1. Assessment of Risk and Need
Douglas B. Marlowe, J.D., Ph.D.
National Association of Drug Court Professionals

2. Exigent Risk History of violence or dangerousness
Records check
Interview collaterals
GAIN-Q Behavioral Health Scale; TCU Hostility Scale
Substance abuse and psychosis, combat-related PTSD, mania or frontal brain injury
Mental status assessment or psychiatric history
Any substance abuse screen (CAGE, DAST, AUDIT, etc.)
Psychopathy
PCL-R

3. Risk of Dangerousness Tools
COMPAS Violence Scale
Violence Risk Appraisal Guide (VRAG)
Sex Offender Risk Appraisal Guide (SORAG)
Historical-Clinical-Risk 20 (HCR-20)
Classification of Violence Risk (COVR)
Static-99

4. Prognostic Risk
~ Any validated recidivism risk tool

5. Prognostic Risk ~ Any validated recidivism risk tool
Prior criminal history
Current age < 25 years
Delinquent onset < 16 years
Substance abuse onset < 14 years
Prior rehabilitation failures
Antisocial Personality
Criminal values
Familial history of crime or addiction
Criminal associations
Instability (chronic homelessness, unemployment)

6. Recidivism Risk Tools Level of Service Inventory-Revised (LSI-R)
Wisconsin Risk and Need Assessment Scale (WRN)
Risk and Needs Triage (RANT)
Correctional Offender Management Profiling for Alternative Sanctions (COMPAS)
Ohio Risk Assessment System – Community Supervision Tool (ORAS-CST)   
Post Conviction Risk Assessment (PCRA)

7. Criminogenic Needs Substance Dependence or Addiction
Triggered binge response
Cravings or compulsions
Withdrawal symptoms

8. } DSM-5 Criteria Substance Use Disorder- 2 in 12 months Must be causal
Often taken in larger amounts than anticipated
Persistent desire or unsuccessful efforts to quit
Great deal of time obtaining or using the substance
Cravings
Failure to fulfill major role obligations
Persistent social or interpersonal problems
Important activities given up
Recurrent use in physically hazardous situations
Persistent physical or psychological problems
Tolerance
Withdrawal }
Must be causal
Mild = 2 to 3
Moderate = 4 to 5
Severe ≥ 6

9. } DSM-5 Criteria Substance Use Disorder- 2 in 12 months
Often taken in larger amounts than anticipated (i.e. binges)
Persistent desire or unsuccessful efforts to quit
Great deal of time obtaining or using the substance
Cravings
Failure to fulfill major role obligations
Persistent social or interpersonal problems
Important activities given up
Recurrent use in physically hazardous situations
Persistent physical or psychological problems
Tolerance
Withdrawal }
Must be causal
Mild = 2 to 3
Moderate = 4 to 5
Severe ≥ 6

10. } DSM-5 Criteria Substance Use Disorder- 2 in 12 months
Often taken in larger amounts than anticipated (i.e. binges)
Persistent desire or unsuccessful efforts to quit
Great deal of time obtaining or using the substance
Cravings
Failure to fulfill major role obligations
Persistent social or interpersonal problems
Important activities given up
Recurrent use in physically hazardous situations
Persistent physical or psychological problems
Tolerance
Withdrawal }
Must be causal
Mild = 2 to 3
Moderate = 4 to 5
Severe ≥ 6

11. } DSM-5 Criteria Substance Use Disorder- 2 in 12 months
Often taken in larger amounts than anticipated (i.e. binges)
Persistent desire or unsuccessful efforts to quit
Great deal of time obtaining or using the substance
Cravings
Failure to fulfill major role obligations
Persistent social or interpersonal problems
Important activities given up
Recurrent use in physically hazardous situations
Persistent physical or psychological problems
Tolerance
Withdrawal }
Must be causal
Mild = 2 to 3
Moderate = 4 to 5
Severe ≥ 6

12. } DSM-5 Criteria Substance Use Disorder- 2 in 12 months
Often taken in larger amounts than anticipated (i.e. binges)
Persistent desire or unsuccessful efforts to quit
Great deal of time obtaining or using the substance
Cravings
Failure to fulfill major role obligations
Persistent social or interpersonal problems
Important activities given up
Recurrent use in physically hazardous situations
Persistent physical or psychological problems
Tolerance
Withdrawal }
Must be causal
Mild = 2 to 3
Moderate = 4 to 5
Severe ≥ 6

13. Criminogenic Need Tools
Substance Dependence &Abuse Diagnostic Tools
Global Appraisal of Individual Needs (GAIN)
Structured Clinical Interview for the DSM-IV (SCID)
Psychiatric Research Interview for Substance and Mental Disorders (PRISM)
Diagnostic Interview Schedule (DIS)
Texas Christian University (TCU) Drug Dependence Screen-II
Drug Abuse Screening Test (DAST-20)

14. Criminogenic Need Tools (cont.)
Mental Illness
Brief Jail Mental Health Screen (BJMHS)
GAIN-Q, GAIN-SS, ASI Psychiatric, etc.
Severe Functional Impairment
Low IQ, disinhibition
Lack of employable skills
Poor daily living skills (ADLs)

15. LSI-R Third Generation (3G) tool Meta-analyses: mean r = .36
compared to .27 for 2G tools, and .10 for 1G judgments
Kelly & Welsh (2008):
N= 276 male drug offenders released from special prison
Return to custody within approximately 15 months
Total Score predicted return to custody: r = .25; r2 = .08.
Drug & Alcohol Score also predicted return to custody: r = .16; r2 = .04

16. LSI-R (cont.) Lowenkamp & Latessa (2002): Holsinger et al (2006):
Predictive validity highly variable across different programs and populations
Holsinger et al (2006):
Not predictive for Native Americans
Whiteacre (2006):
Higher false positives and false negatives for African-Americans

17. LSI-R (cont.) Fass et al. (2008):
Total Score significantly predicted rearrest within 1 year
AUC = .60; r2 = .03
Higher false positives for African-Americans

18. COMPAS Fourth Generation (4G) tool Fass et al. (2008):
276 males released from halfway houses in NJ
Not significantly predictive of re-arrest within 1 year
AUC = .53
Significantly higher false positives and false negatives for African-Americans

19. COMPAS (cont.) Brennan et al. (2009) Northpointe (test developers)
2,328 probationers, both male and female
Rearrests within ~ 1 to 5 years
All but three scales predicted felony recidivism (AUC = .70 in combination)
Recidivism Risk Index predicted felony recidivism (AUC = .70)
Equivalent prediction by gender, race and ethnicity