Citation

Grossi LM, Cabeldue M, Brereton A. J. Forensic Psychol. Res. Pract. 2021; 21(4): 317-337.

Copyright

(Copyright © 2021, Informa - Taylor and Francis Group)

DOI

10.1080/24732850.2021.1877022

PMID

unavailable

Abstract

Adjudicative competence evaluations are the most common forensic evaluation to occur in the United States. As a result of these evaluations, pretrial defendants are often found to be incompetent to stand trial and ordered for competency restoration, with psychotic symptoms as a major barrier to competency. Traditional competency restoration services are sometimes insufficient for restoring such defendants to competency within a reasonable period of time. This can lead to a finding that a defendant is unrestorably incompetent to stand trial and potentially a dismissal of charges. However, if not all available interventions are attempted during the course of competency restoration, this may be perceived as a miscarriage of justice for victims. In other cases, defendants with psychotic symptoms may lack insight into their mental illness, and after being successfully restored to competency, become non-adherent with their prescribed medication regimens and decompensate before their cases are resolved. The authors contend that use of Cognitive Behavior Therapy for psychosis (CBT-p) as an adjunct to traditional competency restoration services may be a means of restoring more defendants to competency, and also strengthening the durability of restored competency, when psychotic symptoms are identified as a barrier to adjudicative competence. This makes use of the skill sets of many clinically trained treatment providers working in forensic settings, and is consistent with recent trends of applying empirically-based interventions designed for use with non-forensic patients in forensic contexts. A case example is included to demonstrate the potential application of CBT-p to competency restoration during the course of individualized intervention. © 2021 Taylor & Francis Group, LLC.

Language: en

Keywords

United States; adult; human; learning; suicide; male; training; quality of life; bipolar disorder; schizophrenia; anxiety; psychosis; hemodialysis; mindfulness; hospitalization; posttraumatic stress disorder; pharmacist; Cognitive behavior therapy; risk factor; psychoeducation; mental disease; victim; psychiatrist; cognitive defect; automutilation; cognitive therapy; social psychology; medical student; emotion; palliative therapy; olanzapine; social phobia; lorazepam; clonazepam; justice; skill; emotionality; spontaneous abortion; Article; mental health care personnel; muscle relaxation; Positive and Negative Syndrome Scale; anosognosia; recidivism; DSM-5; medication compliance; cognitive behavioral therapy; doctor patient relationship; cognitive remediation therapy; CBT-p; competency restoration; forensic treatment; treatment adaptations