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Chaimowitz GA, Simpson AIF. Charting a New Course for Forensic Psychiatry. J Am Acad Psychiatry Law 2021; 49:157-160. [PMID: 34131057 DOI: 10.29158/jaapl.210013-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Gary A Chaimowitz
- Dr. Chaimowitz is Professor of Psychiatry, Department of Psychiatry and Behavioural Neurosciences, McMaster University, St Josephs Healthcare, Hamilton, ON, Canada. Dr. Simpson is Chair of Forensic Psychiatry, Department of Psychiatry, Centre for Addiction and Mental Health + University of Toronto, Toronto, ON, Canada.
| | - Alexander I F Simpson
- Dr. Chaimowitz is Professor of Psychiatry, Department of Psychiatry and Behavioural Neurosciences, McMaster University, St Josephs Healthcare, Hamilton, ON, Canada. Dr. Simpson is Chair of Forensic Psychiatry, Department of Psychiatry, Centre for Addiction and Mental Health + University of Toronto, Toronto, ON, Canada
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Leung PC, Looman J, Abracen J. To Reoffend or Not to Reoffend? An Investigation of Recidivism Among Individuals With Sexual Offense Histories and Psychopathy. Sex Abuse 2021; 33:88-113. [PMID: 31538857 DOI: 10.1177/1079063219877173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Although psychopathy is a well-established risk factor for recidivism among those who have committed sexual offenses, there are nonetheless some individuals with sexual offense histories who are high in psychopathy but do not recidivate. This population-nonrecidivating psychopathic sex offenders (NRP-SOs)-was the focus of the current investigation. Data from 111 individuals with sexual offense histories who received a Hare Psychopathy Checklist-Revised (PCL-R) rating of at least 25 (suggesting the presence of psychopathy) were analyzed. With recidivism operationalized as the accrual of any new serious-that is, violent or sexual-charges, 39 recidivated (RP-SOs), whereas 72 did not (NRP-SOs). A logistic regression was conducted to assess whether NRP-SOs could be differentiated from RP-SOs. Being older at the time of release, a lesser criminal history, and being married predicted nonrecidivism. PCL-R factor scores and sexual deviance were not predictive. These findings highlight the heterogeneity that exists, even among those high in psychopathy.
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Affiliation(s)
| | - Jan Looman
- Forensic Behaviour Services, Kingston, Ontario, Canada
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Hall RCW, Hatters Friedman S. Comic Books, Dr. Wertham, and the Villains of Forensic Psychiatry. J Am Acad Psychiatry Law 2020; 48:536-544. [PMID: 33023900 DOI: 10.29158/jaapl.200041-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Comic books have been part of popular culture since the 1930s. Social activists quickly became concerned about the risk that comic books posed for youth, including that their content was a cause of juvenile delinquency. Dr. Fredric Wertham, a forensic psychiatrist, led efforts to protect society's children from comic books, culminating in multiple publications, symposia, and testimony before a Senate subcommittee on juvenile delinquency in 1954. During the course of his activities, and quite possibly as a backlash, comics started to represent psychiatrists and particularly forensic psychiatrists as evil, clueless, and narcissistic characters (e.g., Dr. Hugo Strange went from being a mad scientist to a mad psychiatrist). Clinical forensic psychiatrists who were not necessarily evil were often portrayed as inept regarding rehabilitation. There are very few positive portrayals of forensic psychiatrists in the comic book universe, and when they do occur, they often have severe character flaws or a checkered history. These negative characterizations are woven into the fabric of contemporary comic book characters, whether represented in comic books or other media offshoots such as films and television.
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Affiliation(s)
- Ryan Chaloner Winton Hall
- Dr. Hall is Associate Professor, College of Medicine, University of Central Florida, Orlando, FL. Dr. Hatters Friedman is the Phillip J. Resnick Professor of Forensic Psychiatry, Case Western Reserve School of Medicine, Cleveland, OH. Dr. Hatters Friedman is involved in the editorial leadership of The Journal; however, she did not participate in any aspect of this article's review and acceptance.
| | - Susan Hatters Friedman
- Dr. Hall is Associate Professor, College of Medicine, University of Central Florida, Orlando, FL. Dr. Hatters Friedman is the Phillip J. Resnick Professor of Forensic Psychiatry, Case Western Reserve School of Medicine, Cleveland, OH. Dr. Hatters Friedman is involved in the editorial leadership of The Journal; however, she did not participate in any aspect of this article's review and acceptance
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Schwartz-Mette RA, Righthand S, Hecker J, Dore G, Huff R. Long-Term Predictive Validity of the Juvenile Sex Offender Assessment Protocol-II: Research and Practice Implications. Sex Abuse 2020; 32:499-520. [PMID: 30714853 DOI: 10.1177/1079063219825871] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The current study evaluated the predictive validity of the Juvenile Sex Offender Assessment Protocol-II (J-SOAP-II) scores in a sample of juveniles who recidivated sexually or nonsexually as adults. Participants included 166 juveniles who had previously sexually offended and were followed into adulthood for an average of 10.75 years. Results of area under the receiver operating characteristic curve (AUC) analyses supported the predictive validity of the J-SOAP-II Total Score, Scale 1, and Static Score in regard to adult sexual recidivism, and predictive validity was found for all J-SOAP-II scores (except Scale 1) in regard to adult nonsexual recidivism. Implications for future research on the assessment of risk factors and treatment needs for adolescents who commit sexual offenses are discussed.
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Cardona N, Berman AK, Sims-Knight JE, Knight RA. Covariates of the Severity of Aggression in Sexual Crimes: Psychopathy and Borderline Characteristics. Sex Abuse 2020; 32:154-178. [PMID: 30394860 DOI: 10.1177/1079063218807485] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Whereas risk assessment literature on sexual offending has primarily focused on prediction of subsequent sexual crimes, and not the severity of those crimes, the first aim of the present study was to identify variables that predict the amount of damage to victims in sexual crimes compared with those that predict general aggressiveness. The second aim was to ascertain whether adding emotional instability measurements, as in borderline personality disorder (BPD), would add incremental variance to that captured by the facets of the Psychopathy Checklist-Revised (PCL-R). Trained raters assessed on the PCL-R, BPD, and measures of severity of sexual and nonsexual violence 302 adults who had sexually offended. PCL-R's Antisociality and two externalizing BPD factors (one from the standard and one from the alternative criteria) were significant predictors of violence both in sexual and nonsexual crimes. In contrast, deficits in the PCL-R's Affective facet (2) predicted victim damage in sexual contexts only, whereas the Lifestyle Impulsivity facet (3) of the PCL-R predicted violence in nonsexual contexts only. These findings suggest that adding measures of emotional dysregulation to commonly used instruments like the PCL-R, which assesses callousness and antisociality, may be beneficial for predicting violence.
