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Quantitative Research Design

Vital in the conducting a research study is eliciting knowledge of the different designs and having the ability to choose the most practical design deviated by the research question.  Quantitative research designs aim to establish the relationship between an independent and dependent variable within a population by gathering data to classify and count features and construct statistical models as an effort to explain observations (University of Southern California, 2016).   Quantitative research designs are either descriptive, with measurements of subjects taken once and only establishes associations between variables, or experimental, with measurements taken before and after treatment establishing causation (University of Southern California, 2016).  Quantitative research deals with logic, numbers and taking an objective stance by focusing on numeric and detailed and convergent reasoning to generate a variety of ideologies about a research problem (University of Southern California, 2016). Among the quantitative design lies methods including experimental and quasi-experimental methods as discussed below. 
Experimental Method

Experimental research envelops the scientific method to objectively establish a cause and effect relationship among variables involved in a study (“Baltimore County Public Schools,” 2015).   The use of manipulation and control of variables establishes the cause and effect relationships that exist among the variables (“Baltimore County Public Schools,” 2015).  The independent variable is manipulated to determine the effect on the dependent variable, or the variable responding to the manipulation (“Baltimore County Public Schools,” 2015).    The controlled variable is constant in the experiment and is responsible for responses from external stimuli (“Baltimore County Public Schools,” 2015).   For example, criminologists may study the relationship between impulsivity and criminal behavior (“Law.jrank.org”, 2016).  In the example the independent variable is impulsivity, and criminal behavior is the dependent variable (“Law.jrank.org”, 2016).  Researchers would develop a scale of impulsivity that serves as a predictor of criminal behavior (“Law.jrank.org”, 2016). 

  Experimental research should consist of two comparison groups, a varied “independent variable before assessment of change in the dependent variable, and random assignment of at least two comparison groups” (“Law.jrank.org”, 2016). A pre-test would measure the dependent variable before the intervention, and the post-test would measure the variable outcome after intervention (“Law.jrank.org”, 2016).  Random assignment allows for identification of the effect of intervention while reducing bias during group selection (“Law.jrank.org”, 2016).  For example, researchers may aim to identify the most efficient treatment for domestic violence offenders.  Randomly assigning offenders to different intervention programs, allows control over the type of intervention used for each offender.  Upon entrance, the offenders undergo assessment and anger measurement.  After completing the programs, the reassessment and analysis of anger levels allow for comparison of data to occur (“Law.jrank.org”, 2016).  The treatment program which yielded the highest desired result would be identified as the more efficient treatment program.  From the different programs, researchers could draw what parts elicited the highest desired result and combine them together to develop the most effective program, after repeating the experiment with the new program.

Quasi-Experimental Method

Similar to the experimental method, the quasi-experimental method also aims to establish a cause and effect relationship among variables (“Baltimore County Public Schools”, 2015).   However, the quasi-experimental method exists in acknowledgment that rarely is it possible to implement perfect control in real world experiments as implementing control may violate the ethics codes of psychologists (Brown & Sleath, 2016).  For instance, when measuring the cause and effect relationship among violence and the community ethical boundaries may be violated as inflicting harm to an individual is against the APA Code of Ethics (American Psychological Association, n.d.).  Quasi-experimental methods identify the independent variable but do not manipulate it, rather the effects the independent variable causes to the dependent variable is measured (“Baltimore County Public Schools”, 2015).   Additionally, random assignment does not occur in quasi-experimental research as in experimental studies (“Baltimore County Public Schools”, 2015).   Instead, groups are pre-existing and naturally formed (“Baltimore County Public Schools”, 2015), such as studying a community or certain culture.  Control groups are identified and exposed to intervention and then a comparison is made between the control and groups who are not exposed (“Baltimore County Public Schools”, 2015).   Since the independent variable is not manipulated and there is no set of “forced” control, the data must be measured carefully, as external variables both identified and unidentified may impact the outcome (“Baltimore County Public Schools”, 2015).   

When evaluating the implementation of an intervention and its effects, quasi-experimentation occurs.  For instance, when evaluating an implemented domestic violence intervention, the intervention is given to survivors or offenders who relate in the experience of domestic violence but may be void of any other similarities.  Since the intervention is assigned to a group with different backgrounds, the only control that can be elicited would be the implementation of the intervention.  After observing the outcome of those receiving the intervention, the data is compared to those who have domestic violence experience but did not receive the intervention.  The differences or similarities in the outcome explain the effect of the intervention.

Personal Research Project

Hypothesis:  Early intervention for at-risk youth families will mediate family dysfunction and reduce negative behavior that leads juveniles to the corruption of detention facilities and promotes positive behavior modification that restores dysfunction and creates a positive environment which supports juveniles in maximizing potential in adulthood.  The goal of the research is finding the effect of early intervention on at-risk youth.  The research will yield two results:  the correlation of early intervention programs and the juvenile crime rate as well as the relationship between interventions and the juvenile recidivism rate.  The aim is to prove without intervention, at-risk youth continue the cycle of criminal behavior and violent tendencies, higher rates of recidivism in youth and adulthood, and maintain a higher potential of adulthood incarceration.  Additionally, the research will prove with intervention, negative (criminal and violent) behavior is deterred and modified which decreases recidivism for incarcerated youth and reduces the potential of adulthood incarceration, developing into a positive and active member of society.  However, interventions should be imposed early as possible in childhood to maximize the potential effect of the intervention.

The study sample will consist of youth from broken or dysfunctional homes riddled with poverty or low-income socioeconomic status who have had exposure to violence, abuse of all natures (sexual, physical, verbal, emotional, etc.), lower education levels, and substance abuse exposure.  The sample subjects will be studied through interviews, observation, and incarceration rate statistical analysis over a five-year period with half given intervention before or after the first incarceration.  The second sample will be studied in the same manner, but void of the interventions.  Due to the nature of the sample, randomization would not be sufficient as control would be difficult.  Therefore, the quasi-experimental design via control group time series, in a sense.  The control group will be youth not receiving interventions, and the effect of the intervention of the other group will be compared to the control to establish the actual effect of the intervention methods.   
References
American Psychological Association. (n.d.). Ethical principles of psychologists and

           code of conduct including 2010 amendments. Retrieved from http://www.apa.

           org/ethics/code/principles.pdf

Baltimore County Public Schools. (2015). Retrieved from https://www.bcps.org/offices/lis/researchcourse/develop_quantitative.html

Brown, S., & Sleath, E. (2016). Research methods for forensic psychologists a guide to completing your research project. Retrieved from https://books.google.com/books?id=JtEBCgAAQBAJ&pg=PT52&lpg=PT52&dq=example+of+quasi-experimental+research+in+forensic+psychology+.&source=bl&ots=s2FEFa9LGx&sig=aC9lmmFvq5Mcb-TlCeK5rmpNq7E&hl=en&sa=X&ved=0ahUKEwjXlKi6kPrPAhVljVQKHYPACbYQ6AEIczAR#v=onepage&q=example%20of%20quasi-experimental%20research%20in%20forensic%20psychology%20.&f=false.

law.jrank.org. (2016). Retrieved from http://<a href=”http://law.jrank.org/pages/923/Criminology-Criminal-Justice-Research-Methods-Quantitative-research-methods.html”>Criminology and Criminal Justice Research: Methods – Quantitative Research Methods</a>

University of Southern California, (2016). USCLibraries. Retrieved from http://libguides.usc.edu/writingguide/quantitative

  

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Mock Research Proposal on Juvenile Delinquency Intervention Programs

The U.  S.  Commerce reported people under the age of eighteen account for over twenty-five percent of the U.S. population and these statistics are rising suggesting a large diversity of issues affecting children, such as the at-risk youth who penetrate the juvenile justice system (Ramirez, 2008).  In 2002, the Federal Bureau of investigations reported 1.5 million children were arrested from minor crimes such as loitering to major crimes including murder with many crimes in between (Ramirez, 2008).  Statistically, the juvenile incarceration rates have dropped from 15% in 2006 to 10.8% in 2012 (Puzzanchera & Kang, 2014), however, the population increase is suspected to attribute to a portion of the decrease.  It is believed that juvenile delinquency is attributed to dysfunctional homes including abuse, domestic violence exposure, addiction in the environment, and a breakdown of the family unit due to forces such as poverty, financial stress, and pressure to accommodate social acceptance (Mann & Reynolds, 2006).  As society continues to diversify, it becomes more complex, mobile, and dysfunctional as youth tend to use harsher experimentation and more violent means to settle issues the justice system has evolved into a dumping ground for these issues (Ramirez, 2008).  Additionally, 60-70% of these youths suffer from some type of mental health issue and lack the resources necessary to deal with the issue (Ramirez, 2008).  Alternatives to detention to teach youth at risk for developing delinquent behavior will prove to be effective in teaching skills to cope in stressful familial environments, acknowledge problem areas, and begin to make more positive decisions leading them to success in lieu of falling into the trap of external family such as gangs and the potential incarceration time.  Community release programs will monitor youth and aid in developing social skills, learning trade, and assisting in education which will direct them toward a more promising future void of becoming a “product of their environment”.  
Several studies have implicated numerous causes that hold potential of early intervention that leads to societal conformity by reducing the negative behavior and promoting the maximum potential of the offender.  Donges, reports that little research implicates the juvenile perception, opinion, and thought on the causes and effects of their behavior (2015).  Specifically, Donges research found a trend of being victim of bullying as a primary negative impact on behavior and education, despite the juveniles proving their educational ability by attaining their diplomas (Donges, 2015).  Another study found the underrepresentation of inner-city minority youth in earlier research conducted on the interpersonal relationships within the family and with society (Madden-Derdich, Leonard & Gunnell, 2002).  Rees and Porgarsky found peers may influence each other’s delinquent behavior and intervening in early adolescent relationships, guiding them to elicit more positive behavior will influence positive behavior and deter delinquent behavior reducing potential future delinquency indicating the need for further research of the causes of juvenile delinquency in the educational environment (2011).  Another study conducted by Schwalbe and Maschi found practiced probation varies across the board, with younger youths receiving more interaction and accountability-based approaches (2009).  Ironically, the study did not implicate a variance in treatment based on characteristics of offense, rather age of individual (Schwalbe & Maschi, 2009).  It was inferred this variance was attributed to allowing older offenders deserved freedom of choice and consequence and more youthful offenders necessitating guidance and direction (Schwalbe & Maschi, 2009).  Research indicates several causes of juvenile delinquent behavior, of the majority, it appears a disconnect in family union, social ineptness, and educational support are areas of risk.  Developing interventions to promote positive changes in the key areas will create a motivation in the juvenile to modify behavior and conform to the acceptable societal standard. 

