What plans do you have for this summer? We hope you plan to come to the Summer Training Institute for in person workshops at John Jay College this June! The instructors are internationally recognized experts, prolific authors, and engaging presenters. Below are highlights of two of the programs offered during Summer Institute on Juvenile Competency and Forensic Evaluation Report Writing. For more information on all of the workshops offered and social events during the week visit, Summer Training Institute. We hope to see you there!
2-Day Best Practices in the Evaluation of Juvenile Competence
Young offenders with Fetal Alcohol Spectrum Disorder (FASD) demonstrate more impairment of psycholegal abilities than young offenders without prenatal alcohol exposure. This is the bottom line of a recently published article in Law and Human Behavior. Below is a summary of the research and findings as well as a translation of this research into practice.
Featured Article | Law and Human Behavior | 2014, Vol. 38, No. 1, 10-22
Evaluating the Psycholegal Abilities of Young Offenders With Fetal Alcohol Spectrum Disorder
Kaitlyn McLachlan, University of Alberta Ronald Roesch, Simon Fraser University Jodi L. Viljoen, Simon Fraser University Kevin S. Douglas, Simon Fraser University
Individuals with a diagnosis of fetal alcohol spectrum disorder (FASD) experience a range of physical, cognitive, and behavioral deficits thought to interfere with their ability to competently navigate the arrest, interrogation, and trial process. This study examined the psycholegal abilities of young offenders with FASD, including their understanding and appreciation of Miranda rights, and adjudication capacities (factual knowledge of criminal procedure, appreciation of the nature and object of the proceedings, ability to participate in a defense and communicate with counsel). Two groups of young offenders (50 with FASD and 50 without prenatal alcohol exposure) completed Grisso’s Instruments for Assessing Understanding and Appreciation of Miranda rights and the Fitness Interview Test—Revised to assess overall rates of impairment in youth with FASD, as well as differences between the groups. Potentially important predictors of psycholegal abilities were also evaluated. Results indicated the majority of young offenders with FASD (90%) showed impairment in at least one psycholegal ability, and rates of impairment were significantly higher than the comparison group. However, considerable within-group variability was observed. IQ and reading comprehension emerged as robust predictors of participants’ psycholegal abilities, while the FASD diagnosis differentiated participants’ scores on the FIT-R. These findings underscore the importance of individualized and comprehensive forensic assessments of psycholegal abilities in this population when warranted. Additional system level strains for this population are discussed, including problems in approaching competency remediation, and the potentially growing need for accommodation and forensic assessments in the face of limited financial and professional resources in legal settings.
Two groups of young offenders—50 offenders with FASD and 50 offenders with no history of prenatal alcohol exposure—were compared with respect to their scores on two measures of psycholegal abilities: Grisso’s Instruments for Assessing Understanding and Appreciation of Miranda Rights and the Fitness Interview Test – Revised. In addition, predictors of psycholegal abilities, such as IQ and reading ability, were also examined in these two groups.
After being recruited and providing informed consent to participate, participants were administered a battery of measures, including a semi-structured interview asking about demographic information and previous legal experiences, clinical forensic assessment measures (Grisso’s Miranda Instruments; Fitness Interview Test – Revised; Canadian Rights Comprehension Supplement; Rights Comprehension Confidence), and intellectual and academic testing (WASI; WRAT-4). Scores on the various measures for the offenders with FASD were compared to those obtained by the offenders without prenatal alcohol exposure.
Comprehension of Rights
Results indicated that the offenders with FASD had considerable difficulty with comprehension of rights as measured by Grisso’s Instruments for Assessing Understanding and Appreciation of Miranda Rights and the Canadian Rights Comprehension Supplement. More than half (60%) of the offenders with FASD demonstrated impaired performance on the Comprehension of Miranda Rights (defined as earning a “zero” on one or more of the four warnings). Approximately one-third (34%) demonstrated impaired understanding of at least one warning prong on the comparatively easier Comprehension of Miranda Rights-Recognition (CMR-R) instrument. Finally, near three-quarters (72%) demonstrated impaired performance on the Comprehension of Miranda Vocabulary (CMV) instrument.
“Participants with FASD earned significantly lower scores across [Grisso’s] four instruments, relative to the comparison group, indicating that offenders with FASD had substantial difficulty both understanding and appreciating their rights” (p. 15).