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Abstract
This article contextualizes new knowledge about forensically interviewing and assessing children when there are concerns about child abuse. The article references the impact of the Child Abuse Prevention and Treatment Act and the circumstance in the 1980s where investigators and clinicians had little guidance about how to interview children about alleged sexual abuse. It further speaks to the consequences of lack of interview guidelines and how videotaped interviews in the McMartin Pre-school cases served as the catalyst for the backlash against child interviewers and their interview techniques. Painful as the backlash was, it led to research and evidence-based practice in interviewing children about child sexual and other abuse. Principal among the practice innovations were forensic interview structures to be used when there is alleged child sexual and other abuse and the strong preference for one interview by a skilled interviewer, who is nevertheless a stranger to the child. Although these innovations satisfied many professionals in the child maltreatment field and critics of child interviewers, the new practices did not address a number of abiding issues: 1) how to meet the needs of children who are unable to disclose maltreatment in a single interview, 2) how to determine which children are suggestible in a forensic interview, and 3) how decisions are made about the likelihood of abuse, based upon the child's information during the interview. The articles in this special section address these cutting-edge issues.
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Duron JF, Remko FS. Considerations for Pursuing Multiple Session Forensic Interviews in Child Sexual Abuse Investigations. J Child Sex Abus 2020; 29:138-157. [PMID: 30095357 DOI: 10.1080/10538712.2018.1504263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 05/16/2018] [Accepted: 07/01/2018] [Indexed: 06/08/2023]
Abstract
Multiple session forensic interviews (MSFI) are a useful tool in the field of child sexual abuse forensic interviewing given the complexity of disclosures and the variety of child-centered needs observed in practice. This paper focuses on the Children's Advocacy Centers of Texas (CACTX) model for conducting MSFIs, illustrated by a description of the statewide training models offered to member centers and enumeration of the MSFI protocol guidelines implemented by one center. A brief history and review of the single session forensic interview (SSFI) is provided followed by considerations for MSFIs in order to establish the development of current and new practices. Clarification of terms are outlined with examples of cases to distinguish between multiple sessions and subsequent sessions. The MSFI guidelines presented demonstrate how an MSFI can fit with the SSFI model.
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Affiliation(s)
- Jacquelynn F Duron
- School of Social Work, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
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Duron JF. Searching for Truth: The Forensic Interviewer's Use of an Assessment Approach While Conducting Child Sexual Abuse Interviews. J Child Sex Abus 2020; 29:183-204. [PMID: 29932818 DOI: 10.1080/10538712.2018.1484833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 04/17/2018] [Accepted: 05/31/2018] [Indexed: 06/08/2023]
Abstract
This study examined the assessment approach interviewers use while conducting interviews to assess truth as narratives are gathered in children's disclosure statements by examining 100 forensic interviews completed at a Children's Advocacy Center. A descriptive review was used to examine the steps engaged by interviewers as they followed a protocol and content analysis was used to identify interviewers' questioning strategies as they assessed children's disclosure narratives during interviews. Findings indicate that interviewers apply a protocol in order to support advancing to a phase of eliciting details in children's narratives. Questioning strategies included using a variety of question types to progress from general to specific, incorporating interview aids sparingly as necessary, and integrating multidisciplinary team feedback. Findings suggest that an assessment approach is inherent to the process of actively conducting a forensic interview. Rather than assessment beginning strictly upon completion of children's narratives, this paper describes how interviewers incorporate an assessment framework throughout interviewing.
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Affiliation(s)
- Jacquelynn F Duron
- School of Social Work, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
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Abstract
Following the Court of Appeal case of R v Edwards in England and Wales, there has been increasing pressure for expert psychiatric witnesses to comment explicitly on how a defendant’s mental disorder affects their culpability. Culpability is the degree to which a person can be held morally or legally responsible for their conduct, but defining culpability has proved difficult. Mental disorder does not translate easily into degrees of legal culpability. Although psychiatric evidence will often be central to such cases, the determination of culpability is a matter for the court, and experts should not comment on it explicitly. Nevertheless, certain areas of psychiatry may have a bearing on culpability, and ways in which experts may comment on these are suggested. Given the pressure on judges to determine culpability, experts need to be honest about the limits of medical science to answer legal questions and the professional necessity to remain within their area of expertise.
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Murphy JFA. Doolin Memorial Lecture 2019. Ir Med J 2019; 112:1013. [PMID: 32212599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- J F A Murphy
- The National Maternity Hospital, Holles Street, Dublin 2
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Abstract
INTRODUCTION Therapeutic relationship in forensic psychiatry is believed to be affected by the coercive setting and the role conflict of the therapists as both treaters and court-appointed experts. The aim of the study was to examine and compare the therapeutic relationship in forensic and general psychiatric settings. MATERIAL AND METHODS 52 forensic patients and 66 general psychiatric patients filled in the Psychopathy Personality Inventory - Revised (PPI-R), the Inventory of Interpersonal Problems - German Version (IIP-D), the Questionnaire on Motivation for Psychotherapy (Fragebogen zur Erfassung der Psychotherapiemotivation (FPTM)) as well as the Working Alliance Inventory - Short Revised (WAI-SR). We applied descriptive analyses, calculated univariate t-tests as well as multivariate T-tests and performed general linear models. RESULTS The quality of the therapeutic alliance does not differ significantly between forensic and general psychiatric patients. Moreover, patients of forensic psychiatry consider therapeutic techniques applied by their therapists as more valuable for achieving their therapeutic aims than patients of the general psychiatry. DISCUSSION The therapeutic relationship in forensic psychiatry is as viable as in general psychiatry. This can be regarded as a result of the long-term therapy in the context of forensic psychiatry which allows more time to be spent on relationship building than in a general psychiatry setting where therapy is limited to a few weeks.
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Affiliation(s)
- Stefanie Otte
- Universität Ulm, Klinik für Forensische Psychiatrie und Psychotherapie am BKH Günzburg
| | - Judith Streb
- Universität Ulm, Klinik für Forensische Psychiatrie und Psychotherapie am BKH Günzburg
| | - Katharina Rasche
- Universität Ulm, Klinik für Forensische Psychiatrie und Psychotherapie am BKH Günzburg
| | - Irina Franke
- Universität Ulm, Klinik für Forensische Psychiatrie und Psychotherapie am BKH Günzburg
| | - Stefanie Nigel
- Universität Ulm, Klinik für Forensische Psychiatrie und Psychotherapie am BKH Günzburg
| | - Felix Segmiller
- Universität Ulm, Klinik für Forensische Psychiatrie und Psychotherapie am BKH Günzburg
| | | | - Nenad Vasic
- Klinikum Christophsbad Göppingen, Klinik für Psychiatrie und Psychotherapie
| | - Manuela Dudeck
- Universität Ulm, Klinik für Forensische Psychiatrie und Psychotherapie am BKH Günzburg
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Wall BW, Aoun EG. Diversity and Inclusion Within AAPL. J Am Acad Psychiatry Law 2019; 47:274-277. [PMID: 31467072 DOI: 10.29158/jaapl.003870-19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Barry W Wall
- Dr. Wall is Clinical Professor of Psychiatry, Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, and Director, Forensic Service, Eleanor Slater Hospital, Rhode Island Department of Behavioral Healthcare, Developmental Disabilities, and Hospitals, Cranston, Rhode Island. Dr. Aoun is Clinical Instructor of Psychiatry at New York University and a Forensic Psychiatry Research Fellow at Columbia University, New York, New York.