Purpose, Question, & Hypothesis

The goal of the research is finding the effect of early intervention on at-risk youth with the purpose of gaining an understanding of the cause and effect relationship between juvenile delinquents and early interventions. The research will yield two results:  the correlation of early intervention programs and the juvenile crime rate as well as the relationship between interventions and the juvenile recidivism rate.  The aim is to prove without intervention, at-risk youth continue the cycle of criminal behavior and violent tendencies, higher rates of recidivism in youth and adulthood, and maintain a higher potential of adulthood incarceration.  Additionally, the research will prove with intervention, negative (criminal and violent) behavior is deterred and modified which decreases recidivism for incarcerated youth and reduces the potential of adulthood incarceration, developing into a positive and active member of society. This study will investigate the question:  Will early intervention of the family unit that is geared toward social development, positively reinforced behavior, family unification, and educational support, reduce the juvenile delinquency rate in at-risk households as opposed to detention?  It is hypothesized that early intervention focused on social development, behavior modification, family unification, and educational support for at-risk youth families will mediate family dysfunction and reduce negative behavior.  Reducing or modifying negative behavior will reflect a decrease in juvenile delinquency, potential adult incarceration, and lower juvenile recidivism rates.  

Theoretical Framework

Delinquency intervention programs have proven most effective when they target modifying behaviors and factors which influence offending drawn from criminological theories (Fagan, 2013).  Several criminological theories implicate parental practices as direct and indirect causes of juvenile delinquency (Fagan, 2013).   Per the social learning theory, learning positive and negative behaviors are learned via social interactions and parents are primary influences on prosocial and anti-social behavior (Fagan, 2013).  Donges also indicated the theoretical educational psychology perspective via Banduras Social Learning Theory as a basis for research (2015).  If Bandura’s theory is correct that learning occurs through observation, the delinquent behavior may have been acquired through exposure to those behaviors (Donges, 2015).  For example, parents who elicit behaviors associated with deviance and incarceration model negative behaviors that the child learns (Fagan, 2013).  Additionally, a parent who fails to correct deviant behavior or support deviant behavior increase potential for a child’s perception of deviant behavior as acceptable (Fagan, 2013).   

Edwin Sutherland’s differential association theory proposes values, attitudes, behavior, techniques, and motives for criminal behavior are learned via social interaction with others (Rees & Pogarsky, 2011).  Like Bandura’s social learning theory, Sutherland implicates other influences as potential factors panning into deviant behaviors.  Per Sutherland, in order for deviant behavior to occur, a person learns prerequisite techniques for deviant behavior, a higher definition set for deviant behavior than those unfavorable to the crime, and an objective opportunity to carry out the behavior exists (Rees & Pogarsky, 2011).  Additionally, differential association theory is structured to the broad social organizations including family, neighborhoods, schools, and employment (Rees & Pogarsky, 2011).

The general strain theory supports stress including parent-child conflict and maltreatment evoke strong negative feelings that lead the child to engage risky and deviant behaviors including substance use, aggression, or other negative behaviors to subside those negative emotions (Fagan, 2013).  Finally, Fagan explains “integrated and life-course theories of crime assert that the degree to which parents model positive behavior; supervise and effectively discipline children; and establish close, affective bonds with youth are all important in shaping delinquency” (p.  620).    It was found that parent influence wanes on importance as children age and seek independence (Fagan, 2013).  Additionally, life-course theories identify adverse prenatal and early childhood experience as stronger predictors of delinquency in comparison to peer exposure of deviant behavior (Fagan, 2013).  The accumulation of risk factor exposure increase potential for juvenile delinquency that leads into a pattern of adult offending (Fagan, 2013). 

Operational definitions

The dependent variable is family dysfunction and negative behaviors.  Family dysfunction includes homes riddled with poverty or low-income socioeconomic status who have had exposure to violence, abuse of all natures (sexual, physical, verbal, emotional, etc.), lower education levels, and substance abuse exposure.  The sample subjects will be studied through interviews, observation, and incarceration rate statistical analysis over a five-year period with half given intervention before or after the first incarceration.  The second sample will be studied in the same manner, but void of the interventions.  Due to the nature of the sample, randomization would not be sufficient as control would be difficult.  

  The control group, or dependent variable,  will be youth not receiving interventions, and the effect of the intervention of the other group will be compared to the control to establish the actual effect of the intervention methods.   Effectiveness would be tracked every three months over a five-year period.  The tracking would consist of the intervention type, what behavior or aspect of youth risks it targets, and strength of effectiveness.  Effectiveness will be found by tracking percentage of use of the intervention by the youth and parent.

Literature review 

Previous literature implicates early interventions should be imposed early as possible in childhood to maximize the potential effect of the intervention.  As discussed above, several studies emphasize the impact of familial relationships in conjunction with social relationships as setting the acceptable standard for a child.  Literature implicates the parent-child relationship, parenting processes, social influence, and educational needs as primary areas of risk increasing the likelihood of juvenile delinquency.

Donges posits little research has been conducted that allows juveniles a voice due to the lack of insight into the lived experiences of delinquents which may aid in predicting and preventing delinquent behavior (2015).  The educational environment is identified as a possible factor of juvenile delinquency gearing research toward the exploration of the description of such experiences as an attempt to determine the commonalities in the perceptions of experience shared by the sample population (Donges, 2015). Therefore, Donges explored the educational experience as well as the experiences of peer and teacher associations and interactions (2015).  A qualitative study using Yin’s model as a collective case study,  purposeful sampling was used to select samples which were at least eighteen years old and no longer involved in the justice system (Donges, 2015).  Data collection convened through semi-structured interviews on a face-to-face basis using open-ended questions in a location chosen by the interviewed subject (Donges, 2015).  The interview transcripts were reviewed by the participants once written and data analysis was conducted with the thematic analysis approach to identify similarities among the subjects (Donges, 2015).  The research concluded several similarities: The subjects expressed they were all victims of bullying from their peers, hindered social interactions, and disciplinary issues were typical, as well as low self-esteem and low self-efficacy, implicating them as factors attributing to delinquency potential (Donges, 2015).  However, the study revealed all participants earned a diploma or GED, indicating the ability for academic success when placed in an environment that allows them to achieve success without the negative environmental impacts (Donges, 2015).   Donges research elicits the potential that juveniles hold potential for success.  His findings imply negative and hindered social interactions lead to low self-esteem and low self-efficacy supporting the need for interventions aimed at improving social interactions will increase feelings of self-worth and motivate juveniles to choose more positive behaviors.

A qualitative study conducted by Madden-Derdich, Leonard, & Gunnell explored the interrelationships of multi-ethnic, inner-city delinquent youths, and their parents to gain an understanding of the issues children and parents identify as familial problems, and the contextual factors believed to have contributed to or hindered interventions of the problems (2002).   Via in-depth interviews, researchers interviewed youths involved with the juvenile justice system and their parents to learn the motivations attributed to deviant behavior (Madden-Derdich, Leonard, & Gunnell, 2002).  Interviews delved into parental conflict, interpersonal peer relationships, and interpersonal parental relationship with the youth(Madden-Derdich, Leonard, & Gunnell, 2002).  Identification of problem areas, contextual factors leading to delinquency or hindering interventions, and parent perception of parental practice and youth concern were the three domains explored via open-ended questions under the consideration of an ecological framework and previous research on familial interaction processes and delinquency (Madden-Derdich, Leonard, & Gunnell, 2002).  All interviews were recorded, and data reduction was used to analyze the transcripts of the interviews and identify themes and patterns across all samples, allowing for coding and categorizing of the themes (Madden-Derdich, Leonard, & Gunnell, 2002).  The data analysis was conducted by a team of three researchers who analyzed parent interviews separate from the youth for a comparison to take place between the two subject samples (Madden-Derdich, Leonard, & Gunnell, 2002).  The data analysis further validated previous research, but also revealed a conflicting theme:  Youth implicated family interaction as causes of delinquent behavior and the hindrance of positive intervention outcomes, but parents connected the need for the child to modify behavior in both scenarios (Madden-Derdich, Leonard, & Gunnell, 2002).  This conflict implicated the need for further research and brought to light the possibility that the parent has an active concern for the youths behavior which increased delinquency, or the parent may underestimate their influence on the juveniles behavior due to feelings of lack of empowerment in the parental role (Madden-Derdich, Leonard, & Gunnell, 2002).  The study identified a crucial factor in childhood deviance:  Opposition between parent role and child perception.  The research necessitates interventions geared to family unification and counseling services to address the opposition causing dysfunction within the parent-child relationship.  

