The competency issue is raised when an officer of the court (defense, prosecution, or judge) has reason to believe there is a bona fide doubt as to a defendants competence. 8The McGarry criteria (or questions) are known as the Competency to Stand Trial Instrument and are a widely used assessment procedure in the area Although the CST appears to be a reliable instrument (Nicholson et al., 1988; Randolph, Hicks, & Mason, 1981), concerns have been raised about its high false-positive rate because the majority of defendants screened as incompetent are later found to be competent in subsequent evaluations (Nicholson & Kugler, 1991). Identifying persons feigning limitations in their competence to proceed in the legal process, Attorney-client decisionmaking in criminal cases: Client competence and participation as perceived by their attorneys, The MacArthur Adjudicative Competence Study: Development and validation of a research instrument, The role of demographic, criminal, and psychiatric variables in examiners predictions of restorability to competency to stand trial, Competency for trial: A screening instrument, Evaluating the psycholegal abilities of young offenders with fetal alcohol spectrum disorder, Hospitalization of criminal defendants for evaluation of competence to stand trial or for restoration of competence: Clinical and legal issues, Clinician variation in findings of competence to stand trial, Outcome of hospitalization for defendants found incompetent to stand trial, A comparison of instruments for assessing competence to stand trial, Competent and incompetent criminal defendants: A quantitative review of comparative research, Psychometric properties of the MacArthur Competence Assessment Tool-Criminal Adjudication, A meta-analytic review of competency to stand trial research, The Competence Screening Test: A replication and extension, Social worker assessments of competency to stand trial, Recent interview-based measures of competence to stand trial: A critical review augmented with research data, The detection of feigned mental disorders on specific competency measures, Competence to stand trial: Clinical reliability and the role of offense severity, Psychopathology and competence to stand trial, Community examiners evaluations of competence to stand trial: Common problems and suggestions for improvements, Prevalence of serious mental illness among jail inmates, An examination of the relationship between competency to stand trial, competency to waive interrogation rights, and psychopathology, Adjudicative competence evaluations of juvenile and adult defendants: Judges views regarding essential components of competence reports, Fitness to stand trial evaluations: A comparison of referred and non-referred defendants, Diagnosis, current psychiatric symptoms, and the ability to stand trial, An evaluation of malingering screens with competency to stand trial patients: A known-groups comparison, Factors influencing 2,260 opinions of defendants restorability to adjudicative competency, Developing a forensic service delivery system for juveniles adjudicated incompetent to stand trial, The Georgia Court Competency Test: The baserate problem. The standardized results, while only one component of competency evaluations, achieve four major objectives by systematizing the evaluation of key points, reducing the subjectivity in recording competency-related information, providing normative comparisons, and demonstrating the inter-rater reliability of observations and findings. 41, p 19). For instance, interview-based competency measures are typically composed of several dozen relevant constructs that are operationally defined. The modern standard for defining competence to stand trial was established in Dusky v. United States (1960), in which the U.S. Supreme Court held: It is not enough for the district judge to find that the defendant is oriented to time and place and has some recollection of events, but that the test must be whether he has sufficient present ability to consult with his lawyer with a reasonable degree of rational understandingand whether he has a rational as well as factual understanding of the proceedings against him. The Georgia Court Competency Test (GCCT) was developed by Wildman et al.

As a result, the presented material is typically very short (i.e., fewer than 10 words) on the ECST-R competency scales. An investigation of the construct of competence: A comparison of the FIT, the MacCAT-CA, and the MacCAT-T, Future directions in the restoration of competence to stand trial, Personality Assessment in Clinical Psychology, Psychological Assessment of Older Persons. It assesses response style to provide an indication of malingering or feigning incompetency, as well as scale scores on four aspects of competency: factual understanding of the courtroom proceedings, rational understanding of the courtroom proceedings, consult with counsel, and overall rational ability.

We must tackle directly the professional objections to evidence-based practice.

Moreover, the objectivity of evidence-based researchers has been called into question because they are motivated by payment and publication to produce noteworthy results.4 The acceptance of evidence-based methods within the psychiatric community is clearly influenced by both concerns regarding research design and polarized professional attitudes. Their field reliability study reviewed evaluators in over 200 cases, with each case requiring three independent evaluations by Hawaii law.

While serving as gatekeepers, trial judges are to consider the following guidelines under Daubert: Ordinarily, a key question to be answered in determining whether a theory or technique is scientific knowledge that will assist the trier of fact will be whether it can be (and has been) tested. The U.S. Supreme Court held that defendants committed solely on the basis of incompetency cannot be held more than the reasonable period of time necessary to determine whether there is a substantial probability that he will attain that capacity in the foreseeable future (p. 738). Some variability was due to clinician discipline (psychologists, psychiatrists, and social workers conducted the evaluations), which Murrie et al. Of interest, that criticism was leveled specifically at the ECST-R rather than being evaluated critically for competency measures in general.