| | - Elie G Aoun
- Dr. Wall is Clinical Professor of Psychiatry, Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, and Director, Forensic Service, Eleanor Slater Hospital, Rhode Island Department of Behavioral Healthcare, Developmental Disabilities, and Hospitals, Cranston, Rhode Island. Dr. Aoun is Clinical Instructor of Psychiatry at New York University and a Forensic Psychiatry Research Fellow at Columbia University, New York, New York
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Gold L. Reflections Prompted by the Maintenance of Certification. J Am Acad Psychiatry Law 2019; 47:347-349. [PMID: 31467073 DOI: 10.29158/jaapl.003871-19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Liza Gold
- Dr. Gold is Clinical Professor of Psychiatry, Georgetown University School of Medicine, Arlington, Virginia.
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Jeandarme I, Habets P, Kennedy H. Structured versus unstructured judgment: DUNDRUM-1 compared to court decisions. Int J Law Psychiatry 2019; 64:205-210. [PMID: 31122631 DOI: 10.1016/j.ijlp.2019.04.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 03/26/2019] [Accepted: 04/18/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Criteria to determine in which level of security forensic patients should receive treatment are currently non-existent in Belgium. Courts largely rely on the evaluations of the prison psychiatrists and psychologists to form their decision. None of the few available instruments - e.g., the DUNDRUM-1 - is currently used to provide structured clinical judgment when determining security level. METHOD DUNDRUM-1 scores were collected for 150 forensic patients. Security levels according to DUNDRUM-1 assessment were compared to security levels as decided by the court. RESULTS There was little agreement between DUNDRUM-1 scores and proposals for secure care made by the court. The DUNDRUM-1 predicted eventual admission to a high security setting, but not a medium security setting. CONCLUSION The DUNDRUM-1 is an instrument that can help clinicians and judges to make more reliable and transparent decisions regarding secure care. However, further research with regard to practical applicability is needed.
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Affiliation(s)
- Inge Jeandarme
- Knowledge Centre for Forensic Psychiatric Care (KeFor), OPZC, Rekem, Belgium.
| | - Petra Habets
- Knowledge Centre for Forensic Psychiatric Care (KeFor), OPZC, Rekem, Belgium.
| | - Harry Kennedy
- National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Ireland.
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Blake GA, Ogloff JRP, Chen WS. Meta-analysis of second generation competency to stand trial assessment measures: Preliminary findings. Int J Law Psychiatry 2019; 64:238-249. [PMID: 31122635 DOI: 10.1016/j.ijlp.2019.04.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 04/23/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Since the 1990s, standardized competency to stand trial assessment measures have been developed to improve the reliability and validity of expert assessment and opinion in legal settings. This study aimed to meta-analyze the psychometric properties of the four 'second generation' assessment tools: the MacCAT-CA, MacCAT-FP, ECST-R and CAST*MR. METHOD A systematic search of published and unpublished studies was undertaken on PsycNet, PubMed, Scopus, Web of Science and Science Direct up until February 2018. Test manuals were sourced and attempts at finding grey literature included contacting study authors and test developers. RESULTS Eleven studies were included in the final analysis. The MacCAT-CA, ECST-R and CAST*MR demonstrated acceptable subscale internal consistencies and interrater reliability. The MacCAT-CA and CAST*MR discriminated between competent and incompetent defendants with large effects. The MacCAT-FP had insufficient reliability data and poor discrimination. There was insufficient data to meta-analyze the factor structure, sensitivity, specificity, or effect sizes between types of clinical presentation on any tool. CONCLUSIONS Very few studies have investigated the psychometric properties of the selected tools. Many studies were excluded for not providing original data or simply re-reporting the psychometric properties stated in test manuals. Whilst the MacCAT-CA and ECST-R have promising psychometric properties, ongoing construct validation is required.
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Affiliation(s)
- Grant A Blake
- Centre for Forensic Behavioural Science, Swinburne University of Technology and Forensicare, Melbourne, Australia.
| | - James R P Ogloff
- Centre for Forensic Behavioural Science, Swinburne University of Technology and Forensicare, Melbourne, Australia
| | - Won Sun Chen
- Department of Statistics, Data Science and Epidemiology, Swinburne University, Australia
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Briken P, Turner D, Thibaut F, Bradford J, Cosyns P, Tozdan S. Validation of the Change or Stop Testosterone-Lowering Medication (COSTLow) Scale Using the Delphi Method Among Clinical Experts. J Sex Marital Ther 2018; 45:148-158. [PMID: 30040595 DOI: 10.1080/0092623x.2018.1491910] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 06/15/2018] [Accepted: 06/19/2018] [Indexed: 06/08/2023]
Abstract
Guidelines for pharmacological treatment of patients with paraphilic disorders have been developed by a working group of the World Federation of Societies of Biological Psychiatry (Thibaut et al., 2010 ). With an increasing duration of experience and number of treated patients as well as aging patients, change of or withdrawal from testosterone-lowering medications (TLM) has become an important issue. The current study aimed to assess the quality of a structured professional judgment procedure that helps switching or discontinuing TLM in patients with paraphilic disorders. We used the Delphi method to estimate the quality of 10 factors originally proposed by the authors. A total of 30 experts participated in the first stage; 18 experts participated in the second stage. The experts' assessment resulted in an instrument of 15 factors that can be used to structure the process of changing or discontinuing TLM. These factors can be grouped into five broader categories: age and duration of treatment; therapeutic alliance; psychopathology and risk factors; motivation; and compliance and level of control. The developed COSTLow-R Scale provides an instrument that can be used to structure the process of changing or discontinuing TLM in patients with severe paraphilic disorders.
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Affiliation(s)
- Peer Briken
- a Institute for Sex Research and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Daniel Turner
- a Institute for Sex Research and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf , Hamburg , Germany
- b Department of Psychiatry , University Medical Center Mainz , Mainz , Germany
| | - Florence Thibaut
- c Centre of Psychiatry and Neurosciences, Faculty of Medicine Paris Descartes, University Hospital Cochin (site Tarnier) , Paris , France
| | - John Bradford
- d Institute of Mental Health Research , Ottawa , Canada
| | - Paul Cosyns
- e Collaborative Antwerp Psychiatric Research Institute, University Forensic Centre , Antwerp , Belgium
| | - Safiye Tozdan
- a Institute for Sex Research and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf , Hamburg , Germany
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Wilpert J, van Horn JE, Boonmann C. Comparing the Central Eight Risk Factors: Do They Differ Across Age Groups of Sex Offenders? Int J Offender Ther Comp Criminol 2018; 62:4278-4294. [PMID: 29478392 DOI: 10.1177/0306624x18758899] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Following the risk-need-responsivity (RNR) model, cognitive-behavioral therapy is considered most effective in reducing recidivism when based on dynamic risk factors. As studies have found differences of these factors across age, exploring this seems beneficial. The current study investigates the Central Eight (C8) risk factors across six age groups of outpatient sex offenders ( N = 650). Results showed that recidivism rates and age were inversely related from 19 years and up. Half of the C8 did not predict general recidivism at all, substance abuse, antisocial cognition, antisocial associates, and history of antisocial behavior in only one or several age groups. However, factors differed between age groups, with the youngest group demonstrating the most dysfunction in several areas and the oldest group the least. It is concluded that the C8 risk factors seem to lose significance in the older age groups. Results may benefit targeting treatment goals.
