EBP Simplified

Assess Actuarial Risk/Need

All interventions must begin with an assessment of what is wrong and the most appropriate intervention. What exactly is “actuarial” anyway? Actuarial simply refers to a set of statistics that calculate probabilities of a specific event. The reason probability statistics are emphasized is because human judgment of the risk of future crime is typically quite bad, in part because emotions and other biases get in the way. 

When you think about the risk, need, and responsivity concepts in terms of visiting a medical doctor, it is simple to understand.

Need: The first question the doctor must answer is, “What is the problem?” or “What is creating a problem?”

Need Law #1:  You cannot intervene until you know what is causing a particular condition.

Need Law #2:  Treating symptoms is okay. When time and motivation allows, treating the underlying cause is an admirable goal.

Need Law #3:  You do not treat symptoms or conditions that do not exist.

Risk: The next question the doctor must answer is, “How big of an intervention is required to adequately address the issue?”

Risk Law #1:  The intensity of the intervention should match the severity of the condition. 

Risk Law #2:  Every intervention has some sort of side effects.

Risk Law #3:  If the side effects of the solution are greater than the improvement of the condition, do not use that intervention.

Responsivity: Lastly, the doctor must figure out, “What about this particular patient will interact positively and/or negatively with the various treatment options available?”  

Responsivity Law #1:  There are almost always several options of interventions for a given condition.

Responsivity Law #2:  There is always an interaction between client characteristics (personal and situational) and the intervention.

Responsivity Law #3:  The best intervention is the one that is most likely to be met with cooperation from the client, even it if it is not your first choice.

Assessment Bottom Line: All interventions begin with an assessment and a goal. If you get the assessment or the goal wrong, the interventions will not address the real problem.