Gender-Sensitive Violence Risk Assessment. The FAM: An Additional Guideline to the HCR-20V3 for Assessing Risk for Violence in Women

Although women are only a minority in the penitentiary system and in forensic psychiatry, it seems that worldwide in the past two decades female violence is on the rise. The assessment of risk for violence in women differs in several aspects from violence risk assessment in men. Mental health professionals from daily practice recognize these differences and have expressed the wish for more specific guidelines for risk assessment in women. Despite the great advances in risk assessment over the past decades, almost no specific tools have been developed for the assessment of violence risk in female offenders. Most of the commonly used risk assessment tools are developed and validated in mainly male populations and there is limited evidence for the usefulness of these tools in female populations.

The Female Additional Manual (FAM; De Vogel et al., 2011, 2014) is a recently developed additional guideline to the HCR-20 or HCR-20V3 for assessing risk for violence in women. The FAM provides eight specific risk factors for women as well as additional guidelines to two HCR-20 V3 items. The aim of the FAM is to provide mental health professionals clinically relevant and useful guidelines for accurate, gender-sensitive assessment of violence risk, which offers concrete guidelines for risk management in women. Preliminary findings of a prospective study with the FAM in a Dutch forensic psychiatric hospital show good results for the interrater reliability and predictive validity for incidents of violence to others and self-destructive behaviour during treatment.

In the workshop, we will first review the literature on violence by women and violence risk assessment, including both risk and protective factors in women. Subsequently, the development and coding procedure of the FAM isdiscussed, as well as preliminary research results with the FAM. Participants will practice coding the FAM in addition to the HCR-20V3 for a clinical case and the value of the combined use of the HCR-20V3 and FAM for violence risk assessment and management in women will be discussed.

Learning Objectives:

Learn more about specific risk factors and risk assessment in female forensic psychiatric patients

Learn more about the Female Additional Manual (FAM)


Vivienne de Vogel is a psychologist and head of the Department of Research at De Forensische Zorgspecialisten (a Dutch forensic center including the Van der Hoeven Kliniek) in Utrecht, the Netherlands. Since 2001, she has been involved in the implementation and study of the SPJ model in the Netherlands and is considered as one of the leading experts in violence risk assessment in The Netherlands. Her current research focuses on protective factors and violence (risk assessment) in women. She is the first author of two risk assessment tools: the SAPROF (Structured Assessment of Protective Factors for violence risk) for the assessment of protective factors and the FAM (Female Additional Manual), an additional manual to the HCR-20 for violence risk assessment in women. Next to this, she works as a practitioner, particularly with respect to the assessment and management of violence risk in female forensic psychiatric patients.

Anouk Bohle is a psychologist and works as a sociotherapist at the Van der Hoeven Kliniek in Utrecht, the Netherlands.

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