MAFP Comps Exam -forensic psych
Running head: COMPREHESIVE EXAMINATION
Argosy University Comprehensive Examination
MA Forensic Psychology
COMPREHESIVE EXAMINATION
Psychological Theory and Practice/ Triage and Assessment
Introduction
The importance and rationale of conducting a pre-trial evaluation are to establish or
rather determine the competence level of a defendants and consequently establishing whether
or not the defendant can act with legal effectiveness. Different factors such as social and
cultural are all factors that should be taken into consideration when conducting a pre-trial
evaluation. The defendant, in this case, is a 27-year-old Asian male and currently residing in
Chicago, Illinois. The defendant, whose name is Mr. Jones, has been charged with possession
of a controlled substance and specifically MFG/DEL 1<15 GR COCAINE/ANLG which
constitutes to a class 1 felony offense. Based on the evaluation of the background, the
defendant seems to be of sound and also showcases the ability to make the rational decision
and also have the ability to clearly distinguish right from wrong.
The defendant appears to have sufficient literacy skills despite having being
diagnosed with dyslexia and hence has the ability to comprehend the place, time, place, and
even situation. Furthermore, from an observation perspective; although the defendant appears
to be a well-developed young person he has a history of mental illness that includes
psychiatric hospitalization either when he was 12 or 13 years old. However, despite
hospitalization at one point, the defendant is unable to remember if he was diagnosed with a
mental disorder at the same time denies any medical prescription at that time. One notable
recurring issue that the defendant admits to being experiencing is frequent mood swings with
periods where he reports feeling irritable and at times hype. The defendant is reasonably
educated and has no previous criminal record. The purpose of this pre-trial evaluation is to
COMPREHESIVE EXAMINATION
determine any hidden medical, psychological or medical issues that may have influenced the
behavior of the behavior.
This analysis will revolve in resolving the question of whether the defendant is
incompetent or not or whether his ability to understanding what is happening around it is
influenced by a mental condition. Consultation and working with a professional team will
allow me to analyze the past relevant information including mental history, criminal and past
medical history that would then result in a primary diagnosis. Recommendations for
additional assessments for the defendants when necessary would be added to this particular
case.
COMPREHESIVE EXAMINATION
A:
Some specific assessment conducted to enhance my understanding of the client’s
problems
One of the tests that would be utilized in this case is the Wechsler Assessment. This is
an IQ test that will help to determine or rather measure the level of intelligence of the
defendant. At the same time, the Wechsler Assessment will also measure the cognitive ability
of the defendant (Spies & Plake, 2003). One notable behavior in the defendant is that he is
has admitted to using marijuana heavily since he was 17 years old. As a result, this
assessment will also look into analyzing the impact that this behavior of substance abuse may
have had on the defendant in the long term. The assessment that would be utilized in this case
is the Chemical Dependency Assessment Profile. This assessment will help to assess drug use
and alcohol use and any other chemical dependency issues or problems that the defendant
may be having.
Additional assessments would include MMPI-2 which would be significant in
revealing the significant personality patterns and emotional disorders of the defendant. At the
same time, the MMPI-2-RF assessment would also be utilized as it is equally useful and
important because of its ability to provide more detailed information regarding the
personality characteristics, interpersonal functioning, clinical symptoms and behavior
tendencies (Spies & Plake, 2003).
Understanding either emotional or mental problems that the defendant may have to
require the focus on specific variables which should be measured. The diagnostic impression
is operationally created based on the symptoms experienced by the defendant. The symptoms
replicated by the defendant, in this case, involve the feeling of hyper and irritated that closely
COMPREHESIVE EXAMINATION
relate or rather resemble the manic and depressive episodes. However, from observations, the
hyper and irritated episodes are not long lasting and extreme as the defendant denies ever
feeling depression, perceptual disturbance or anxiety.