“In spite of substantially more impaired performance across Grisso’s four instruments, participants with FASD provided similar mean ratings of both understanding and confidence about waiver decisions relative to the comparison group” (p. 16). While there was a relationship between higher scores on Grisso’s instruments and confidence in the group of offenders without prenatal alcohol exposure, this “relationship did not hold up in the FASD group, suggesting their confidence judgments did not as accurately reflect actual understanding and appreciation of their rights” (p. 16).
With respect to predictors of comprehension, as a general finding “young offenders with weaker intellectual and reading abilities, regardless of diagnostic group [FASD v. no prenatal alcohol exposure], experience significantly more difficulty understanding and appreciating their arrest rights compared with participants with stronger skills in these areas” (p. 17).
Fitness to Stand Trial
Results indicated that participants in the FASD group demonstrated considerable difficulty across the three sections of the FIT-R: Understanding, Appreciation, and Communication. “In total, 76% of young offenders in the FASD group demonstrated impaired performance on the Understanding scale, 24% had impaired scores on the Appreciation scale, and similarly, 24% had impaired scores on the Communication scale” (p. 17).
“Participants in the FASD group earned significantly lower scores on the FIT-R (with lower scores reflecting a greater degree of impairment) across the three subscales. They had more difficulty understanding elements of the arrest and trial process, appreciating their involvement and possible consequences of the proceedings, and adequately participating in their defense through appropriate communication with counsel, than comparison participants” (p. 17).
“Overall, 76% of young offenders with FASD demonstrated impairments in one or more domains on the FIT-R, compared to only 28% in the comparison group” (p. 17).
Even after controlling for IQ, group membership (FASD v. no prenatal alcohol exposure) “remained a significant predictor of scores on the Understanding and Communication subscales, suggesting that some aspect of the FASD diagnosis contributed to raters’ evaluation on these indicators” (p. 18).
Translating Research into Practice
“As a group, a high proportion of young offenders with FASD showed deficits in their psycholegal abilities, and rates of impairment were substantially higher in this group compared with other young offenders” (p. 18).
“Offenders with FASD may not demonstrate flagrant symptoms of mental illness, such as poor orientation or appreciation of the trial process that is delusional in nature. However, they are more likely to have significant cognitive impairments, coupled with behavioral and emotional challenges that may substantially increase their risk of meeting the threshold for a finding of incompetence in court. These findings speak to the need to carefully assess these [competence-related and decisional] capacities in young defendants with an FASD diagnosis” (p. 19).
With respect to remediation of these deficits, it appears that “extra time and effort on the part of lawyers and judges to explain important case-specific concepts and court procedures is likely warranted. Intervention recommendations designed to optimize learning for young offenders with FASD might include using simple language, repeating information, ensuring attention is captured before communicating information, gauging comprehension frequently to assess adequacy of learning, and using applied or multimodal methods of presenting information” (p. 18).
Of course, it is also important to highlight that not all offenders with FASD demonstrated impaired performance on measures of psycholegal ability, thus there is a variability of legal skills within this group of offenders, just as in all adolescents more generally. Thus, while it may be important for police, lawyers, and clinicians to remain mindful of the increased vulnerability of this group of offenders in legal contexts, “it is nevertheless important to undertake an individualized approach when assessing the psycholegal abilities of a young person with FASD” (p. 19).
“A final result worth highlighting is the limited awareness and misplaced confidence young offenders with FASD held in terms of their own legal knowledge, lending mixed support to speculation about whether they have sufficient insight to make decisions about their rights. Though many young offenders with FASD showed compromised understanding and appreciation of their rights, as a group they tended to feel more confident about their decision-making abilities than was warranted. Combined, these factors may increase a young suspect’s risk for making poor decisions based on limited understanding of their rights while expressing misplaced confidence to police or lawyers” (p. 19).
Other Interesting Tidbits for Researchers and Clinicians
Waiver of Rights in Canada v. United States
“Many young offenders with FASD showed substantial deficits in their arrest rights comprehension, raising the question of whether they faced an increased risk of providing invalid rights waivers without substantial efforts to clarify their meaning and relevance. The U.S. case law does not require extensive clarification efforts from police, Canadian officers are tasked with ensuring that young suspects understand and appreciate arrest warnings in order to secure a knowing and intelligent waiver. Unequipped to identify vulnerable suspects, it remains unclear whether they have the necessary training or skill to accomplish this task. This may constitute an area of inquiry for forensic clinicians who are tasked with assessing the admissibility of waivers and statements in court” (p. 18).
Join the Discussion
As always, please join the discussion below if you have thoughts or comments to add!
