 factors.  Each item is scored as 0 (not present), 1 (possibly present) or (not present), 1 (possibly present) or 2 (definitely present) to yield a score 2 (definitely present) to yield a score out of 40. out of 40.

HCR-20 Cont…HCR-20 Cont…

It includes variables that capture relevant It includes variables that capture relevant past, present, and future considerations. It past, present, and future considerations. It can be regarded as an important first step can be regarded as an important first step in the risk assessment process. The manual in the risk assessment process. The manual provides information about how and when provides information about how and when to conduct violence risk assessments, to conduct violence risk assessments, reviews the research on which the risk reviews the research on which the risk factors are based, and suggests key factors are based, and suggests key questions which should be addressed when questions which should be addressed when making judgments about risk. making judgments about risk.

Spousal Assault Risk Assessment Guide Spousal Assault Risk Assessment Guide (SARA)(SARA)

Kropp, Hart, Webster, & Eaves, 1995Kropp, Hart, Webster, & Eaves, 1995

This is a a 20 item set of risk factors This is a a 20 item set of risk factors for use in the assessment of spousal for use in the assessment of spousal assault. It can be used to help gauge assault. It can be used to help gauge risk of future violence in men risk of future violence in men arrested for spousal assault. arrested for spousal assault.

Gather information by interviewing Gather information by interviewing offender, victim, reviewing offender, victim, reviewing documents, etcdocuments, etc

Score items either as being present Score items either as being present (yes), possibly or partially present (yes), possibly or partially present (?), or absent (no).(?), or absent (no).

Speculate about the kinds of intimate Speculate about the kinds of intimate partner violence the person might partner violence the person might commit and plausible scenarioscommit and plausible scenarios

Speculate about risk management Speculate about risk management strategies for each scenariostrategies for each scenario

MonitoringMonitoring SupervisionSupervision TxTx Risk managementRisk management

What does it all mean?What does it all mean?

Management StrategiesManagement Strategies

IncarcerationIncarceration Couples counsellingCouples counselling Vocational assistanceVocational assistance Individual counsellingIndividual counselling Specialized treatmentSpecialized treatment Psychiatric treatmentPsychiatric treatment HospitalizationHospitalization Detox / substance abuse treatment Detox / substance abuse treatment

LimitationsLimitations

It should be noted that the quality of risk It should be noted that the quality of risk assessments is limited by the quality of the assessments is limited by the quality of the information on which it is based. information on which it is based.

Risk is dynamic; therefore if there is an Risk is dynamic; therefore if there is an important change in the individuals life important change in the individuals life circumstances, it may be necessary to circumstances, it may be necessary to update the risk assessment. Important update the risk assessment. Important warning signs that should trigger a re-warning signs that should trigger a re-assessment include: major change in assessment include: major change in relational status; abuse of alcohol or other relational status; abuse of alcohol or other substances; major change in employment; substances; major change in employment; significant change in mental status; and any significant change in mental status; and any commission of related offences.commission of related offences.

The Bad NewsThe Bad News

Not everyone who commits a violent Not everyone who commits a violent offence has a prior history of violence offence has a prior history of violence or any prior history with mental or any prior history with mental health services.health services.

Risk assessments only look at the Risk assessments only look at the “plausible future NOT the probable “plausible future NOT the probable future”future”

Example “risk message”:Example “risk message”:

Based on a comprehensive risk assessment, it is my opinion Based on a comprehensive risk assessment, it is my opinion that, Mr. MC currently poses a moderate risk for spousal that, Mr. MC currently poses a moderate risk for spousal assault should he remain with his partner, the victim in the assault should he remain with his partner, the victim in the index offence.index offence.

Mr. MC has a criminal history that may be characterized as Mr. MC has a criminal history that may be characterized as serious and persistent in nature. The history is serious serious and persistent in nature. The history is serious because it has involved the use or threat of use of firearms. because it has involved the use or threat of use of firearms. The history is persistent because it spans over a period of The history is persistent because it spans over a period of 30 years. 30 years.

If Mr. MC commits violence in the future, the most plausible If Mr. MC commits violence in the future, the most plausible scenario is a repeat of his past violence: while using scenario is a repeat of his past violence: while using alcohol, becoming angry and engaging in threatening or alcohol, becoming angry and engaging in threatening or assaultive behaviour to express his anger. If the threats or assaultive behaviour to express his anger. If the threats or assaults involve the use of weapons (e.g., guns), they could assaults involve the use of weapons (e.g., guns), they could be life threatening in nature. The likelihood of this scenario be life threatening in nature. The likelihood of this scenario would be reduced if Mr. MC continues to abstain from using would be reduced if Mr. MC continues to abstain from using alcohol and drugs, but increase if he begins to use alcohol alcohol and drugs, but increase if he begins to use alcohol or drugs again.or drugs again.

StalkingStalking

Unwanted and repeated Unwanted and repeated communication, contact, or other communication, contact, or other conduct that deliberately or recklessly conduct that deliberately or recklessly causes people to experience reasonable causes people to experience reasonable fear or concern for their safety or the fear or concern for their safety or the safety of others known to them. safety of others known to them.

