YEAR

COMPETENCIES

AUTHOR SOURCE SELECTION ABSTRACT
2009 Parallel assessment of competence to stand trail Greg Wolber PhD psychology journal 8011 Assessing competence to stand trial in defendants who refuse to cooperate presents a number of challenges. Determining whether malingering is an element is an initial step. However, even when malingering is believed to be present, it is desirable for a variety of reasons to present the court with detailed evidence of the defendant s functional capacity. This article provides a brief overview of case law relevant to malingering, and discusses how the courts may view evidence of malingering relative to competency to stand trial. It then presents the authors method for collecting data and reporting to the court when defendants are non-cooperative and the possibility of mental impairment has been ruled out. The authors conceptualize this as parallel assessment of competence to stand trial, in that the evidence presented is indirectly related to specific competency abilities. Suggestions for report language, types of data, and future research are provided.
2009 Competence to proceed at trial-evaluation dilemmas and approaches to competency restoration Clarence Watson JD, MD
Solange Margery, MD
Robert Thompson PsyD
Psychiatry CD 10566 This presentation will cover the legal requirements for competence to stand trial, dilemmas of the evaluation process and therapeutic approaches to the restoration of competence. There will be a short description about the use of medications and the landmark cases that have defined their use in current practices. The presenters will then offer a general overview of key aspects of the psychoeducational programs designed to help restore competence and the varied impact on specific populations such as defendants with mental retardation. There will be a review of innovative and creative ideas that some institutions are researching or have recently implemented in their psychoeducational programs (e.g., mock trials). The presenters will discuss the benefits that institutions have seen after strengthening the psychoeduca-tional part of their restoration for competence programs. Included in the discussion will be case examples and response to various restoration interventions. Clarence Watson, J.D., M.D. is the Clinical Director of Forensic Services at Delaware Psychiatric Center in New Castle, Delaware. Solange Margery, M.D. is the Assistant Director of Residency Training in the Department of Psychiatry at Thomas Jefferson University Hospital in Philadelphia. Robert G. Thomp-son, Psy.D. is a clinical and forensic psychologist at the Delaware Psychiatric Center in New Castle.

2009 Competency to stand trial-a brief evaluation Albert Kastl PhD
John Podboy PhD
psychology CD 10581 Many authors have described detailed evaluations regarding competency to stand trial, and psychological instruments have also been developed. However, in some jurisdictions, there are severe limitations because of cost containment. The presenters describe a brief examination which considers the major issues in such assessments, namely, understanding the current legal situation, legal issues and procedures, the role of criminal justice personnel, and the ability to rationally cooperate with counsel. Attendees should be able to understand the nature of extensive assessments for competency to stand trial. They will also be provided a brief examination and will grasp the limitations of all examinations of this type. Dr. Albert Kastl has conducted hundreds of clinical assessments in the course of 40 years of clinical practice in Northern California. Dr. John Podboy maintains an extensive forensic practice in state and federal courts throughout the United States.
2008 Updating your approach to competence to stand trial assessments John T. Philipsborn, JD
psychiatry CD

This presentation will approach the assessment of competence to stand trial from the perspective of the latest case law on the issue, emphasizing that lawyers are being trained to approach competence issues with specific standards of practice in mind. Attendees can expect a review of case law from around the country in this presentation. Attendees should be able to describe both the static legal definitions of competence to stand trial and some of the more recent additions to those definitions, together with the standards of practice that will be applied both to their work on competence evaluations, and to their testimony in court.--
2008 Competence to stand trial-related skills in a sample of urban youth Carl Dreyer PsyD
Kathleen Hart PhD
psychology journal 9016 Recent trends in the management of juveniles through juvenile and family courts have brought increased attention to the trial-related abilities of children and adolescents. In the present study, we surveyed 294 low income, urban public school students in grades 5, 7, 9, and 11 to measure their knowledge of court proceedings. Students responses to a group-administered version of the Georgia Court Competence Test revealed that the majority do not possess basic information about court proceedings. Not surprisingly, younger students demonstrated less understanding than older students, but even older students were not able to demonstrate a competent level of understanding using criteria developed in previous studies. The results are discussed in light of emerging studies, and with reference to the challenges that such findings pose for juvenile courts.
2008 Forced medications to restore adjudicative competency Aditi Mehta MD
Kathleen Franco MD
Psychiatry Journal 8098 Assessment of competence to stand trial is probably the most common evaluation done by psychiatrists for the court system. Approximately 7000 defendants are involuntarily committed each year to public hospitals for restoration of competence. The issue of forced medications to restore competency is a complex one. Most states rely on landmark decisions to make decisions regarding forced medications for this purpose. Before commitment reforms these mentally ill defendants were committed for long time to restore competency. Currently the law has defined situations and time duration for restoration. If they cannot be restored within this time, charges are dropped and they may be civilly committed. In this article we review literature on the assessment of competency to stand trial. We also discuss landmark decisions like Riggins v. Nevada, Sell v. U.S. and Jackson v. Indiana that have shaped policies on forcibly medicating defendants to restore competency.
