Facilitating Shared Decision Making in Forensic Psychiatry: The HKT-R Spider App

Abstract

The Historical Clinical Future-Revised [HKT-R] is a risk assessment tool to support forensic psychiatric professionals in their clinical decisions to prevent future recidivism. A self-report version and App has been developed in co-creation with patients and professionals, the so-called HKT-R Spider App. This App aims to helps patients understand their offense-related risk- and protective factors and become more involved in their treatment. By comparing patient’s self-reports on 14 clinical and seven future-related factors with staff observations, this App aims to facilitate shared decision making. In this study, we examined whether perceptions of risk and protective factors between patients (n = 32) and staff (n = 8) corresponded or differed. Exact agreement was low. Professionals assessed patients significantly higher at risk for eight clinical and four future HKT-R factors. Patients assessed themselves significantly more at risk for psychosis. Score correlations ranged from negative to high-strong. The use of the visual HKT-Spider App is promising as a conversation starter and tool for patients and professionals for shared personalized decision making. It visualizes a treatment trajectory. Patients report that the App is user friendly, informative and useful in the dialogue with their professionals. Further implementation in the forensic field is needed.