The symptoms described by the patient closely relate to bipolar disorder but
considering the non-severity level that the defendant displays, it also appears similar to
cyclothymic disorder. Cyclothymia is a mild mood disorder that displays short periods of
elevated mood also known as hypomania and also mild depression (Perugia, Hantouchec &
Vannucchia, 2017). The mood swings alternate between these two episodes but the low and
high mood swings never reach severity that takes place in full mania or major depressive
episodes (Perugia, Hantouchec & Vannucchia, 2017)
. At the same time, the mood swings may be influenced by long term use of
marijuana. However, at this point, there is still no primary diagnosis for the defendant until
initial determination. Additionally, it is best to determine a primary diagnosis further along in
the assessment process when more information has been determined and analyzed. In
conclusion, at this moment, there is no primary diagnosis and further assessment is required.
COMPREHESIVE EXAMINATION
Assess for Suicidality, Homicidally, Psychosis and Current Substance Abuse
It is essential to determine the presence of any homicidal, psychosis, suicidal and
current substance abuse in the defendant as soon as possible during the assessment process.
This is because these are factors that can influence the behavior of the defendant and possibly
the frame of mind that he was in when he was arrested or committing the crime for which he
is being charged (Beck, Kovacs & Weissman,1979). At the same time, this assessment step is
crucial to ensure that the defendant is not a danger to not only himself but at the same time to
people around him. This process is also crucial in assessing how the defendant reacts to the
current stressors he is facing.
The defendant does not have a criminal record and this is the first time that he has
experienced any involvement with law enforcement of this magnitude. This is without a
doubt a stressing factor or stressor that could in one way or another impact on one or more of
the behaviors listed in this subtopic (Beck, Kovacs & Weissman,1979). The rationale of
assessing suicidal behavior consists of analyzing and identification of the relationships that
exists between three specific factors. The three categories of behaviors under analysis in
suicidal behavior identification are; the presence of deadly desires in individual plans for
suicide and thirdly, a passive suicidal desire (Beck, Kovacs & Weissman,1979).
It is essential to evaluate the suicidal ideation of an individual for the purpose of
reducing any if present risk of self-harm. Additionally, implementation of protector factors
can be crucial in redirecting the thinking process of an individual hence changing their mind
frame against suicidal behavior (Beck, Kovacs & Weissman,1979). Moreover, it is important
to note that if there are immediate violence tendencies detectable in an unsuspecting person,
then the Tarasoff steps should be applied immediately for the purpose of offering an early
COMPREHESIVE EXAMINATION
warning. This is especially true or relatable for the case of psychosis because of the
possibility of a confused mental state that a defendant may be experiencing that can cause a
dissociation from reality and hence cause violent behavior (Greg Merrill, 2013).
On the other hand, assessing homicidal ideations is an elaborate part of the pre-trial
assessment process that involves determining whether or not the defendant is contemplating
to cause harm to other individuals. This is crucial as it can help to detect possible homicidal
plans hence saving alive or lives (Runeson, Odeberg, Pettersson, Edbom, Adamsson &
Waern, 2017). This reinforces the importance of risk assessment in the pre-trial assessment
process. Risk assessment in homicidal ideations plays the crucial role in early detection and
identification of possible homicidal ideations. Mental health providers play a crucial role and
at the same time act as the first line of defense in knowing or identification of specific
information that may act as a warning sign (Runeson, Odeberg, Pettersson, Edbom,
Adamsson & Waern, 2017).
This would then result in addressing of these warning signs which is an instrumental
step in deterring violent behavior. Mental health providers are bound by law to ensure that
individuals who are at risk of being harmed or killed through the violent act of a defendant
are protected (Runeson, Odeberg, Pettersson, Edbom, Adamsson & Waern, 2017). The
specific law that bounds mental health providers is the Tarasoff law. The severity of
homicidal tendencies or rather the desire an individual has to kills can be identified through a
complement risk assessment. This assessment is based on a scale that helps an evaluator
determine if a defendant is a low, moderate or high risk for homicidal tendencies (Tarasoff v.
