Objective: Child welfare agencies have moved toward standardized risk assessment measures to improve the reliability with which child's risk of abuse is predicted. Nevertheless, these tools require a degree of subjective judgment. Research to date has not substantially investigated the influence of specific context and worker characteristics on professional judgment in the use of risk assessment measures. Method: This research utilized standardized patients performing in scenarios to depict typical child welfare cases. Ninety-six workers interviewed two "families," completed risk assessment measures, and then participated in interviews regarding their subjective views of their decision making and performance. Results: There was considerable variability in risk appraisals. Confidence in risk assessment performance was related to age, acute level of stress, and the worker's perceived ability to engage family members. Confidence in risk assessment was further related to case variables. Confidence was not related to level of risk assessed. Conclusion: The variation in risk assessment appraisals in this study, despite at times high rates of worker confidence in their appraisals, speaks to the need for ongoing consultation and increased decision support strategies even among highly skilled and trained workers. (Contains 1 table.)