Evaluators who did not consider psychological, medical and/or criminal records as part of a competency evaluation were more likely to opine incompetent defendants as restorable than those who did consider these records. This is the bottom line of a recently published article in Psychology, Public Policy, and Law. Below is a summary of the research and findings as well as a translation of this research into practice.
Featured Article | Psychology, Public Policy, and Law | 2013, Vol. 19, No. 4, 498-508
Factors Influencing 2,260 Opinions of Defendants’ Restorability to Adjudicative Competency
Janet I. Warren, University of Virginia Preeti Chauhan, John Jay College of Criminal Justice, The City University of New York Lauren Kois, John Jay College of Criminal Justice, The City University of New York Ashley Dibble, Virginia Commonwealth University Jeff Knighton, University of Virginia
We examined 2,260 forensic assessments in which the evaluator opined that the defendant was incompetent to stand trial. In approximately one half of these evaluations (52%), the evaluator concluded that the defendant was likely to be restored to competency in the foreseeable future. This opinion was reached more frequently with defendants who were female, under the age of 60, suffering from an affective or psychotic disorder with previous psychiatric hospitalizations, and who were noncompliant with psychiatric medication at the time of the offense. Similarly, defendants were viewed as more likely to be restored to competency if the evaluation had been requested by the defense, the defendant was seen as not impaired on the capacity to understand legal proceedings element of the Dusky v. United States standard, the evaluator had a terminal degree of EdD and the defendant’s psychological, medical, and/or criminal records had not been obtained and considered as part of the forensic assessment. Using chi-square automated interaction detector analyses (CHAID; Kass, 1980), we found that psychiatric diagnosis was the most powerful variable in classifying opinions concerning the restorability of incompetent defendants. Defendants diagnosed with an affective or psychotic disorder were more likely to receive an opinion of likely/probable restoration than those defendants diagnosed with pervasive developmental, organic, substance-use, personality, or other disorders. These data suggest that the clinical condition of the defendant lies appropriately at the center of this process of predictive opinion formulation. The results also indicate that referral biases and/or crime-specific motivations for finding offenders restorable, often suggested as possible contaminants to this process, are not statistically significant in our large sample of forensic referrals.
adjudicate competence, competency to stand trial, capacity to stand trial, fitness to stand trial, trial competency, forensic evaluation
Summary of the Research
Researchers examined opinions regarding competency to stand trial for 9,921 evaluations of adult criminal defendants conducted between 1990 and 2007 in the Commonwealth of Virginia. Of these, evaluators rendered an opinion regarding restorability in 2,260 cases. Statistical analyses of various factors—referral and evaluator characteristics, demographic characteristic, offense, diagnoses, and records reviewed—were conducted for these 2,260 opinions in an attempt to determine factors related to opinions regarding restorability of incompetent defendants.
Results of these analyses indicated a number of interesting outcomes. When opinions regarding restorability were examined with respect to the specific Dusky prong (understand or assist) implicated in the incompetency decision, defendants who did not demonstrate impaired understanding were more likely to be considered restorable.
When demographic variables were examined, men and defendants over the age of 60 were less likely to be considered restorable (whereas women and defendants younger than 60 years were more likely to be considered restorable). Race/ethnicity did not differentiate between those opined restorable and not restorable.
Defendants who were referred for competency evaluation by the defense were more likely to be considered restorable whereas those who were referred by the prosecution or the court were less likely to be considered restorable.
Defendants who had prior convictions were more likely to be opined restorable than those without prior convictions, but type of crime (violent or nonviolent) was not related to restorability.
Defendants with affective and psychotic disorders were most likely to be considered restorable whereas those with pervasive developmental disorders, Autism, or organic disorders were least likely to be considered restorable.
Defendants who were taking medication at the time of the offense were less likely to be considered restorable compared to those who were not taking medication at the time of offense.
Perhaps most interesting,
“If an evaluator received psychological, medical, and/or the defendant’s criminal records, he or she was less likely to give an opinion of probable restorability, as opposed to evaluators who did not receive these documents. There was a trend suggesting that when evaluators did not obtain the offense information, they were more likely to opine that the defendants were likely to be restored to competency. Reviewing the warrant, the reasons for the evaluation, and defendant and witness statements were not significant factors in evaluators’ opinions of restorability” (p. 503).