Regents 1976).
COMPREHESIVE EXAMINATION
On the other hand, psychosis is a symptom that directly correlates to the presence of a
mental illness in a defendant. Therefore, any signs of psychosis are indications to the
presence of impairment of reality which can then result in strange feelings and emotions such
as suicidal ideations. Different factors can result to lack of detection of an existing
psychological disorder within certain cultures due to different factors including religious and
cultural beliefs. Therefore, it is essential to understand the different types of psychosis when
conducting an evaluation to ensure that a diagnosis is not missed.
Assessing for psychosis is a crucial step for a mental health provider to get an in-
depth understanding of the frame of mind of a defendant. This process can then be influential
in addressing the dominant mental issues present or even point out to the lack of any mental
illness (Harris & Michael, 2000). The final necessary assessment in this process is assessing
the current substance abuse record of the defendant. This is important especially given that
the defendant is being charged with a drug-related crime and specifically the possession of a
controlled substance (Harris & Michael, 2000). If the defendant has a history is currently
utilizing the drug for which he was arrested for possessing or other controlled substances, it is
possible that his actions may be influenced by substance. Continuously and long term
substance abuse has been known to interfere with the thinking process and even influence the
behaviors of users. Since the defendant has a history of substance abuse, it is important for
him to undergo substance abuse evaluation and treatment combined with cognitive behavior
therapy.
COMPREHESIVE EXAMINATION
Psychological Theory and Practice/ Diagnostic Impression
B: Diagnostic impression according to the DSM-5.
Providing a diagnostic impression with the guidance of the DSM-5 handbook requires
a systematic and stepwise process that would help in delivering an accurate diagnostic
opinion based on information provided (First, 2013). Although the defendant has had a
history of drug use and specifically the use of marijuana since he was 17 years old, I can rule
out drug use as the cause of the defendant’s symptoms. This is because the information
provided by the patient indicates that he has been experiencing the symptoms and episodes
before he began marijuana use and they continue to recur even when he stops using the
marijuana. At the same time, there are no medical conditions that can be linked to the
symptoms displayed by the defendant. This is because the medical history of the defendant
does not showcase any medical disease or condition that would justify the symptoms
exhibited by the defendant (First, 2013).
The primary diagnosis for the defendant will be identified on the basis of a differential
diagnostic process. Specifically, the process will focus on assessing for the existing of either
bipolar disorder or cyclothymic disorder which are two mental disorders that share similar
symptoms and can easily be mistaken or misdiagnosed (Perugia, Hantouchec & Vannucchia,
2017). The application of the differential diagnostic process will enable the assessor in this
case to determine the disorder that closely relates to symptoms exhibited by the defendant
hence ability to make an educated guess but not necessarily a primary diagnosis.
Analysis of DSM-5’s differential diagnostic criteria for bipolar disorder categorizes
the defendant in the category of Cyclothymic Disorder mainly because the hypomanic
symptoms experienced do not meet the provided criteria for a manic episode experience in
COMPREHESIVE EXAMINATION
bipolar disorder. At the same time, the depressive symptoms also do not meet the criteria of a
major depressive episode (provisional) (American Psychiatric Association, 2013). I was able
to determine that the primary diagnosis for bipolar disorder does not meet the criteria based
on the information provided by the defendant. This is because the defendant indicated that he
has never felt major depression during the irritated episodes he experienced and has never
depression of extreme hopelessness all which are key symptoms in bipolar disorder. That is,
the present symptoms of the defendant do not meet the complete standard set for bipolar or
any other mood disorders apart from cyclothymic disorder (American Psychiatric
Association, 2013). Therefore, the provisional diagnosis for the defendant is cyclothymic
disorder and the specified severity level is moderate (American Psychiatric Association,
2013).