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Affiliation(s)
- Julia Wilpert
- 1 De Forensische Zorgspecialisten, Utrecht, The Netherlands
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Hershkowitz I, Melkman EP, Zur R. When Is a Child's Forensic Statement Deemed Credible? A Comparison of Physical and Sexual Abuse Cases. Child Maltreat 2018; 23:196-206. [PMID: 29034734 DOI: 10.1177/1077559517734059] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
A large national sample of 4,775 reports of child physical and sexual abuse made in Israel in 2014 was analyzed in order to examine whether assessments of credibility would vary according to abuse type, physical or sexual, and whether child and event characteristics contributing to the probability that reports of abuse would be determined as credible would be similar or different in child physical abuse (CPA) and child sexual abuse (CSA) cases. Results revealed that CPA reports were less likely to be viewed as credible (41.9%) compared to CSA reports (56.7%). Multigroup path analysis, however, indicated equivalence in predicting factors. In a unified model for both types of abuse, salient predictors of a credible judgment were older age, lack of a cognitive delay, and the alleged abusive event being a onetime less severe act. Over and beyond the effects of these factors, abuse type significantly contributed to the prediction of credibility judgments.
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Affiliation(s)
| | - Eran P Melkman
- 2 Department of Education, Rees Centre for Research on Fostering and Education, University of Oxford, Oxford, United Kingdom
| | - Ronit Zur
- 3 Child Investigations Service, Ministry of Labour and Social Affairs, Jerusalem, Israel
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Recupero PR. The Notion of Truth and Our Evolving Understanding of Sexual Harassment. J Am Acad Psychiatry Law 2018; 46:23-30. [PMID: 29618532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The notion of truth and its determination in legal proceedings is contingent on the cultural setting in which a claim is argued or disputed. Recent years have demonstrated a dramatic shift in the public dialogue concerning sexual harassment. This shift reflects changing cultural mores and standards in the workplace and society as a whole, particularly with respect to the validity of women's voices. The subjective reality experienced by victims of sexual harassment is inherently tied to the legal system's treatment of women throughout history. In determinations of truth, our understanding of which information and perspectives are relevant, and our expectations regarding the credibility of complainants and the accused, are undergoing a period of rapid change. The discourse surrounding the #MeToo movement suggests that the "reasonable-person" standard so often applied by courts is poorly suited to sexual-harassment litigation. As our understanding of what constitutes "severe," "pervasive," and "unwelcome" conduct continues to evolve, forensic psychiatrists must strive to uphold the values of respect for persons in the search for the truth.
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Affiliation(s)
- Patricia R Recupero
- Dr. Recupero is Clinical Professor of Psychiatry, Alpert Medical School of Brown University, and Senior Vice President, Education and Training, Care New England Health System, Providence, RI.
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Abstract
Forensic psychiatry has often been neglected in nonwestern countries, including the African continent. Our aim was to assess the practices and needs for improvement in the field of forensic psychiatry in Rwanda. During a one-week visit conducted in October 2017, we interviewed key-informants working at decisional levels in the domains of health, justice and security. Two clinical workshops involving psychiatrists, psychologists and nurses were held in psychiatric facilities, including at Ndera, the main psychiatric hospital of the country. Three axes of development and improvement were identified: First there is a need for a clearer, more coherent and updated legislative framework. Second, the absence of a forensic secured unit, which compromises both quality of care for forensic patients and security of the other patients and staff, should be remediated. Third, the supervision and training in this specialized domain should be provided through international collaborations. Hopefully, Rwanda could become in the next few years a driving force for other African countries in the field of forensic psychiatry.
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Affiliation(s)
- Ariel Eytan
- Medical Direction, Belle-Idée, Geneva University Hospitals, Thônex, Switzerland
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Kelly M. The Pursuit of Excellence in Forensic Psychiatry Education. Acad Psychiatry 2017; 41:780-782. [PMID: 28983812 DOI: 10.1007/s40596-017-0815-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 09/11/2017] [Indexed: 06/07/2023]
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22
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Ford E, Gray S, Subedi B. Finding Common Ground: Educating General Psychiatry Residents About Forensic Psychiatry. Acad Psychiatry 2017; 41:783-788. [PMID: 28424982 DOI: 10.1007/s40596-017-0688-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 02/15/2017] [Indexed: 06/07/2023]
Affiliation(s)
- Elizabeth Ford
- New York University School of Medicine, New York, NY, USA.
| | - Susan Gray
- New York University School of Medicine, New York, NY, USA
| | - Bipin Subedi
- New York University School of Medicine, New York, NY, USA
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Bloom JD, Novosad D. The Forensic Mental Health Services Census of Forensic Populations in State Facilities. J Am Acad Psychiatry Law 2017; 45:447-451. [PMID: 29282235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This article focuses on the development of a Forensic Mental Health Services Census (FMHSC), proposed to differentiate between five different patient populations institutionalized in state facilities. The FMHSC would comprise patients who are civilly committed for mental illness or sexual dangerousness, those found incompetent to stand trial, those committed after a verdict of not guilty by reason of insanity, and those voluntarily committed. The census would be performed by state mental health authorities for each of these populations within the particular jurisdiction and then would be reported to a national coordinating organization. These data are important because of the large number of persons involved and the significant resources devoted to the management and treatment of each involuntary group. The census is necessary for clinical, research, and policy purposes, to provide more rational management of these populations, both within and across jurisdictions.
