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Risk assessment
Therapists use various methods to assess individual sex offenders' recidivism risk. Some risk assessment tools consider factors that have been empirically linked by research to sexual recidivism risk. These factors include biological and demographic markers, criminogenic correlates, behavioral and developmental indicators, and clinical markers that have shown to be associated with reoffending on some level. However, the quality of the empirical studies that link various factors to sexual recidivism risk vary widely in terms of methodological rigor. For example, some studies link certain factors to sexual recidivism risk through clinical anecdotal evidence, which is not methodologically rigorous, while other studies have used more rigorous experimental methods.

There are at least four classifications of structured sexual recidivism risk assessment tools: empirical actuarial, mechanical, adjusted actuarial, and structured professional judgement. Of these classifications, empirical actuarial tools are the most methodologically rigorous because they contain explicit empirical risk factors, defined in advance, that are combined mechanically using explicitly defined guidelines into a score or risk category, and then linked to a recidivism probability estimate. Structured professional judgement (SPJ) tools are among the least methodologically rigorous risk assessment tools, because these tools specify items to be considered, but the items may or may not be empirically related to outcome, and ultimately the clinician can consider whichever factors they choose and make a final assessment like “low,” “moderate,” or “high” risk. Clinicians may also use unstructured sexual recidivism risk assessments, where they do not use any structured guidelines to aid in their risk assessment.

Researchers and practitioners consider some factors as "static", such as age, number of prior sex offenses, victim gender, relationship to the victim, and indicators of psychopathy and deviant sexual arousal, and some other factors as "dynamic", such as an offender's compliance with supervision and treatment. By examining both types of factors, a more complete picture of the offender's risk can emerge, compared with static or dynamic factors used alone.

There is no single assessment tool that clinicians must use for assessing sexual recidivism risk, but there are tools that are widely used, such as the Static-99R. The Static-99R is the most popular actuarial scale in the United States. The Static-99R is a 10-item scale for ranking a sex offender’s relative risk of sexual recidivism compared other offenders. This scale is based on demographic and criminal history data, for example, age at release and number of prior sex offenses. Researchers have shown that the Static-99R is valid across a wide range of individuals (in terms of demographics, such as race/ethnicity). However, the Static-99R has only a modest ability to discriminate correctly between sex offenders and non sex offenders. This means that a randomly selected sex offender would be correctly classified as higher risk than a randomly selected non sex offender with "modest" accuracy. In addition, the Static-99R does not account for every factor that makes a sex offender more likely to reoffend. Despite these shortcomings, the Static-99R is arguably the highest quality tool, in terms of methodological rigor, that is available to clinicians to assess sex offender risk of recidivism.