An integrated case formulation approach in forensic practice: the contribution of Occupational Therapy to risk assessment and formulation

Forensic services focus on risk reduction and extol the value of multidisciplinary working. Due to the complex relationship of personality disorder and risk, a multidisciplinary approach to risk assessment, formulation, management and reduction is essential. Occupational Therapists provide a unique perspective; however, current literature pertaining to the contribution of Occupational Therapy is negligible. This paper aims to initiate discussion of the value of Occupational Therapy contributions to risk assessment and formulation with personality disordered offenders. A new approach is described that integrates occupational adaptation and multiple sequential functional analysis to provide a structured framework for Occupational Therapy risk assessment and formulation. A single case report is presented to demonstrate the advantages of the approach for identifying offenders’ strengths and difficulties, predicting risk of reoffending, identifying offence paralleling behaviour and informing and evaluating efficacy of intervention, thereby supporting the aims of forensic practice settings to assess, manage, treat and reduce risk.