Rees and Pogarsky studied the influence of best friends is dependent on the level of delinquency of the remaining friend group deviating criminal tendencies as necessitating reinforcement from the remaining group as supportive or deterrent of the behavior.  Rees and Pogarsky report a concordance in delinquency among associated individuals (2011).  This association is attributed to “birds of a feather flock together” mentality, but the nature of the association is dependent on the degree of influence (Rees & Pogarsky, 2011).  Exploring the criminological perspectives of selection, influence (differential association theory), and mechanisms of peer influence, a direct correlation of influence was evident (Rees & Pogarsky, 2011).  Using pre-existing research, Rees and Pogarsky conducted a comparison study of the different perspectives but little evidence was found indicating a direct correlation (2011).  Indulging in past research, the researchers aimed to prove the size of the remaining friend group affects the degree of influence over the focal friend (Rees & Pogarsky, 2011).  Delinquent behaviors examined were substance use, smoking, fighting, and generalized delinquency (Rees & Pogarsky, 2011).  Conducting a qualitative study, Rees and Pogarsky tested their theoretical expectations with data from a multi-wave panel of adolescents aged 7-18, in which data was retrieved from the National Longitudinal Study of Adolescent Health utilizing the Add Health sample comprising a combination which made up 132 high schools and middle schools (2011).  School selection was stratified ensuring equal representation of size type, urbanization, geographies, and racial composition and methods of data collection included brief questionnaires given in the school setting, more in-depth interviews of the samples at certain intervals of time which included interviews with caretakers (Rees & Pogarsky, 2011).  Questionnaires were used to establish best friends through rankings and allowed for measuring delinquency (Rees & Pogarsky, 2011).  Controls included age, gender, ethnicity, and parental and school attachment (Rees & Pogarsky, 2011).   Rees and Pogarsky’s research indicated positive relationships between delinquency and the respondent at the initial interview and second interview consistent across all delinquent behaviors and a comparison of results found consistencies with past delinquent behavior indicative of future delinquent behavior as found in previous studies (2011).  Also found was the influence of the best friend decreased with a larger group of remaining friends indicating best friends and the remaining group were equally influential in delinquent behavior depending on group size consistent with past research as well (Rees & Pogarsky, 2011).  Rees and Pogarsky’s study supports Donge’s study in that both found social interaction as partially responsible for deviant behavior in juveniles.

Another study implicated education as also bearing responsibility for juvenile deviant behaviors.  Sanger, Spilker, Williams, and Belau implicated the suggestions of research that violence within the schools is a great concern to educators especially in areas involving communication, behavior, and learning problems for all grades (2007).  As in both previos studies, it was found that previous research lacked opinions of the youth as well as research lacked the exploration of delinquent student behavior and education learning experiences (Sanger, Spiker, & Williams, 2007).   The goal of the study was to gain insight into the implications that motivate violent behavior in students which will, in turn, assist educators in the planning of intervention programs for students involved in violence (Sanger, Spiker, & Williams, 2007). The initial study was conducted on incarcerated female adolescents, age 15 to 18 via interviews using principles, as disciplinarians, and speech-language pathologists as communication specialists which revealed the implication of a connection between violence and communication (Sanger, Spiker, & Williams, 2007).  The team used a survey divided into parts:  The participants background and educational history, a like-scale explored statements about violence, and open-ended questions about the perception of violence among peers, educational providers knowledge, the understanding of violent behavior motivation, and the relationship of educational providers and students (female youth perception of services for youth involved in violences and positive and negative learning experiences) (Sanger, Spiker, & Williams, 2007).     A mixed-methods design allowed researchers to collect quantitative data and analyze qualitative data gathered from recorded interviews that collected data spoken and observed behaviors.  Data analysis included transcription of interviews and like scale anaylsis which revealed teachers are now more concerned with violence and should be included in developing interventions in the school along with the agreement that schools have a shortage of specialists and programs for youth involved in violence (Sanger, Spiker, & Williams, 2007).  Analysis of qualitative data indicated themes of effective teaching, classroom environment, learning challenges and disabilities, and motivation and uncertainty encompassed the coded ideas that necessitate the need for the development of intervention programs for violence within the schools which implicates the need for educators and schools to understand their role in motivating acceptable behavior void of violence (Sanger, Spiker, & Williams, 2007).  More importantly, female youth agree implementing intervention at the school level could prove beneficial in tackling the juvenile delinquency rate before youth are introduced to the juvenile justice system.

Need For Research

As discussed above, the need for further research is necessary to understand the causes of juvenile delinquency.  However, all previous literature emphasizes implications for future research necessitating the need for early intervention programs that encompass social development, education support, educational interventions for youth involved in violence, and   family counseling which aims to unify the family structure as a safe and supportive environment.  An additional study was conducted on the parole officers tactics when servicing juvenile delinquents within the confines of a jail cell and upon return to the community (Schwalbe & Maschi, 2009).  Schwalbe and Maschi indicated the need for varying levels of interventions dependent on the motivations and age of the offender (Schwalbe & Maschi, 2009) solidifying value of juvenile treatment and effectiveness of interventions promoting rehabilitation.  All literature discussed permeates a trending theme:  Juvenile delinquent behavior is learned through familial modeling, social experience, learning experience, and can be adapted with the proper tools including interventions which build social skills and personal value towards an acceptable moral code, family counseling concentrated on preserving and positively strengthening familial foundations, and educational support services that aim to teach the value of education, social acceptance, and elicit feelings of self-worth.

Methodology 

Statistics indicate juvenile delinquency is a problem that needs prompt attention.  Consistencies in the Research discussed above pointed out that research supported and built on the previous literature.  Cross comparisons validate previous empirical findings in addition to identifying varying perceptions of causes of “delinquency” between the parent and child, child and society, and child and the educational system.  This emergence implicates the necessity of family intervention and future direction of research.  Several studies validated the youth perception and opinion and its necessity in treatment intervention which justifies the need for compliance from all parts to gain a full understanding of cause and implement proper interventions that will ellicit positive behavior modification.  Discussed below, one will learn how we can benefit from learning what type and degree of interventions will best fit at-risk youth and reduce the delinquency and recidivism rate.

Quantitative Design via Control Group Time Series Design will be conducted on a large sample that is equal under all criterial categories.  More specifically, invitations for the study should be made to approximate 500 families:  250 incarcerated, 250 for at-risk of incarceration.  The goal is to have a minimum of 75-100 subjects in each set of categories.  Category A are those currently incarcerated and receiving services, category B are those qualifying as at-risk in the community receiving services, and category C, the control group accommodating those incarcerated and those in the community who do not receive services which will be used as the comparison group.

 Initial observation via interview series with follow-up interview observations of the three groups of subjects along with comparison of incarceration violations, new incarcerations, recidivism rates, positive contributions, positive familial occurrences, all pertaining to just the subjects in the study.  Observation series should be made after 30, 120, 210 days and consistently every 90 days over the course of a 2 year and a five-year period.  Consistent and continued observation indicates reliability and validity of earliest results and further defines the effect of intervention over a longer period.

Participants

Participant recruitment will occur through the Department of Children Services, the juvenile justice system, schools in poverty stricken neighborhoods, homeless organizations, group homes for non-fostered youth, and teen centers designed to “occupy” empty hours.  Meeting with Chairs of these places, we would discuss the proposition and the desired outcome.  We would then ask the chairs to invite those families that they feel would most benefit or comply.

Recruits should meet the following criteria:  Incarcerated youth, at-risk youth in the community, receiving intervention services and incarcerated youth, at-risk youth in the community not receiving intervention services.  Additionally, the immediate family members (parents and siblings of the incarcerated youth).  Incarcerated youth includes juveniles age 10-17 serving time for crimes of violence, theft, truancy, and substance use or sale.  Those who are not incarcerated should meet at risk youth criteria including youth from broken or dysfunctional homes riddled with poverty or low-income socioeconomic status who have had exposure to violence, abuse of all natures (sexual, physical, verbal, emotional, etc.), lower education levels, gang ties, and substance abuse exposure.  Additionally, a control group will be formed from the chosen sample.  Half of the members of each group will not be given intervention.  This will allow for a comparison to occur after data is gathered.

The use of factorial ANOVA tests allow for the incorporation of more than one independent variable because it allows testing for differences and we can explore the effects of the interactions between the independent variables.  In this case, we would compare the independent variable and the dependent variable to the control group.  Factorial ANOVA testing will allow a visual graph that shows progression, regression, and no effect of treatment.  Additionally, a correlation process would be used to measure the effectiveness of the interventions.  The correlation would measure the behavior modification and its association to a specific intervention.  Using the Pearson’s r as the numerical data (+1, -1,0), we can see the strength of the intervention measured.  Once the relationship is determined, inferential statistics will allow us to determine the probability of proving the null hypothesis.

The Alpha level should be .05 to accept or fail the null hypothesis.  Stating a 95% confidence level would imply the results are not 100%.  When testing in a community, we must make a generalization based on the majority outcome of a small sample.  When using a small sample to prove an entire population, we should consider the possibility of false reporting or inaccurate reporting of participants.  Also, there are so many factors being studied in this proposal, and we are searching for an effectiveness of interventions that may be modified to everyone.

Limitations 

Due to the privacy and confidentiality laws outlined in the APA Code of Ethics, juvenile studies have extra protections which may hinder the research process (American Psychological Association, n.d.).  Previous research and case studies are difficult to find as not many are made public explaining a shortage of interpersonal cases discussed.  Previous esearch indicated limitations with parent-child interviews as the parent and child disconnect from understanding each other (Madden-Derdich, Leonard, & Gunnell, 2002).  This may surface in the proposed study as parents and juveniles may portray feelings outside of their actual in fear of admitting wrong doing.  Answers to questions may be deceptive in regards to effectiveness of interventions as participants may attempt to prove interventions more successful than they actually are.  A possible threat to validity is heightened or exaggerated response to treatment.  Properly recording data and tracking progress appropriately will ensure valid results.  Recording interviews for transcribing and having subjects review the transcript before measurement also takes away a level of threat of misreporting.  Misreporting of changes and use of interventions may also be misreported.  To decrease misreporting it will be necessary to verify youth reporting by comparing all interviews against each other and report consistencies as “true” data. Defining at-risk-youth in terms of environment, social, and economic status may prove difficult or deceptive in the sense that not all youth living in these areas meet the at-risk potentials.  Through careful selection and assessment, deception can be reduced to minimal.  The selection process is also a limitation as the chairs of certain organizations may not want to reveal eligible participants or may choose participants biasly.

Ethical issues

According to the APA Code of Ethics 3.04, psychologists are mandated to take reasonable steps to avoid harm to humans (American Psychological Association, n.d.).  A study incorporating counseling to address past experience holds potential to hurt the psyche.  All participants receiving interventions are at risk of re-hatching past trauma that may cause psychological torment.  Although part of the healing process is to recognize trauma and learn to grow from it, the reprecussions may cause harm to the individual.  However, in this study, dealing with past trauma will prove to rectify causes of delinquent behavior and promote a healing process that will aid in modifying the negative behaviors including violence, aggression, and substance use.

