Home » Articles » LukeNotes » Risk Assessment & Safety Plans: Case Study
LukeNotes
Download PDF version of this article

Risk Assessment & Safety Plans: Case Study

LukeNotes, Fall 2015

Father Henry, a provincial for his community, called Saint Luke Institute recently. Ten years earlier, Father George had come to Saint Luke following an allegation that he had touched a 15-year-old girl inappropriately. The clinical assessment indicated that Fr. George had mild depression and seemed to have narcissistic traits that may have contributed to the alleged misconduct and to difficulties in community life. He completed residential treatment and was discharged with a continuing care plan that included recommendations regarding outpatient treatment, ministry (none) and functioning in the residence. He participated in his Continuing Care workshops.

“I Need Advice!”

Fr. Henry said he was not calling about further assessment or treatment, but advice. Fr. George was having difficulty accepting that he could not engage in ministry. He was becoming more edgy, and members of the community were beginning to avoid him. Now Fr. George had made an official request to move to another house in a different city. This house was next to the Order’s high school. The Order considered Fr. George’s past allegation credible and Fr. Henry and the priest-administrator of the school had concerns. Fr. Henry was seeking to understand the risks of a move.

Risk Assessment

The clinical director recommended a risk assessment:

  • Actuarially based indictors of the level of risk to reoffend are more accurate than clinical judgment alone.
  • Recommendations regarding placement and other factors for a safety plan would be provided.
  • The information could better focus his current treatment program.
  • There would be an opportunity for discussion between the two priests and the psychologist.

The clinical director added that a risk assessment provides very helpful information, but is not a guarantee of behavior. The Order needs to decide the amount of risk it is willing to assume. They agreed the risk assessment would be performed at the provincial office, where official documents are kept and near Fr. George’s residence. The psychologist would review the relevant files, administer objective instruments that measure risk and interview Fr. George and Fr. Henry. Conclusions would be presented on the second day.

File Review

After obtaining Fr. George’s release to review his file, Dr. Jones reviewed the personnel documents, and those referring to known offenses and legal consequences, previous assessment and therapy, the current safety plan and compliance reports from supervisors.

There were no indications of legal issues distinct from the original allegation. The files included residential treatment and continuing care summaries, but no treatment documentation for the previous five years. (Dr. Jones discovered that Fr. George had declined to sign an information release for his therapist. Billing information revealed that he had not seen a therapist in six months.)

Finally, Father’s safety plan had been written by the Review Board two years previously, but there were no compliance reports. He was listed as “moderate” risk, but it was not clear how the Board reached this conclusion.

Interviews

A provincial council member at the time of the original incident, Fr. Henry was aware of the situation. As provincial, he had reviewed the personnel file and conducted annual visitations. He found Fr. George to be frustrated; he would cooperate begrudgingly and was not interested in speaking about his situation.

He was surprised that Fr. George had discontinued therapy. He had never insisted on a Release of Information since Fr. George was not returning to ministry. He also had thought it might be easier for Fr. George to engage in therapy if he felt freer to be open.

He was not aware that compliance reports were part of the safety plan and said that Fr. George’s supervisor sees his role primarily as one of support. He had no specific concerns about Fr. George and boundaries. Fr. George did not strike him as someone who would reoffend, though he did have concerns about the proposed move.

Dr. Jones then met with Fr. George for several hours. He was experiencing a great deal of loneliness and some depressive symptoms more recently. He felt somewhat alienated from some community members, his family had been visiting him less and one of his sisters had died. He candidly discussed the original incident, though minimizing his responsibility.

He thought that a move would solve his boredom and frustration. He felt that the province was not supporting him and was surprised that no one challenged him when he stopped therapy.

He could articulate some of the relapse prevention principles he had learned in therapy and acknowledge some of his problematic personality tendencies. However, he seemed to overestimate his progress in regard to treatment issues.

Objective Tests

Two tests were administered. The Static-99R is based on actuarial tables of static factors that predict the risk of reoffending, such as age, sexual partner history, number of admitted allegations, gender of and relationship to victims, etc. Fr. George scored a 2 (low/moderate). The Stable-2007 measures risk factors that can change, but endure for several months up to a couple of years, such as coping skills, social integration and capacity for empathy. Fr. George scored a 5, moderate risk to reoffend.

Feedback Session

Dr. Jones summarized his findings and explained the test scores. Low-to-moderate risk meant that living near a high school would entail some risk, especially given the age of the alleged victim.

Dr. Jones offered ways to reduce risk at the current residence or a new setting that could be part of a safety plan:

  1. Fr. George engages in weekly therapy; basic progress is documented through attendance reports and inquiries during semi-annual visits with his provincial.
  2. The supervisor writes compliance reports every six months and attends an annual workshop and/or receives training in this ministry.
  3. When leaving his residence, Fr. George is accompanied by a person familiar with his history, who is willing to take responsibility for making sure he is prudent with any interpersonal interactions.
  4. If living on a school campus, he is accompanied in any areas to which students have access.
  5. A vacation protocol allows Fr. George to visit his family for two weeks annually while ensuring he is safe from potentially increased risk.
  6. The safety plan is reviewed annually.

Finally, Dr. Jones suggested that Fr. George re-engage in therapy with several goals: discussing his depression; speaking about his struggles with relationships, feeling empathy and identifying with peers; and gaining problem-solving and communication skills for community life. A Continuing Care workshop or other activity within a safe environment may help him feel that he could engage again in a program of growth with hope.

Final Reflections

Fr. George found he liked having different ways of working on issues and was willing to stay at his present residence. The assessment also triggered more interest to engage in therapy. Fr. Henry noted he also seemed more relaxed and more like a brother of the community.

Father David Songy is a psychologist and president of Saint Luke Institute.