Samenvatting
In this article we present the results of a study into the interrater reliability of a structured instrument for violence risk assessment. Two independent researchers and two clinicians (treatment supervisors and group leaders) coded the Dutch version of the hcr-20 for sixty patients in a forensic psychiatric hospital. We examined differences between researchers and clinicians in coding the hcr-20, and possible interference of clinicians' feelings towards their patients. The interrater reliability of the hcr-20 was high. Group leaders scored significantly lower on the hcr-20 than researchers did. There were no significant differences between the mean hcr-20 scores of treatment supervisors and researchers. There was, however, a significant difference in the interpretation of the scores: treatment supervisors gave more ‘low risk’ judgments than researchers. Furthermore, feelings of clinicians towards their patients influenced their risk assessments. Feelings of being controlled and manipulated by the patient resulted in higher hcr-20 scores, whereas positive feelings (helpful, happy, relaxed) predicted lower risk ratings.
Samenvatting
Verschillen onderzoekers en behandelaars in hun inschatting van het risico van gewelddadige recidive bij forensisch psychiatrische patiënten? In dit artikel proberen we deze vraag te beantwoorden. De hcr-20, een risicotaxatie-instrument voor gewelddadig gedrag, werd door behandelaars (groepsleiders en hoofden behandeling) en onderzoekers gecodeerd voor zestig patiënten uit de Dr. Henri van der Hoeven Kliniek, forensisch psychiatrisch instituut te Utrecht. Dit prospectieve onderzoek had drie doelen: het in kaart brengen van verschillen tussen behandelaars en onderzoekers in het coderen van de hcr-20; het onderzoeken of gevoelens van behandelaars ten opzichte van hun patiënten invloed hebben op de risicotaxatie; en het vaststellen van de interbeoordelaarsbetrouwbaarheid van de hcr-20. De groepsleiders gaven gemiddeld significant lagere hcr-20-scores dan de onderzoekers. Tussen de hoofden behandeling en de onderzoekers werden geen significante verschillen gevonden in gemiddelde hcr-20-scores, maar wel in de interpretatie hiervan: de hoofden behandeling kwamen vaker tot de conclusie ‘laag risico’ dan de onderzoekers. Als behandelaars het gevoel hadden te worden overheerst of gemanipuleerd door de patiënt, resulteerde dit in hogere hcr-20-scores. Positieve gevoelens (willen helpen, blijdschap, ontspanning) hingen daarentegen samen met lage hcr-20-scores. De interbeoordelaarsbetrouwbaarheid van de hcr-20 was hoog.
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De auteurs bedanken alle behandelaars en onderzoekers die aan dit onderzoek hebben meegewerkt. Een speciaal dankwoord gaat uit naar Cécile Vandeputte-Van de Vijver, die samen met de eerste auteur de trainingen verzorgde en tevens als onderzoeker fungeerde.
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de Vogel, V., de Ruiter, C. Verschillen tussen onderzoekers en behandelaars in het inschatten van het risico van gewelddadig gedrag. DITH 23, 22–31 (2003). https://doi.org/10.1007/BF03060302
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DOI: https://doi.org/10.1007/BF03060302