The vast majority of defendants are competent to understand the charges against them, appreciate the legal consequences, make decisions about how to proceed with their cases, and able to communicate rationally with their attorneys.

An interesting addition to the Gowensmith et al.

In fact, this approach is embraced by the AAPL Task Force in its summary statement about competency measures: Instead, psychiatrists should interpret results of testing in light of all other data obtained from clinical interviews and collateral sources (Ref. 32, p 154).

The feigning scales were developed by using two primary detection strategies: rare symptoms and symptom severity. A semi-structured interview gathers information to score 13 items related to legal issues, such as appraisal of available legal defenses, quality of relating to attorney, capacity to disclose pertinent facts, and capacity to testify relevantly. Items are scored on a 5-point scale, ranging from total incapacity to no incapacity. The CAI manual contains clinical examples of levels of incapacity, as well as suggested interview questions. It is important though, for evaluators to keep in mind that many defendants with such a diagnosis are considered to be competent.

Several points should be emphasized: 1.

Competence can even arise in death penalty cases in which the competence to proceed with appeals or to be executed is questioned (Cunningham, 2013). With reference to forensic concerns, can the concept be empirically tested and does the research have the potential to disprove the conclusion?

(1998) found that evaluators did review basic issues such as ability to assist counsel, but typically need not pay attention to decisional competence issues, as only 12% of the reports discussed whether the defendant understood what rights were given up when entering a guilty plea. Thus, once it is established that a person does have a mental disorder or cognitive deficits, the next step is to demonstrate how that mental disorder impairs a defendants legal abilities. Research on report content suggests that many reports do not contain the details called for in Utah, as evaluators often fail to relate specific abilities and deficits to the particular case (Heilbrun & Collins, 1995). Finally, general acceptance can yet have a bearing on the inquiry. 37, p S34).

Competence issues also arise in noncriminal settings such as immigration removal proceedings (Filone & King, 2015), but that is beyond the scope of this article.

For the third scale (CWC), it is theoretically possible to score in the severe range based only on ratings of 2.

Calculated as the standard error of measurement (SEM), each competency measure produces small SEMs, indicating a high level of accuracy (Table 2).

Rogers has pioneered the use of empirically validated forensic measures for more than two decades, beginning in 1984 with the publication of the R-CRAS (Rogers Criminal Responsibility Assessment Scales)28 for assessing criminal responsibility and later the Structured Interview of Reported Symptoms (SIRS)29 for feigned mental disorders.

Duration of Commitment . The ECST-R is composed of both competency and feigning scales. This is because a competency evaluation focuses on a defendants present mental state and its relationship to the ability to proceed with his or her case, whereas a criminal responsibility assessment requires a retrospective evaluation of past mental states.

speculated may have been due to differences in training and also how they viewed the relationship between psychosis and competence. Competency restoration practices are reviewed later. This section will provide a brief overview of possible FAIs that clinicians can use when evaluating competency. Thank you for your interest in recommending The Journal of the American Academy of Psychiatry and the Law site. Another pertinent consideration is whether the theory or technique has been subjected to peer review and publication. A major strength of the three competency measures is the excellent data on their reliability and errors in measurement.

For assessments, the use of reliable and valid measures is the most direct and empirically defensible method of achieving this standardization.

Not surprisingly, they had the most difficulty in fully understanding those directly involved in scientific method (Guidelines 1 and 3). The Competency Screening Test (CST) is a screening measure for identifying clearly competent defendants and thus avoiding inpatient evaluations (Lipsitt, Lelos, & McGarry, 1971). 9, p 592). This and other research (Hubbard & Zapf, 2003; Morris & Parker, 2008) suggests that it may be difficult to predict who will be restored, but this research is unlikely to affect court practice since most incompetent defendants are restored with treatment, so judges may decide to order treatment for a limited period even for those in a low success group.

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Next, we examine these measures in light of error and classification rates.

A small group of 10 professionals (lawyers, administrators, and forensic psychologists) rated the appropriateness of the CAST-MR content.

It describes relevance as a matter of fit; scientific validity is not sufficient unless it fits the specific matter under consideration by the trial court. The use of medication raises the question of whether an incompetent defendant can refuse to consent to being medicated. WebCOLLINS - BOOK PROOF (DO NOT DELETE) 4/9/2019 4:44 PM No.

The Daubert guidelines ask that experts address the error rates associated with their methods.

There is no explicit prohibition forbidding the offering of an ultimate opinion and, in many ways, a well-written report should make the evaluators opinion obvious even if it is not directly stated.

The competency measures are markedly divergent in their assessment of Dusky's consult-with-counsel prong.

They are followed by a more in-depth examination of competency measures as a form of evidence-based practice.

Aarons et al.7,8 have gone a step further in studying how professional attitudes toward evidence-based practice are reflected in effective interventions.