APA Ethics Code 3.10 addresses informed consent which must be written and explained in a language understood by all participants (American Psychological Association, n.d.).  In this study, participants will be as young as ten years old.  A child of this age may not have a full understanding of what the research entails making it necessary for parental permission. Also , the participant holds the right to withdraw from the study at any time with consequence pertaining to the effectiveness of treatment only (code 8.02) (American Psychological Association, n.d.).  It is the psychologists responsibility to ensure the safety of the child participant and that he is actin in the best interest for the welfare of the child (American Psychological Association, n.d.).  Since the data obtained in the study will be used to establish a potential treatment plan for future use, the psychologists must make participants aware that certain information may be exposed to other parties, but the psychologist is obligated under code 4.01 to maintain confidentiality of all clients and if the information is going to be shared 4.02 madates the psychologists to gain permission from participants while withholding any personally identifiable information about the participant (code 4.07) (American Psychological Association, n.d.).  

Additionally, since recording will be taking place in the study, the psychologist is obligted to gain permission from participants with the assurance the interview will not be used outside of the studies intent (code 8.03) (American Psychological Association, n.d.).  To ensure accuracy and of transcription, the participants will receive a copy of the transcription to verify accurate reporting.  The transcription will not be analyzed until a final acceptance from the participant is gained.

Dissemination strategy

Dissemination of research in the mental health field includes utilizing interventions outside of the study, the extent to which the interventions are implemented properly, and identifying possible barriers of the success of the implemented model (  ).  In the proposed research, diffusion into the community should include family preservation organizations and child protective service agencies as they direct their attention toward at-risk families.  Additionally, intervention programs should be diffused into the juvenile correction facilities as part of sentencing and the parole system as part of community supervision obligations.  Implementing interventions at the junctions of the juvenile and the delinquent behavior will prove effective in modifying behavior as a reward for past negative behavior for which punishment has already been completed.  Additionally, channeling services into the school systems will help deter delinquent behavior before the justice system takes control.  The research will prove the earliest intervention to have the best promise for the future.

Summary

As juvenile delinquency continues to be of concern, it is no necessarily a doom for the communities.  This research is necessary in learning ways that will prove most beneficial in rehabilitating troubled youth or even stopping youth from deviating down the road of delinquency.  Previous research supports the need for the earliest interventions through the family, community, and educational system.  A quantitative study will reveal positive effects on social deficits, family dysfunction, and educational capacities currently perceived as useless.  A five year study will indicate the best treatment in a generalization to the community as whole to reduce delinquent behavior and reduce recidivism.
References:
American Psychological Association. (n.d.). Ethical principles of psychologists and

           code of conduct including 2010 amendments. Retrieved from http://www.apa.

           org/ethics/code/principles.pdf

 Donges, W. E. (2015). A qualitative case study: The lived educational experiences of former juvenile delinquents. The Qualitative Report, 20(7), 1009-1028. Retrieved from https://login.libproxy.edmc.edu/login?url=http://search.proquest.com.libproxy.edmc.edu/docview/1704359939?accountid=34899

Fagan, A.  A. (2013).  Family-focused interventions to prevent juvenile delinquency.  Criminology & Public Policy, 12(4), 617-650.  Doi: 10.1111/1745-9133.12029

Madden-Derdich, D., Leonard, S. A., & Gunnell, G. A. (2002). Parents’ and children’s perceptions of family processes in inner-city families with delinquent youths: A qualitative investigation. Journal of Marital and Family Therapy, 28(3), 355-69. Retrieved from https://login.libproxy.edmc.edu/login?url=http://search.proquest.com.libproxy.edmc.edu/docview/220945809?accountid=34899

Mann, E. A., & Reynolds, A. J. (2006). Early intervention and juvenile delinquency prevention: Evidence from the chicago longitudinal study. Social Work Research, 30(3), 153-167. Retrieved from https://login.libproxy.edmc.edu/login?url=http://search.proquest.com.libproxy.edmc.edu/docview/212142238?accountid=34899

Puzzanchera, C.  and Kang, W.  (2014).  “Easy Access to FBI Arrest Statistics 1994-2012” Online.  Available:  http://www.ojjdp.org/ojstatbb/exaucr/

Ramirez, F.  (2008, April/May). Juvenile delinquency current issues, best practices, and promising approaches. GPSOLO. Retrieved from http://www.americanbar.org/newsletter/publications/gp_solo_magazine_home/gp_solo_magazine_index/juveniledelinquency.html

Rees, C., & Pogarsky, G. (2011). One bad apple may not spoil the whole bunch: Best friends and adolescent delinquency. Journal of Quantitative Criminology,27(2), 197-223. doi:http://dx.doi.org.libproxy.edmc.edu/10.1007/s10940-010-9103-9

Sanger, D., Spilker, A., Williams, N., & Belau, D. (2007). Opinions of female juvenile delinquents on communication, learning and violence. Journal of Correctional Education, 58(1), 69-92. Retrieved from https://login.libproxy.edmc.edu/login?url=http://search.proquest.com.libproxy.edmc.edu/docview/229783105?accountid=34899

Schwalbe, C. S., & Maschi, T. (2009). Investigating probation strategies with juvenile offenders: The influence of officers’ attitudes and youth characteristics. Law and Human Behavior, 33(5), 357-67. doi:http://dx.doi.org.libproxy.edmc.edu/10.1007/s10979-008-9158-4

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Forensic Risk Assessment

​Forensic risk assessments are designed to predict the potential tendency of future offending to identify needs of intervention (Brown & Singh, 2014).  Risk assessment protocols have been employed to prioritize risk reduction strategies for those in need of interventions (Brown & Singh, 2014).   There are three approaches to evaluating risk assessments:  unstructured clinical judgement (UCJ), actuarial assessment, and structured professional judgement (SPJ) (Brown & Singh, 2014).  The UCJ approach subjectively analyzes clinical skills and experience (Brown & Singh, 2014).  Benefits of the UCJ approach include flexibility in tailoring risk assessments per individual, the incorporation of varieties of case-specific risk and protective static and dynamic factors, and it is inexpensive.  However, UCJ approaches reflect low rates of reliability, predictive validity in addition to its vulnerability to bias, and violence rates are predicted on a chance level rather than scientific formulae (Brown & Singh, 2014).  Actuarial assessments use statistic methodology to assess risk and/or proactive, static, and/or dynamic standards associated with interest in the adverse event (Brown & Singh, 2014).  Items are weighted with the amount of variance for prediction of interest in the adverse event and cross-referenced with recidivism rate estimates (Brown & Singh, 2014).  Benefits of the actuarial approach include rapid assessment, objectivity and transparency through the assessment process, containment of readily available historical information, low bias, and they generate recidivism estimates (Brown & Singh, 2014).  However, the actuarial approach is unable to apply “group-based recidivism rates to” individuals, estimated recidivism rates are unstable when applied to different jurisdictions, and case-specific information is not able to be incorporated to modify recidivism estimates (Brown & Singh, 2014).  The SPJ approaches address the inflexibility of the actuarial approach by assessing risk and/or proactive, static, and/or dynamic factors associated with theory and research suggestions of interest in the adverse event (Brown & Singh, 2014).  Scores provide guidance in making categorical risk judgements in combination with clinical experience implicating the scores as used as part of larger formulation processes (Brown & Singh, 2014).      Benefits of SPJ assessments include they address weaknesses in the actuarial approach, they focus on individuals rather than groups, the ability to consider information not included in item specific tools, and the predictive ability is non-significant to actuarial approaches (Brown & Singh, 2014).  However, the SPJ approach is less objective, introduces decision-making bias, and administration takes longer than the other approaches (Brown & Singh, 2014).  I think that each of the three approaches carries its own benefits and weaknesses.  However, it seems that each approach somehow supports the weaknesses of the others which strengthens the benefit of the assessment in general.  I prefer the term assessment of risk.  When assessing risk you identify risk factors associated with certain behaviors.  Identifying those risk factors allows the professional to predict future behavior.?

Brown, J., & Singh, J. P. (2014, December). Forensic Risk Assessment: A Beginner’s Guide. Archives of Forensic Psychology, 1(1), 49-59. Retrieved from http://www.archivesofforensicpsychology.com/web/wp-content/uploads/2015/01/Brown-and-Singh1.pdf

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Federal Guidelines in Individual Forensic Assessments

          Clinicians use psychological testing to reinforce data gathered throughout the assessment process.  In the forensic setting, psychological evaluations determine competency to stand trial, the possibility of malingering, child custody, and other issues regarding civil, criminal, and family law (Ewing, 1996).  Due to the circumstances encompassing the need for psychological tests, it is vital that forensic professionals are aware of the appropriate tests and their administration in addition to the laws and rules that govern their employment and admissibility of information drawn from these instruments (Ewing, 1996).  Most importantly, forensic professionals perform psychological testing for legal purposes and interpret them “within applicable constitutional considerations and rules of evidence and procedure”  (Heilbrun, 1992).
APA

Statutes or case law that vary in description and extent set the standard for legal issues (Heilbrun, 1992).  The APA developed a Code of Ethics as a directional guide for the practitioner to maintain the highest ideals of psychology while ensuring compliance with the respect of human civil rights and avoid unethical practices (“American Psychological Association”, 2016).   The APA also developed The Specialty Guidelines for Forensic Psychology as an effort to improve the quality of service, enhance development and practice, encourage the highest level of professionalism, and help practitioners to conduct themselves in a professional manner (“American Psychological Association”, 2016).  The guidelines apply in all matters regarding educational system, the judicial system, and administrative systems despite their generalization to all cases that may arise (“American Psychological Association”, 2016).  However, the guidelines are not mandatory, but intended to provide further guidance to ensure ethical and legal practices and should be used in conjunction with the Ethical Principals of Psychologists and Code of Conduct (“Specialty guidelines for forensic psychology,” 2013). 