2008 The two-phase approach to competency evaluation Daniel Greenfield MD, MPH Psychiatry journal 8103 This article discusses the distinction in the exculpatory criminal insanity defense between the strictly cognitive M Naghten insanity defense test and the emotional/affective/cognitive insanity defense test of the Model Penal Code (MPC) of the American Law Institute (ALI). A parallel is drawn between the continuum of those two tests and what the authors call the Two-Phase (cognitive-mental state) evaluation approach to the forensic psychiatric/psychological evaluation of a defendant s criminal competency to stand trial (CST) status, focusing on the elements of the CST status in one representative jurisdiction, the state of New Jersey. Finally, drawing on six case vignettes, the authors discuss subtleties and nuances of clinical presentations of defendants in forensic psychiatric/psychological CST evaluations, and emphasize the need for evaluators to consider both overt cognitive and subtle emotional/affective/cognitive (mental state) aspects of their evaluees clinical presentations in their CST evaluations.
2008 The unrestorable incompetent defendant-length of attempted restoration and factors contributing to a decision of unrestorable Greg Wolber PhD psychology journal 7002 no abstract
2008 Updating your approach to competence to stand trial assessments John T. Philipsborn, M.ED., JD psychiatry CD 10634 This presentation will approach the assessment of competence to stand trial from the perspective of the latest case law on the issue, emphasizing that lawyers are being trained to approach competence issues with specific standards of practice in mind. Attendees can expect a review of case law from around the country in this presentation. Attendees should be able to describe both the static legal definitions of competence to stand trial and some of the more recent additions to those definitions, together with the standards of practice that will be applied both to their work on competence evaluations, and to their testimony in court.--John Philipsborn is a criminal defense lawyer in San Francisco. His extensive trial and appellate work has resulted in numerous published decisions dealing with forensic mental health issues.
2008 Updating your approach to competence to stand trial assessments John T. Philipsborn, M.Ed., J.D. psychology CD 10667 This presentation will approach the assessment of competence to stand trial from the perspective of the latest case law on the issue, emphasizing that lawyers are being trained to approach competence issues with specific standards of practice in mind. A review of case law from around the country will be presented. Attendees should be able to describe both the static legal definitions of competence to stand trial and some of the more recent additions to those definitions, together with the standards of practice that will be applied both to their work on competence evaluations, and to their testimony in court.--John Philipsborn is a criminal defense lawyer in San Francisco. His extensive trial and appellate work has resulted in numerous published decisions dealing with forensic mental health issues. He has published extensively for the legal profession on forensic mental health matters.
2008 Competence to stand trial-related skills in a sample of urban youth Carla Dreyer PsyD
Kathleen Hart PhD
psychology journal 10785 Recent trends in the management of juveniles through juvenile and family courts have brought increased attention to the trial-related abilities of children and adolescents. In the present study, we surveyed 294 low income, urban public school students in grades 5, 7, 9, and 11 to measure their knowledge of court proceedings. Students responses to a group-administered version of the Georgia Court Competence Test revealed that the majority do not possess basic information about court proceedings. Not surprisingly, younger students demonstrated less understanding than older students, but even older students were not able to demonstrate a competent level of understanding using criteria developed in previous studies. The results are discussed in light of emerging studies, and with reference to the challenges that such findings pose for juvenile courts.
2008 The unrestorable incompetent defendant: length of attempted restoration and factors contributing to a decision of unrestorable
Greg Wolber PhD psychology journal 10789 The length of time for attempted restoration until an opinion is provided to the court that a defendant is unrestorably incompetent to stand trial is discussed. Factors potentially contributing to length of attempted restoration are also discussed along with a review of the relevant literature. Additionally, clinicians/administrators at forty-five public (state operated) forensic hospitals (representing forty-four states and the District of Columbia) were asked to provide information (primarily based on professional experience) about the amount of time required until an incompetent defendant is opined to be unrestorably incompetent to stand trial at their respective facilities. Also requested was information concerning diagnostic categories most often opined to be unrestorable. The length of time most frequently reported (mode) was twelve months (38% of the states), although responses varied considerably. Several states reported a bimodal distribution, that is, defendants with organic conditions were generally found unrestorable in considerably shorter periods of time than those experiencing non-organic psychosis. Developmental disability, severe dementia and brain injury, along with refractory and persistent mental illness, e.g., long-term schizophrenia, were cited as the clinical entities that most frequently led to an opinion of unrestorable to competency to stand trial. Additional factors reported to impact a decision of unrestorable were legislated requirements that a determination be made within a certain period of time, severity of the index offense(s) and medication trials.
2007 Competency/Informed Consent and Issues of Sexual Activity
in Individuals with Autism and Developmental Disabilities
David Holmes EdD
10359 When considering sexual activity among those with autism and other developmental disabilities, the law is clear that there must be mutual consent based upon the capacity to understand the implications of such activity. Informed consent is frequently the benchmark for such understanding. This presentation will review the myriad of variables that have been utilized to establish informed consent as it pertains to those with autism/developmental disabilities
2007 Juvenile competency to stand trial: problems and pitfalls Thomas Evans PhD psychology CD 10365 Juvenile competency to stand trial continues to be an issue with which juvenile courts across the United States continue to struggle. For example, are strict Dusky criteria applied, or are juvenile "norms" to be applied? Unfortunately, there are no established norms or data available to guide psychologists in their evaluations. Further, are youths' competency related abilities to be compared to same aged youths, or is competency to be defined strictly by abilities defined by statute regardless of age?
2007 Juvenile Adjudicative Competence and the Juvenile Competency Quiz Brian C. Partridge, Psy.D.
Susan B. Cave, Ph.D.
psychology CD 10367 The current study investigated a semistructured interview tool, the Juvenile Competency Quiz (JCQ), used in competency to stand trial evaluation for juvenile defendants. The results support the preliminary use of the JCQ as a measure of juvenile competence-related abilities in forensic evaluations. Learn the benefits for using the JCQ to help assess juvenile competency to stand trial.
