Short-Term Assessment of Risk & Treatability (START)

Presented by: Sarah L. Desmarais, PhD, Tonia L. Nicholls, PhD

1 Hour / 1 CE

On Demand | Self-Paced Professional Training

This on-demand professional training program on Short-Term Assessment of Risk & Treatability (START): An Introduction to Structured Professional Judgement is presented by Sarah Desmarais, PhD, and Tonia Nicholls, PhD.

This program provides foundational training on the use of the Short-Term Assessment of Risk and Treatability (START), a 20-item structured professional judgment guide developed to support decisions and case planning for persons with mental health and/or criminal justice needs and who may pose a risk of violence to self or others. The START provides for the differential coding of clinically relevant strengths and vulnerabilities to inform the assessment and management of violence and related risks (suicide, self-harm, substance abuse, victimization, etc.). This approach has been implemented and evaluated in more than 70 studies and translated into eight languages. It is recognized as a best practice for the assessment and management of violence and related risks.

This program describes the development, design, and format of START as well as the results of existing and ongoing research. A case-based approach is used to focus this program on the process of using the START to guide assessment and the use of START assessments to improve outcomes.

Learning Objectives

Upon completion of this training, participants will be able to:

1 Describe the rationale for adopting the START into clinical practice
2 Describe the relevance of the START for diverse populations, settings, and decision contexts
3 Describe the various components of the START and how to assess them
4 Describe how protective factors and risk factors can both be simultaneously present or absent
5 Describe how to integrate historical and current information to empirically inform evidence-based risk assessment
6 Describe the intersection of related case outcomes (e.g., suicide, substance abuse, violence)
7 Demonstrate and justify a START assessment
8 Describe the empirical research support for START
9 Describe how the START can be used in practice to support rapport building and engagement
10 Describe how the START can inform case formulations

Intended Audience

This training is intended for clinicians, correctional staff, and behavioral health professionals who want to develop skills in using the Short-Term Assessment of Risk and Treatability (START) for managing violence and related risks. It is suitable for those specializing in forensic psychology, correctional mental health, psychiatry, social work, and community-based behavioral health, as well as allied professionals involved in risk assessment and management.
Examples of Relevant Professionals:
- Mental Health Professionals
- Correctional staff (e.g., parole and probation officers)
- Behavioral health professionals
- Forensic psychologists
- Correctional mental health clinicians
- Psychiatrists
- Nurses
- Social workers
- Allied behavioral health professionals
Experience Level

This training is appropriate for licensed and pre-licensed mental health professionals at various stages of experience with structured risk assessment tools.
- Beginner: Participants new to structured professional judgment tools or the START will gain foundational knowledge of its components, rationale, and application in diverse clinical settings.
- Intermediate: Participants with some experience in risk assessment will deepen their understanding of integrating START into case formulation, interpreting empirical research, and applying START to complex case scenarios.
- Advanced: Participants with extensive experience in risk assessment and management will refine their skills in using START to inform nuanced clinical decision-making, support engagement, and address intersecting risk domains.
Practice Setting

Participants typically work in secure and community-based settings where structured risk assessment informs case planning and supervision for individuals with mental health and/or justice involvement. Environments emphasize multidisciplinary collaboration, integrating START into treatment, monitoring, and safety management across healthcare, correctional, and court-linked services.

Examples of Practice Settings:
- Jails and prisons
- Probation and parole offices
- Forensic psychiatric hospitals/units
- Inpatient psychiatric units
- Community mental health centers
- Outpatient behavioral health clinics
- Specialty/problem-solving courts
- Emergency departments and crisis stabilization units
- Residential treatment and step-down programs
- Reentry and diversion services

Training Instructors:

Sarah L. Desmarais, PhD

Sarah L. Desmarais, Ph.D., is the President at Policy Research Associates, Inc. (PRA) since 2022. She is responsible for the strategic priorities of PRA and oversight of PRA operations. Dr. Desmarais received her PhD in Forensic Psychology and Law from Simon Fraser University and completed a postdoctoral fellowship in Population and Public Health at the University of British Columbia. Prior to joining PRA, Dr. Desmarais was a tenured Professor of Psychology and University Faculty Scholar at North Carolina State University.

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Tonia L. Nicholls, PhD

Dr. Tonia Nicholls was promoted to full Professor in the Department of Psychiatry at the University of British Columbia (UBC) in 2017. She is also the Scientific Director of Forensic Research with British Columbia Mental Health and Substance Use Services (BCMHSUS). She holds several cross-appointments, including the School of Population and Public Health, UBC and is an Adjunct Professor in the Department of Psychology, Simon Fraser University. She is Past-President of the International Association of Forensic Mental Health Services (2023-2025).

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CE Sponsorship Information

Palo Alto University, Continuing & Professional Studies (CONCEPT) is approved by, recognized by, or maintains sponsorship provider status with the following boards and agencies. We maintain responsibility for all content in our CE/CPD programs. For more information, visit here.

American Psychological Association (APA): Approved sponsor of continuing education for psychologists.
Association of Social Work Boards (ASWB): Approved continuing education provider (ACE program, Provider #1480), 11/22/2023–11/22/2026.
Canadian Psychological Association (CPA): Approved to sponsor continuing education for psychologists.
National Board for Certified Counselors (NBCC): Approved Continuing Education Provider (ACEP No. 7190).

Sponsorship Approval Statements

Palo Alto University, Continuing and Professional Studies (CONCEPT) is approved by the American Psychological Association to sponsor continuing education for psychologists. Palo Alto University, Continuing and Professional Studies (CONCEPT), is approved by the Canadian Psychological Association to offer continuing education for psychologists. Palo Alto University, Continuing and Professional Studies (CONCEPT) has been approved by NBCC as an Approved Continuing Education Provider, ACEP No. 7190. Programs that do not qualify for NBCC credit are clearly identified. Palo Alto University, #1480, is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved as ACE providers. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. Palo Alto University maintains responsibility for this course. ACE provider approval period 11/22/23-11/22/26. Social workers completing this course receive (clinical or social work ethics) continuing education credits. Continuing and Professional Studies, Palo Alto University, is recognized by the New York State Education Department's State Board for Psychology as an approved provider of continuing education for licensed psychologists #PSY-0103. Palo Alto University, Continuing and Professional Studies (CONCEPT) is solely responsible for all aspects of the programs. Palo Alto University, Continuing & Professional Studies (CONCEPT), is recognized by the New York State Education Department's State Board for Social Work as an approved provider of continuing education for licensed social workers #SW-0356. Palo Alto University, Continuing and Professional Studies, is recognized by the New York State Education Department’s State Board for Mental Health Practitioners as an approved provider of continuing education for licensed mental health counselors. #MHC-0073.