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Affiliation(s)
- Joseph D Bloom
- Dr. Bloom is Clinical Professor, Department of Psychiatry, University of Arizona College of Medicine-Phoenix, Phoenix, AZ. Dr. Novosad is Staff Psychiatrist at the Atlanta VA Medical Center, Atlanta, GA.
| | - David Novosad
- Dr. Bloom is Clinical Professor, Department of Psychiatry, University of Arizona College of Medicine-Phoenix, Phoenix, AZ. Dr. Novosad is Staff Psychiatrist at the Atlanta VA Medical Center, Atlanta, GA
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24
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Christmanson K. [Legally uncertain forensic psychiatry?]. Lakartidningen 2017; 114:ESTR. [PMID: 28829483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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25
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Tully J. HCR-20 shows poor field validity in clinical forensic psychiatry settings. Evid Based Ment Health 2017; 20:95-96. [PMID: 28710066 PMCID: PMC10688547 DOI: 10.1136/eb-2017-102745] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 06/14/2017] [Indexed: 01/08/2023]
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26
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Melkman EP, Hershkowitz I, Zur R. Credibility assessment in child sexual abuse investigations: A descriptive analysis. Child Abuse Negl 2017; 67:76-85. [PMID: 28242369 DOI: 10.1016/j.chiabu.2017.01.027] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 01/18/2017] [Accepted: 01/31/2017] [Indexed: 06/06/2023]
Abstract
A major challenge in cases of child sexual abuse (CSA) is determining the credibility of children's reports. Consequently cases may be misclassified as false or deemed 'no judgment possible'. Based on a large national sample of reports of CSA made in Israel in 2014, the study examines child and event characteristics contributing to the probability that reports of abuse would be judged credible. National data files of all children aged 3-14, who were referred for investigation following suspected victimization of sexual abuse, and had disclosed sexual abuse, were analyzed. Cases were classified as either 'credible' or 'no judgment possible'. The probability of reaching a 'credible' judgment was examined in relation to characteristics of the child (age, gender, cognitive delay, marital status of the parents,) and of the abusive event (abuse severity, frequency, perpetrator-victim relationship, perpetrator's use of grooming, and perpetrator's use of coercion), controlling for investigator's identity at the cluster level of the analysis. Of 1563 cases analyzed, 57.9% were assessed as credible. The most powerful predictors of a credible judgment were older age and absence of a cognitive delay. Reports of children to married parents, who experienced a single abusive event that involved perpetrator's use of grooming, were also more likely to be judged as credible. Rates of credible judgments found are lower than expected suggesting under-identification of truthful reports of CSA. In particular, those cases of severe and multiple abuse involving younger and cognitively delayed children are the ones with the lowest chances of being assessed as credible.
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Affiliation(s)
- Eran P Melkman
- School of Social Work, University of Haifa, Haifa, Israel.
| | | | - Ronit Zur
- Department of Child Investigations, Ministry of Labour and Social Affairs, Jerusalem, Israel
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Brown JM, Haun J, Zapf PA, Brown NN. Fetal Alcohol Spectrum Disorders (FASD) and competency to stand trial (CST): Suggestions for a 'best practices' approach to forensic evaluation. Int J Law Psychiatry 2017; 52:19-27. [PMID: 28502700 DOI: 10.1016/j.ijlp.2017.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 03/25/2017] [Accepted: 04/24/2017] [Indexed: 06/07/2023]
Abstract
Fetal Alcohol Spectrum Disorders (FASD), an umbrella term for neurodevelopmental conditions caused by prenatal alcohol exposure, is overrepresented in the U.S. juvenile and adult criminal justice systems. The brain damage in FASD manifests in a combination of cognitive and adaptive impairments that potentially reduce ability to function adequately during the criminal justice process, including capacity to stand trial (CST). Despite the high risk of arrest and conviction in this population, relatively little research guides CST assessment for defendants who have or may have FASD. Therefore, the purpose of this article is to describe how FASD may affect CST and suggest ways forensic professionals might modify assessment protocols to address possible effects of FASD-associated impairments on adjudicative capacity.
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Affiliation(s)
- Jerrod M Brown
- Concordia University, St. Paul, MN, USA; Pathways Counseling Center, St. Paul, MN, USA; The American Institute for the Advancement of Forensic Studies, St. Paul, MN, USA.
| | - Jeffrey Haun
- University of Minnesota, Minneapolis, MN, USA; State Operated Forensic Services, St. Peter, MN, USA
| | - Patricia A Zapf
- John Jay College of Criminal Justice, The City University of New York, NYC, NY, USA; Consolidated Continuing Education and Professional Training, FL, USA
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28
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Felthous AR. Toward a useful standard for hospitalizing pretrial jail detainees. Int J Law Psychiatry 2017; 52:103-110. [PMID: 28365036 DOI: 10.1016/j.ijlp.2017.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 02/14/2017] [Indexed: 06/07/2023]
Abstract
Severely mentally ill jail detainees require an adequate spectrum of mental health services during detainment. For some this means a limited period of treatment in a mental hospital, just as some mentally ill individuals in the community occasionally require hospital treatment. Unfortunately, this appropriate level of treatment is often denied or neglected for jail detainees with adverse consequences for them. Among the reasons for this neglect, may be standards for hospital transfer that are no longer practical and can be easily skirted by policymakers and administrators with little interest in ensuring this level of care for mentally ill jail inmates. A more realistic standard and justification would recognize the need for hospitalization for the mentally disordered detainee who because of psychotic anosognosia refuses appropriate treatment including medications and/or whose severely decompensated condition is worsening or failing to improve despite attempts at treatment in the jail.
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Affiliation(s)
- Alan R Felthous
- Department of Psychiatry and Behavioral Neuroscience, Saint Louis University School of Medicine, 1438 South Grand Blvd., St. Louis, MO 63104, United States.
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Keune LH, de Vogel V, van Marle HJC. The evaluation stage of the Hoeven Outcome Monitor (HOM): Towards an evidence based groundwork in forensic mental health. Int J Law Psychiatry 2017; 51:42-53. [PMID: 28256255 DOI: 10.1016/j.ijlp.2017.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This study examined if a macro-, meso-, and micro outcome measurement instrument that constitutes the evaluation stage of a Dutch forensic psychiatric outcome monitor, the Hoeven Outcome Monitor (HOM), can provide a first step towards a more evidence based groundwork in forensic mental health. General, serious, very serious, special, and tbs meriting recidivism during treatment, after treatment, and overall were charted for forensic psychiatric patients discharged from a Dutch forensic psychiatric centre between 1999 and 2008 (N=164). Re-conviction data were obtained from the official Criminal Records System, and the mean follow-up time was 116.2months. First, the results showed that the macro-measurements provide comparative outcome measures to generate insight into the overall effectiveness of forensic psychiatric treatment. Second, the meso-measurements yielded clinically relevant treatment outcome data for all discharged patients to generate a complete view of treatment effectiveness. Finally, the micro-measurements allowed access to detailed patient and treatment effectiveness assessments that provides the empirical foundation to conduct aetiological research into the prediction and control of high-risk behaviour. Thus, an outcome measurement instrument in line with Evidence Based Medicine and best practice guidelines was designed that provides an empirically sound evaluation framework for treatment effectiveness, and an impetus for the development of effective interventions to generate an evidence based groundwork in forensic mental health.
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Affiliation(s)
- Lobke H Keune
- Research Department De Forensische Zorgspecialisten, P.O. Box 174, 3500 DA Utrecht, The Netherlands.
| | - Vivienne de Vogel
- Research Department De Forensische Zorgspecialisten, P.O. Box 174, 3500 DA Utrecht, The Netherlands.
| | - Hjalmar J C van Marle
- Erasmus University Medical Centre, P.O. Box 2040, 3000 CA, Rotterdam DP-0424, The Netherlands; Erasmus School of Law Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam DP-0424, The Netherlands.
