Principles of Forensic Mental Health Assessment

343 Pages·2001·3.32 MB·English

by  Kirk Heilbrun (auth.)

Principles of Forensic
Mental Health Assessment
Perspectives in
Law & Psychology
Sponsored by the American Psychology-Law Society / Division 41 of the
American Psychological Association
SeriesEditor: RONALDROESCH,Simon Fraser University
Burnaby, British Columbia, Canada
Editorial Board:MARY DURHAM, JANE GOODMAN-DELAHUNTY,
THOMAS GRISSO, STEPHEN D. HART, MARSHALISS,
EDWARD P. MULVEY, JAMES R. P. OGLOFF,
NORMAN G. POYTHRESS, JR., DON READ, AND
REGINA SCHULLER
Volume 1 THE CRIMINAL JUSTICE SYSTEM
Edited by Bruce Dennis Sales
Volume 2 THE TRIAL PROCESS
Edited by Bruce Dennis Sales
Volume 3 JUVENILES' WAIVEROFRIGHTS
Legal and Psychological Complications
Thomas Grisso
Volume 4 MENTAL HEALTH LAW
Major Issues
David B. Wexler
Volume 5 HANDBOOK OF SCALES FOR RESEARCH IN CRIME AND
DELINQUENCY
Stanley L. Brodsky and H. O'Neal Smitherman
Volume 6 MENTALLY DISORDERED OFFENDERS
Perspectives from Law and Social Science
Edited by John Monahan and Henry J. Steadman
Volume 7 EVALUATING COMPETENCIES
Forensic Assessments and Instruments
Thomas Grisso
Volume 8 INSANITY ON TRIAL
NormanJ.Finkel
Volume 9 AFTER THE CRIME
Victim Decision Making
Martin S.Greenbergand R.BarryRuback
Volume 10 PSYCHOLOGY AND LAW
The State of the Discipline
EditedbyRonaldRoesch,StephenD. Hart, andJamesR. P. Ogloff
Volume 11 JUDICIAL DECISION MAKING
Is Psychology Relevant?
Lawrence S. Wrightsman
Volume 12 PRINCIPLES OF FORENSIC MENTAL HEALTH ASSESSMENT
Kirk Heilbrun
Principles of Forensic
Mental Health Assessment
Kirk Heilbrun
MCP Hahnemann University
Philadelphia, Pennsylvania
and
Villanova University
Philadelphia, Pennsylvania
KLUWER ACADEMIC PUBLISHERS
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eBookISBN: 0-306-47382-8
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To Patty and Anna
Preface
Most of the literature in forensic mental health assessment is organized
around the particular legal issue that is the focus of a given assessment,
tool, or research study. This book starts with a different assumption: There
are broad principles of forensic assessment that are applicable across
different legal issues. If such principles exist, they should be derived from
and supported by sources of authority in ethics, law, science, and profes-
sional practice. This is what I seek to do in this book, with each of the 29
broad principles of forensic mental health assessment described and ana-
lyzed from the perspective of these sources of authority.
There are a number of individuals who have contributed in various
ways to making this a better book. It seems best to begin with a general
acknowledgment: Those interested in forensic mental health assessment,
particularly my colleagues from the American Psychology–Law Society
and the American Board of Forensic Psychology, have been an extraordi-
narily helpful and congenial group. I have learned a great deal from them
over the years and they challenged me to undertake the daunting task of
trying to capture the broad views of the field in this book.
I grew up in a home in which books, ideas, and achievement were
valued and interspersed with love and humor. Thanks to my parents,
Alfred and Marian Heilbrun, for providing such a home for my sisters,
brother, and me. Special thanks to my wife Patty, and our daughter Anna;
this book is dedicated to you.
I first began thinking about principles of forensic mental health as-
sessment during my postdoctoral fellowship year under Ned Megargee.
He taught me valuable organizing skills that year and showed me how to
apply the highest standards to research and scholarship in criminal justice.
My "inpatient forensic" years were mainly spent at the Forensic Service at
Florida State Hospital in Chattahoochee, where Stewart Parsons and Sam
Cunningham allowed me to learn so much, and have so much fun, that I
am surprised I ever left. I am grateful to both of you.
vii
viii PREFACE
At one time, there was discussion about making this a book with three
authors. Although I did not eventually collaborate with Stan Brodsky and
Norm Poythress in writing this volume, it is hard to imagine how two
colleagues could have been more helpful in shaping many of the ideas that
went into describing principles of forensic mental health assessment.
Thanks to you both.
Work on the book began in earnest after our move to Virginia. John
Monahan, Richard Bonnie, Gary Hawk, Janet Warren, Larry Fitch, Randy
Thomas, and Russ Petrella were among those who contributed to making
those years incredibly stimulating for me. Each contributed in valuable
ways to an environment in which forensic mental health assessment was
accorded the highest standards possible. In a similar way, a number of my
colleagues from around the United States and Canada have been partic-
ularly helpful with concepts, standards, analysis, and providing good
