Sexual Violence (RSVP-V2 & SVR-20-V2)

In recent years, several guidelines have been proposed for evaluating the risk of violence. The various risk assessment instruments’ goal has shifted from predicting violence to understanding its causes and preventing its (re)occurrence. Some risk assessment tools fail to predict the risk of reoffending for specific populations with adequate accuracy, perhaps due to the nuances of those variations applied to different populations in different locations at other times. As there is a collection of instruments that are well validated for various groups, selecting an assessment tool should ultimately be driven by the purpose of the evaluation.

Sexual violence is an act, attempt, or threat of bodily harm involving contact or communication of a sexual nature that is intentional and unauthorized.

The definition is complex, and each part can be further explained.

• Act, attempt, or threat: An action, whether complete or incomplete, committed by perpetrators on their own or with others’ knowledge, support, or assistance
• Bodily harm: Actual or potential physical or psychological harm and is more than incidental or fleeting
• Contact or communication: An interaction, either direct or indirect, with or about other people that is taken by any means necessary
• Of a sexual nature: An act, attempt, or threat involving the expression or experience of sexuality
• Intentional: Nonaccidental; harm is intended
• Unauthorized: Without consent, reason, and rationale and is likely to violate the law

Sexual violence risk assessment tools have been created to aid practitioners in addressing and managing the risk posed by perpetrators of sexual violence. Generally, these assessment measures fall into the actuarial approach and the structured professional judgment (SPJ) approach.

• The actuarial approach does not incorporate clinical judgment or discretion. All components of the assessment process are structured.
• Structured professional judgment incorporates structured identification and measurement of evidence-based risk factors and clinical judgment.

The RSVP is a widely used set of structured professional guidelines for assessing and managing sexual violence risk. It involves an assessment of an individual’s propensity for future sexual violence and formulating management strategies to reduce that risk. In 2022, the second version of the RSVP, the RSVP-V2 was published. The latest iteration of the tool includes significant updates, reflecting advances related to research, practice, and the law and incorporating feedback from diverse professionals around the world. 

The RSVP-V2 includes 23 risk factors for sexual violence across two domains:

1. Nature of Sexual Violence (5 factors)
2. Perpetrator Characteristics (18 factors)

The factors that are included for sexual violence risk assessment using the RSVP-V2 are:

• Empirically Valid: They are related to future sexual violence according to the scientific and professional literature
• Practically Useful: They help make decisions about and monitor the institutional and community management of individuals who have engaged in abusive sexual behavior
• Legally Acceptable: They are not discriminatory
• Parsimonious: They are reasonably comprehensive and minimize redundancy

• The prevalence of sexual violence has long been challenging to establish, partly due to the reluctance of victims to disclose their victimization. Reliance on reports to law enforcement to understand gender-based violence results in information loss.
• Self-report research has found that individuals who engage in sexual violence are approximately twice as likely to avoid detection than to be apprehended for the crime.
• Research has found that Annual Security Reports, published by the department of public safety, undercounted incidents of sexual misconduct on college campuses.
• The primary outcome of individuals reporting sexual violence was providing victim services, not perpetrator management and treatment.
• Decades of victimization surveys have identified that rape, sexual assault, domestic violence, dating violence, and stalking—are significant problems among college students.
•  25% of college women experience a sexual assault during their college career
• 32% experience dating violence
• 34% experience attempted or completed unwanted kissing, sexual touching using physical force, the threat of physical force, or verbal coercion

Risk factors on the RSVP-V2 are largely similar to other assessment tools. However, specific attention must be paid to sexual deviation as this is a unique risk factor for sexual violence. Paraphilic behaviors are behaviors that are viewed as outside of the typical range of sexual behaviors, and therefore, sexually deviant. The DSM recognizes eight forms of paraphilias: Exhibitionism, voyeurism, pedophilia, sexual masochism, sexual sadism, transvestic fetishism, fetishism, and frotterurism.

• Paraphilia: A specific mental disorder where the focus of sexual arousal is problematic. It ought to be thought about in particular ways.
  • Paraphilia starts in childhood and is evident by puberty. Then, in the late teens and early 20s, apparent patterns begin to emerge, and after that, most people’s arousal patterns do not undergo dramatic or rapid change.
  • Paraphilias are given specific names, and many paraphilias are not specific.
  • Individuals may have multiple or co-occurring paraphilias, but they are usually related.
  • Paraphilia cannot simply be inferred because of behavior. For example, an individual may be aroused despite the relationship, an age difference, or a non-consensual encounter, not because of it.
    
    • What evaluators have to do is talk to people about their thoughts.
    • What are the thoughts that you have when you think about sex?
    • What do you think about when images of sex pop into your head?
    • When do you have fantasies? What are they?
    • When you have physical urges, what do you do?

• It helps to mitigate bias in judgment. Research has found that when human resource officials, equal employment opportunity officers, and jurors make predictions of subjective sexual harassment, they may overestimate the importance of sexual objectification.
• Risk judgments made using SPJ guidelines appear to have an accuracy equivalent to that of risk judgments made using actuarial tools. Improve clinicians’ ability to predict the chance that an individual will behave violently.
• The laws regulating the process of violence risk assessment have become much more developed. Some statutes explicitly require that specific instruments are administered in a risk assessment. For example, Virginia’s Sexually Violent Predator statute mandates using a specific instrument and specifies the cutoff score that allows further proceeding in the commitment process.