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30
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Goethals KR. [Temptations for the Belgian forensic psychiatry]. Tijdschr Psychiatr 2017; 59:326-328. [PMID: 28613363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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Abstract
Approaches to forensic report writing in psychiatry, psychology, and related mental health disciplines have moved from an organization, content, and stylistic framework to considering ethical and other codes, evidentiary standards, and practice considerations. The first part of the article surveys different approaches to forensic report writing, including that of forensic mental health assessment and psychiatric ethics. The second part deals especially with psychological ethical approaches. The American Psychological Association's Ethical Principles and Code of Conduct (2002) provide one set of principles on which to base forensic report writing. The U.S. Federal Rules of Evidence (2014) and related state rules provide another basis. The American Psychological Association's Specialty Guidelines for Forensic Psychology (2013) provide a third source. Some work has expanded the principles in ethics codes; and, in the third part of this article, these additions are applied to forensic report writing. Other work that could help with the question of forensic report writing concerns the 4 Ds in psychological injury assessments (e.g., conduct oneself with Dignity, avoid the adversary Divide, get the needed reliable Data, Determine interpretations and conclusions judiciously). One overarching ethical principle that is especially applicable in forensic report writing is to be comprehensive, scientific, and impartial. As applied to forensic report writing, the overall principle that applies is that the work process and product should reflect integrity in its ethics, law, and science. Four principles that derive from this meta-principle concern: Competency and Communication; Procedure and Protection; Dignity and Distance; and Data Collection and Determination. The standards or rules associated with each of these principles are reviewed.
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Affiliation(s)
- Gerald Young
- York University, Glendon Campus, Toronto, Ontario, Canada.
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Anderson GD, Anderson JN, Krippner M. "I Only Want to Know What You Know": The Use of Orienting Messages During Forensic Interviews and Their Effects on Child Behavior. J Child Sex Abus 2016; 25:655-673. [PMID: 27561121 DOI: 10.1080/10538712.2016.1194356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The purpose of this research was to evaluate orienting messages within the CornerHouse Forensic Interview Protocol in two formats: provided both at the outset and as needed throughout the interview compared to previous practice in which orienting messages were provided only as the opportunity arose. Through the content analysis of 120 videotaped forensic interviews and corresponding case files in which children were interviewed for sexual abuse allegations, results suggest that the use of orienting messages both at the beginning and as needed lead to significantly more autonomous responses from children, that use of more orienting messages was significantly related to more autonomous responses from children, and that the specific orienting messages of "can't/won't say" and "ask me a question" significantly predict more autonomous responses among children. Implications for practice include the use of orienting messages as a way to provide a respectful and safe experience for children participating in forensic interviews.
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Affiliation(s)
| | | | - Megan Krippner
- c Department of Social Work , Minnesota State University , Mankato , Minnesota
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33
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Martin K, Martin E. Factors influencing treatment team recommendations to review tribunals for forensic psychiatric patients. Behav Sci Law 2016; 34:551-563. [PMID: 27147124 DOI: 10.1002/bsl.2244] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 03/14/2016] [Accepted: 03/23/2016] [Indexed: 06/05/2023]
Abstract
It is the responsibility of forensic psychiatric hospitals to detain and treat patients, gradually reintegrating them into society; decisions to release patients must balance risk to the public with maintaining the least restrictive environment for patients. Little is known about the factors considered when making such decisions and whether these factors have been empirically linked to future risk of violence. The current study explores the factors predictive of forensic treatment teams' recommendations for patients under the care of the Ontario Review Board (ORB). Factors differ depending on level of security; decisions on medium secure units were influenced by the presence of active symptoms and patients' overall violence risk level and decisions made on minimum secure units were influenced by the number of critical incidents that occurred within the recommendation year. Understanding the factors used to make recommendations to the ORB tribunal helps treatment teams to reflect on their own decision-making practices. Furthermore, the results serve to inform us about factors that influence length of stay for forensic psychiatric patients. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Krystle Martin
- Ontario Shores Centre for Mental Health Sciences, Whitby, ON, Canada
| | - Erica Martin
- Ontario Shores Centre for Mental Health Sciences, Whitby, ON, Canada
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34
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Dreßing H, Meyer-Lindenberg A. [DSM-5: What is new and what is relevant to forensic psychiatric assessment?]. Versicherungsmedizin 2016; 68:4-7. [PMID: 27111950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
DSM-5 lists a number of new diagnostic categories and also major changes in diagnoses that have previously been in use. The diagnostic sections of the DSM-5 and certain fundamental changes are presented. Some of the implications with respect to expert opinions are discussed. Certain aspects of the DSM-5 section on somatic symptom disorder will be discussed in more detail, since complaints of physical symptoms without an adequate medical explanation are very frequently encountered in the general population.
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Melnick I. Passageway: A Novel Approach to Success of Conditional Release - Principles and Constructs of the Model Residential Program for the Forensic Mentally III Patient. Behav Sci Law 2016; 34:396-406. [PMID: 27097984 DOI: 10.1002/bsl.2227] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
With the advent of psychotropic medications and with the deinstitutionalization of psychiatry starting in 1968, patients were prematurely discharged from forensic state hospitals. Due to lack of resources, psychiatric forensic patients ended up in the correctional system or homeless with the reduction of psychiatric beds in forensic and civil state hospitals. Lacking proper training and medication management, the recidivism rate of this population was close to 10% for rearrest and about 35% for revocation of conditional release (CR; Manguno-Mire et al., ). A new treatment modality was created to successfully transition patients from the forensic state hospital system to the community. This article describes and analyzes the principles and constructs of Passageway, a model residential program for patients found not guilty by reason of insanity or those incompetent to proceed to CR. The CR allows for a program like Passageway to be successful in transitioning patients back into the community. This is accomplished with minimal government funding, and since 1982 has resulted in a 0% recidivism rate, for any known arrests or convictions and for recommittal of a felony, defined in the state of Florida as, "any criminal offense that is punishable under the laws of this state, or that would be punishable, if committed in this state, by death or imprisonment in a state penitentiary. " (Fla. Stat. § 775.08). Copyright © 2016 John Wiley & Sons, Ltd.
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36
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Schel SHH, Bouman YHA, Braun PC, Bulten BH. [The quality of life of patients in long-term forensic psychiatric care]. Tijdschr Psychiatr 2016; 58:863-871. [PMID: 27976784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Quality of life (QoL) is an important issue in long term forensic psychiatric care (LFPC).<br/> AIM: To provide an overview of the knowledge that has been obtained over the last few years about patients' QoL in LFPC.<br/> METHOD: The quality of life in LFPC has been researched every year since 2007. The research has involved the use of the Forensic Inpatient Quality of Life Questionnaire (FQL) which was developed specifically for patients in LFPC. During the longitudinal research project several studies were conducted in order to identify some of the factors that possibly define patients' QoL.<br/> RESULTS: The QoL of patients in LFPC seems to depend less on patient characteristics and more on the environmental circumstances and on the degree to which the patients have accepted these circumstances. Research has also shown that professional carers do not seem to be sufficiently aware of the QoL of their patients.<br/> CONCLUSION: The fact that it is mainly environmental circumstances that are being associated with QoL offers a positive perspective on improving/optimizing QoL of patients in LFPC. Professional carers could, for instance, be trained to discuss QoL with their patients in a structured manner. This would enable carers to identify potential aspects that require further improvement and to optimise these aspects in discussion with their patients.