History

Historically, the law and the use of expert witnesses has been controversial as the general public perception maintains that expert testimony is based on the “junk science”  of professionals who will find evidence in anything for a fee (Melton, Petrila,  Poythress, & Slobogin, 2008).  It has also been speculated that professional experts use the legal process to undermine the political judgment of legislation (Melton, Petrila,  Poythress, & Slobogin, 2008). Due to the controversies associated with expert witnesses, law schools have incorporated traditional mental health law into the curriculum to clearly define the use of social science evidence (Melton, Petrila,  Poythress, & Slobogin, 2008).  However, it is important to note that the law regarding expert witnesses may deviate from the conformity of the norms of mental health practices and scientific inquiry (Melton, Petrila,  Poythress, & Slobogin, 2008).  

  The rejection of expert testimony throughout history called for reformation in latter years.   Frye VS The United States in 1923 set the Frye Standard of today which allows incorporating psychology and law by allowing expert testimony to count as evidence before a court of justice (Dye, n.d.).  In 1993, the U.S. Supreme Court ruled in Daubert VS Merrell Dow Pharmaceutical, Inc creating the Daubert standard.  The Daubert Standard allowed expert witness testimony with the consideration of the methodology used, the degree of potential error, and scientific evidence available as evidence in a court of law (Dye, n.d.).   People VS Hawthorne in Michigan in 1940 clarified that an expert witness criteria should not be based on a medical degree, rather depth and expertise of knowledge in the particular area, but continued to maintain the controversy surrounding expert witnesses (Dye, n.d.).   Hidden VS Liberty Mutual Insurance made expert testimony in regards to psychological testing as valid and credible deviating psychological testing as a means to establish disability (Dye, n.d.).   These cases began to set the standard on acceptable evidence in a court in regards to psychological testing and expert testimony.

Rights and Responsibilities

Attaining  and eliciting informed consent for evaluation and explaining the parameters of the assessment, identifying that all information attained may be disclosed to those involved in the legal proceedings, as well as other limitations of privacy and confidentiality supports ethical practice and provides justified intentions of the forensic professional (American Psychology-Law Society, 2011).   A clinician required to testify in a legal matter must report any risk of a dual relationship (Hugaboom, n.d.), including the potential of violation of APA Ethical Standard 4:  Privacy and Confidentiality in regards to the legal matter (American Psychological Association, n.d.).  In the event of those above, it is imperative that the clinician separates the forensic role from the therapeutic role and never combine the two functions (Hugaboom, n.d.).  At the severance of a professional relationship and incorporation of a forensic role, the therapist must depict any potential compromise of objectivity and disclose any possible conflicts of interest (Hugaboom, n.d.).

Test takers rights are encompassed by the APA and become the responsibility of the professional to ensure the test taker receives these rights (“American Psychological Association”, 2016).  As with all mental health affiliations, the test taker has the right to be informed and treated with respect, void of impartiality, and should be made aware of materials available to assist in the test-taking process and have reasonable access to all materials (“American Psychological Association”, 2016).   In conjunction with the APA’s standard of informed consent, test takers should be given access to a brief description of the test, it’s nature and purpose, whether scores will be exposed, and what the intended use of the results, unless the exposure will prove detrimental to the result (“American Psychological Association”, 2016).

Under the American Disabilities Act, test takers are required reasonable accommodations in test administration which increases the validity of the scores (“American Psychological Association”, 2016).  The preventative measures taken to ensure the accuracy of the scores and prevent dishonesty should also be shared with the test taker (“American Psychological Association”, 2016).  The test taker should also be notified of any materials needed for the test, any prohibitions, and any rules that are to be followed (“American Psychological Association”, 2016).  The potential of re-testing and scoring measures in addition to any associated fees or feedback should be discussed as well (“American Psychological Association”, 2016).  It is also necessary to inform test takers of all instructions prior to testing taking (“American Psychological Association”, 2016). 

  Testing must be employed and interpreted by appropriately trained professionals, making it the responsibility of the professional to choose an appropriate test for intended purposes and encompass knowledge for test takers who qualify for special accommodations (“American Psychological Association”, 2016).  A forensic psychologist breaks ethical standards if he or she practices outside areas of expertise attained through educational training and should have a fundamental knowledge in legal, factual, and civic standards in which they practice allowing them the privilege of expressing opinion, but continuing to render the highest levels of professional conduct (American Psychology-Law Society, 2011).  Regarding psychological assessment and treatment, the forensic practitioner is encouraged to elicit scientific and vocational knowledge by choosing assessment tools appropriate for the issue and exposing any limitations associated with the tool (Hugaboom, n.d.).

The administrator should ensure testing conditions do not interfere with the testing process or cause a hindrance in performance affecting the scores (“American Psychological Association”, 2016).  Test takers have the right to know why they are taking a test and if the test is optional (“American Psychological Association”, 2016).  In this respect, it is the responsibility of the professional to engage in testing activities only after receiving informed consent, except when testing is mandated by a court of law, employment, or government regulation (“American Psychological Association”, 2016).  If the individual chooses not to take the test, the professional should make them aware of the pros and cons of taking the test, consequences associated with refusing, and informing the test taker of any deviations away from the test standard and why those deviations were taken (“American Psychological Association”, 2016).

Written or oral results of test scores should be delivered in a reasonable amount of time by the test emloyer (“American Psychological Association”, 2016).  Reviewing test scores should include scoring methods, ways to improve, test retaking, void of stigmatization, and options of a second opinion (“American Psychological Association”, 2016).  When interpreting test results, care should be utilized by considering the purpose of the assessment and identifying and considering factors that may affect accuracy or judgment (American Psychology-Law Society, 2011).  Despite indifferences that may occur due to cultural diversity, Ethical Codes support the fair and equal treatment for all humans (American Psychological Association, n.d.).  The scores and accommodations should be maintained confidentially with access only allowed to those approved at the time of informed consent or with a signed a release of records (“American Psychological Association”, 2016).   It is the responsibility of the professional to maintain patient rights as advised by the APA.  Disregarding patient rights violates the Code of Ethics set forth by the APA and therefore holds the potential of sanction and possibly losing their license (“American Psychological Association”, 2016).  Although the interpretations and perceptions of assessments may differ among the diverse cultures, professional standards do not change and should always be upheld and abandon or adapt ethicality.
References

American Psychological Association. (2016). Retrieved from http://www.apa.org/science/programs/testing/rights.aspx

American Psychological Association. (n.d.). Retrieved from http://www.apa.org/ethics/code/code-1992.aspx

American Psychology-Law Society. (2011). Specialty guidelines for forensic

psychology. Retrieved from https://www.apa.org/practice/guidelines/

forensic-psychology.pdf

Dye, S. (n.d.). Forensics. Retrieved from http://forensicpsych.umwblogs.org/psychology-and-law/court-cases/

Ewing, C.  P.  (1996).  Psychological testing and the law.  Behavioral Sciences & the Law, 14(3), 269-270.  Retrieved from:  http://web.a.ebscohost.com.libproxy.edmc.edu/ehost/pdfviewer/pdfviewer?sid=952b729e-5c57-427c-9884-2992e6451627%40sessionmgr4010&vid=1&hid=4106

Heilbrun, K. (1992). The role of psychological testing in forensic assessment. Law and Human Behavior, 16(3), 257-272. Retrieved from https://login.libproxy.edmc.edu/login?url=http://search.proquest.com.libproxy.edmc.edu/docview/914687295?accountid=34899

Hugaboom, Denise (n.d.). “The Different Duties and Responsibilities of Clinical and Forensic Psychologists in Legal Proceedings.” The Review: A Journal of Undergraduate Student Research 5 (2002): 27-32. Web. [accessed:  November 29, 2016]. Retrieved from <http://fisherpub.sjfc.edu/ur/vol5/iss1/4&gt;

Melton, G. B., Petrila, J., Poythress, N. G., & Slobogin, C. (2008). Psychological

evaluations for the courts: A handbook for mental health professionals

and lawyers. (3rd ed.). New York: Guilford Press.

Specialty guidelines for forensic psychology. (2013, January). American Psychologist, 68(1), 7-19. Retrieved from http://www.apadivisions.org/division-41/about/specialty/2006-draft.pdf

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Mock Forensic Individual Assessment

Case Vignette 1
An intoxicated, forty-six-year-old, Caucasian woman refuses a plea bargain and a defense counsel brining her to trial for a burglary arrest.  The woman denies the charge even though she was in possession of the neighbor’s property.   Initial interactions with police proved assaultive and she appeared to be in denial of the charges which caused her to counteract while in the jail, creating a rally protest with other inmates.  Her paranoid state increased as the police contacted her only living relative, her brother.  Her brother disclosed Ms. G is the product of a broken home and foster care system, but received no mental health treatment in the past.  Ms. G confirmed she has not received mental health treatment in the past, but refused to disclose the remainder of her personal history (Argosy University, 2013).

Argosy University

Forensic Mental Health Professional Individual Assessment Report

Course FP6020 
Name: Ms. G

Individual Assessment:

Competency to Stand Trial
Introduction 

Ms.  G is being evaluated for prove or disprove her competency to stand trial.  Ms.  G has refused public counsel and a plea bargain. She suffers from paranoid delusions that can affect her understanding of the charges brought against her.  She denies any wrongdoing despite having the neighbors stolen property in her possession.  At the time of arrest, she was intoxicated and in possession of drugs and elicited a dysphoric affect.

Reason for Referral :

Client, Ms.  G was referred for evaluation to establish her competency to stand trial.  Ms. G appeared to be intoxicated, confused, combative, and irrational causing officers to use the highest levels of constraints.  Her behavior elicited a paranoid delusional state in which she claimed to have access to higher authority over the officers (American Psychiatric Association, 2013).  Incarceration likely heightened the paranoid delusions and caused her to become fearful that officers were trying to kill her brother.  In response to delusions, she rallied inmates and created a protest and hunger strike.    Observation concluded Ms. G was confused, hyperactive, and irrationalized the charges.  Adamant she did not steal the neighbor’s property, she refused counsel representation and a plea bargain leading her to trial indicating she was disoriented at the time arrest.  Unable to engage in conversation, Ms. G was uncooperative and refused to divulge personal information and appeared with a dysphoric affect.  Her thought process and content appeared abnormal as she maintained innocence and a paranoid thought process despite being caught with the property.