Multi-Axis Diagnostic Impression: Based on Principal Diagnosis for the defendant
Axis I: Clinical Disorders Cyclothymic Disorder
Axis II: Personality Disorder None
Axis III: General Medical Conditions None
Axis IV: Psychosocial/Environmental Problems Financial instability
Axis V: Global Assessment of Functioning 80 Transient symptoms
experienced by the defendant are reactions fuelled by psychological stressors
The provisional diagnosis for the defendant indicates the possibility that he may be
suffering from a cyclothymic disorder. The importance of conducting a differential diagnosis
was to ensure that the similarity in the symptoms of the two mental disorders is distinguished.
However, further analysis and assessment are important to ensure provide more clarity and
COMPREHESIVE EXAMINATION
ascertain the existence of the clinical disorder in the highlighted in this process. Conclusively,
provisional information correlates the symptoms of the differential to the differential
diagnosis of a cyclothymic disorder.
COMPREHESIVE EXAMINATION
Legal Theory and Application/ Theoretical Formulation
A: Explain the background, current presentation, and behavior of the defendant using theories
Theoretical perspective for criminal behavior involves analysis of current presentation
with the use of models of criminal behavior. The biological model explains that behavior is
influenced genes and that individuals have little or no control over how they act (Farrington,
& Ttofi, 2012). Utilizing this model to examine the defendant’s behavior, the theoretical
analysis would be that the defendant exhibits a gene that was passed down to him and that he
had no influence over his behavior. The second model is the learning theory of behavior that
stipulates that criminal behavior is learned (Farrington & Ttofi, 2012).
Based on the learning theory, it can be deduced that the defendant theoretically
learned or was taught how to commit the crime he committed. This brings into perspective
the influence that culture and environment may have on an individual and how it may
influence behavior that they exhibit. For instance, if the defendant has friends who possess
controlled substances and even try to sell this substance, it is possible that he may have been
taught or learned to exhibit. The third theory that explains behavior is the social theory which
states that individuals learn their behaviors through imitation, observation or reinforcement
(Farrington & Ttofi, 2012). Applying this theoretical perspective, it can be deduced that the
defendant learned his criminal behavior through the process of watching and learning from
either friends or close relatives.
The therapeutic treatment approaches that would be recommended for this defendant
includes psychotherapy. Psychotherapy, in this case, should combine both cognitive and well-
being therapy for more efficiency. Cognitive behavior therapy, in this case, would focus on
COMPREHESIVE EXAMINATION
the identification of any negative behaviors of belief and unhealthy beliefs. Additionally, this
process would work on replacing the identified negative behaviors or beliefs with healthy and
positive ones. Moreover, well-being therapy would help in managing stress and at the same
time the development of coping techniques for the defendant. Combination of both these
methods would result in significant improvement of psychological symptoms exhibited by
the defendant.
COMPREHESIVE EXAMINATION
Legal Theory and Application/ Victimology
B: How the type of crime in the can impact a victim and others in a similar situation
An individual arrested with the possession of controlled substance such as cocaine
with the intent to sell the substance, the victims, in this case, include individuals who would
have used the substance and as a result, suffered the side effects. Immediate victims, in this
case, include the family members of the defendant who would be impacted by feelings of
blame, shame, and even guilt. For instance, the children of the defendant may experience the
shame of being associated with defendant and hence harbor some ill-feelings towards
defendants.
At the same time, the children would be separated from their father because of the
crime committed. Growing up without one parent may impact on the development and even
result in emotional issues. Other family members such as siblings of the defendant may be
impacted by the feeling of guilt and blame. That is, the siblings may feel like they could have
maybe done something to prevent the crime from occurring if they had intervened.
Apart from the possession of controlled substance, the defendant was also involved in
a physical altercation with other individuals that subsequently resulted to the police at the
scene. In this case, the victims or victim would include individuals who were on the receiving
end of the physical alteration. A fight can impact an individual in different ways including
causing physical harm to the victim causing them to have to seek medical attention. In a
similar situation, such a victim would also be impacted be emotionally in the sense that they
would be feeling afraid and scared. In severe cases, such victims may suffer from trauma
resulting from the fighting and causing flashbacks that would further deteriorate the mental
condition of the victim.