2007 Conducting Forensic Assessment Screens of Competency to Stand Trial for Misdemeanor Criminal Cases
Lori Martinez, Psy.D. and Maxann Shwartz, Ph.D. psychology CD 10368 This presentation will focus on the process of conducting brief forensic assessment screens of competency to stand trial for defendants facing misdemeanor charges. Specifically, the presenters will discuss the purpose and need to provide courts with efficient and ethical assessments, the pros and cons of a time limited assessment of a large volume of defendants, and will also review and discuss the report format and procedures used. Lori Martinez, Psy.D. is a licensed clinical and forensic psychologist in private practice in New Mexico.
2007 Applying Legal Competency in the Indian Practice of Sati Vishaal Mehra MD psychiatry journal 7035 "Sati" (aka suttee) is the Indian practice of a widow, after the death of her husband, committing suicide on her husband's funeral pyre. This ancient tradition, although rare, has existed in India for centuries, but has been outlawed since 1829. However, in spite of this, there have been reported incidents of sati as recently as 2002. Using this act as an example, interesting forensic issues are brought forth, namely, the challenge to determine an individual s competency to commit suicide. This also forces one to consider powerful cultural factors and personal biases that may influence an evaluator striving to make an objective assessment of another individual s competency.
2006 Competency to seek death Ansar Haroun MD
Valerie Rice PhD
psychiatry tapes 3213 We live in a culture that has historically prized living over dying, but there are groups of people who may value death over life, including terminally ill patients, the elderly who are tired of living, war heroes who wish to sacrifice their lives for their country, immature adolescents who wish to join the military, believing they are invincible, death row inmates who prefer execution to endless appeals for life, potential donors of body parts who may be courting an earlier death, surrogate decision makers of disabled children who believe death is preferable to a life of disability. How should society respond to such wishes? Should the treating doctor be permitted to impose her idiosyncratic values on the patient? Should the law be blindly followed? Or, should we formulate an ethical response? We will discuss both the actual response of most doctors, contrast it with the correct legal response, and propose an ideal ethical response.
2006 Fiduciary competency - bumbling through Linda Gummow PhD psychology tape 3236 Litigation alleging mental incompetency to either avoid financial responsibility or to gain financial advantage by taking control of the assets of another is becoming more common. The financial and personal stakes in this type of litigation are often high. Psychologists are sometimes asked to render opinions on the mental state of the involved individuals. There are few guidelines to help the psychologist make this determination, and the existing guidelines are seldom followed. The presenter hopes to bridge the gap between practice and policy. Strategies for the assessment of fiduciary competency will be suggested. Case examples will be used to illustrate the range and scope of fiduciary competency issues. Attendees will understand the following: 1) legal standards that can be applied to the assessment of fiduciary competency; 2) situations in which fiduciary competency is raised; and 3) procedures that can be used to evaluate fiduciary competency.
2006 Restoration of competency to stand trial-expectations of the court for forensic examiners Byron Herbel MD
Robert Cochrane PsyD
psychiatry journal 7057 no abstract
2006 Competency to seek death

Ansar Haroun MD
Valerie Rice PhD


psychiatry CD 10690 We live in a culture that has historically prized living over dying, but there are groups of people who may value death over life, including terminally ill patients, the elderly who are tired of living, war heroes who wish to sacrifice their lives for their coun-try, immature adolescents who wish to join the military, believing they are invincible, death row inmates who prefer execution to endless appeals for life, potential donors of body parts who may be courting an earlier death, surrogate decision makers of dis-abled children who believe death is preferable to a life of disability. How should society respond to such wishes? Should the treating doctor be permitted to impose her idiosyncratic values on the patient? Should the law be blindly followed? Or, should we formulate an ethical response? We will discuss both the actual response of most doctors, contrast it with the correct legal re-sponse, and propose an ideal ethical response. Valerie Rice, Ph.D. is an Assistant Clinical Professor of Psychiatry at UCSD Senior Behavioral Health Program, with extensive experience in evaluating the decision-making capacity of geriatric patients; Ansar Haroun, M.D. is a Clinical Professor of Psychiatry and Pediatrics, and Adjunct Professor of Law, in San Diego. He is also Supervising Psychiatrist for the Superior Court of California, County of San Diego.octors, contrast it with the correct legal response, and propose an ideal ethical response.
2006 Fiduciary competency - bumbling through Linda Gummow PhD psychology CD 10710 Litigation alleging mental incompetency to either avoid financial responsibility or to gain financial advantage by taking control of the assets of another is becoming more common. The financial and personal stakes in this type of litigation are often high. Psychologists are sometimes asked to render opinions on the mental state of the involved individuals. There are few guidelines to help the psychologist make this determination, and the existing guidelines are seldom followed. The presenter hopes to bridge the gap between practice and policy. Strategies for the assessment of fiduciary competency will be suggested. Case examples will be used to illustrate the range and scope of fiduciary competency issues. Attendees will understand the following: 1) legal standards that can be applied to the assessment of fiduciary competency; 2) situations in which fiduciary competency is raised; and 3) procedures that can be used to evaluate fiduciary competency. Linda J. Gummow, Ph.D. is a clinical neuropsychologist who is in private practice in Salt Lake City. She has evaluated individuals for both civil and criminal competency.
