Randy K. Otto

The practice of forensic psychology. A look toward the future in light of the past.

In a 1987 American Psychologist article, Tom Grisso summarized the state of forensic psychological assessment, noted its limitations and potential, and offered suggestions for researchers and practitioners interested in contributing to its future. Since that time, there have been many important developments in the field of forensic psychology, as well as in clinical psychology more generally, some of which were anticipated and recommended by Grisso, and some of which were not. Forensic psychology is now at a crossroads, and the specialty must make an effort to respond to current challenges if it is to aid in the administration of justice by assisting legal decision makers. The need to distinguish between and identify levels of forensic knowledge and practice, establish guidelines for practice, educate legal consumers, and devote more attention to treatment issues in forensic contexts is highlighted.

Assessing and managing violence risk in outpatient settings.

Psychologists and other mental health professionals practicing in essentially all clinical settings are called on to assess and manage clients who may pose a risk of violence to third parties. Over the past 25 years much has been learned about the relationship between violence and mental disorder, and about assessing violence risk. In this article risk factors for violence among persons with mental disorder are reviewed, clinical assessment strategies are discussed, and a model for thinking about treatment and other types of interventions designed to minimize violence risk is offered.

Improving clinical judgment and decision making in forensic evaluation

Psychologists, psychiatrists and other mental health professionals are frequently involved as expert witnesses in legal proceedings. However, clinical judgment and decision making, which play a role in almost all clinical evaluations, have problems and limitations. Mental health professionals who conduct forensic examinations should be aware of these problems and take steps to address them. This article details the limitations of clinical judgment and decision making, and suggests ways to minimize associated problems, thereby improving the validity and utility of forensic evaluations.

International Perspectives on the Practical Application of Violence Risk Assessment: A Global Survey of 44 Countries

Mental health professionals are routinely called upon to assess the risk of violence presented by their patients. Prior surveys of risk assessment methods have been largely circumscribed to individual countries and have not compared the practices of different professional disciplines. Therefore, a Web-based survey was developed to examine methods of violence risk assessment across six continents, and to compare the perceived utility of these methods by psychologists, psychiatrists, and nurses. The survey was translated into nine languages and distributed to members of 59 national and international organizations. Surveys were completed by 2135 respondents from 44 countries. Respondents in all six continents reported using instruments to assess, manage, and monitor violence risk, with over half of risk assessments in the past 12 months conducted using such an instrument. Respondents in Asia and South America reported conducting fewer structured assessments, and psychologists reported using instruments more than psychiatrists or nurses. Feedback regarding outcomes was not common: respondents who conducted structured risk assessments reported receiving feedback on accuracy in under 40% of cases, and those who used instruments to develop management plans reported feedback on whether plans were implemented in under 50% of cases. When information on the latter was obtained, risk management plans were not implemented in over a third of cases. Results suggest that violence risk assessment is a global phenomenon, as is the use of instruments to assist in this task. Improved feedback following risk assessments and the development of risk management plans could improve the efficacy of health services.

Use of the MMPI-2 in Forensic Settings

ABSTRACT The MMPI-2 is the psychological testing instrument most frequently used in forensic treatment and evaluation contexts. This practice mirrors use of its predecessor–the MMPI–in forensic settings and likely reflects the empirical derivation and rich research base of the instruments. Given its use and acceptance by psychologists, expert testimony based on the MMPI-2 has rarely been excluded from legal proceedings. MMPI-2-based testimony has been excluded, however, when the instrument was used in ways that are not supported by the empirical literature. Thus, the question is not whether it is appropriate to use the MMPI-2 in forensic settings, but rather, for what purposes may the MMPI-2 be used in forensic settings? In this article, appropriate and inappropriate forensic uses of the MMPI-2 are identified, recent developments are discussed, and areas worthy of further investigation are identified.

Juveniles Evaluated Incompetence to Proceed: Characteristics and Quality of Mental Health Professionals’ Evaluations

The authors studied quality of evaluations of juveniles whose competence to proceed was at issue before the court and characteristics of mental health professionals completing these reports. Many evaluators failed to address important legal issues and offered incomplete descriptions of the youths, their capacities, and the evaluation techniques used. Evaluators commented on legal competency factors in most reports, as required by law, but often failed to identify the cause of the noted incapacity or whether children met commitment criteria (also required by law). Although core competence-related abilities identified in Florida law were addressed in the majority of evaluations, assessments were less than optimal in other psycholegal and clinical domains. Seven recommendations are offered for conducting juvenile competency evaluations that are professionally sound and meet legal requirements.

The Utility of Psychological Testing in Assessing Emotional Damages in Personal Injury Litigation

Psychological testing and assessment instruments frequently play a small but important role when psychologists assist the courts as emotional damage experts in personal injury matters. However, examiners frequently, if sometimes inadvertently, mislead the court with test interpretations that are based on clinical rather than forensic populations and that fail to appreciate the lack of robustness of clinical measures in this forensic context. Whereas published computerized interpretations repeatedly remind experts that personality test results should only be used as a method to generate hypotheses about the examinee that are to be subjected to further investigation and consideration, experts all too often inform the courts of test interpretations as if the test results were measures of clinical constructs rather than plaintiffs’ self-reports of symptoms.

Evaluations of Competency to be Executed: Legal Contours and Implications for Assessment

With the Supreme Courts decision in Ford v. Wainwright (1986), and the increasing numbers of persons sentenced to death, mental health professionals working in criminal settings can anticipate increased involvement in proceedings examining a condemned prisoners competency to be executed. This article explores the legal context and clinical aspects of such evaluations. First, the substantive legal test and legal procedures surrounding an assessment of competency to be executed are presented. Salient elements of the legal process of determining competency are discussed. Next, assessment techniques are reviewed. Finally, the issue of mental health professionals answering the ultimate legal issue, as applied to competency to be executed evaluations, is addressed.

Competencies in the Criminal Process

Because the Anglo-American criminal justice system is based on an adversarial approach, it is crucial that those involved in the legal process be able to participate competently. Therefore, procedures in the legal system have evolved to ensure that those individuals involved in it are competent. Competency decisions concern an individual’s capacities to understand and participate in legal proceedings. Courts have traditionally relied on mental health professionals to help determine whether an individual is competent to participate in legal proceedings. Nonetheless, discontent with the practices of mental health professionals in assessing competencies has been widely expressed.

Convergent Validity of a Screening Measure Designed to Identify Defendants Feigning Knowledge Deficits Related to Competence to Stand Trial

Because some defendants undergoing evaluation of their competence to stand trial may feign limitations in their ability to understand and participate in the legal process, assessment of their response style is critical. Preliminary research indicates that the Inventory of Legal Knowledge (ILK) has some potential to identify persons feigning competence related impairments. This study examined the convergent validity of the ILK using a sample of criminal defendants who, while undergoing competency evaluations, were administered the ILK and other response style measures. Moderate correlations between the ILK and these other tools provided some support for the ILK as a measure of response style.