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., is a professor of psychology at North Carolina State University. She received her Ph.D. from the Law and Forensic Psychology Program at Simon Fraser University and completed postdoctoral training in population and public health at the University of British Columbia. Dr. Desmarais’ research examines the assessment and treatment of risks and needs associated with criminal behavior, violence, and terrorism. She has more than 120 peer-reviewed publications in journals including the Law and Human Behavior, Criminal Justice and Behavior¸ and American Journal of Public Health. Her research has been funded by grants and contracts from agencies including the Canadian Institutes of Health Research, National Institute of Mental Health, the National Institute on Drug Abuse, National Institute of Justice, and the MacArthur Foundation. Her work has been featured in media outlets such as the Washington Post, Last Week Tonight with John Oliver, and The Atlantic. Dr. Desmarais is a co-author of the Short-Term Assessment of Risk and Treatability (START) and the Short-Term Assessment of Risk and Treatability: Adolescent Version (START:AV), structured professional guides for assessing and managing risks associated with behavioral health problems. She has contributed to the development of related resources including the START Outcome Scale (SOS), the START User Feedback Survey, and the START Instructors’ Guide and Workbook. Dr. Desmarais trains and consults with agencies worldwide on the implementation of START, START:AV, and other strategies to support evidence-based practices and decision-making in behavioral health and criminal justice settings.

Tonia L. Nicholls, PhD

Dr. Tonia L. Nicholls is a Professor, Department of Psychiatry, University of British Columbia, Adjunct Professor, Department of Psychology, Simon Fraser University, and Distinguished Scientist at the Forensic Psychiatric Services Commission, BC Mental Health & Substance Use Services.
  • 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

    Course Evaluation

    • Evaluation

    • Submission Verification

Develop a Specialty Area of Practice

Transforming mental health professionals into experts

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    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!

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