10 Hours | 10 CEs

This self-paced training program on Short-Term Assessment of Risk and Treatability (START) is presented by Sarah Desmarais, PhD, and Tonia Nicholls, PhD.

It provides training in the Short-Term Assessment of Risk and Treatability, a 20-item clinical guide for the dynamic assessment of seven risk domains. START represents a refinement in the assessment of risk in that it provides for the differential coding of both patient strengths and vulnerabilities while allowing for the recording of case-specific factors. START guides clinicians toward an integrated, balanced opinion to evaluate the client’s risk across multiple domains and to guide treatment and management decisions. Clinicians are routinely required to make decisions and provide recommendations regarding the admission, discharge, and management of persons who may pose a risk of violence to self or others. This remains a challenging task, with divergent approaches and measures available to assist with these decisions. Traditional approaches have focused largely on individual risk factors while neglecting to consider patients’ strengths or external/environmental triggers, and have been concerned mainly with long-term risk to others.

The program reviews the literature that bears on the development of START and supports its utility as a clinical evaluation and planning guide and as a research tool. Additionally, it briefly describes the development, design, format, and implementation of START, and provide results from existing and ongoing research. It focuses on how START can inform decision-making regarding internalized and externalized aggression, as well as other risks relevant to maintaining staff and client safety.

  • Understand the role of static and dynamic strength / risk factors in risk assessment and risk management.
    Become increasingly familiar with the role of strengths and vulnerabilities in client management and safety planning
  • Learn how to administer, interpret, and implement START assessments.

Learning Objectives

Upon completion of this course you will be able to:

  • Describe the role of static and dynamic strength in risk assessment

  • Describe risk factors in risk assessment and risk management

  • Describe the of strengths in client management and safety planning

  • Describe the vulnerabilities in client management and safety planning

  • Demonstrate how to administer START Assessments

  • Demonstrate how to interpret START Assessments

  • Demonstrate how to implement START assessments

  • Describe the empirical and theoretical rationale for assessing multiple and overlapping adverse outcomes (e.g., violence to others, suicide, self-harm, self-neglect, substance abuse)

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.

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.

Collect Badges, Earn Certificates

This is a badge-earning course, which means it will help you earn a certificate that can be showcased on digital platforms like LinkedIn.

VIEW CERTIFICATES

  • 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.

Course Preview

Curriculum

  • 1

    Welcome

    • Review Before Proceeding
  • 2

    Course Materials

    • START Item Explanations

    • START Risk Estimate Definitions

    • Case Study - Mr. V

    • Coding Notes - Mr. V

    • Summary Sheet - Mr. V

    • Summary Sheet - Blank

    • Coding Notes - Blank

  • 3

    An Introduction and Summary of Research Evidence

    • Lesson 1 Video

    • de Ruiter & Nicholls (2011)

    • Lesson Quiz

  • 4

    Applying the START

    • Lesson 2 Video

    • Nicholls et al. (2008)

    • Webster et al., (2006)

    • Lesson Quiz

  • 5

    Current Status of the START

    • Lesson 3 Video
  • 6

    Scoring Strengths and Vulnerabilities

    • Lesson 4 Video

    • START Manual

    • Lesson Quiz

  • 7

    START Items 1 - 5

    • Lesson 5 Video

    • Lesson Quiz

  • 8

    START Items 6 - 10

    • Lesson 6 Video

    • Lesson Quiz

  • 9

    START Items 11 - 17

    • Lesson 7 Video

    • Lesson Quiz

  • 10

    START Items 18 - 21

    • Lesson 8 Video

    • Lesson Quiz
  • 11

    Specific Risk Assessments: The Seven START Risk Domains

    • Lesson 9 Video

    • Lesson Quiz
  • 12

    Evaluation

    • Instructions

    • Evaluation

    • Submission Verification

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  • Convenience & Flexibility

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

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