Generally, administration is the same as for the HCR-20, SAM, or the SARA. It involves: 

1. Gather the case information and chunk it in terms of risk factors
2. Think about the presence of risk factors and rate them
3. Think about the relevance and changes in risk factors over time and rate them. “Recent changes” are described as changes within the last year.
4. Develop a formulation of sexual violence perpetration
5. Identify possible scenarios of sexual violence, such as “What are we worried they are going to do?”
6. Develop scenario-based management plans, such as  “What do we think we need to do to prevent it?”
7. Form conclusory opinions, including “How are we going to communicate this?”

• Familiarity with the literature. Rely on books and articles to keep up to date on the fundamental subject matter by reading recent reviews and summaries of the literature.
• Expertise in assessment.
• Ability to develop a logical and compelling argument using the relevant and present risk factors. Research has found improvements in accuracy after training for clinical decision-making, general violence risk assessment, and sexual violence risk assessment.
• No research supports that years of experience make someone better at formulating an argument, meaning that younger clinicians and clinicians new to the field of sexual violence risk assessment have even footing. Literature on expertise does suggest the longer someone has been doing something, the faster and more efficient they get– but this does not improve the quality or the accuracy of the opinion they can provide.

Pros

• The RSVP was the first SPJ tool to incorporate steps for management plans explicitly.
• It is a comprehensive assessment requiring treatment and management consideration to minimize an individual’s risk of (re)offend. Research states that adding additional risk assessment instruments is redundant.
• The assessment is individualized, complex, and dynamic and helps with prevention via planning
• Re-assessments allow for monitoring of change
• Research supports the utility of the tool in practice:
• Interrater reliability – ratings are reliable across raters
• Concurrent validity – ratings correspond with those made with widely used actuarial sexual violence assessments
• Predictive validity – evaluations predict sexual recidivism with accuracy
• It can be used with male and female individuals over the age of 18. Differences between genders can be seen in the scenarios for sexual violence, not in terms of the risk factors.

Cons

• Methodological issues and limitations in sexual offender and sexual violence research include:
• Limited exploring sexual violence with various gender and sexual identifies
• Methodological variability makes it difficult to combine or compare results across studies
• Most research is on version one.

Before the publication of the Risk for Sexual Violence Protocol (RSVP), the SVR-20 was the only SPJ tool used to assess the risk of sexual violence in adults. The SVR-20 has been used in many different research studies around the world. It has been the focus of considerable discussion and debate and subjected to qualitative and quantitative (meta-analytic) review. Despite the interest in the tool, the authors decided it was important to develop a new version of the SVR-20 in light of advances in the field of sexual violence risk assessment. Therefore, the SVR-20, similar to the RSVP, is also on its second version, titled the SVR-20 V2.

Sexual violence risk assessment is complex and the process is continuous. The risk assessment  has multiple phases and stages, many stakeholders, and several goals. Sexual violence risk assessment can be characterized as an endeavour that is complex. It requires coordination of many professionals, over an extended period. While the RSVP-V2 is best for individuals with specialized or advanced expertise, the SVR-20 V2 is sometimes much easier for people to use if they do not have specialized training or are not doing treatment-oriented assessments.

The SVR-20 is not as focused on the formulation as the RSVP-V2. Instead, evaluators broadly identify the risk factors and then develop management plans. So it is a little bit more straightforward than the RSVP-V2.

The SVR-20 V2 has 20 basic risk factors in 3 domains:

1. Psychosocial adjustment
2. Sexual offending
3. Future plans

The SVR–20 V2 structures professional risk judgments. No exact procedure is provided for translating the ratings on the items into an overall evaluation of risk. Instead, evaluators are directed to use their professional judgment to rate the risk as low, moderate, or high. Lastly, scores on the SVR–20 V2 are not linked to expected recidivism rates. However, the risk factors on the tool are empirically associated with the likelihood of recidivism and the the nature, severity, imminence, and frequency or duration of recidivism. 

The SVR-20 V2 allows evaluators to craft appropriate and realistic plans for evaluees, as research has found that having a concrete plan is a key factor in helping individuals desist from reoffending. The SPJ approach is flexible and person centered. Meaning that plans are tailored to the evaluee’s needs and include targets such as a residence, employment, family relationships, and relationships with correctional and health care professionals.

For more information on the RSVP-V2 and SVR-20 V2 check out CONCEPT’s trainings by Dr. Stephen Hart, whose expertise is in the field of clinical-forensic psychology, with a special focus on the assessment of violence risk and psychopathic personality disorder.

Want something more in depth? CONCEPT offers a 40-hour course on the Foundations of Violence Risk Assessment and Management that incorporates the RSVP-V2 amongst other tools, such as the HCR-20, SARA, and SAM.

Interested professionals are also encouraged to check out the Certificate in Violence Risk, a curriculum comprised of 70 hours of foundational training in Violence Risk Assessment and 80 hours of specialty training!