2006 Competency to seek death Ansar Haroun MD psychiatry CD 10774 We live in a culture that has historically prized living over dying, but there are groups of people who may value death over life, including terminally ill patients, the elderly who are tired of living, war heroes who wish to sacrifice their lives for their country, immature adolescents who wish to join the military, believing they are invincible, death row inmates who prefer execution to endless appeals for life, potential donors of body parts who may be courting an earlier death, surrogate decision makers of disabled children who believe death is preferable to a life of disability. How should society respond to such wishes? Should the treating doctor be permitted to impose her idiosyncratic values on the patient? Should the law be blindly followed? Or, should we formulate an ethical re-sponse? We will discuss both the actual response of most doctors, contrast it with the correct legal response, and propose an ideal ethical response. Valerie Rice, Ph.D. is an Assistant Clinical Professor of Psychiatry at UCSD Senior Be-havioral Health Program, with extensive experience in evaluating the decision-making capacity of geriatric patients; Ansar Haroun, M.D. is a Clinical Professor of Psychiatry and Pediatrics, and Adjunct Professor of Law, in San Diego. He is also Supervising Psychiatrist for the Superior Court of California, County of San Diego.

2005 Denial of mental illness as a barrier to competency to stand trial Greg Wolber PhD psychology journal 9010 R.D. was charged with assault. She has a long-standing history of a major mental illness with delusions and auditory hallucinations. Available evidence indicates that she was likely psychotic at the time of the alleged offense. During her evaluation for competency to stand trial, R.D. appeared to be in partial remission from her mental illness. In terms of competence, she seemed to have a good understanding of her charge and potential outcomes for her case. She also seemed to have a good factual understanding of the roles of difference courtroom personnel and of possible pleas. She reported that she had confidence in her attorney and that she could work with her defense counsel. However, she adamantly denied that she had a mental illness and she seemed incapable of considering any possible plea that would indicate that she might have a mental illness. This would include the consideration of a possible insanity defense which her attorney believed could have been a viable option for her. R.D. stated, "No way I m saying that I was crazy. I wasn't. God told me that I was right and that I was doing a good thing. He [the victim of the assault] was taking over minds for evil purposes." R.D.'s thinking about her choices concerning her pending trial appeared to be distorted. The fact that she denied that she was mentally ill seemed to have a significant bearing on her ability to plead and this denial likely represented a barrier to her competence to stand trial. This article presents discussion and case examples concerning the denial of major mental illness as a potential barrier to competency to stand trial. Defendants who are otherwise competent to stand trial may deny the fact that they have a mental illness with accompanying impaired judgment and distorted thinking. This can negatively impact their competence to make decisions during and about the trial process. Competency to stand trial when there is denial of major mental illness is examined for the following clinical instances: 1) making decisions relevant to court proceedings to include pleading, e.g., the insanity defense; 2) the complexities/context of individual cases; 3) major mental illness versus personality features, e.g., narcissism; and 4) neurocognitive dysfunction. Examples based on actual cases are presented.
2005 Applying Legal Competency in the Indian Practice of Sati Vishaal Mehra MD psychiatry tape 3166 "Sati" (aka suttee) is the Indian practice of a widow, after the death of her husband, committing suicide on her husband's funeral pyre. This ancient tradition, although rare, has existed in India for centuries, but has been outlawed since 1829. However, in spite of this, there have been reported incidents of sati as recently as 2002. Using this act as an example, interesting forensic issues are brought forth, namely, the challenge to determine an individual s competency to commit suicide. This also forces one to consider powerful cultural factors and personal biases that may influence an evaluator striving to make an objective assessment of another individual s competency.
2004 Restoration of competency to stand trial-expectations of the court for forensic examiners Timothy Michals MD and Steven Samuel PhD psychiatry tapes 3111 It has been estimated that one-third of all admissions of mentally disordered criminal offenders to state and federal mental health facilities are for incompetence to stand trial. The issue of competency to stand trial has been characterized as the most significant mental health inquiry pursued by the system of criminal law. As such, findings from a forensic psychiatry competency evaluation exert a substantial influence in the court decisions. Our experiences with evaluating criminal defendants competency, some with mental retardation, revealed an array of intensive training programs whose ostensive goal is to render the defendant competent to assist counsel and to become a meaningful and informed participant in the trial process. Participants will become familiar with the current status of training programs for restoration of competency, and will understand the fundamental issues raised by a competency evaluation.
2003 Performing competency evaluations on geriatric patients Carla Rodgers MD psychiatry tapes 3017 This lecture will focus on how to do competency evaluations on elderly patients who may present as incompetent because of physical illnesses such as cardiovascular disease, diabetes or infection. Distinguishing depression from dementia is also a key issue which will be addressed. The use of collateral data will be discussed. Actual case material will illustrate the various points.
2003 Informed consent and competency evaluation for the medically ill patient Jose Maldonado MD psychiatry tapes 3024 Elements of the competency evaluation, exceptions to informed consent, legal and medical precedents, and how to write accurate forensic reports on competency issues will be addressed. The difference between legal and ethical standards for capacity and competence, who makes the decision for incapacitated patients, and what standards for decision making are appropriate in cases of temporary or permanent incapacity in previously competent patients, and in never-competent patients will be discussed.