COMPREHESIVE EXAMINATION
It is unclear whether or not this is the first time that the defendant has been in
possession of the controlled substance found on him during his arrest. The only clear thing is
that this is the first time that the defendant has been arrested for this crime. Therefore,
victims, in this case, include drug users influenced by either the behavior of the defendant or
any other individual in possession of a drug or who would have been successful in selling the
drugs. The impact to the community may include an increase in crime level and also
decreased the level of security in the vicinity where these types of crimes take place. Families
would have to deal with taking care of their loved one who is suffering from addiction and
some even paying the ultimate price of death. The impact of a crime such as cocaine
possession is far-reaching and has an extensive range of victims.
COMPREHESIVE EXAMINATION
Legal Theory and Application/ legal Implication
C: Description of the psycho-legal standards and/or definitions for Competency to
stand trial, Duty to warn, Risk of dangerousness, and Insanity
The psycho-legal definition of the term Competency to Stand Trial is that any
individual standing before a court of law is presumed to be competent. Competence, in this
case, encompasses the ability to understand for instance charges leveled against the
individual. The question of incompetency is normally raised in instances where a defendant is
unable to participate in a trial because of severe mental disorders that impact on their frame
of mind. At the same time, this definition encompasses the ability of defendants to fully
understand the legal repercussions or penalties of the crime charged against if convicted.
Duty to Warn is a provision for mental health providers that compels them to disclose
confidential information about a client in an event of a case where they feel that the person
may be of danger to a third party. Psychologists are bound by the law to explain to their client
about the limitation upon which their confidentiality agreement may be breached. That is, it is
considered the priority of a psychologist or any other mental health professional to protect a
potential victim by warning him or her about potential harm that would result from the
release of a defendant.
Insanity in the psycho-legal standards is a concept that allows a defendant to be
considered legally insane consequently making the individual unanswerable for the crime
charged within the court of law. In an insanity defense, a defendant must prove without
reasonable doubt that he or she has no understanding or grasp of the wrongdoing charged
with because of an underlying or exiting cognitive limitations. Therefore, an insane defendant
is considered to lack the ability to prevent or stop him or herself from committing a crime
COMPREHESIVE EXAMINATION
because of volitional impairments. A court of law has the final authority of determining the
incompetence or competence level of a defendant. However, courts often involve or rather
utilize the services of psychiatric hospitals for treatments and even assessments for the time
where competency could be restored.
Identify and describe one or more landmark case(s) for each standard
1. Competency to stand trial case
Drope v. Missouri, 420 US 162 - Supreme Court 1975
In this case, the trial court had neglected to requests competency trial for the
defendant and was also were not informed of the possible indisposed condition of the accused
because of a suicide attempt (Drope v. Missouri, 1975). The Missouri court in this particular
instance ruled that the trial of the defendant should be discontinued until the further
assessment was conducted on accused to ascertain that he was competent to stand trial. The
exact wording provided by the Missouri court, in this case, was that “the defendant did not
demonstrate any inadequacy in the legal procedures protecting his rights” (Drope v. Missouri,
1975). This ruling was made regardless of the weight of evidence provided in regards to the
competency of the defendant. On the issue of reversal, the ruling indicated that “when the
issues of competency are raised, regardless of who raises it, the motion should be
granted” (Drope v. Missouri, 1975).
Duty to Warn Case
Tarasoff v. Regents of University of California, 551 P.2d 334
Tatiana Tarasoff was murdered as a result of the failure of University of Reagents and
four psychiatrists at the Cowell Memory Hospital to provide her with a warning that she was
COMPREHESIVE EXAMINATION
in potential danger as a result of homicidal ideation by one of their clients (Tarasoff v.
