14 Hours | 14 CEs

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

This training program provides foundational training on the use of the Short-Term Assessment of Risk and Treatability (START), a 20-item structured professional judgement 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 training program describes the development, design, and format of START as well as the results of existing and ongoing research. A case-based approach will be used to focus this training 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 course you will be able to:

  • Describe the rationale for adopting the START into clinical practice

  • Describe the relevance of the START for diverse populations, settings, and decision contexts

  • Describe the various components of the START and how to assess them

  • Describe how protective factors and risk factors can both be simultaneously present or absent

  • Describe how to integrate historical and current information to empirically inform evidence based risk assessment

  • Describe the intersection of related case outcomes (e.g., suicide, substance abuse, violence)

  • Implement and justify a START assessment

  • Describe the empirical research support for START

  • Describe how the START can be used in practice to support rapport building and engagement

  • Describe how the START can inform case formulations

Presented By

Sarah L. Desmarais, PhD

Sarah L. Desmarais, Ph.D. has been a Senior Vice President at Policy Research Associates, Inc. (PRA) since 2021. She is responsible for developing and providing oversight on research projects, as well as administrative and management duties in support of a variety of other projects. Dr. Desmarais received her Master’s and PhD in Forensic Psychology and Law from Simon Fraser University. She completed a postdoctoral fellowship in the School of 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. Before that, she was an Assistant Professor at the University of South Florida with joint appointments in the Department of Community and Family Health and the Department of Mental Health Law & Policy. Dr. Desmarais works on issues at the intersection of public health, community safety, and social justice. Her current research is focused on evidence-based practices for reducing detention rates, especially among people with behavioral health needs. She provides technical assistance, evaluation services, and consultation to behavioral health, criminal justice, and intelligence agencies throughout the United States and abroad on problems and solutions for implementation, policy, and practice.

Tonia L. Nicholls, PhD

Dr. Nicholls is Professor, Department of Psychiatry, UBC and Distinguished Scientist and Lead, Forensic Research BC Mental Health and Substance User Services and President-Elect, International Association of Forensic Mental Health. She holds cross-appointments at UBC including the SPPH and an Adjunct appointment in the Department of Psychology, SFU. Her research examines the intersections of law and mental health related to the provision of services to persons in conflict with the law and diverse marginalized populations focusing on assessment and treatment of violence, criminality, and the development and implementation of EBP. She has published manuals to support the translation of research into practice and has engaged in large-scale implementations and evaluations; these include violence risk assessments and mental health screening in correctional settings, mental health assessments, and treatment planning (see manuals). Her scholarly work has earned her and her teams multiple grants and awards totaling over $15 million. Recently she received a CIHR Foundation award (> $2 million; 2015-2022) to fund her research.
  • Intended Audience

    This self-paced course is intended for mental health and other allied professionals.

  • Experience Level

    This self-paced course is appropriate for beginner, intermediate, and advanced level clinicians.

  • CE / CPD Credit

    APA, ASWB, CPA, NBCC Click here for state and other regional board approvals.


  • 1


    • Review Before Proceeding

  • 2


    • Lesson 1 Video

    • START: The Case for a New Structured Professional Judgment Scheme

    • Lesson Quiz

  • 3

    START Items

    • Lesson 2 Video

    • START Item Explanations

    • Case Study - Clare

    • Lesson Quiz

  • 4

    START Risk Estimates

    • Lesson 3 Video

    • START Risk Estimates

    • Lesson Quiz

  • 5

    Case Coding - Billy

    • Lesson 4 Video

    • Case Study - Billy

    • START Coding Form

    • START Summary Sheet

    • Submission Directions

    • START - Billy Case Submission

    • Submission Verification

  • 6

    Discussion - Billy

    • Lesson 5 Video

    • Lesson Quiz

  • 7

    Risk Formulation

    • Lesson 6 Video

    • Lesson Quiz

  • 8

    START Review and Reminders

    • Lesson 7 Video

    • Lesson Quiz

  • 9

    Case Study - Mr. L

    • Lesson 8 Video

    • Case Study - Mr. L

    • START Coding Form

    • Start Summary Sheet

    • Submission Directions

    • START - Mr. L Case Submission

    • Submission Verification

  • 10

    Discussion - Mr. L - Part 1

    • Lesson 9 Video

  • 11

    Discussion - Mr. L - Part 2

    • Lesson 10 Video

  • 12

    Integrating START

    • Lesson 11 Video

    • Lesson Quiz

  • 13


    • Lesson 12 Video

  • 14


    • Instructions

    • Evaluation

    • Submission Verification

Develop a Specialty Area of Practice

Transforming mental health professionals into experts

  • Expert Instructors

    Professional training developed and delivered by the field's leading experts

  • CE Credit

    Earn CE credit for meaningful professional training that will elevate your practice

  • Convenience & Flexibility

    Learn at your own pace, from wherever you might be!

Looking to train a group?

Custom training options for groups of 5 to 500+

Contact us to talk about group training rates and how we can make annual training and new staff onboarding simple!