2003 A practical approach to evaluating the competence of juvenile offenders Paul Deardorff, PhD
psychology tape 3039 This presentation will focus on the practical matter of how to conduct a competency evaluation of a juvenile offender legal issues, interview questions, appropriate test measures, reports, how to prepare for testimony. Emphasis will be placed on commonly asked questions by both prosecution and defense.
2003 Juvenile competency to stand trial: problems and pitfalls Thomas Evans PhD psychology journal 844 Due to changes in state law, it is now easier to impose adult sentences on juveniles. This has led to a steady increase in the number of referrals for juvenile competence to stand trial evaluations. Very little is currently known about youths referred for competency, and even less is known regarding the trial related skills and abilities they must possess. Further, it is not known whether these skills are fluid, thereby requiring adjustment for age considerations. This study specifically focused on the cognitive capacity of youths referred to the Cuyahoga County Juvenile Court for competency evaluation. The IQ scores of youths found competent to stand trial were compared to the IQ scores of those found incompetent to stand trial. As expected, the IQ scores of those found competent to stand trial were higher. However, the Full Scale IQ scores of those found competent were far below the juvenile norms expectation of competency. Thus, while IQ scores are important data to be included in all competency evaluations, they should by no means be considered the only or even the main factor in evaluations of juvenile competence to stand trial, since no clear cut-off score emerges as an accurate predictor of competence. Thus, it is important to view juvenile competence as a set of skills that are nonspecifically related to intelligence quotients. Given that the majority of juvenile competency evaluations are referred due to suspected cognitive deficits, the relationship between IQ and these skills must be further investigated in future studies.
2003 Competency to stand trial and criminal responsibility: an examination of racial and gender differences among African American and Caucasian pretrial defendants Roslyn Caldwell PhD psychology journal 386 This investigation examined the differences between races and genders with respect to treatment histories, diagnoses, psycholegal decisions, and treatment recommendations. A total of 168 Caucasian males, 30 Caucasian females, 126 African American males, and 33 African American females were referred to an outpatient community mental health facility for evaluations of competency to stand trial and criminal responsibility. Consistent with the distribution of psychological disorders in general clinical settings, African Americans were more frequently diagnosed with psychotic disorders, while Caucasians were more frequently diagnosed with mood and substance related disorders, and other Axis I disorders. In addition, males were more frequently diagnosed with mood disorders, and females were more frequently diagnosed with a combination of psychotic, other Axis I disorders, and substance-related disorders. Results pertaining to psycholegal decisions revealed that defendants diagnosed with psychotic disorders were more likely to be found incompetent to stand trial. These results offer several insights into the nature of pretrial evaluations and the factors that effect psycholegal decisions.
2002 Juvenile competency to stand trial, challenges--restoration training Gwen Levitt DO
Jeffrey Trollinger MEd
psychiatry journal 1049 With the increase in juvenile crime, there are more and younger children entering the criminal justice system. Since these defendants must be afforded due process, competency to stand trial has become an issue. In Maricopa County, Arizona, there are so many cases of children being found incompetent, training programs have been initiated to work with these juveniles. Providing comprehensive training with this group of individuals can be both challenging and frustrating. This article reviews the available literature on the topic, characterizes the types of diagnostic categories and issues encountered, and proposes ways in which to address training curricula.
2002 Involuntary treatment to restore competency Alan A Abrams MD, JD psychiatry tapes 2011 Following Riggins v. Nevada, the D.C. Circuit has issued significant decisions regarding the use of involuntary medications to restore competency to stand trial. A discussion of 6th Amendment fair trial issues with regard to self representation by mentally ill, but competent, defendants will be included. Attendees will learn under what conditions an incompetent defendant can be forcibly medicated.
2002 Competence to stand trial in the context of mental retardation Susan Pearlson, MD psychiatry tapes 2046 The defendant with limited intelligence presents special problems in evaluating competence to stand trial. Determination of mental retardation does not automatically render a defendant incompetent. However, the presence of "a reasonable degree of rational understanding" can be difficult to determine. The author presents a case of contested competence to stand trial involving a 51-year-old man with a full-scale IQ of 64, charged with first and second-degree criminal sexual conduct. This case is discussed, relevant literature is reviewed, and an approach to assessment is offered. Attendees will be able to explain the impact of limited intelligence on assessment of competence to stand trial, and will be able to describe ways to assess competence, taking into account the defendant s limitations.
2002 The psychologist s role in assessing child witness competency Brett Trowbridge PhD, JD psychology tape 2059 Most jurisdictions' tests of child witness competency stress three basic requirements: perception, memory, and ability to communicate. Psychologists assist courts in helping to determine whether child witnesses are competent or whether they were competent when they made earlier out-of-court statements. Participants will learn how to conduct such evaluations - tests that might be used and materials that might be reviewed, and how to become involved in these cases.

2002 Juvenile competency to stand trial Gwen Levitt DO psychiatry journal 8081 no abstract
2001 Retrospective evaluation of Miranda reading levels and waiver competency Daniel Greenfield MD, MPH
psychology journal 289 Variation and range in the reading comprehension levels of criminal suspects being "Mirandized" may render that process inapplicable and void in particular cases. Drawing on survey research from the 21 counties of New Jersey, the authors review data documenting wide variation in these areas; discuss reading theory as applied to these data; and present three practical recommendations for the use of these data in the forensic psychiatric/psychological retrospective evaluation of the validity of Miranda issues in given cases.