models as scientist-practitioners. Steve Golding, Randy Otto, Joel Dvoskin,
Ira Packer, Randy Borum, Jim Ogloff, Steve Hart, Dick Rogers, and Stuart
Greenberg particularly come to mind; thanks to each of you. In addition to
helping in similar ways, Alan Goldstein has for years directed a superb
continuing education program for the American Academy of Forensic
Psychology. The workshops I have presented for AAFP over the years
have forced me to organize and communicate many of these ideas in a
(hopefully) more coherent way, and I appreciate the chance to do so.
My association with the Law–Psychology program at MCP Hahn-
emann University and Villanova School of Law, directed by Don Bersoff,
has provided an invaluable opportunity to improve the conceptual and
legal components of this book. Don has been a good friend and colleague
during the time I have spent as codirector of the program. Several law–
psychology students (David DeMatteo, Geff Marczyk, Lori Peters, and
Kim Picarello) provided tireless research assistance, for which I am very
grateful. Other legal and scholarly help was provided by the works of
Chris Slobogin, John Petrila, and Michael Perlin. In addition, Perlin gra-
ciously agreed to review the manuscript while in town to speak at Villa-
nova (and did so in typically Perlin-esque fashion, giving an amazingly
detailed review and subsequent suggestions that took six months to imple-
ment). Ron Roesch reviewed the manuscript at a time when it needed a
push; as always, Ron provided superb help in his low-key, extraordinarily
effective way.
The most resounding "thank you" goes to Tom Grisso. He served as
the editor for this book long after his tenure as editor for the AP-LS book
series ended, and for that I am very grateful. I am even more grateful for
his time, energy, substantive contributions, and insistence on adherence
to the highest possible standards. His contributions to this book have been
enormous. Thanks, Tom.
Contents
I. INTRODUCTION
CHAPTER1. DEVELOPING PRINCIPLESOF FORENSIC MENTAL
HEALTH ASSESSMENT
Forensic versus Therapeutic Assessment 9
A Structure for Organizing Principles of FMHA 14
Deriving and Analyzing Principles 16
II. PREPARATION
CHAPTER 2. FIRSTCONTACTS
Identify Relevant Forensic Issues 21
Accept Referrals Only within Area of Expertise 26
Decline Referral When Evaluator Impartiality Is Unlikely 36
Clarify Role with Attorney 46
Clarify Financial Arrangements 51
Obtain Appropriate Authorization 58
CHAPTER 3. DEFININGTHE EVALUATOR'S ROLE
Avoid Dual-Role Relationships of Therapist and Forensic
Evaluator 65
Determine the Role to Be Played within Forensic Assessment if
the Referral Is Accepted 73
CHAPTER 4. USINGA MODEL
Select and Employ a Model to Guide Data Gathering,
Interpretation, and Communication 84
ix
x CONTENTS
III. DATA COLLECTION
CHAPTER 5. SELECTION
Use Multiple Sources of Information for Each Area Being
Assessed 99
Use Relevance and Reliability (Validity) as Guides for Seeking
Information and Selecting Data Sources 107
Obtain Relevant Historical Information 115
Assess Relevant Clinical Characteristics in Reliable and Valid
Ways 121
Assess Legally Relevant Behavior 129
CHAPTER 6. ADMINISTRATION
Ensure that Conditions for Evaluation Are Quiet, Private, and
Distraction-Free 136
Provide Appropriate Notification of Purpose and/or Obtain
Appropriate Authorization before Beginning 141
Determine Whether the Individual Understands the Purpose of
the Evaluation and Associated Limits on Confidentiality 153
IV. DATA INTERPRETATION
CHAPTER 7. ASSESSING RESPONSE STYLE
Use Third-Party Information in Assessing Response Style 167
Use Testing When Indicated in Assessing Response Style 176
CHAPTER 8. INCORPORATING SCIENTIFIC REASONINGAND DATA
Use Case-Specific (Idiographic) Evidence in Assessing Causal
Connection between Clinical Condition and Functional
Abilities 190
Use Nomothetic Evidence in Assessing Causal Connection
between Clinical Condition and Functional Abilities 196
Use Scientific Reasoning in Assessing Causal Connection
between Clinical Condition and Functional Abilities 206
CHAPTER 9. MAKING ASSERTIONSAND CLARIFYING LIMITS
Do Not Answer the Ultimate Legal Question Directly 213
Describe Findings and Limits so that They Need Change Little
under Cross Examination 226
CONTENTS xi
V. COMMUNICATION
CHAPTER 10. COMMUNICATING CLEARLY
Attribute Information to Sources 241
Use Plain Language; Avoid Technical Jargon 246
Write Report in Sections, According to Model and Procedures 249
CHAPTER 11. TESTIFYING EFFECTIVELY
Base Testimony on Results of Properly Performed FMHA 257
Testify in an Effective Manner 267
VI. APPLYING THE PRINCIPLES
OF FORENSIC MENTAL HEALTH ASSESSMENT
CHAPTER 12. IMPLICATIONSFOR RESEARCH, TRAINING, PRACTICE,
AND POLICY
Implications for Research 286
Implications for Training 299
Implications for Practice 301
Implications for Policy 305
REFERENCES 309
CASES 332
INDEX 335