Presentation 

At the time of arrest, officers reported Ms. G to be intoxicated, confused, combative, and irrational causing the use of the highest levels of constraints.  Her behavior elicited a paranoid delusional state in which she claimed to have access to higher authority over the officers (American Psychiatric Association, 2013).  Incarceration heightened the paranoid delusions and caused her to become fearful that officers were trying to kill her brother.  In response to delusions, she rallied inmates and created a protest and hunger strike.  Officer observations concluded Ms. G was confused, hyperactive, and irrationalized the charges.  Adamant she did not steal the neighbor’s property, she refused counsel representation and a plea bargain leading her to trial indicating she was disoriented at the time arrest.  

At the time of the MSE, Ms.  G was unable to engage in conversation, uncooperative, refused to divulge personal information and appeared with a dysphoric affect.  She reported with hostile responses which elevated when asked about arrest behavior and items in her possession.  Ms.  G’s mood was perceived as annoyed and aggressive as she was perceived to continuously shake her leg and roll her eyes.  Little eye contact was held with Ms. G as she tended to look through evaluator and stare at the wall.  She fidgeted often in her chair most often when asked about information she did not want to divulge or about the incident leading to her arrest.  She was oriented to person, place, and time and understood why she was arrested, though claiming her innocence and blaming officers for planting drugs on her.  She was not aware of how or when, but claims she was not in possession of any drugs at the time of arrest.   When discussing the charge of burglary, she became agitated, perceived through a harsh, loud tone in voice and flailing of hands claiming the officers arrested her to gain access to her brother so they could kill him.  Although she was unaware why officers wanted to hurt her family. Her thought process and content appeared abnormal as she maintained innocence and a paranoid thought process despite being caught with the property.  

Ms. G’s demeanor and rise in hostility indicates potential malingering in her self-perceived level of guilt.  Her refusal to divulge certain information indicates that she takes a defensive stance in regards to her sense of self-responsibility and is uncooperative.

Current Life Situation 

Per her brother, Ms.  G is a transient who has spent her adulthood moving around the country.  Her employment consists of picking up odd jobs, selling drugs, and living with boyfriends to survive.  Her brother is her only remaining relative with whom she has only intermittent contact.  

Ms. G divulged that she currently lives with her boyfriend who supports her financially with paid employment.  She tends to the “home duties”, but picks up odd jobs such as house cleaning from time to time to supplement her boyfriend’s income.  She claims that she has been homeless in the past, but that is not currently her situation.  Ms.  G stated she did not move around all the time due to not having a home, rather for the love of traveling and seeing new places. 

Background Information

Ms. G lost her parents in a car crash at age four and was placed with her brother in the foster care system.  Her and her brother were split apart and were not reunited until she was eighteen and found him with the help of a private investigator.  Only basic medical information was made available to either party indicating biological parents as healthy, loving and caring parents, who both worked to support the family.  Foster care reports explain a foster home willing to take both siblings was not available resulting in the separation.  As a young child, Ms. G began manifesting temperamental outbursts, aggressive behavior, and defiance causing her to be relocated to several foster homes as a young child.  In early adolescents, she was detained for a six-month period for assault on another adolescent.  She returned to the foster care system and began drinking and using drugs at fifteen years old.  At seventeen she was detained and served one year in the juvenile detention facility for possession with intent to sell.  She was released to a group home where she was doing well and attempted to gain her high school diploma.  The counselors in the home helped her contact a private investigator who helped her reunite with her brother.  After locating her brother, she left the group home to live with a boyfriend and started selling drugs.  She continued selling drugs and moving from boyfriend to boyfriend to survive and have a home.  She has traveled all over the United States with different boyfriends.  She has two prior burglary charges, one possession, and three assault charges.

Psychological History 

Ms.  G refused to speak of her mental health other than exposing she has never received treatment for mental health except for counseling services provided during her juvenile incarcerations and the group home.  However, drug abuse was prevalent in her early adolescence and has continued into adulthood.  Early childhood traumatic experiences imply the possibility of depression or other mental health deficiencies. Her brother verified that he was not aware that she’d ever received mental health treatment either.

Substance Use History 

At the time of arrest, Ms. G was found to be intoxicated and in possession of drugs.  Her brother indicated drug dealing as a means of survival at the age of eighteen.  Ms. G has struggled with alcohol and drugs for twenty-one years via usage and selling.  Her brother admits to drinking frequently three to four times a week and smoking marijuana daily.  Ms.  G maintains she does not use drugs, but drinks several times a week, almost daily.  However, the substance she was in possession of tested positive as methamphetamine.  Her urine screening was positive for alcohol, methamphetamine, cocaine, and marijuana.  Ms.  G claims when she was younger she smoked weed and drank with her friends, but nothing more.  When told of her positive drug screening, she claimed the results were not true and officers are lying.  A second test reported the same results from different officers.  Her denial of drug use was documented.

Medical History

Ms.  G reported that she is healthy and feels fine.  However, she has not seen a doctor in a couple of years.  She has no insurance, so she goes to the hospital emergency room only when necessary.  The last time to the hospital she had fallen and sprained her ankle.   

Objective Testing :

                   Tests Administerd

Mini-Mental State Examination-2 (MMSE-2)

The MMSE-2 is a performance-based rapid test that tests for cognitive impairments in adults (Folstein, Folstein, & White, 2010).  The initial mental health assessment indicates Ms. G likely has a diagnosis of delusional disorder, unspecified (American Psychiatry Association, 2013).  However, in Ms. G’s circumstance, she was found intoxicated and in possession of a legal substance which may have been the cause of her disorientation at the time of arrest (American Psychiatry Association, 2013).  Ms.  G lost her parents at age four and she and her brother were placed in the foster care system which resulted in sibling separation indicators of adjustment disorder in childhood (American Psychiatry Association, 2013).  Past trauma indicates PTSD with the manifestation of other mental health incapacities as a coping mechanism.

Substance Abuse Subtle Screening Inventory-3 (SASSI-3)

The SASSI-3 is a self- report screening psychometric test that allows professionals to make inferences about possible substance abuse disorders (Miller, 1983-1997).  SASSI was employed to rule out cause of irrational and delusional behavior attributed to substance use.  Although Ms.  G claimed to not have a substance use problem, SASSI results were indicative of moderate dependence of substances with inference made of alcohol, cocaine, and methamphetamine as indicated in urine screening.  

Thematic Apperception Test (TAT)

The TAT is a personality test that reveals dominant drives, sentiment, emotions, and conflicts of personality in individuals over four years of age (Murray, 1935).  The TAT was employed as part of a battery of personality testing to gain a further understanding of Ms. G’s internal personality traits.  Ms.  G elicited a pattern of fear of abandonment and loss, intoxication as cause for impulsive behaviors, and feelings of “somebody watching her”.  These findings provide support for adjustment and delusion disorders as indicated as potential diagnoses in the MSE.  

Minnesota Multiphasic Personality Test, Second Edition (MMPI-2)

The MMPI-2 is a self-administered personality inventory that evaluates personality traits, maladaptive adjustment, and symptoms of psychological illness (Drayton, 2009).  The MMPI-2 will establish the possibility of clinical syndromes, personality patterns, psychosocial stressors, and severity of disturbance (Shapse, 2016).   Exaggerated responses indicate Ms. G is dealing with stress and attempting to avoid disclosing pertinent information.  The MMPI clinical profile indicated a tendency to act impulsively in socially unacceptable manners.  However, she places blame to others and feels no responsibility for her actions.  She is highly suspicious of others and tends to blame them for her irrational and hostile frame of mind.  She fears the world and blames others for wrongly accusing her which is elicited in her negative behavior and delusional mind set.  Subtests of the MMPI-2 (MAC-R and APS) suggested high probability of substance abuse in general providing further support for the SASSI that was employed.  Interpersonal relationships encompassed her sense of dependence and insecurity with coping consisting of manipulation with little to no guilt.  

MacArthur Competence Assessment Tool – Criminal Adjudication (MacCAT-CA)

The MacCAT-CA tests areas of reasoning, appreciation, and understanding through a structured interview of a hypothetical criminal case to clarify the defendant’s ability to fully comprehend what is happening in regards to their own legal matter (Poythress, Nicholson, Otto, Edens, Bonnie, Monahan, & Hoge, 1999).  Ms.  G reported with her guard up and delusional ideations that the police had planted drugs on her and she did not burglarize the neighbor.  However, she provided enough information to emanate the factual understanding of her charges and legal proceedings she is facing.  Due to the delusions, it was difficult to determine her rational understanding of the entire situation, but she did declare she knew the mayor and other higher ups who could dismiss officers from their job indicative of her ability to rationalize the legal process and cause and effect behaviors.  The evaluator opined Ms. G is competent to stand trial.

Findings :

Diagnostic Impressions 

AXIS I: Post Traumatic Stress Disorder with delayed expression, Alcohol abuse, methamphetamine abuse, cocaine abuse

AXIS II: Delusion Disorder, unspecified

AXIS III: NONE

AXIS IV: No primary support group, unemployed, dependent on boyfriend for housing, no mental health treatment

AXIS V: GAF= 78 (Transient symptoms that manifest in response to psychosocial stressors:  mild symptoms which cause some difficulty in social and occupational functioning)

Conclusion

Ms.  G suffers from PTSD which manifested in response to the traumatic loss of her parents, incorporation into foster care at a young age, and separation from her brother.  Symptoms did not manifest immediately, rather a slow manifestation over time.  Her primary coping mechanism has been substance abuse since adolescence totaling twenty-one years.  Her substance abuse reacted with PTSD causing a manifestation of symptoms of delusional disorder causing a paranoid state of mental functioning.  Malingering and deception were ruled out.  The employment of a battery of psychological testing implicated Ms.  G as competent to stand trial as she has factual understanding of the charges, the legal process, and consequences for her behavior.