Translating Research into Practice
These results are consistent with the body of research that exists regarding evaluators’ opinions of the restorability of incompetent defendants. An important caveat is that this research base focuses on evaluator opinions regarding restorability and not on whether defendants are actually restored to competence. An important point developed in this research that has not been addressed in other research to date is the difference in opinions regarding restorability that results from the way in which the evaluation is conducted. That is, evaluators who considered collateral information, such as psychological, medical, and/or criminal records, were less likely to opine the defendant to be restorable. Current best practices for the evaluation of competence to stand trial indicate that collateral information sources are an important, if not required, data point to consider. Evaluators should be aware that the types of data that they consider, or fail to consider, in a competency evaluation can have a significant impact on the outcome of the evaluation. Every effort should be made to collect and consider relevant collateral or third party data sources in the evaluation of adjudicative competence. Neglecting to do so may have significant consequences for the evaluation outcome.
Other Interesting Tidbits for Researchers and Clinicians
Researchers will be interested in the statistical analyses used in this study. Chi-square automated interaction detector analyses (CHAID) was the primary means of examining these data. “CHAID explores the interaction of factors that contribute to restoration opinions by running a series of cross-tabulations and then incorporating them into a decision tree. This method of analyses selects the best predictor variable for the first ‘parent node’ and then repeats this process until a decision tree, comprised of ‘child nodes,’ is provided” (p. 501). In essence, these analyses provide information regarding the conceptual model used by forensic evaluators in making decisions. CHAID appears to be a useful way of examining decision making by evaluators and could be extended to decision making in other contexts.
Analyses also examined the discipline of the evaluator in relation to restorability opinions (no difference were found) as well as the terminal degree of the evaluator. Evaluators with an EdD were more likely to opine incompetent defendants as restorable whereas those with a PsyD or an MD were least likely to opine incompetent defendants as restorable.
Join the Discussion
As always, please join the discussion below if you have thoughts or comments to add!
Oxford University Press has published a book series entitled Best Practices in Forensic Mental Health Assessment. This series has made a significant impact on the field of forensic psychology by offering concise, empirically based information regarding best practices for forensic assessment in a variety of areas. The series consists of 20 books, each written by well-known and well-respected leaders in the field of forensic psychology.
The Best Practices Series
The series editors—Kirk Heilbrun, Tom Grisso, and Alan Goldstein—wrote the first book for the series, Foundations of Forensic Mental Health Assessment (2008), which provides an overview of the foundational considerations in forensic mental health assessment. Each of the 19 books that follow uses a similar format, with a description of the legal context, the forensic mental health concepts, and the empirical foundation and limits for each content area followed by detailed information on preparing for the evaluation, data collection, interpretation, and report writing and testimony. The books are targeted towards mental health and legal professionals involved in various aspects of forensic mental health assessment. They represent an accumulation of decades of knowledge that has been distilled into best practices to be followed by those involved in these evaluations.
The book series is organized into 3 sections of titles—Criminal, Civil, and Juvenile & Family—each of which will be described in more detail below. This series is a must-have for anyone interested or involved in forensic mental health assessment as has quickly become the standard for forensic mental health assessment. Professionals not familiar with this series risk uncomfortable questions on cross-examination about their assessment techniques and practices and how they conform to currently accepted standards of forensic mental health assessment.
Each of the titles in the series is briefly described below.
“This is an excellent book that provides a concise overview of evaluating competence to stand trial. The authors highlight the most important points and walk readers through the evaluation and testimony process, combining research with practice. Novice clinicians will gain much from the insights in this book, and seasoned veterans will not be disappointed.”–Doody’s
While the notion of insanity and the fact that it is unfair to hold “mentally impaired” people fully and criminally responsible for their actions has a long history, the concepts associated with criminal responsibility are still complex and difficult to define. In recent years, the field has developed a greater consensus regarding essential data collection methods, as well as how to manage the type of reasoning that is required in fitting data to the legal definitions. This volume offers guidance for the forensic mental health examiner, based on tradition as well as the latest developments for improving practice in criminal responsibility evaluations.
This volume is part of the Best Practices in Forensic Mental Health Assessment series. It focuses on evaluations for civil committment of Sexually Violent Predators (SVPs). These are the offenders who are determined by the court to present sufficient risk to the community to justify being detained beyond the expiration of their maximum criminal sentences.
Part of the successful Best Practices in Forensic Mental Health Assessment series. Includes helpful step-by-step information on performing violence risk assessments. User-friendly format includes bulleted lists, helpful tips, and key issues to avoid.