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Mammarella BTM. An Evidence-Based Objection to Retributive Justice. Yale J Health Policy Law Ethics 2016; 16:289-326. [PMID: 29756753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Advancements in neuroscience and related fields are beginning to show, with increasing clarity, that certain human behaviors stem from uncontrolled, mechanistic causes. These discoveries beg the question: If a given behavior results from some combination of biological predispositions, neurological circumstances, and environmental influences, is that action unwilled and therefore absolved of all attributions of credit, blame, and responsibility? A number of scholars in law and neuroscience who answer "yes" have considered how the absence of free will should impact criminal law's willingness to justify punishments on the basis of retribution, with some arguing that criminal law ought to dispense with retributive justice because the concept of blameworthiness is out of touch with scientific reality. This Note posits a more practical reason for reform by reviewing available empirics on the way people perceive human agency. The research suggests that as the science of human agency becomes increasingly vivid and reductionistic, laypeople will become proportionally less willing to attribute blame, and these shifting societal intuitions will ultimately diminish criminal law's moral credibility. The practical effects of low moral credibility might include diminished compliance, cooperation, and acquiescence with criminal laws, as well as increased general deviance. Importantly, this Note observes that these effects will likely manifest even if people retain a belief in free will. Further, ontological reality plays no part in this Note's argument; whether we in fact have free will is irrelevant. This Note instead contributes to the discourse by highlighting the implications of oncoming shifts in lay conceptions of both particular behaviors and the natural world writ large.
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van Marle HJC. [Determining freedom of choice in forensic psychiatry is of great importance to psychiatry as a whole]. Tijdschr Psychiatr 2016; 58:92-94. [PMID: 26881341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Boumans C, Postulart D, Van Os J. [Answer]. Tijdschr Psychiatr 2015; 57:700-701. [PMID: 26470405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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41
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Goethals K. [Reaction on 'Risk assessment: when the numbers do not tell the story']. Tijdschr Psychiatr 2015; 57:699-700. [PMID: 26401612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Boumans CE, Postulart D, van Os J. [Risk assessment: when the numbers do not tell the story]. Tijdschr Psychiatr 2015; 57:535-538. [PMID: 26189423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Combalbert N, Andronikof A, Armand M, Robin C, Bazex H. Forensic mental health assessment in France: recommendations for quality improvement. Int J Law Psychiatry 2014; 37:628-634. [PMID: 24631526 DOI: 10.1016/j.ijlp.2014.02.037] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The quality of forensic mental health assessment has been a growing concern in various countries on both sides of the Atlantic, but the legal systems are not always comparable and some aspects of forensic assessment are specific to a given country. This paper describes the legal context of forensic psychological assessment in France (i.e. pre-trial investigation phase entrusted to a judge, with mental health assessment performed by preselected professionals called "experts" in French), its advantages and its pitfalls. Forensic psychiatric or psychological assessment is often an essential and decisive element in criminal cases, but since a judiciary scandal which was made public in 2005 (the Outreau case) there has been increasing criticism from the public and the legal profession regarding the reliability of clinical conclusions. Several academic studies and a parliamentary report have highlighted various faulty aspects in both the judiciary process and the mental health assessments. The heterogeneity of expert practices in France appears to be mainly related to a lack of consensus on several core notions such as mental health diagnosis or assessment methods, poor working conditions, lack of specialized training, and insufficient familiarity with the Code of Ethics. In this article we describe and analyze the French practice of forensic psychologists and psychiatrists in criminal cases and propose steps that could be taken to improve its quality, such as setting up specialized training courses, enforcing the Code of Ethics for psychologists, and calling for consensus on diagnostic and assessment methods.
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Affiliation(s)
- Nicolas Combalbert
- EA 2114, Université François-Rabelais de Tours, 3 rue des Tanneurs, BP 4103, 37041 Tours Cedex 01, France.
| | - Anne Andronikof
- Laboratoire IPSé, EA 4432, Université Paris Ouest Nanterre La Défense, 200 avenue de la république 92001 Nanterre, France
| | - Marine Armand
- Laboratoire IPSé, Université Paris Ouest Nanterre La Défense, 200 avenue de la république, 92001 Nanterre, France
| | - Cécile Robin
- Ecole Nationale de la Magistrature, 10, rue des frères Bonie, 33080 Bordeaux cedex, France
| | - Hélène Bazex
- Ecole Nationale de la Magistrature, 10, rue des frères Bonie, 33080 Bordeaux cedex, France
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Morrissey C, Beeley C, Milton J. Longitudinal HCR-20 scores in a high-secure psychiatric hospital. Crim Behav Ment Health 2014; 24:169-180. [PMID: 24265120 DOI: 10.1002/cbm.1893] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Revised: 07/08/2013] [Accepted: 10/01/2013] [Indexed: 06/02/2023]
Abstract
BACKGROUND The HCR-20 is a widely used 20 item structured professional judgement aid to risk assessment and management, but longitudinal studies of its value are rare, particularly with people at high risk of reoffending. AIMS To investigate whether the HCR-20 discriminates between patient subgroups in one high-security hospital in England, whether scores reduce with hospital treatment and whether lower scores predict discharge. METHODS Repeated HCR-20 ratings were made by clinical teams across five services within the hospital, two of them (women and men with intellectual disability) national services. A database of 3337 HCR-20 ratings, from 532 patients over a period of 5 years, was examined using mixed effects models. RESULTS As expected, HCR-20 scores were high overall, but there were differences between services in the ratings obtained. Female patients and men with intellectual disability had the highest total score. There was a significant relationship between discharge and lower clinical risk score, but not between total and risk scale scores and discharge. There were significant changes in scores over time, although these were small and may not be clinically meaningful. Differences between services were observed, with women evidencing greater change. CONCLUSIONS It is unsurprising that patients in two national services (for men with intellectual disability and women) have the highest HCR-20 scores; however, the finding of relatively greater risk reduction in women needs further investigation. Although we did not find ceiling effects in this sample, the clinical value of frequently repeated HCR-20 ratings may be limited for high-risk populations where any change is likely to be slow.
