1 Hour / 1 CE

On Demand | Self-Paced Professional Training

This on-demand professional training program on 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 professionals who want to develop or enhance their skills in assessing and managing violence and related risks using the Short-Term Assessment of Risk and Treatability (START). It is suitable for individuals specializing in forensic psychology, correctional mental health, psychiatry, social work, and community-based behavioral health, as well as those working in allied behavioral health roles.

    • Correctional staff
    • Parole officers
    • Probation officers
    • Behavioral health professionals
    • Forensic psychologists
    • Correctional mental health clinicians
    • Psychiatrists
    • Nurses
    • Social workers
    • Allied behavioral health professionals
    • Mental Health Professional

  • Experience Level

    This foundational training is designed for licensed and pre-licensed mental health professionals seeking to develop or strengthen their understanding and application of the Short-Term Assessment of Risk and Treatability (START).

    • Beginner: Participants are new to START or structured professional judgment tools and seek to understand the rationale, components, and evidence base for START, as well as its application across diverse populations and settings.
    • Early Career: Participants have limited experience with risk assessment and are looking to build foundational skills in integrating protective and risk factors, using case-based approaches, and applying START to inform case formulation and management.

  • Practice Setting

    Mental health professionals who use the Short-Term Assessment of Risk and Treatability (START) typically work in environments where there is a need to assess and manage risks related to violence, self-harm, and other behavioral concerns among individuals with mental health and/or criminal justice involvement. These settings are often multidisciplinary and may involve collaboration with legal, medical, and social service systems. The work environment can range from secure facilities to community-based programs, requiring professionals to balance safety, therapeutic engagement, and case management.

    • Correctional facilities (prisons, jails, detention centers)
    • Forensic psychiatric hospitals and units
    • Community mental health centers
    • Probation and parole offices
    • Crisis intervention teams
    • Inpatient and outpatient behavioral health clinics
    • Residential treatment programs
    • Assertive community treatment (ACT) teams
    • Court-based mental health diversion programs

Presented By

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. She also 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. Dr. Desmarais has authored more than 130 peer-reviewed publications in journals including the American Journal of Public Health, Criminal Justice and Behavior, and Law and Human Behavior. She has held grants and contracts from foundations, state, and federal agencies, such as the National Institutes of Health, the National Institute of Justice, the National Science Foundation, and the MacArthur Foundation.

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Sarah L. Desmarais, PhD

Presented By

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.

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Tonia L. Nicholls, PhD

Training Outline

Key topics covered in this training include:


  • The development, design, and format of START

  • The results of existing and ongoing START research

  • A case-based approach to guide assessment and the use of START assessments to improve outcomes

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. 

  1. American Psychological Association (APA): Approved sponsor of continuing education for psychologists.

  2. Association of Social Work Boards (ASWB): Approved continuing education provider (ACE program, Provider #1480), 11/22/2023–11/22/2026.

  3. Canadian Psychological Association (CPA): Approved to sponsor continuing education for psychologists.

  4. National Board for Certified Counselors (NBCC): Approved Continuing Education Provider (ACEP No. 7190).



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) maintains responsibility for this program and its content. 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), SW CPE 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 and 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. Palo Alto University, Continuing and Professional Studies (CONCEPT) has been approved by NBCC as an Approved Continuing Education Provider, ACEP No. 6811. Programs that do not qualify for NBCC credit are clearly identified. CONCEPT Professional Training, #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. CONCEPT Professional Training 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.