Regents, 1976). This ruling was focused on protecting third parties from potential harm by
the defendant and compelled mental health professionals to prioritize the safety of these
individuals. According to the ruling “A defendant owes a duty of care to all persons who are
foreseeably endangered by his conduct, concerning all risks that make the conduct
unreasonably dangerous” (Tarasoff v. Regents 1976). The defendants, in this case,
represented mental health facilities and professionals.
Insanity Case
Foucha v. Louisiana, 504 U.S. 71 (U.S. 1992).
In the Foucha v. Lousiana case, the defendant who had been acquitted of burglary
charges around an insanity defense attempted to appeal to the courts about his eligibility for
release from mental institution he had been placed. The defendant was however unaware that
eligibility decision for the release of an individual who had or has been institutionalized in a
mental hospital rested with the courts which had to ascertain that the release happened only
when the person was determined not to be a danger to others (Paulsen, 1992)
Describe the elements or issues that a mental health professional usually focuses
on when assessing a person’s adjudicative competency, a risk of dangerousness and
insanity,
One of the key elements that mental health professionals focus on when assessing
competency, insanity, and risk of dangerousness of the reasoning on an individual. That is,
the way that individual reasons in terms of decisions making techniques and processing of
logic and help in determining the frame of mind of a person hence make an appropriate
COMPREHESIVE EXAMINATION
assessment. The second element that is under consideration is the understanding level of the
defendant or the client. In this case, understanding can include the ability to correctly
interpret information and also the analysis of whether or not a client is in touch with the
reality.
Research and Evaluation/ Forensic Evaluation
A: Tests to address the psycho-legal issues of Competence to stand trial, Risk of dangerousness, and Insanity).
The main that I would utilize in this case is the MacArthur Competence Assessment
Tool-Criminal Adjudication (Mac CAT-CA). The Mac CAT-CA test is appropriate for this
assessment since it assesses the competence related abilities in a defendant including
appreciation, understanding, and reasoning (Mossman, Noffsinger, Ash, Frierson, Gerbasi,
Hackett & Wall, 2007). The second test that would be suitable in this case is the MacArthur
Violence Risk Assessment which a test that would assess the probability that defendant may
engage in violent behavior (Wood, Anderson & Glassmire, 2017). The third test that is
suitable for this method is the Rogers Criminal Responsibility Assessment Scales (R-CRAS).
This test is relevant in evaluating the psychological factors that are prominent for evaluation
of insanity (Greg Merrill, 2013). Both of these tests are standardized psychometric
instruments that would be influential in assessing the three key areas addressed in psycho-
legal issues.
The anticipated conclusions based on information provided in the vignette.
The defendant from the information provided in the vignette appears to have a good
understanding and perception of what is happening around him. However, there appears to be
the possibility that the defendant may be suffering from a clinical disorder which may mean
COMPREHESIVE EXAMINATION
that he may not be in control of his actions and possibly be a danger to himself. As a result,
one of the possible anticipated conclusions would be for the defense team to enter an insanity
plea which would then result in the institutionalization of the defendant in a mental facility.
COMPREHESIVE EXAMINATION
Research and Evaluation/ Treatment Recommendations and Empirical Support
Develop a research question and a testable research hypothesis regarding offenders or the
type of crime that is discussed in the vignette
Research question: What factors influence criminal behavior?
Testable Research Hypothesis: Impulsive behavior primarily influences criminal behavior
Explanation of the variables in your question
Independent variables are those that can be changed and are not influenced by other factors.
In the research question, impulse behavior is an independent variable.
The dependent variable, on the other hand, cannot be changes and their existence or
occurrence if influenced by other factors. In this case, the dependent variable is criminal
behavior.
Research Question:
How do changes in impulsive behavior influence criminal behavior in an individual?
Type of research study that could answer your question
Research Design: The research design that would be relevant in this research question is a
qualitative research method and a specific case study. This is because in understanding the
factors that influence criminal behavior, establishing a bounded system would help to gather
more accurate information that would answer the question explicitly. In this case, a case
study would be effective in understanding what may have resulted or lead to the crime
committed by the defendant.