2001 Non competent to be executed Gwen Levitt DO psychiatry tape 1052 no abstract
2000 Competency issues with juvenile offenders Kathleen J Hart PhD psychology tape 1041 As the crimes committed by juveniles become increasingly violent and the response of the juvenile court becomes increasingly adversarial, the question of children s competence to stand trial becomes a more pressing issue. In most states, juveniles are held to the competence standards that apply to adults, as described in the Dusky decision. The panel will address ethical and practical issues in the competence evaluations of juveniles; evaluation strategies in competence assessment, including formal measures and interview strategies; developmental issues and the notion of competence; and will present preliminary data from a study formally assessing juveniles competence to stand trial using a new instrument.
2000 Checklist for evaluating Miranda waiver competency Daniel Greenfield MD, MPH
psychiatry journal 953 Two sets of factors which operate at the time of Miranda rights administration to a criminal suspect during the course of arrest and interrogation are defined and discussed. These factors are "clinical" (pertaining to the suspect undergoing "Mirandizing") and "legal" (pertaining to the circumstances of the Mirandizing). The factors are organized into the Miranda Checklist Inventory (MCI), a systematic inventory which can be used as a guide for the forensic mental health professional in retrospectively evaluating an adult or juvenile s competency to have waived his or her Miranda rights. The MCI is presented as the Appendix to this article.
1999 Assessment of competency of the elderly Albert J Kastl PhD psychology tape 1189 Current probate statutes have become far more specific about domains to be assessed to determine competency among elderly individuals. Specific areas to be evaluated include short-term memory, attention, communication skills and logical reasoning. The specific California Probate Code will be reviewed to ensure thoroughness in the evaluation process. Participants will learn current codes in this domain, will review appropriate methodology to meet those codes, and will be informed of the complications of making inferences based on a limited data base.



1999 Agreement rates, government psychologists - competency to stand trial Rodolfo Buigas, PhD
psychology tape 1130 The Federal Courts rely on the expert opinions of psychiatrists and psychologists when a defendant s competency to stand trial is raised. Early studies have examined the frequency of agreement and disagreement between the courts and forensic experts and found it to be high. A novel approach to this issue would be to explore those factors that might contribute to such high agreement between the court s decisions and those of the forensic experts. Variables such as amount of collateral sources of data utilized, extensiveness of psychological measures, and length of evaluation period were explored within the context of competency to stand trial evaluations ordered by the federal courts and conducted by a government agency (Bureau of Prisons) on a diverse ethnic and racial population.
1999 Competency to stand trial and the paranoid spectrum J Robert Noonan PhD

psychology journal 285 Criminal defendants with paranoid disorders are frequently referred by the courts for evaluation of competency to stand trial. While these defendants share with other psychologically-based referrals potential difficulty rationally understanding the proceedings, they also present unique challenges for the psychologist who must accurately assess their capacity to reasonably consult with their attorneys in developing a defense. Since mistrust and unwillingness to relinquish control are hallmarks of this diagnostic spectrum, it becomes crucial to ascertain the extent to which the essential collaborative aspect of competency can be met. This article presents evaluation scenarios with defendants diagnosed with delusional disorder, paranoid schizophrenia, and paranoid personality disorder; identifies issues likely to be encountered with each condition; and explores evaluation strategies and outcomes.
1999 Competency to be executed Franklin Master MD psychiatry journal 286 The death row case of a convicted murderer is described chronologically in detail, including the crime itself and the appeal process. This case is unique in that the defendant s mother intervened in federal court to block her son's execution by declaring herself as his "next friend." The controversy describing the psychiatrist s role in assessing a condemned individual s competency to be executed and its ethical dilemma is explored.
1999 Competency of the mentally retarded patient and surrogate decision making in NY AJ D'Allesandro psychology tape 1132 This presentation will focus on the competency of mentally retarded patients, all DSM-IV categories (Axis II): mild, moderate, severe, and profound, to give consent for surgery or for an invasive procedure. The psychiatric assessment of the patient is discussed. The Surrogate Decision making Committee is described. The eligible patient population is described. The form used to determine competency is illustrated. The purpose of this presentation is to show the process that has to be carried out to allow medically invasive procedures on those individuals incompetent to give their own consent. It also discusses the psychiatrist s role as the expert in determining competency.
1998 Competency testing comes of age Paul Good PhD psychology tape 1095 Competency to stand trial is the most frequently asked forensic question and yet practitioners seem to lack appreciation of it and scientific rigor in carrying out evaluations. Very few clinicians are using standardized measures to assess competency and rely simply on mental status observations or minimal legal criteria. Participants will obtain copies of two of the best measures of competency and understand how to use them in interviews. Fourteen dimensions of competency will be discussed and participants will be provided with a comprehensive construct to assess.

1998 Are competency exams really competent? Edward J. Hyman, PhD psychology tape 1098 The history of forensic determinations of competency will be briefly reviewed. Current approaches to determining competency will be overviewed, and a coherent methodology for scientifically appropriate forensic competency exams will be detailed. The role of adjunctive data and psychodiagnostic results will be established. Deficiencies in prevailing practices will be scrutinized. Examples from several current cases will be provided, including the recent Presita Park murder defendant s competency trial. Recent decisions regarding competency will be outlined. The varying practices of assorted locales will be reviewed. The objective of this presentation is to review current practices in competency examinations and to provide participants with a systematic and scientifically coherent approach to the issues of competency.