Recommendations

It is my professional opine that Ms.  G is competent to stand trial at this point in time.  Ms.  G has elicited factual understanding of her circumstance.  She has rationalized retaliation as a mean of gain as elicited in her confrontation with the officers.  Her approach and success of staging a protest and hunger strike indicate her ability to fully understand cause and effect behaviors as a reasonable accommodation.  These factors surfaced in her MMPI-2 profile as well as the McCAT-CA.  Additionally, her repeat offending history indicates her need for mental health services to address her current deficits and promote rehabilitation for reunification into general society.  Recommendations for Ms.  G include a substance abuse program as the SASSI-3 and MMPI-2 profile supported the initial impression of high probability of substance abuse in the MMSE.   Attaining sobriety holds potential to decrease delusional thoughts that cause her paranoid tendencies.  Psychotherapeutic counseling will prove beneficial to help Ms. G learn to cope with the loss of her parents and the severance of her relationship with her brother.  Other childhood traumatic experiences need to be dealt with and understood in order for her to elicit positive growth and maintain sobriety as substance abuse and risky behavior appear to be her primary coping mechanism.  Both herself and brother may benefit from family therapy to help build a positive relationship and restore from the early separation.  As an incentive to complete a mental health and substance abuse program, life skills training to help establish permanent housing and regular employment will help create a sense of independence and self-worth she probably has never felt decreasing her chance of re-offending upon release. 

Jennifer L.  Olivas, B.A.                December 20, 2016 

Final Assessment Report
Reason for Referral:

Competency to Stand Trial

Client, Ms.  G was referred for evaluation to establish her competency to stand trial.  Ms. G appeared to be intoxicated, confused, combative, and irrational causing officers to use the highest levels of constraints.  Her behavior elicited a paranoid delusional state in which she claimed to have access to higher authority over the officers.  Incarceration likely heightened the paranoid delusions and caused her to become fearful that officers were trying to kill her brother.  In response to delusions, she rallied inmates and created a protest and hunger strike.  Observation concluded Ms. G was intoxicated, confused, combative, hyperactive, and irrationalized the charges.  Adamant she did not steal the neighbor’s property, she refused counsel representation and a plea bargain leading her to trial indicating she was disoriented at the time arrest.  Unable to engage in conversation, Ms. G was uncooperative and refused to divulge personal information and appeared with a dysphoric affect.  Her thought process and content appeared abnormal as she maintained innocence and a paranoid thought process despite being caught with the property.

Current Life and Background Information

Ms.  G reported her irritation with being arrested and “framed” for possession claiming she did not steal from her neighbor.  She understood that the evaluator was there to gather information to prove that she had mental problems.  She denied that anything was wrong with her and the officers are trying to use her to gain access to and kill her brother.  

Ms.  G claimed to be healthy, only visiting doctor in the emergency room when necessary such as when she sprained her ankle.  She claims she has received only services provided to her when she was incarcerated as a juvenile and when she was in the last group home, but claims that it was just counseling to check up on her.  She did not complete high school nor a GED program.  

Currently, Ms.  G is living with her boyfriend who is her primary supporter for about six months.  She picks up house cleaning and other odd jobs from time to time to help support herself and her boyfriend.  She claims they have a good relationship, but argue sometimes because she feels like he is keeping tabs on her and doesn’t trust her.  She also claims he sometimes gets upset because she questions him about where he was.  Ms.  G never had children.  Aside from her boyfriend, Ms. G only has her brother to provide moral and emotional support, but she doesn’t get to talk with him often.

When asked why she was arrested, Ms.  G became defensive and claimed to have done nothing wrong and the officers “framed” her.  She was shocked she was being arrested and didn’t understand why, until she got to the station and learned they planted drugs on her and were trying to get to her brother.  During her arrest, she tried to defend herself because she knew she had not done anything wrong and she knew she had to fight for what was right.  She is not normally an aggressive person, unless someone is trying to get her, then she retaliates by any means possible.  She claims she was arrested so they could kill her only family member.  Her arrest history includes two juvenile incarcerations, two burglary charges, one possession, and three assault charges.  

Discussing her charges, she claimed that she did not have her neighbor’s property and has no clue what property her arrest was over because she only had her belongings like her wallet and keys.  She is adamant that she had no drugs, nor does she use drugs despite failing her drug screening.  She attributed her failed drug screening to officer’s trying to set her up so they can have her out of the way to get her brother.  Though she is not aware why they want to kill him.  She did admit to having a few drinks that day as she does most days of the week, but continually denied using drugs.

Ms.  G knew that with her prior charges, she would likely be facing “serious” jail time even with the plea bargain.  She claims to know the mayor and if she could talk to the judge, he would have to “listen to the mayor and let her out.”  She would explain to the judge what the officers were up to and he would understand why she reacted how she did because she had no stolen property and the officers are just after her brother.  She claims to have no enemies, rather friendly with most people, but maintained foul play from the officers who have tried all extremes, including poisoning her to get to her brother.  She was not bothered by any detriment officers or their families would suffer if they were relieved from their positions.

Ms.  G has no recollection of her parents, but has an intermittent relationship with her brother she wants to improve.  She was in several foster homes throughout her childhood, but would not disclose any major events sans some people were nice, some were not.  She did expose having endured a few painful disciplines that caused her run away.  She was disciplined for fighting with other kids in the home, having bad grades, and forgetting to do chores or not doing them good enough.  She was detained and incarcerated for assault and possession with intent to sell when she was a teen.  However, she claimed the other girl started the fight and the drug charge was because she was holding it for her boyfriend.  Her final thought at the end of the interview was that she’s “being honest and her brother needs protection because the officers are going to kill him, please don’t think I’m crazy.”

Ms. G has endured trauma throughout her entire life that has never been dealt with.  Her ability to exhibit a sound understanding of the events leading to and after detainment imply she is competent to stand trial and the adjudication process.  Although mental health impairments are evident and exposed through the battery of tests employed, Ms.  G elicited a factual understanding beyond negative behavior equates to punishment.  She retaliated towards officers by staging a protest and hunger strike during her confinement, inferred to be an attempt to gain access to the judge as she requested.  Consistent with delusion disorder, Ms.  G accepts no responsibility for any of her behaviors that resulted in negative consequences, rather placed blame on others.  She emanates a fear that people are “out to get her family” despite physical and scientific evidence that her thoughts are surreal.  Ms.  G consistently turns to alcohol and drugs (inferred, client denies) to cope with past traumatic events since she was fifteen years old.  Her coping mechanism has turned into a substance abuse disorder which appears to drive her irrational and hostile behaviors.  

Testing Battery

A series of tests were employed to evaluate Ms. G’s competence.  The Mini-Mental State Examination-2 (MMSE-2) is a performance-based rapid test that assesses for cognitive impairments in adults (Folstein, Folstein, & White, 2010).  The initial mental health assessment indicates Ms. G likely has a diagnosis of delusion disorder, unspecified (American Psychiatry Association, 2013).  However, in Ms. G’s circumstance, she was found intoxicated and in possession of a legal substance which may have been the cause of her disorientation at the time of arrest (American Psychiatry Association, 2013).  Ms.  G lost her parents at age four and she and her brother were placed in the foster care system which resulted in sibling separation risk factors of adjustment disorder in childhood (American Psychiatry Association, 2013).  Past trauma indicates PTSD with the manifestation of other mental health incapacities as a coping mechanism.  Additionally, at the time of her arrest, Ms. G was intoxicated and in possession of methamphetamines.  Her denial of substance abuse despite her history and current charges necessitated the use of a substance abuse screening.  The MMSE-2 indicated a marked increase of negative behavior with intoxication involved in every respect dating back to adolescence.  The MMSE-2 served as the base of Ms. G’s evaluation and indicated the need for further information gathering.

The second test employed was the Substance Abuse Subtle Screening Inventory-3 (SASSI-3) to establish the probability that Ms. G suffers from a substance abuse disorder.  The SASSI-3 is a self- report screening psychometric test that allows professionals to make inferences about possible substance abuse disorders (Miller, 1983-1997).  SASSI was employed to rule out cause of irrational and delusional behavior that can be attributed to substance use.  Despite her denial of a substance issue on the face value items, Ms. G reported higher probability on the indirectly related items which ruled out evasiveness and malingering and deception in her test.  Although Ms.  G claimed to not have a substance use problem, SASSI results were indicative of moderate dependence of substances with inference made of alcohol, cocaine, and methamphetamine as indicated in urine screening.  Despite SASSI-3 results, the traumatic history of Ms. G was indicative of PTSD and a delusion disorder which weighed as the probable cause of the substance abuse.

The third test employed was the Thematic Apperception Test (TAT).  The TAT is a personality test that reveals dominant drives, sentiment, emotions, and conflicts of personality in individuals over four years of age (Murray, 1935).  Although the TAT is not a definitive scoring test it serves as a basis to understanding the mindset of the individual.  In Ms.  G’s case, it was necessary to understand the primary drive of behavior by establishing a pattern in the thought mind set.  This would also indicate potential cause or basis of her delusional thoughts and paranoia.  The TAT was employed as part of a battery of personality testing to gain a further understanding of Ms. G’s internal personality traits.  Ms.  G elicited a pattern of fear of abandonment and loss, intoxication as cause for impulsive behaviors, and feelings of “somebody watching her”.  These findings provide support for PTSD (fear of abandonment) and delusion disorders (“watching”) as indicated as potential diagnoses in the MSE.  The TAT should not be relied upon, rather used as a support for other personality test findings such as the MMPI-2.

Next, the Minnesota Multiphasic Personality Test, Second Edition (MMPI-2) was employed.  The MMPI-2 is a self-administered personality inventory that evaluates personality traits, maladaptive adjustment, and symptoms of psychological illness (Drayton, 2009).  The MMPI-2 will establish the possibility of clinical syndromes, personality patterns, psychosocial stressors, and severity of disturbance (Shapse, 2016).   Exaggerated responses indicate Ms. G is dealing with stress and attempting to avoid disclosing pertinent information.  The MMPI clinical profile indicated a tendency to act impulsively in socially unacceptable manners.  However, she places blame to others and feels no responsibility for her actions.  She is highly suspicious of others and tends to blame them for her irrational and hostile frame of mind.  She fears the world and blames others for wrongly accusing her which is elicited in her negative behavior and delusional mind set.  Subtests of the MMPI-2 (MAC-R and APS) suggested high probability of substance abuse in general, providing further support for the SASSI that was employed.  Interpersonal relationships encompassed her sense of dependence and insecurity with coping consisting of manipulation with little to no guilt.  Her MMPI-2 profile indicates a deficit in interpersonal relationships attributed to the sudden loss of her parents, separation from her brother, and the constant change of foster homes.  Her fear of the world is attributed to her fear of abandonment and therefore recluses and copes through substance abuse.  Excessive substance abuse holds potential to bring on delusions and paranoia which is consistent with Ms. G’s ideation that the officers want to kill her brother.  This indicative of a fear of loss and abandonment and she reacts through any means to protect her brother from her delusions.  An understanding of the causes of behavior led to the understanding that Ms.  G had a functional mental status and she was cognitively sound, but areas of reasoning, appreciation and understanding needed to be assessed in order to declare competency.

