The CARE 2 is now available.
It is a tool to assess the approximate risk of future violence that a young person poses. It provides intervention strategies to reduce risk of future violence. It is a major revision of the original CARE.
Dr. Kathy Seifert
Dr. Kathy Seifert
The CARE 2 is available at http://drkathyseifert.com/book.html.
YOUTH VIOLENCE:AN OVERVIEW OF RISK AND PROTECTIVE FACTORSAssessing risk and protective factors associated with different personal and psychological environments has proven to be a useful way for clinicians to gain insights into the personal functioning of individuals. Within this model, the level of personal functioning is seen as a weighted balance between risk and protective factors.
In cases where an individual is exposed to or experiences a preponderance of risk factors rather than protective factors, the scales tip away from positive personal unctioning. In cases where an individual is exposed to or experiences a preponderance of protective factors, personal functioning is enhanced. Understanding the risk and protective factors associated with particular behaviors provides a quick index of the stressors and supports that exist for an individual and can allow clinicians to make judgments regarding future functioning.
CARE 2 is based on this type of model. Specifically, it uses research on the risk and protective factorsassociated with youth violence to provide insights into the functioning of youth at risk for violentbehavior. It was developed as a prevention tool, so that youth who are at risk could be identified asearly as possible. In this way, appropriate interventions could be started early in a child’s life. This approach is consistent with studies that have demonstrated that earlier interventions have a higher probability of success (Olds, Henderson, hamberlin, & Tatelbaum, 1986; Thornton, Craft, Dahlberg, Lynch, & Baer, 2000). In addition to its demonstrated ability to identify youth at risk for violent behavior, the CARE 2 assessment form includes information that can be used as a case management planning tool. It assists the clinician in developing treatment plans to meet youth needs (Seifert, Phillips, & Parker, 2002).Because youth at risk for violent behavior often have an array of problems, CARE 2 is designed to provide the clinician with data that give a broader view of such youth and to allow the clinician to plan a more complete intervention. The scores derived from CARE 2 help the clinician to gauge the intensity of the potential behavior problems and to identify appropriate treatment modalities.
Juveniles accounted for 12% of all violent crime arrests in 1997. Boys under the age of 15 accountedfor the largest increase (30%) in juvenile arrests for violent crimes in 1995 (Butts & Snyder, 1997). Problem behaviors often began before the age of 13. Some juveniles committed serious violent acts as early as age 10 (Browning, Huizinga, Loeber, & Thornberry, 1999). Based on this data, the CARE 2 sample included youth of all ages. Additionally, girls appear to be involved in substantially more violent crime than they were a decade ago. Arrests of girls for violent crimes are up 64% to 137%, depending on the offense reviewed (Weiler, 1999). Therefore, despite the fact that females commit fewer violent offenses than males, there is a substantial population of violent girls with aggressive behaviors. Consequently both males and females were included in the CARE 2 sample. There are 4 separate age and gender norms for the CARE 2.
Violence is a problem that transverses settings, including outpatient, inpatient, and prisons. Arboleda-Flórez, Holley, and Crisanti (1996) found a significant relationship between mental illness, substance abuse, and violence. It is not thought that either one has a causal relationship to the other, but that they can be co-occurring disorders. For that reason, the sample includes those with identified mental illness, both inpatient and outpatient.
Clinical judgment alone has not been found to be effective in predicting violence. Actuarial tools based on statistical analyses and guided interview instruments established on literature reviews have been found to be more effective than clinical judgment (Quinsey, Harris, Rice, & Cormier, 1998). The existing tools and many studies have identified risk factors, such as past violent acts, and resiliency factors, such as a supportive adult and school success, that are associated with violence (Christle, Jolivette, & Nelson, 2000). CARE 2 was developed using the various factors that have been identified in
the literature and statistical analyses. It is not merely an interview guide, but a reliable and valid
measurement tool that provides additional data to the clinician charged with making an important