1998 Assessing competency to make or change a will Janet Munson, PhD psychology tape 2171 Psychologists can be called upon to provide the courts with expert testimony regarding a person s testamentary capacity. A brief overview of how the mental capacity construct is conceptualized with respect to wills will be presented, along with a framework for conducting legally relevant assessments of testamentary capacity. Special challenges to the assessment will be illustrated in case examples.
1998 Alvaro Calambro: competency to be executed- forensic case review and analysis Franklin Master MD psychiatry tapes 9084 The death row case of this convicted murderer is described chronologically, including details of the crime itself and the current appeal process. This interesting and challenging case is unique in that the defendant s mother intervened in federal court to attempt to block her son s execution by declaring herself his "next friend," a legal defense procedure that only applies if the defendant has been declared mentally incompetent. The controversy of the psychiatrist s "participation" in criminal cases, by assessing a criminal s competency to be executed, will be explored in this presentation. Attendees are urged to actively participate in the discussion period. The entire role of the psychiatrist as participant in state executions is one of divided opinion. Psychiatrists will learn about the "next friend" legal procedure in contesting court ordered executions and will better understand the forensic psychiatrist s ethical position in determining competency for execution for the court.

1998 Competency to stand trial in low-IQ juveniles Geoffrey McKee PhD psychiatry journal 837 Previous research has indicated that adolescents of low intelligence are more likely to be found incompetent to stand trial (IST). Little, however, is known about the specific trial abilities and deficits of this population. This study of 108 juvenile felony defendants undergoing pretrial court-ordered evaluations compared the competency to stand trial (CST) abilities of nonpsychotic juveniles of low intelligence (borderline intellectual functioning and mental retardation) to juveniles of normal intelligence. Results indicated that low-IQ juveniles were three times more likely to have CST deficits and as less likely to know the penalties they faced, the prosecutor s role, or the adversarial nature of court proceedings. Moreover, the low-IQ group was less able to assist in their defense (disclose crime facts, work with attorney, understand plea bargaining). The groups were equivalent on some factual elements (knowing charges and pleas of guilty versus not guilty, judge s and attorney s role) and rational elements of legal proceedings (understanding the charges severity and definition, proper behavior in court) and in their motivation to avoid incarceration. Nonstatistical comparison to the competency abilities of a reference group of 88 nonpsychotic, normal-IQ adult defendants is presented. Implications of the data for the assessment of juveniles CST and restoration of incompetent juveniles are discussed.
1996 Development of scales for the computer-assisted determination of competency Rodolfo Buigas, PhD
psychology tape 1439 The increased use of mental health professionals by the courts to perform evaluations of competency to stand trial has led to the modest proliferation of specialized procedures. One of the relatively newer and more comprehensive measures, the Computer Assisted Determination of Competency (CADCOMP) incorporates relevant demographical, historical, psychopathological and legal information collected directly from the defendant in an interactive computer format. The information is organized into a concise narrative report designed to assist the mental health professional in rendering a competency judgment. The comprehensive report has been found useful as a screening measure of trial competency. In an attempt to increase the utility of the measure, eighteen scales were constructed. The scales were developed with the goal of identifying and quantifying specific psycholegal abilities and psychopathological symptoms.
1996 Competency evaluations with special interest on court decision of People v. Brandon Robert L Meyer PhD psychology tape 10033 Primary focus of this presentation will be on competency to stand trial and the recent implications of People v. Brandon. Among topics to be discussed are: implications of psychotropic medications as they apply to competency; review of historic competency background; current formulation of the competency test; procedural issues; standards for raising the issue; reasons the evaluation is sought; disposition of the incompetent defendant; the legal standard; and inappropriate hospitalizations.
1996 Assessment of competency to stand trail Leslie K. Knutson, Ph.D. psychology tape 1310 no abstract
1995 Competency to stand trial: evaluations and testimony Michael Armour PhD psychology tape 1695 no abstract
1994 Conducting pretrial evaluations with deaf defendants-restoration to competency Lynn M Garvin PhD psychology tape 10061 This is a case of a deaf patient on a forensic evaluation ward in a state hospital. Special considerations in conducting pretrial evaluations with deaf defendants, diagnostic complexities, assessment considerations, treatment issues and acquiring services for deaf, forensic patients will be addressed. Sensitivity to the deaf culture in terms of stylistic communication differences are discussed relating to diagnostic and treatment considerations. The patient, because he was unable to comprehend court proceedings at the time of his evaluation, was found incompetent to stand trial and was admitted to a forensic ward for further monitoring and restoration to competency. The testing process, results, implications for patient care and nontraditional ways of building a therapeutic relationship are discussed.
1993 Problems in the restoration of competence to stand trial Sander Fogel MD psychiatry journal 8049 no abstract
1992 Miranda, trial competency and Hispanic immigrant defendants Matthew Johnson PhD and Luis Torres psychology journal 6096 This article describes an evaluation approach used to assess criminal competencies in Hispanic immigrant defendants, who were fluent only in Spanish. Case one involved a Cuban male from the Mariel group charged with burglary. The referral questions were competency to stand trial and competency to waive Miranda rights. Case two was a male immigrant from the Dominican Republic charged with distribution of a controlled dangerous substance. The evaluation focused on competence to stand trial. Discussion includes psychometric issues, interview approach, malingering and commentary on the findings of opposing experts.