Importance of research to the field of forensic psychology
COMPREHESIVE EXAMINATION
The importance of this research is that it would provide more information on how
influential impulsive behavior is to criminal behavior. Criminal behavior forms the basis of
forensic psychology and in this field of scientific study, understanding the reason for the
occurrence of certain elements largely influence actions taken during forensic assessment
process (Vitriol, J. 2008). This can also influence recommendations made in regards to
possible solutions to dealing with certain criminal behavior. The aim of forensic investigators
is to influence criminal behavioral but this is becoming increasingly difficult due to the
dynamic nature at which criminal behavior occurs. This research will provide more clarity on
issues that influence criminal behavior and hence help to establish a pattern that would
facilitate in understanding criminal behavior pattern.
COMPREHESIVE EXAMINATION
Leadership, Consultation, and Ethics/ Ethical Issues
A: Ethical and legal dilemmas this vignette
One of the ethical dilemmas resented in this case involve or rater surrounds the
determination of the competency of a defendant. By law, the courts have the authority and
capacity to determine the competency of a defendant. However, in reality, things take a much
different turn as clinicians often make a determination of competency based on the outcome
of the assessment (Howe, 2009). An ethical dilemma may present itself in an instance where
the decision on competency is influential in treatment options or legal process selected. Legal
dilemmas, on the other hand, may originate from the decision made by the judge and how it
impacts the mental well-being of the defendant (Khan & Shaikh,2008). Different issues such
as cultural differences should be taken into consideration during this assessment, however, an
ethical dilemma may present itself in ow this factors may favor the defendant or even fail to
apply effects to the assessment process (Howe, 2009).
Immediate steps and rationale
One of the immediate steps that I would undertake is to re-visit and familiarize myself
with the ethical decision-making model. This would help me to establish a procedure or
guideline that would help in following every standard and also making sound judgment
throughout the process. At the same time, I would familiarize myself with the ethical codes
and ensure that they are applicable to every step undertaken in this assessment process. Most
importantly, familiarizing myself with relevant state laws will also be instrumental in
ensuring that all the guidelines stipulated in the law are observed during the assessment.
When to seek consultation in an ethical dilemma
COMPREHESIVE EXAMINATION
Although consultation may take place at any given time during the assessment
process, there are key areas where ethical dilemmas may call for a further consultation. One
of these instances, as outlined in ethical principles of psychologists, is when a problem or
dilemma becomes elaborate to the extent that it interferes with the related duties of a
psychologist (American Psychological Association, 2002). This measure is outlined in
section 2.06 where professional consultation and assistance is permitted especially when it
either involves keeping or terminating the relationship with the client or defendant. At the
same time, general B encourages psychologists to consult with their peers to ensure that their
clients attain the best services (American Psychological Association, 2018).
COMPREHESIVE EXAMINATION
Interpersonal Effectiveness/ Diversity/Multicultural Competencies
A: What diversity factors, cultural considerations, or other demographic variables
pertaining to this client would you take into account in rendering a diagnostic impression
choosing assessment measures, forming case conceptualizations, and designing and treatment
plan? Be sure to discuss cultural/diversity factors that could apply even if they are not
explicitly mentioned in the vignette.
Some of the diverse factors that I would consider when rendering a diagnostic
impression would be the gender of the defendant, the race, religious beliefs and inclinations,
gender, physical abilities, and the socio-economic status. These factors are all influential in
the behavior of an individual hence key elements in understating current manifestation and
criminal behavior of the defendant. This factors would also come in handy when selecting the
assessment test selected unless the test chosen is standardized.
Despite coming from a minority racial group, the defendant appears to have a good
understanding of the English language and is fully assimilated into the American culture.
