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Occupational therapy risk assessment

Research
in forensic mental health practice:
an exploration
Kevin Cordingley 1 and Susan Ryan 2

Key words: Forensic occupational therapists are one of the members of the multidisciplinary
Forensic mental health, team who participate in the risk assessment process. However, the forensic
risk assessment. occupational therapy risk assessment literature is largely descriptive and
experience based, with little empirical research.
This study investigated forensic occupational therapists ideas about risk
assessment and what risks they assess. A qualitative approach, using three focus
groups of therapists working in different forensic settings, provided the data.
The analysis of the data found that four themes emerged: risk perceptions and
interpretations, fundamental information, risk behaviours and occupations,
and environments.
These themes support a number of aspects of risk assessment in the forensic
occupational therapy literature and could be categorised under the components
of the person, the environment and occupational performance and participation.
There was, however, limited evidence in the literature and in this study about
the risks associated with occupations and about client-centred approaches to
risk assessment. Further research of these aspects, and a comparison between
forensic occupational therapy risk assessment and multidisciplinary risk
assessment, is recommended.

Introduction
There are guidelines for occupational therapy risk management, within which
risk assessment is integrated (College of Occupational Therapists [COT]
1 Brunel University, Uxbridge, Middlesex.
2 The University of Newcastle, New South Wales,
2006). This provides a useful general framework for risk assessment because
Australia.
it includes identifying any hazards and potential risks, the potential for
harm and what might be the consequences (COT 2006). Clinical risk
Corresponding author: Kevin Cordingley, assessments completed by various disciplines in 64 out of 67 forensic
Lecturer in Occupational Therapy, psychiatric units in the United Kingdom indicated no uniformity in the
School of Health Sciences and Social Care, assessments used and inadequately developed tools, potentially causing a
Mary Seacole Building, Brunel University,
lack of continuity in care through the system (Kettles et al 2003). It was
Uxbridge, Middlesex UB8 3PH.
Email: kevin.cordingley@brunel.ac.uk recommended that risk assessment should be standardised, drawing on a
stronger research base for the current tools (Kettles et al 2003). This study
Reference: Cordingley K, Ryan S (2009) was concerned with the specific requirements for occupational therapy
Occupational therapy risk assessment in risk assessment in forensic mental health settings.
forensic mental health practice: an exploration.
British Journal of Occupational Therapy,
72(12), 531-538.

DOI: 10.4276/030802209X12601857794736
Literature review
Defining risk
The College of Occupational Therapists Ltd.
Kettles (2004) used concept analysis to explore and evaluate the meaning
Submitted: 26 April 2007.
of forensic risk, producing a modified version of Woods definition (2001,
Accepted: 26 October 2009.
cited in Kettles 2004, p491):

British Journal of Occupational Therapy December 2009 72(12) 531

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