Cross Examination of Psychological and Psychiatric Experts in Competency Cases

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Cross Examination of Psychological and Psychiatric Experts in Competency Cases David W. Thompson, Ph.D., ABPP Clinical Psychology Associates Burlington, Wisconsin

This workshop will... Review critical areas of testimony Identify fatal mistakes Facilitate evisceration when appropriate Provide useful tools

This workshop will not... Dwell on basic direct- or cross-examination techniques Exhaustively review the topic area

Overview Challenging Expert s Qualifications Questioning Expert s Methods Special Topics Dual Roles Children & Young Adolescents

But first Psychologist Graduate School Internship Scientist/Practitioner Model Board Certification Psychiatrist Medical School Internship Residency Board Certification

APA Ethical Principles and Code of Conduct Latest version published in 2002 Available on-line at www.apa.org/ethics/homepage.html Comprehensive Competence Bases for Scientific and Professional Judgements Release of Test Data

Specialty Guidelines for Forensic Psychologists Originally published 1991 Currently under revision Aspirational model engaged regularly as experts and represent themselves as such...(p. 656) Copy included with handouts

American Academy of Psychiatry & the Law Ethical Guidelines for the Practice of Forensic Psychiatry https://www.aapl.org/ethics.htm Included in handouts

American Psychiatric Association s The Principles of Medical Ethics Available on the web at http://www.psych.org/psych_pract/ethics/pp aethics.pdf Included in handouts

The Errors Experts Make Carelessness and Negligence Attitude Errors Loss of Perspective Failure to Come Clean Intention to Help (Greenberg, 2004)

Challenging Qualifications Basic licensure Advanced Qualifications Board Certification Experience

Qualifications Licensed by Wisconsin Dept. of Regulation & Licensing (s.455, Wis. Stats.) Doctorate National Examination State written and oral examinations Documentation of training & experience See 455.02(2m) for exceptions See 455.03 Temporary Practice

Advanced Qualifications National Register of Health Service Providers in Psychology Verification of credentials Approved internship Supervised practice www.nationalregister.org

Board Certification Not comparable to physicians Vanity Boards American Board of Professional Psychology (ABPP) Others

Experience Psychiatrists Test and measurement courses Training in standardized testing Use of tests Psychologists Familiarity with specific CST instruments

Experience All Experts Experience with specific population Familiarity with legal criteria and standards

Vanity Boards Pay a fee Unproctored multiple choice test Continuously extended grandfathering period

Zoe D. Katze Board Certified in Hypnotherapy Subsidiary of American Board of Forensic Examiners

Zoe D. Katze A fully credentialed cat. ABA Journal E- report (October 25, 2002).

American Board of Forensic Psychology ABPP specialty board Credential and ethics review Proctored written test Work sample review Oral examination

Fatal Error Board Eligible Term not permitted by ABFP See letter from ABFP

Challenging Methods Documents reviewed All relevant? Attempt to obtain? Testing Testing used? Appropriate tests? Standardized administration?

Challenging Methods Specific CST concerns Did expert contact defense attorney? Scope of evaluation Limited to court personnel roles? Juvenile waiver? Assertions about intellectual functioning

Fatal Error Billing an insurance company for a forensic evaluation Medical vs. legal necessity Exception: Some medical competency assessments (DPOA for Healthcare)

General Testing Issues Normative samples Cross validation Psychometric Properties Standardized administration

Testing: Use of Projective Tests Projective Theory Examples: Rorschach Inkblots Thematic Apperception Test (TAT) Projective Drawings Lack of empirical support

Testing: Use of Projective Tests Rorschach Exner s Comprehensive System Current Controversy--For Norms OK Ritzler, Erard, & Pettigrew (2002)

Testing: Use of Projective Tests Rorschach Exner s Comprehensive System Current Controversy--Against Norms duplication Over pathologize Grove, Barden, Garb, & Lilienfeld (2002)

Adult CST Tests MacArthur Competence Assessment Tool Criminal Adjudication (MacCat-Ca) Examination of Competence to Stand Trial Revised (ECST-R) Competence Assessment for Standing Trial for Defendants with Mental Retardation (CAST*MR)

MacCat-Ca Published 1999 Adults 18 years and older Not mentally retarded 22 items scored by objective criteria Understanding (Factual Understanding) Reasoning (Assist Counsel) Appreciation (Rational Understanding)

ECST-R Published 2004 Adults 18 years and older IQ 60 or above Semi-structured & structured interview Consult with counsel Factual Understanding Rational Understanding Response style scale

CAST*MR Published 1992 Adults with mental retardation Multiple choice format read to subject Basic Legal Concepts Skills to Assist Defense Understanding Case Events

Juvenile CST Tests None Grisso s structured interview format Juvenile waiver issues

Juvenile CST Developmental considerations Attention variables Capacity Abstraction abilities

Summary Is the expert properly qualified? Training Credentials Experience Were the methods appropriate? Testing? Contact with defense attorney? Does the opinion follow from the above?

Questions? David W. Thompson, Ph.D., ABPP Clinical Psychology Associates 345 Milwaukee Ave. Burlington, WI 53105 262-763-9191 x11 dthompson@clinicpsych.com www.clinicpsych.com