““old behaviour, new crime”old behaviour, new crime” Best person to judge whether the Best person to judge whether the

stalkers behaviour has crossed the line stalkers behaviour has crossed the line is the victimis the victim

Complicated CasesComplicated Cases

Diversity of stalking Diversity of stalking may involve long-standing or may involve long-standing or

continuing conductcontinuing conduct Intimidation may be implicit or explicitIntimidation may be implicit or explicit• Diversity of perpetratorsDiversity of perpetrators May involve multiple perpetratorsMay involve multiple perpetrators Varied motivations and/or mental stateVaried motivations and/or mental state

Diversity of victimsDiversity of victims May involve multiple victimsMay involve multiple victims Varied personal and situational Varied personal and situational

vulnerabilitiesvulnerabilities

Types of StalkersTypes of Stalkers

Former Intimate PartnerFormer Intimate Partner Most common (50-75%)Most common (50-75%) Anger or distress over the breakup of the Anger or distress over the breakup of the

relationshiprelationship Offender often has a personality, substance Offender often has a personality, substance

abuse, or mood disorderabuse, or mood disorder Often intimate partner violence preceded Often intimate partner violence preceded

the breakupthe breakup Relatively high risk for serious physical Relatively high risk for serious physical

harmharm

Love ObsessionalLove Obsessional Relatively common (10-20%)Relatively common (10-20%) Offender is casually acquainted with the Offender is casually acquainted with the

victimvictim Stalking communicates desire to establish Stalking communicates desire to establish

an intimate relationshipan intimate relationship Offender usually has serious social Offender usually has serious social

maladjustmentmaladjustment Offender may have a personality, cognitive, Offender may have a personality, cognitive,

or developmental disorderor developmental disorder Relatively low risk for serious physical harmRelatively low risk for serious physical harm Young females in service industries are Young females in service industries are

usually victims (waitress, bank teller, clerks)usually victims (waitress, bank teller, clerks)

GrudgeGrudge Relatively common (10-20%)Relatively common (10-20%) Offender has a casual or professional Offender has a casual or professional

relationship with the victimrelationship with the victim Stalking communicates anger and desire for Stalking communicates anger and desire for

retribution or justiceretribution or justice Offender may have a personality disorder or Offender may have a personality disorder or

in some cases a psychotic disorderin some cases a psychotic disorder Risk for serious physical harm varies greatlyRisk for serious physical harm varies greatly Never happy, always complainingNever happy, always complaining Feel entitled and demand respectFeel entitled and demand respect Feel disrespectedFeel disrespected

ErotomaticErotomatic

Relatively rare (5-10%)Relatively rare (5-10%) Offender is unacquainted or only casually Offender is unacquainted or only casually

acquainted (possibly through the media)acquainted (possibly through the media) Stalking communicates belief that the Stalking communicates belief that the

victim loves the offendervictim loves the offender Offender suffers from a cognitive or Offender suffers from a cognitive or

psychotic disorderpsychotic disorder Risk for serious physical harm varies greatlyRisk for serious physical harm varies greatly Delusional, out of touch with realityDelusional, out of touch with reality Unpredictable but usually not violentUnpredictable but usually not violent

Stalking Assessment & Management (SAM)Stalking Assessment & Management (SAM)Kropp, Hart, & Lyon, 2008Kropp, Hart, & Lyon, 2008

Nature of StalkingNature of Stalking Communicates about victimCommunicates about victim Communicates with victimCommunicates with victim Approaches victimApproaches victim Direct contactDirect contact Intimidates victimIntimidates victim Threatens victimThreatens victim Violent toward victimViolent toward victim Stalking is persistentStalking is persistent Stalking is escalatingStalking is escalating Stalking involved supervision violationsStalking involved supervision violations

Perpetrator Risk FactorsPerpetrator Risk Factors AngryAngry ObsessedObsessed IrrationalIrrational UnrepentantUnrepentant Antisocial lifestyleAntisocial lifestyle Intimate relationship problemsIntimate relationship problems Non-intimate relationship problemsNon-intimate relationship problems DistressedDistressed Substance use problemsSubstance use problems Employment and financial problemsEmployment and financial problems

Victim Vulnerability FactorsVictim Vulnerability Factors Inconsistent behaviour toward perpetratorInconsistent behaviour toward perpetrator Inconsistent attitude toward perpetratorInconsistent attitude toward perpetrator Inadequate access to resourcesInadequate access to resources Unsafe living situationUnsafe living situation Problems caring for dependentsProblems caring for dependents Intimate relationship problemsIntimate relationship problems Non-intimate relationship problemsNon-intimate relationship problems DistressedDistressed Substance use problemsSubstance use problems Employment and financial problemsEmployment and financial problems

Questions?Questions?

Thank YouThank You

Stanley K. Wong, M.A., R. Psych.Stanley K. Wong, M.A., R. Psych.Clinical and Forensic PsychologistClinical and Forensic Psychologist

Community Geographic Team Resources - Community Geographic Team Resources - LethbridgeLethbridge

Southern Alberta Forensic Psychiatry Southern Alberta Forensic Psychiatry ServicesServices

(403) 308-0005(403) 308-0005

Stanley.wong@albertahealthservices.caStanley.wong@albertahealthservices.ca