Religious beliefs can be barriers or obstacles to obtaining or reaching out to mental health
providers. This comes from different beliefs that may in most cases different from scientific
information. Gender is also a key factor to consider mainly because of the limitation that it
may have on different people. For instance, men have traditionally been urged to always keep
or maintaining a brave face at all time which then makes it difficult for them to show their
vulnerable side. This can make it difficult for such individual to seek help with mental
disorders because of fear of being viewed as being weak. Other factors such as
socioeconomic status may also limit the ability to limit or promote the ability to access
mental health facilities.
COMPREHESIVE EXAMINATION
COMPREHESIVE EXAMINATION
References
American Psychological Association (2002). "Ethical principles of psychologists and code
of conduct"
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental
disorders (5th Ed.). Arlington, VA: American Psychiatric Publishing.
American Psychological Association. (2013). Specialty guidelines for forensic psychology.
The American Psychologist, 68 (1), 7.
American Psychological Association. (2018). Ethical Principles of Psychologists and Code
of Conduct. Retrieved from http://www.apa.org/ethics/code/?item=13#1010
Beck, A. T., Kovacs, M., & Weissman, A. (1979). Assessment of suicidal intention: the
Scale for Suicide Ideation. Journal of consulting and clinical psychology, 47(2), 343.
Drope v. Missouri, 420 U.S. 162, 95 S. Ct. 896, 43 L. Ed. 2d 103 (1975).
Farrington, D. P., & Ttofi, M. M. (2012). Developmental and psychological theories of
offending. Forensic psychology: Crime, justice, law, interventions, 37-54.
First, M. B. (2013). DSM-5 handbook of differential diagnosis. American Psychiatric Pub:
Greg Merrill, (2013). Assessing Client Dangerousness to Self and Others: Stratified Risk
Management Approaches. Berkeley Social Welfare. Retrieved for http://
socialwelfare.berkeley.edu/sites/default/files/users/Gregmerrill/
Assessing%20client%20dangerousness.
Harris, M. D., & Michael, R. (2000). The malingering of psychotic disorders. Jefferson
journal of psychiatry, 15(1), 7.
COMPREHESIVE EXAMINATION
Howe, E. (2009). Ethical Aspects of Evaluating a Patient’s Mental Capacity. Psychiatry
(Edgmont), 6(7), 15–23.
Khan, A. Y., & Shaikh, M. R. (2008). Challenging the established diagnosis in psychiatric
practice: is it worth it? Journal of Psychiatric Practice®, 14(1), 67-72.
Mossman, D., Noffsinger, S. G., Ash, P., Frierson, R. L., Gerbasi, J., Hackett, M., & Wall,
B. W. (2007). AAPL practice guideline for the forensic psychiatric evaluation of
competence to stand trial. Journal of the American Academy of Psychiatry and the
Law Online, 35(Supplement 4), S3-S72.
Paulsen, A. (1992). Limiting the Scope of State Power to Confine Insanity Acquittees:
Foucha v. Louisiana. Tulsa LJ, 28, 537.
Perugia, G., Hantouchec, E., & Vannucchia, G. (2017). Diagnosis and treatment of
cyclothymia: the “primacy” of temperament. Current neuropharmacology, 15(3),
372-379.
Runeson, B., Odeberg, J., Pettersson, A., Edbom, T., Adamsson, I. J., & Waern, M. (2017).
Instruments for the assessment of suicide risk: A systematic review evaluating the
certainty of the evidence. PLoS one, 12(7), e0180292.
Small, L. B. (1985). Psychotherapists' duty to warn: Ten years after Tarasoff. Golden Gate
UL Rev., 15, 271.
Wood, M. E., Anderson, J. L., & Glassmire, D. M. (2017). The MacArthur Competence
Assessment Tool—Criminal Adjudication: Factor structure, interrater reliability, and
association with clinician opinion of competence in a forensic inpatient sample.
Psychological assessment, 29(6), 776.
COMPREHESIVE EXAMINATION