Risk-Sophistication-Treatment Inventory (RSTI)

The Risk-Sophistication-Treatment Inventory (RSTI) is a semistructured interview and rating scale that is designed to help clinicians assess Risk for Dangerousness, Sophistication-Maturity, and Treatment Amenability as well as treatment needs. The RSTI demonstrates reliability and validity and can assist mental health professionals with the assessment and development of treatment plans for juveniles in forensic settings.

RSTI Description

Each of the three scales (Risk for Dangerousness, Sophistication-Maturity, and Treatment Amenability) of the RSTI contains 15 items that represent both static and dynamic factors. Additionally, each scale of the RSTI consists of three clusters, thus providing psychological information on nine subconcepts. Specifically, the Risk for Dangerousness Scale consists of Violent and Aggressive Tendencies, Planned and Extensive Criminality, and Psychopathic Features clusters. The Maturity Scale is composed of Autonomy, Cognitive Capacities, and Emotional Maturity clusters and allows for the assessment of whether youths are using their maturity prosocially or antisocially. The Treatment Amenability Scale consists of the Psychopathology— Degree and Type, Responsibility and Motivation to Change, and Consideration and Tolerance of Others clusters. These clusters are dynamic, although some types of psychopathology might be more difficult to treat than others.

The RSTI materials include the Professional Manual, the Semi-Structured Interview Booklet, and the Rating Form and are available from Psychological Assessment Resources. The professional manual describes the reliability and validity of the instrument and includes case studies that provide examples of appropriate scoring and interpretation of the results. The interview booklet provides guidance for obtaining background, clinical, and historical information and a sample of the juvenile’s behavioral and psychological functioning. Optional probes are provided throughout the interview to garner further information if needed. The rating form enables the clinician to score the items by reviewing and synthesizing information from collateral sources. Each item is rated on a 3-point scale reflecting the extent to which the individual demonstrates the specific characteristic (0 = absence of the characteristic/ability, 1 = subclinical/ moderate, 2 = presence of the characteristic/ability).

RSTI Development

The RSTI was developed according to conventional scale construction procedures and involved three primary steps. First, item generation entailed an extensive search for items in case law and psychological literature. Descriptions of juveniles and their families were drawn from relevant statutes pertaining to transfer criteria, appellate cases (both successful and unsuccessful), and research (both psychological studies and law reviews) related to the primary constructs and transfer decisions.

The second step involved two separate prototypical analyses. Clinical child and adolescent psychologists were asked to rate the items they considered to be central to Dangerousness, Sophistication-Maturity, and Treatment Amenability. Forensic diplomates were asked to provide ratings of juveniles they had evaluated who had subsequently been transferred to adult criminal courts. Next, National Council of Juvenile and Family Court judges were asked to rate core characteristics for the three loosely defined concepts. Prototypical items for each of the constructs aligned across the raters, indicating that there was general agreement regarding the central components of Risk for Dangerousness, Sophistication-Maturity, and Treatment Amenability.

Structure of the RSTI

Exploratory and confirmatory factor analytic (CFA) procedures were used to examine the structure of the prototypical ratings. CFA results formed the basis for the development of the RSTI scales. Assignment of items to scales relied heavily on consideration of prototypical ratings and factor structures. Items with low prototypical ratings were not included on scales, even though they might have loaded on a factor. For example, reckless and hyperactive characteristics were loaded on the dangerousness factor but were excluded because they received low prototypical ratings and produced inadequate model-fit indices in the CFA.

Internal Consistency and Reliability

Alpha coefficients for the three RSTI factors range from .78 to .83. Intraclass correlations for the RSTI scales range from .74 to .94, indicating good interrater reliability across types of raters and scoring methods. Comparing interview-based RSTI ratings between clinicians and trained graduate student raters resulted in slightly higher reliability, ranging from .81 to .94, indicating that interviews may increase the reliability of ratings.

RSTI Validity

Several studies have reported evidence for the RSTI’s concurrent validity using other measures of psychological constructs to which the RSTI constructs should be related. The RSTI Risk for Dangerousness Scale correlated positively with Conduct Disorder, Violent Conduct Disorder, Psychopathic Traits, and both Reactive and Total Aggression. The Treatment Amenability Scale was associated with older ages of onset of conduct disorder and negatively associated with conduct disorder symptoms.

Criterion validity of the Treatment Amenability Scale was examined by testing the association between file-based RSTI ratings and later treatment compliance and other criteria among male juveniles at a juvenile treatment center. The scale was associated with positive interactions with staff and maintenance of appropriate boundaries, both of which are important to the therapeutic relationship. The Dangerousness Scale was negatively associated with maintenance of appropriate boundaries, and the Maturity Scale was associated with excellent classroom behavior. Criterion validity was assessed in two studies of retrospective outcomes among youths facing transfer to adult court. Relative to youths not transferred to adult court, transferred youths received, on average, significantly higher dangerousness and maturity scores and lower treatment scores.

RSTI Application

The RSTI manual is available from Psychological Assessment Resources. The RSTI is copyrighted and can be purchased as a kit, which includes a manual, 25 structured interview booklets, and 25 rating scales. Mental health professionals with experience in juvenile justice settings can administer the RSTI. The RSTI can be administered in court evaluation units, detention centers, and by consulting clinicians in outpatient settings. The RSTI can be used in evaluations related to recommendations for general disposition decisions, commitment and transfer to adult court and reverse transfer hearings, treatment recommendations, and most important, development of individualized treatment plans.

References:

  1. Leistico, A. R., & Salekin, R. T. (2003). Testing the reliability and validity of the Risk, Sophistication-Maturity, and Treatment Amenability-Inventory (RST-I): An assessment tool for juvenile offenders. International Journal of Forensic Mental Health, 2, 101-117.
  2. Salekin, R. T. (2002). Psychopathy and therapeutic pessimism: Clinical lore or clinical reality.Clinical Psychology Review, 22, 79-122.
  3. Salekin, R. T. (2004). Risk-Sophistication- Treatment-Inventory (RST—i): Professional manual. Lutz, FL: Psychological Assessment Resources.
  4. Salekin, R. T., & Grimes, R. (2008). Clinical evaluations of juvenile offenders facing transfer to adult court. In R. Jackson (Ed.), Learning forensic assessments. New York: Routledge.

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