The Spousal Assault Risk Assessment (SARA) is a structured clinical judgment screening tool used by clinicians, mental health providers, and other professionals to evaluate the risk of future violence in persons who are accused or convicted of spousal assault or intimate partner violence (IPV). The SARA was developed by the British Columbia Institute Against Family Violence, the British Columbia Forensic Psychiatric Services Commission, and several other agencies as part of the Project for Protection of Victims of Spousal Assault. After a brief discussion of IPV in today’s society, this article focuses on the uses, completion process, and reliability and validity of the SARA.
IPV
IPV is prevalent in today’s society. According to the U.S. Centers for Disease Control and Prevention’s 2014 Understanding Intimate Partner Violence Fact Sheet, every minute, 24 people are victims of IPV, including more than 12 million men and women each year. IPV is associated with psychological distress, poor cognitive functioning, depression, drug and alcohol abuse, and suicide. The 2010 National Intimate Partner and Sexual Violence Survey reported that approximately one in four women and one in 10 men who have experienced IPV report short-term and long-term symptoms of post-traumatic stress and other emotional difficulties. For these reasons, risk assessment tools, such as the SARA, are in high demand to aid in the management and treatment of the offender and to reduce the likelihood of recidivism.
Completing the SARA
Accurate completion of the SARA requires collecting a large amount of data on the client, including interviewing the defendant/offender, and victim; completing standardized measures of physical and emotional abuse as well as standardized measures of alcohol and drug abuse, reviewing collateral information (e.g., police reports, criminal offense records); and using other psychological assessment procedures (i.e., personality inventories, cognitive testing and clinical interviews with children, relatives, and/or probation officers). Suggested standardized measures are included in the user’s manual.
After completing these procedures and measures, the clinician rates the client on 20 items on a 3-point scale (0 = absent, 1= possible or partially present, 2 = present), which are grouped into four risk areas: criminal history (i.e., history of assault), psychosocial adjustment (i.e., mental disorders, recent stressors), spousal assault history, and elements of alleged/most recent offense (i.e., use of weapon). The overall risk designation is determined by the clinician and not necessarily tied to the sum of the items. Also contained within the SARA is a section titled Other Considerations that allows for the clinician or mental health professional to note important risk factors not incorporated within the SARA. The user’s manual includes the scoring instructions.
Uses of the SARA
The SARA has been used throughout various stages of the criminal justice process. The SARA can be used during the pretrial phase to assist the judge in determining whether the accused should be granted pretrial release. If the accused is seen as a threat to his or her spouse and/or others, the individual may not be granted bail. The SARA can also be used during the presentencing phase when the judge is determining the sentence or discharge.
Correctional personnel can use the SARA to evaluate the individual and develop an appropriate treatment plan. Correctional personnel may set conditions, such as visitation restrictions or temporary absences, based on their findings. When the offender is being discharged, the SARA can help correctional personnel or parole officers determine the discharge conditions and aid in post-release treatment and management. The SARA’s usefulness is not limited to the criminal justice system but may also serve as a tool in civil cases such as custody agreements and divorces.
Reliability and Validity
Although the SARA is not a psychological test, it is important to evaluate its reliability and validity as an assessment tool. Since it is designed to assess risk of future behavior, interrater reliability is a significant issue. Interrater reliability refers to the degree to which two or more individuals agree on the ratings of a certain phenomenon.
In a study conducted in 2000 on two large groups of adult male offenders (N = 2681), P. Randall Kropp and Stephen D. Hart tested the interrater reliability of the SARA. Interrater reliability was high across correctional officers who had extensive experience and background dealing with these cases and doctoral graduate students who based their opinions on the case history information provided. Intraclass correction coefficient for total score and number of factors present were .84 and .83, respectively. Intraclass correction coefficient for summary risk ratings based on low-, moderate-, and high-risk classification by clinicians was .63. The raters agreed in 69 of 86 cases (80%), and no extreme disagreements existed where an accused person received a high-risk rating and a low-risk rating from two different individuals.
The researchers also found that the SARA had moderate concurrent validity with the Psychopathy Checklist–Screening Version (r =.43 for total score and r = .34 for the summary risk rating). Concurrent validity refers to how well the scale correlates with other tests measuring the same or similar construct. In 2004, Kirk R. Williams and Amy Barry Houghton also found statistically significant correlations between the Domestic Violence Screening Instrument and the SARA for both total scores (r = .54) and the summary risk rating (r = .57; n = 434). In 2008, N. Zoe Hilton and colleagues found moderate to large correlations between SARA total scores and a variety of assessments of psychopathy and risk of violence.
The SARA total score has similar predictive validity when compared with several other IPV risk assessments using the receiver operating characteristic area under the curve (AUC). Predictive validity refers to the likelihood of future events. When compared to the Ontario Domestic Assault Risk Assessment (AUC = .666, k = 5), the Danger Assessment (AUC = .618, k = 4), the Domestic Violence Screening Inventory (AUC = .582, k = 3), and the Kingston Screening Instrument for Domestic Violence (AUC = .537, k = 2), the SARA (AUC = .628, k = 6) scored the second highest on the AUC measure for predictive validity.
References:
- Breiding, M. J., Smith, S. G., Basile, K. C., Walters, M. L., Chen, J., & Merrick M. T. (2011). Prevalence and characteristics of sexual violence, stalking, and intimate partner violence victimization—National intimate partner and sexual violence survey, United States. Morbidity and Mortality Weekly Report 2014, 63(SS-8), 1–18.
- Coker, A. L., Davis, K. E., Arias, I., Desai, S., Sanderson, M., Brandt, H. M., & Smith, P. H. (2002). Physical and mental health effects of intimate partner violence for men and women. American Journal of Preventive Medicine, 23(2), 260–268.
- Kropp, R. P., & Hart, S. D. (2000). The Spousal Assault Risk Assessment (SARA) guide: Reliability and validity in adult male offenders. Law and Human Behavior, 24(1), 101–118. doi:10.1023/A:1005430904495
- Kropp, R. P., Hart, S. D., Webster, C. D., & Eaves, D. (1999). Manual for the Spousal Assault Risk Assessment Guide. North Tonawanda, NY: MutliHealth Systems.
- Messing, J. T., & Thaller, J. (2013). The average predictive validity of intimate partner violence risk assessment instruments. Journal of Interpersonal Violence, 28(7), 1537–1558. doi:10.1177/0886260512468250
- Williams, K. R., & Houghton, A. B. (2004). Assessing the risk of domestic violence reoffending: A validation study. Law and Human Behavior, 28, 437–455. doi:10.1023/B:LAHU.0000039334.59297.f0