This book addresses the evaluation of criminals for capital sentencing, and looks at the history and importance of this process, the legal standards and the procedure for applying this evaluation in court.
Part of the successful Best Practices in Forensic Mental Health Assessment series. User-friendly format and design for on-the-spot reference. Provides an overview of the most up-to-date legal and psychological developments
Part of the successful Best Practices in Forensic Mental Health Assessment series. Provides step-by-step information on evaluating competence to consent to treatment. Contains useful features like key terms, best practice sidebars, and checklists.
Part of the successful Best Practices in Forensic Mental Health Assessment series. Contains useful features like key terms, best practice sidebars, and checklists. Gives step-by-step instructions on conducting guardianship evaluations.
Offers general and specific guidelines of each type of evaluation as well as reviews of relevant cases. Practice guidelines for conducting workplace mental health disability evaluations. Issues specific to evaluations for the Americans with Disabilities Act and Individuals with Disabilities Education Act.
Part of the successful Best Practices in Forensic Mental Health Assessment series. Contains useful features like key terms, best practice sidebars, and checklists. Gives step-by-step instructions on conducting competence evaluations with juveniles.
Part of the successful Best Practices in Forensic Mental Health Assessment series. Provides step-by-step information on conducting risk assessments with juveniles. Contains useful features like key terms, best practice sidebars, and checklists.
Provides a detailed “how-to” for practitioners, including information on data collection, interpretation, report writing and expert testimony. Written by two child custody examiners with years of experience and an exceptional depth of understanding of the area. Synthesizes the highest quality of work in the field to articulate the best practices for these evaluations based upon professional guidelines, law, and research.
Continuing Education Credit
We are please to offer Continuing Education (CE) credit for the Best Practices series. For more information on the titles offered and the number of CE hours offered for each title, please click here.
This morning, I am pleased to be addressing a group of esteemed criminal lawyers, judges, and mental health professionals from across the country at the National Criminal Defense Forum on Forensic Mental Health and the Law in Denver, CO. This 2-day program is being presented by Reilly Pozner, a litigation and trial practice based in Denver, in conjunction with the National Association of Criminal Defense Lawyers (NACDL) Foundation for Criminal Justice. To make my presentation a little more convenient for those in attendance (and a lot more accessible to those who are not), I have included links to my slides below, as well as links to the materials that I reference throughout my talk.
Thank you for the opportunity to be with you for this excellent program!
Click above to Download a PDF of the Presentation Slides
I was thrilled to be asked by the International Association of Forensic Mental Health Services (IAFMHS) to give the Dr. Derek Eaves Keynote Address at the 2013 conference in Maastricht, Netherlands. Those who know me well know that I love to travel and that Amsterdam is one of my favorite cities. Thus, the invitation to travel to Maastricht, about 2 hours south of Amsterdam by train and home of perhaps the best forensic psychology masters program in Europe, was sweet!
The Conference was excellent! Corine de Ruiter, the President of IAFMHS and a Professor of Forensic Psychology at Maastricht University, Vivienne de Vogel, Kim van Oorsouw and 23 student volunteers from Maastricht worked tirelessly to ensure that everything went off without a hitch. No easy feat, as anyone who has ever organized a conference knows (yes, I’ve done two!).
The IAFMHS Conference occurs on an annual basis, typically in June, and includes four Keynote addresses. The first address of the Conference, the Dr. Derek Eaves Lecture, in honor of the first President of the IAFMHS, kicks off the scientific programming, which lasts 3 days.
I was asked to speak on Best Practices in the Evaluation of Competency to Stand Trial and so took the opportunity to think about how I might be able to advance practice in this area. Rather than simply lay out the best practices as described in the book that Ron Roesch and I wrote for the Best Practices in Forensic Mental Health Assessment series published by Oxford University Press, I came up with 5 key areas of improvement that I see as necessary given my review of the various literature on competency. Each of these is discussed in turn during my talk and, to make things interesting for those who don’t conduct competency evaluations as part of their practice, I decided to include photos of my travels in the background of each slide.
The talk went well and the photos resulted in people from all over the world approaching me to introduce themselves and to talk about one of my true passions…travel and adventure vacations. Awesome!
Here is a video of my talk paired with my slides. (Please ignore my weird facial expressions…first time I’ve seen myself give a talk on video…not sure why I’m doing that…)
In my next 3 posts, I will include the other 3 Keynote addresses from IAFMHS 2013 in Maastricht, Netherlands. Stay tuned…