1992 Miranda, trial competency and Hispanic immigrant defendants Matthew Johnson
Luis Torres
psychology tape 1999 This article describes an evaluation approach used to assess criminal competencies in Hispanic immigrant defendants, who were fluent only in Spanish. Case one involved a Cuban male from the Mariel group charged with burglary. The referral questions were competency to stand trial and competency to waive Miranda rights. Case two was a male immigrant from the Dominican Republic charged with distribution of a controlled dangerous substance. The evaluation focused on competence to stand trial. Discussion includes psychometric issues, interview approach, malingering and commentary on the findings of opposing experts.
1990 Assessing competence to stand trial - rethinking roles and definitions John Philipsborn JD, MEd psychology journal 5207 The law will not permit an "incompetent" person accused of crime to proceed to trial, or to be punished. The purpose of this writing is to discuss the difficulties raised by statutory schemes which call on psychiatrists or psychologists to report on the issue of the accused's ability to assist in her own defense.
1990 Applications of competency to consent and right to refuse treatment concepts Santo Bentivegna PhD
Kathleen Garvey RN
psychology journal 5041 Case discussion of a woman hospitalized for 20 years in a county chronic care facility as a the result of a surgical accident which left her quadriplegic. She was referred for an independent psychological examination regarding application by hospital for order authorizing involuntary treatment with psychotropic medication for a paranoid disorder. Assessment for competency, clinical issues, legal steps discussed. Hartman model was used in the successful defense of this patient.
1990 Assessing competence to stand trial John Philipsborn JD psychiatry journal 8010 no abstract
1989 Didactic instruction in inpatient competency treatment K Thomas Nelson PhD psychology tape 10044 Many defendants undergoing competency evaluation have little knowledge of legal issues; this is likely to bear negatively on their competency. Author describes use of didactic presentation given to 36 inmates in treatment and to control groups, presenting results he believes have practical significance for forensic psychologists.
1989 Patient-litigant knowledge of the law-importance in treatment to restore sanity and in competency proceedings K Thomas Nelson PhD psychology journal 8137 no abstract
1988 Adaptive behavior, mallngering and competence
to waive rights-a case study (2)
Spencer DeVault PhD
Donna Long MA, ACSW
psychology journal 8135 no abstract
1987 Pretrial psychiatric examinations in British Columbia Robert Pos MD psychiatry tapes 1780 There is a widespread assumption that, in general, the attitude of the criminal court is to agree with the psychiatrist's recommendations. However, this study holds that when a psychiatrist recommends competency, the court is in agreement only 55% of the time. But when the recommendation is one of fitness to stand trial, the court acts in favor of the recommendation 80% of the time. Ramifications discussed.
1987 Mental health clinicians and the law-competency to consent and right to refuse treatment BJ Hartman PhD, JD
psychiatry journal 5120 Clinicians who utilize somatic therapies without concern for properly given informed consent are at risk of being sued. Psychotherapists who show lack of concern for the doctrine of informed consent would do well to rethink their indifference. Landmark cases involving patients' rights to refuse medication and forcible medication of deteriorating patients by staff discussed.
1987 Assessment of adaptive behavior in helping to determine competence Spencer DeVault
Donna Long MA
psychology journal 6037 no abstract
1987 Mental health clinicians and the law-competency to consent and right to refuse treatment BJ Hartman PhD, JD
psychiatry tape 1736 Clinicians who utilize somatic therapies without concern for properly given informed consent are at risk of being sued. Psychotherapists who show lack of concern for the doctrine of informed consent would do well to rethink their indifference. Landmark cases involving patients' rights to refuse medication and forcible medication of deteriorating patients by staff discussed.
1986 Assessment of competency to stand trial - mental competency vs. legal responsibility Daniel Davis PhD psychology journal 5001 Fitness to stand trial may be the most significant mental health inquiry in criminal law. The issue is raised some 40,000 times a year in the U.S. and approximately 10,000 defendants are sent for treatment to restore competency. Discussion of competency vs. legal responsibility, functional assessment, malingering, assessment instruments and expert testimony. Discussion of relevant legal cases.
1986 Retarded offenders- assessment of trial competency John Chellsen PhD psychology journal 5028 No procedure devised to assist clinicians in assessing competency to stand trial has yet been explicitly developed for use with retarded defendants, who are unduly vulnerable in the criminal justice system, with 67 percent of retarded offenders confessing at time of arrest and 59 percent pleading guilty to the original charges.
1984 Competency and consent in psychiatric treatment- medical ethics, legal trends Glen Peterson MD psychiatry journal 5205 Opportunities to help, or to abuse, are magnified when physical confinement or other enforced measures are sanctioned by society and exercised by the physician; Medical ethics in conflict with legal trends. "Excessive and sweeping legal constrictions of the conditions and techniques of psychiatric treatment do not well serve the mentally ill."
1984 Competency to stand trial Henry Hartman MD psychiatry journal 6005 The whole problem of the role of the psychiatrist in aiding in the evaluation as to competency in the last decade. From this study it is possible to draw a composite picture of the way the use of the competency plea is widely viewed.
1984 Competency to stand trial-the psychiatric appraisal Emil Pawlowki MD
Ann Pawlowski AB
psychology journal 5197 no abstract
1981 Sterilization of incompetents Ronald Shlensky MD, JD
Eric Freibrun BA
psychiatry journal 10301 The power to deprive an individual of the right to procreate is an awesome one. A judicial determination that sterilization is an incompetent's best interests is necessarily a subjective exercise of a judge's discretion. Legal precedents and reasoning are given.