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Affiliation(s)
- Catrin Morrissey
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
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45
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Duggan C, Dennis J. The place of evidence in the treatment of sex offenders. Crim Behav Ment Health 2014; 24:153-162. [PMID: 25042835 DOI: 10.1002/cbm.1904] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Accepted: 02/04/2014] [Indexed: 06/03/2023]
Affiliation(s)
- Conor Duggan
- University of Nottingham and Partnerships in Care, UK
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Fuger KD, Acklin MW, Nguyen AH, Ignacio LA, Gowensmith WN. Quality of criminal responsibility reports submitted to the Hawaii judiciary. Int J Law Psychiatry 2014; 37:272-280. [PMID: 24326082 DOI: 10.1016/j.ijlp.2013.11.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This paper is the third in a series of research reports on quality of forensic mental health evaluations submitted to the Hawaii judiciary. Previous studies examined quality of reports assessing competency to stand trial (CST) and post-acquittal conditional release, in felony defendants undergoing court-ordered examinations. Utilizing a 44-item quality coding instrument, this study examined quality of criminal responsibility reports in a sample of 150 forensic mental health evaluations conducted between 2006 and 2010 by court-appointed panels. Raters attained high levels of agreement in training and quality coding. Similar to the previous studies, overall quality of reports was mediocre, falling below the .80 quality criterion score for report elements, regardless of evaluator professional identification or employment status. Level of agreement between evaluators and judicial sanity determinations was "fair" using Cicchetti's (1994) standards for interpretation of intra-class correlations. Level of agreement was lower than previously published findings for CST reports and better than conditional release reports. Reasons for mediocre report quality and "fair" inter-rater agreement are discussed, including the fact that criminal responsibility evaluations are complex, retrospective in nature, and involve significant degrees of inference. In contrast to CST evaluations, assessment of criminal responsibility involves a mental state at the time of the offense evaluation. Threats to reliability in forensic reports are discussed. Suggestions for improvement of report quality are proffered, including standardization of procedures and report format and use of forensic assessment instruments.
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Affiliation(s)
- Kristen D Fuger
- Argosy University, Hawaii Campus, Honolulu, HI, United States
| | - Marvin W Acklin
- Argosy University, Hawaii Campus, Honolulu, HI, United States.
| | - Annie H Nguyen
- Argosy University, Hawaii Campus, Honolulu, HI, United States
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Perillo AD, Spada AH, Calkins C, Jeglic EL. Examining the scope of questionable diagnostic reliability in Sexually Violent Predator (SVP) evaluations. Int J Law Psychiatry 2014; 37:190-197. [PMID: 24274914 DOI: 10.1016/j.ijlp.2013.11.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Research has suggested questionable reliability of diagnosing mental abnormality during Sexually Violent Predator (SVP) evaluations, despite this being a necessary requirement for SVP commitment. Findings have been inconsistent across studies, and little is known about the extent of such trends across diagnoses and clinicians. The current study includes data from 375 sex offenders referred for evaluation for SVP commitment in New Jersey. Clinicians (n = 128) rendered a variety of diagnoses, most commonly Pedophilia. Results suggested questionable agreement across paraphilic and non-paraphilic diagnoses, although agreement was fair for diagnoses of Pedophilia. Further analyses of cases (n = 49) involving clinicians receiving a large number of referrals (n = 14) were generally consistent with these findings, with no outlier effect apparent. Findings suggest questionable diagnostic reliability to be a widespread issue in SVP evaluations, present across a variety of diagnoses and across the general body of clinicians involved in evaluations.
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Affiliation(s)
- Anthony D Perillo
- John Jay College and the Graduate Center, CUNY, New York, NY, United States.
| | - Ashley H Spada
- John Jay College and the Graduate Center, CUNY, New York, NY, United States
| | - Cynthia Calkins
- John Jay College of Criminal Justice, New York, NY, United States
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Hanson A, Martinez R, Candilis PJ. Case reports: Publication standards in forensic psychiatry. J Am Acad Psychiatry Law 2014; 42:297-304. [PMID: 25187282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Psychiatrists who publish case reports are required to seek informed consent from their subjects on the basis of the ethics-related obligation to maintain patient confidentiality. Academic journals have developed editorial standards to fulfill this obligation. Forensic evaluations do not create a doctor-patient relationship in the traditional sense, and information obtained through a forensic evaluation may also be found in the public domain. This public exposure is particularly likely, given the development of open access publishing standards, online journals, and increasing professional involvement in social media. This article outlines the ethics of informed consent in published case reports for general and forensic psychiatry and offers recommendations for forensic case study publishing. The authors suggest changes in the current requirements stated in The Journal for publication of case reports.
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Affiliation(s)
- Annette Hanson
- Dr. Hanson is Clinical Assistant Professor and Director, Forensic Psychiatry Fellowship, University of Maryland, Baltimore, MD. Dr. Martinez is Robert D. Miller Professor of Psychiatry and Law, University of Colorado Denver Medical School and Director of Forensic Services, Denver Health Medical Center, Denver, CO; Dr. Candilis is Director, Forensic Psychiatry Fellowship, St. Elizabeths Hospital, Department of Behavioral Health, Washington, DC.
| | - Richard Martinez
- Dr. Hanson is Clinical Assistant Professor and Director, Forensic Psychiatry Fellowship, University of Maryland, Baltimore, MD. Dr. Martinez is Robert D. Miller Professor of Psychiatry and Law, University of Colorado Denver Medical School and Director of Forensic Services, Denver Health Medical Center, Denver, CO; Dr. Candilis is Director, Forensic Psychiatry Fellowship, St. Elizabeths Hospital, Department of Behavioral Health, Washington, DC
| | - Philip J Candilis
- Dr. Hanson is Clinical Assistant Professor and Director, Forensic Psychiatry Fellowship, University of Maryland, Baltimore, MD. Dr. Martinez is Robert D. Miller Professor of Psychiatry and Law, University of Colorado Denver Medical School and Director of Forensic Services, Denver Health Medical Center, Denver, CO; Dr. Candilis is Director, Forensic Psychiatry Fellowship, St. Elizabeths Hospital, Department of Behavioral Health, Washington, DC
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American Academy of Psychiatry and the Law (AAPL). AAPL Practice Guideline for forensic psychiatric evaluation of defendants raising the insanity defense. J Am Acad Psychiatry Law 2014; 42:S3-S76. [PMID: 25492121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Martin T, Maguire T, Quinn C, Ryan J, Bawden L, Summers M. Standards of practice for forensic mental health nurses--identifying contemporary practice. J Forensic Nurs 2013; 9:171-178. [PMID: 24158155 DOI: 10.1097/jfn.0b013e31827a593a] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Forensic mental health nursing is a recognized field of nursing in most countries. Despite a growing body of literature describing aspects of practice, no publication has been found that captures the core knowledge, skills, and attitudes of forensic mental health nurses. One group of nurses in Australia have pooled their knowledge of relevant literature and their own clinical experience and have written standards of practice for forensic mental health nursing. This paper identifies the need for standards, provides a summary of the standards of practice for forensic mental health nurses, and concludes with how these standards can be used and can articulate to others the desired and achievable level of performance in the specialty area.
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Affiliation(s)
- Trish Martin
- Author Affiliations: 1Forensicare, Victoria, Australia, 2Monash University, and 3Central Queensland University
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