Use of the HCR-V3 in The Netherlands, Germany, England, and Wales

ijfmhTaylor & Francis has made the recently published Special Issue of the International Journal of Forensic Mental Health available for free download until the end of the year. Check out these great articles on the HCR-20 Version 3.

Introduction to the Special Issue of the HCR-20 Version 3


Kevin S. Douglas


The HCR-20 Version 3 (HCR-20V3) was published in 2013, after several years of development and revision work. It replaces Version 2, published in 1997, on which there have been more than 200 disseminations based on more than 33,000 cases across 25 countries. This article explains (1) why a revision was necessary, (2) the steps we took in the revision process, (3) key changes between Version 2 and Version 3, and (4) an overview of HCR-20V3‘s risk factors and administration steps. Recommendations for evaluating Version 3 are provided.


The Use of the HCR-20V3 in Dutch Forensic Psychiatric Practice


Vivienne de Vogel
Ellen van den Broek
Michiel de Vries Robbé


In this article, the applicability of the recently published HCR-20V3 for violence risk assessment in forensic psychiatric practice is discussed. This revision of the HCR-20 is the result of a multi-year development process based on worldwide empirical research, clinical expertise and consultation. Recently, the HCR-20V3 was implemented in Dutch forensic psychiatric practice by a research team that was also involved in beta-testing and pilot research into the interrater reliability and predictive validity of the first HCR-20V3 Draft version. This paper presents results of this beta-testing and the pilot study, as well as results from a recently conducted survey into the clinical value and applicability of the Dutch HCR-20V3. Overall, the results demonstrate that the HCR-20V3 is a promising revision with sound psychometric properties and improvements compared to the prior version of the HCR-20 for violence risk assessment and management. Furthermore, the first impressions of 192 workshop participants about the HCR-20V3 were positive. To illustrate the applicability of the HCR-20V3 for risk assessment and management in forensic clinical practice, a detailed forensic case study is presented.


The HCR-20V3 in Germany


Sebastian Kötter
Fritjof von Franqué
Manfred Bolzmacher
Sabine Eucker
Barbara Holzinger
Rüdiger Müller-Isberner


This article describes the contributions of the German workgroup to the second revision of the HCR-20 (HCR-20V3). In 2009, a beta-testing of draft 1 of the HCR-20V3 was conducted. The results were considered in the revision process of draft 1. In 2013, an interrater reliability study of the German translation of draft 2 of the HCR-20V3 was conducted. After a two-day workshop five raters (psychologists) without experience in structured professional judgment each rated the same 30 cases. The selected cases covered a range of diagnoses and risk levels. Intraclass Correlation Coefficients (ICCs) and the percentage of agreement were calculated for each item, each sub item, and the Summary Risk Ratings (SRRs). The interrater reliability of the SRRs (ICC = .86) was excellent. For the item-level ratings of the risk factors, the mean ICC for the H scale items and sub-items was .65, which would be “good.” The average item-level ICC of the C scale items (.66) and R scale items (.73) would be categorized similarly. There were some ratings with lower reliability. Possible reasons (lack of variance, or misunderstanding from the training procedure) are discussed.


Predicting Post-Discharge Community Violence in England and Wales Using the HCR-20V3


Michael Doyle
Laura Archer Power
Jeremy Coid
Constantinos Kallis
Simone Ullrich
Jenny Shaw


Structured guidelines are fundamental for risk assessment, formulation and decision-making in medium secure forensic psychiatric services in the UK. The most commonly used guideline for violence risk assessment in the UK is the HCR-20, so it is important that the new version of the HCR-20 (HCR-20V3) is validated in UK samples. The aims of this study were to investigate if the HCR-20V3 has satisfactory interrater reliability and predictive validity for community violence. A prospective confidential inquiry design was used. The HCR-20V3 demonstrated very good inter-rater reliability and significantly predicted community violence at six and twelve months post-discharge, with ROC AUCs of .73 and .70 respectively. Implications for future research and practice are discussed.


Professional Training on the HCR-V3

CONCEPT is pleased to offer online professional training on the development, administration, scoring, interpretation, and clinical implementation of the HCR-V3. The training program takes approximately 20 hours to complete. Professionals are taken through the development of Version 3 and the rationale for revision and update of this instrument. The training program describes why and how the HCR-20 was revised, how Version 3 differs from its predecessors, initial research validation of the HCR-V3, what its risk factors are and how to rate them, how to formulate a case and engage in risk management planning using the HCR-V3. The program includes both didactic and interactive components and allows the opportunity to apply the HCR-V3 to a clinical case.  More information on this professional training program is available here.


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