Forensic Psych Final Part 2

What is the emphasis for civil commitment?

treatment (instead of punishment)

How is civil commitment defined?

less precise than criminal behavior

What is the purpose of commitment?

prevent future behavior (instead of punishing past behavior)

How much protection is afforded to civil commitment?

not as much protection as criminal cases

How long is civil commitment?

no set limit

PA statue for severe mental disability

1) mental illness

2) when capacity to make reasonable judgements/care for themselves poses a threat to themself or others

first step to emergency commitment

physician/responsible party file written application with county administrator - reasonable grounds for severe mental disability

What does the county administrator do in response to an application of civil commitment?

may issue a warrant for person to be taken to facility for emergency examination

Who can take an individual to a facility for emergency examination?

physician, peace officer, other authorized person

How long can an individual be examined at a facility to determine if they need treatment?

no more than 120 hours

What is a 302?

involuntary commitment for "severely mentally disabled"

extended involuntary emergency treatment

when the facility determines the need for treatment will exceed 120 hours (no more than 20 days) - file application

court ordered involuntary treatment

court orders severely mentally disabled to undergo treatment if clear and present danger to self or others (no more than 90 days)

functional demands for civil commitment

- risk of violence towards others

- risk of harm to self (self harm, suicide, disability)

- ability to manage in community with help from family and friends

assessment for mental illness

- diagnosis

- psych testing

- medical/psych records -> records/third party

- interview

assessment for functional impairment (self and others)

- interview

- psych testing

- risk assessment tools

- observations from others

civil competency

the capacity to make independent decisions and conduct legal and financial transactions on one's own behalf.

exceptions to self-determination

1) When significant harm to others will result from one's actions

2) When one is incompetent to make the specific decision in question

guardianship

legal mechanism by which court declares a person incompetent and appoints a guardian

- person or estate

general guardianship

total control over individual's person, estate or both

specific guardianship

restricted to particular types of decisions

- more respectful of autonomy

- medical care

- business deals

- purchases over $100

Who can be guardians?

family, gov agencies, social workers, lawyers

Who requires guardians by law?

- older minors

- civilly committed adults

Who requires guardians in reality?

actually incompetent people

issues of guardianship

1) Does someone need a guardian?

2) Who will guardian be?

3) duties of guardian

Who can request guardianship?

any interested person can petition to have someone declared incompetent and subject to guardianship

Who is responsible for showing competence (restoration)?

the incompetent person

What should the focus be in a psych eval for guardianship?

what the person can and cannot do (not the mental illness itself)

other civil competencies

- Competency to make treatment decisions

- Testamentary capacity (make a will)

malingering

Deliberate faking of a physical or psychological disorder motivated by gain

defensiveness

Deliberate denial/minimization of a physical or psychological disorder motivated by gain

irrelevant responding

disengagement from the assessment process typically reflected in inconsistent responding that is unrelated to the specific content (e.g., not reading test items)

uncooperative

inference that maximum effort was not achieved

reliable

within limits of abilities, answering openly and honestly

Why fabricate symptoms?

- use as defense (insanity)

- avoid sanctions (capital sentencing)

- obtain entitlements (disability)

Why minimize symptoms?

Seeking to preserve or have restored certain rights or entitlements (e.g., guardianship, child custody, civil commitment, parole hearings)

strategies to detect feigning

- clinical interview

- medical findings on disorder

- structured interviews

- interpretations of psych tests

- third party info

caveats to detecting feigning

- must use multiple tests

- no indication of why

- potential for error in response style

- exaggeration ≠ absence of impairment

- well-documented history ≠ genuine

minimum requirements for competence in practice

- Clinical training

- familiar with legal system, forensic assessment, mental disorders, legal implications of working with criminals

exceptions for forensic psychologists

- competence in 1 area does not translate to all areas

- limits of behavioral/medical sciences in the legal system

- possibility for error/poor clinical practice

punishments for failing to obey local practice requirements

- disqualified to testify

- professional disciplinary action

- denial of liability insurance

- civil/criminal liability

Why should clinicians clarify referrals?

- ensure they are competent to give eval

- prevent later conflict about eval or testimony

- scope of eval affects notification to examinee and confidentiality

clarifying fees

- fee structure

- specialized tests

- unanticipated services

- when payment is made

clarifying relationships

- conflict of interest (current/prior activities, obligations, relationships)

- avoid appearance of impropriety

- avoid dual roles

clarifying confidentiality

- must tell examinees of disclosures of normally confidential info

questions to avoid in an interview

- clinical info not relevant to the referral question

- addressing forensic issues not raised in referral

minimum standards of notice

1) who ordered the eval/who report goes to

2) legal issues addressed

3) info important to eval and techniques

4) legal proceedings where testimony is anticipated

5) info that requires disclosure to third parties

6) legal right to decline eval/sanctions for declining

When is freedom to choice to participate restricted?

- if law provides sanctions for nonparticipation (can't use insanity defense)

- in cases it doesn't apply (civil commitment)

What if a client refises to participate?

- advise known sanctions

- individual can speak to lawyer

- advise if report will be sent anyway

- refusal to cooperate should be clearly indicated in report

What do forensic clinicians advocate for?

their data (not the party who hired them or the individual they evaluate)

Who receives forensic reports?

legal personnel - not mental health professionals

Where does the info in forensic reports go?

likely to become public knowledge

Who/what receives close scrutiny during adversary negotiations or proceedings?

report itself and clinician who writes it

What does the forensic report do?

- address the psychological question

- helps clinician organize data

- makes scientific info understandable to a lay audience

- sometimes permits disposition without formal proceedings

What drives and limits content in report writing?

Forensic question

What type of information should be included in a report?

Only necessary information

What is important about the sequence of information in a report?

It should make sense to the reader

What is the difference between fact and inference/opinion in report writing?

Fact is objective, while inference/opinion is subjective

What should you explain regarding your reasoning in a report?

Why you think a certain way

What should you include when rejecting other opinions or conclusions in a report?

An explanation of the rejection

elements of forensic reports

- referral info

- notification

- sources

- historical info

- behavioral observations

- mental status/psych tests

- diagnostics

- response to psycholegal questions

dangers of irrelevant data

- Incrimination

- Embarrassment

- Confusion for the legal professional

examples of irrelevant info

- sexual history

- medical conditions

- gratuitous quotes

probative data

data that helps the court understand clinician's opinion regarding psycholegal question

prejudicial impact

potential unintended consequences of info

clinician

scientist-practitioner committed to pursuit of truth through objective examination of data

attorney

committed primarily to persuasion and defending his/her client

- more interested in credibility

- aimed at enhancing or undermining witness credibility

voir dire examination

determine qualifications of a witness and establish extent and limits of expertise

What happens when an expert witness' credentials are questioned?

judge allows clinician to testify as expert, but advise jury to consider limits to expertise

direct testimony

describing evaluation procedures, data, and conclusions

- explain validity, reliability, and methods of all tests

What does questioning attorney stress in a cross examination?

- evaluation was insufficient

- expert's actions were unessential

- what expert does not know