The Short-Term Assessment of Risk and Treatability: Adolescent Version (START:AV) structures and guides an individualized assessment of vulnerabilities that contribute to adverse outcomes and the strengths that help protect against them.
Intended for use with male and female adolescents (aged 12 to 18) in mental health and justice settings, the START:AV facilitates a review of an adolescent‰?s histories and short-term risk for multiple adverse outcomes including harm to others and rule violations (violence, non-violent offences, substance abuse, unauthorized absences) and harm to the adolescent (suicide, non-suicidal self-injury, victimization, health neglect).
START:AV assessments can be used to guide evidence-based intervention-planning, facilitate communication among professionals involved in the adolescent‰?s care, and provide a framework and common language in developing and monitoring risk and intervention plans.
The START:AV has several key features:
1. Multiple Adverse Outcomes: Rather than focusing on a single outcome (e.g., violence, suicide), the
START:AV recognizes that adverse outcomes tend to be interrelated. As such, to obtain a full
understanding of an adolescent’s needs, it facilitates the integrative assessment of adverse outcomes
that pertain to:
• Harm to others and rule violations (violence, non-violent offenses, substance abuse, unauthorized
absences such as running away and school drop-out); and
• Harm to the adolescent (suicide, non-suicidal self-injury, victimization, health neglect).
In other words, the START:AV focuses not only on behaviors that negatively impact society and other
people, but also on the adolescent’s own safety and well-being.
2. Strengths and Vulnerabilities: Whereas many assessment measures place a strong emphasis on
risk factors, the START:AV aims to provide a balanced assessment by guiding assessors to
simultaneously consider items separately for both strength and vulnerability. In assessment, the goal
is always to elucidate both sides of the coin with a view to marshalling resources.
3. Empirically-Informed/Evidence-Based: The START:AV was adapted for adolescents from a wellestablished
adult measure, the Short-Term Assessment of Risk and Treatability (START, Webster,
Martin, Brink, Nicholls, & Desmarais, 2009). To develop the START:AV, we conducted a series of
systematic reviews, and conducted studies in controlled and real-world implementation contexts. This
research provided support for the reliability, validity, and utility of START:AV (Desmarais et al., 2012;
Singh et al., 2013; Viljoen et al., 2012).
4. Focus on Intervention-Planning: Although the START:AV can be used for risk assessment
purposes alone (e.g., estimating violence risk), its ultimate aim is to guide interventions and treatment
through formulation. To achieve this, the START:AV guides consideration of strengths and
vulnerabilities that are modifiable and relevant to intervention planning. Further, the START:AV is
designed to be sensitive to changes in an adolescent’s functioning so that START:AV assessments
can guide ongoing adjustment to intervention plans and help evaluate treatment outcomes.