The MacArthur Competence Assessment Tool – Criminal Adjudication (MacCAT-CA) tests areas of reasoning, appreciation, and understanding through a structured interview of a hypothetical criminal case to clarify the defendant’s ability to fully comprehend what is happening in regards to their own legal matter (Poythress, Nicholson, Otto, Edens, Bonnie, Monahan, & Hoge, 1999).  Ms.  G reported with her guard up and delusional ideations that the police had planted drugs on her and she did not burglarize the neighbor.  However, she provided enough information to emanate the factual understanding of her charges and legal proceedings she is facing.  Due to the delusions, it was difficult to determine her rational understanding of the entire situation, but she did declare she knew the mayor and other higher ups who could dismiss officers from their job indicative of her ability to rationalize the legal process and cause and effect behaviors.  The evaluator opined Ms. G is competent to stand trial.

Diagnosis

Post-Traumatic Stress Disorder is supported through the meeting of certain criteria of the DSM-5.  Ms.  G experienced the accidental death of her parents, was uprooted from her home and placed with strangers only to then be separated from her brother, her only living relative.  In response to the trauma, Ms.  G has internalized the events which then become triggered by any event that  appears to demonstrate potential loss or abandonment.  Her refusal to talk about her childhood indicates avoidant behaviors associated with PTSD.  Ms. G also reports fears, negative and exaggerated view of the world, and distorted cognitions of causes of events.  Also indicative of PTSD are her angry outbursts and reckless behavior that led to her arrest and displayed throughout her detainment and interview process.  Symptoms appear to be deep rooted and cause Ms. G social and occupational distress.

Delusional disorder, according to the DSM-5, manifests void of hallucinations with no marked impairment of functioning or odd behavior.  The delusions cannot be substance-induced nor can manic or major depressive episodes have manifested.  Ms.  G’s delusional encompasses the belief that she is being targeted by officers as a way for them to get to and kill her brother.  Her current delusional state rates equivalent to a 4 on the four point scale of severity due to her current accusations towards the officers.  

Additionally,  Ms. G suffers from substance abuse disorders consisting of alcohol, methamphetamines, and cocaine.  Although she denies drug use, a urine screen and a SASSI screen indicated otherwise.  The DSM-5 declares substance use disorders as a cluster of symptoms that encompass cognition, behavior, and physiological symptoms that indicate continued use despite substance-related problems.  Identifying substance abuse disorders includes the individual focuses life around the ability to use the substance even though marked impairment is evident in necessary areas such as employment or education.  Additionally, partaking in risky behavior such as burglary while intoxicated and the building of tolerance are indicative of substance abuse disorders.  Ms.  G is not able to maintain employment and has had several dealings in legal repercussions due to her substance abuse.  Her level of tolerance was not disclosed as she continues to deny the issue.

Conclusion and Recommendations

It is my professional opine that Ms.  G is competent to stand trial at this point in time.  Ms.  G has elicited factual understanding of her circumstance.  She has rationalized retaliation as a mean of gain as elicited in her confrontation with the officers.  Her approach and success of staging a protest and hunger strike indicate her ability to fully understand cause and effect behaviors as a reasonable accommodation.  These factors surfaced in her MMPI-2 profile as well as the McCAT-CA.  Additionally, her repeat offending history indicates her need for mental health services to address her current deficits and promote rehabilitation for reunification into general society.  Recommendations for Ms.  G include a substance abuse program as the SASSI-3 and MMPI-2 profile supported the initial impression of high probability of substance abuse in the MMSE.   Attaining sobriety holds potential to decrease delusional thoughts that cause her paranoid tendencies.  Psychotherapeutic counseling will prove beneficial to help Ms. G learn to cope with the loss of her parents and the severance of her relationship with her brother.  Other childhood traumatic experiences need to be dealt with and understood in order for her to elicit positive growth and maintain sobriety as substance abuse and risky behavior appear to be her primary coping mechanism.  Both herself and brother may benefit from family therapy to help build a positive relationship and restore from the early separation.  As an incentive to complete a mental health and substance abuse program, life skills training to help establish permanent housing and regular employment will help create a sense of independence and self-worth she probably has never felt decreasing her chance of re-offending upon release. 

Reflection:

Professional Role

Typically, the professional role encompasses confidentiality and privacy rights along with the declaration of not causing harm to the client (American Psychological Association, n.d.).  However, in the forensic setting, confidentiality does not exist as the professional is employed by a third party to provide services (Kalmbach & Lyons, 2006).  As a Forensic Psychologist, it is imperative to establish the professional role as a third party and outline what information will be shared outside of the client and with whom the information will be shared (Kalmbach & Lyons, 2006).  Although, one may emotionally connect as an advocate for the client, it the professional’s duty to remain objective and unbiased throughout the course of assessment and if he or she must testify (Kalmbach & Lyons, 2006).  In the event the professional is unable to gain compliance with the client in regards to an interview, he or she must make clear invalidity and limitations to those involved in the case including the court (Kalmbach & Lyons, 2006).  It is important to note that the information obtained in the assessment is not protected by confidentiality (Kalmbach & Lyons, 2006) including self-harm or thoughts of harming others, clinical diagnoses, and potential for the future.

Hypothesis

Ms.  G presented as competent to stand trial.  Competency is defined through the use of some “variant of the Dusky Standard” derived from the legal proceeding Dusky v, United States in 1960 (Roesch, Zapf, Golding, & Skeem, n.d., p.  29). The Dusky Standard declares the individual must have the ability to consult with a lawyer with a reasonable degree of rational understanding, in addition to factual understanding of the proceedings against him or her (Roesch, et al., n.d.).  Although an explicit definition of competency to stand trial does not exist,  a common practice does:  Incompetence cannot be declared independent of the legal case facts (Roesch, et al., n.d.).  Evaluators must establish the degree of the defendant’s current ability in regards to the degree of relevancy of the jurisdiction competency standards (Roesch, et.  al, n.  d.).  Due to the Dusky Standard, Ms. G was evaluated on several levels to ensure her comprehension of her legal situation and possible outcomes was intact.  

Assessment Choices

The MMSE-2 is a rapid test which indicates cognitive impairments (Folstein, Folstein, & White, 2010).  Employing the MMSE-2 allowed for brief insights on the potential causes of Ms.  G’s negative behavior.  A subjective and objective snapshot of mental status at a particular time gives the professional an idea what other evaluations are necessary for the individual (Combs, n.d.) and reveals abnormal functioning, dependency (chemical and psychological), competency to stand trial and handle incarceration (Shapse, Ph. D., 2016).   

The SASSI-3 appeared to be pertinent in evaluating Ms. G because the test utilizes direct face values and indirect questioning to establish probability of substance abuse (Miller, 1983-1997).  Due to Ms. G’s denial, it was important to verify suspicion through a test with a high validity and reliability and low potential of being able to exaggerate or malinger (Miller, 1983-1997).  Additionally, per David Pittenger, the SASSI-3 is used in psychological treatment centers to unveil the mask of substance abuse problems hidden by mental illness (Miller, 1983-1997).  In Ms. G’s case it was imperative to identify the existence of substance abuse disorder to define cause of behavior.  

The TAT was employed as a support base for further personality testing.  In the Forensic setting, the TAT would prove to be useful in the evaluation and assessment of individuals involved with violent crimes (Murray, 1935). Although Ms.  G was not currently detained for her aggression, her aggressive behavior manifested while being arrested and retaliatory behaviors surfaced during confinement.  TAT use is beneficial in establishing motives and aggression degree as well as potential triggers (Murray, 1935).  Employing the TAT would “force” Ms. G to express information she has hidden to this point.  Her story telling indicates past trauma and internal drive which was used as a determinant in her competency degree.  Additionally, it could be opined that the TAT may be useful in determining if beliefs and views are indicative of future offending.  

The most widely used psychometric test for measuring adult psychopathology is the MMPI – 2 (Drayton, 2009).  The scoring measures the actual test items against the norms by using questions that are not related to the “health” area to reduce feigning responses (Drayton, 2009).  Nine validity scales assess faking, lying, and defensiveness to indicate accuracy, validity, and reliability of results (Drayton, 2009).  The MMPI-2 established a high probability of substance dependence solidifying the initial thought.  Additionally, personality deficits were found providing support to Ms. G’s diagnoses.

During execution of the MacCAT-CA, the defendant’s ability to learn, recall, and apply new information is assessed, capacity to establish factual information and make rational decisions, and ability to appreciate consequences (Pinals, Tillbrook, & Mumley, 2006).  The MacCAT-CA has also been found useful in gathering relevant data which were inconsistent in the interview process indicating it valuable in detecting malingering and exaggerating (Pinals, Tillbrook, & Mumley, 2006).  The McCAT-CA was used to validate assessments were void of malingering and exaggeration.  Ms.  G had an intricate mental health portfolio that was originally perceived as an attempt to avoid jail time.  Ruling out exaggeration and malingering supported the hypothesis that Ms. G does suffer from mental illness.  However, she maintains the mental capacity to withstand trial which is evident in her ability to thoughtfully retaliate.

Ethical Dilemmas / Multicultural Perspectives

Testing was chosen based on appropriateness to the clients reported history and culture.  The decision was attentive to language and development as consistent with the APA Code of Ethics (American Psychiatric Association, 2013).  Personal ethical dilemmas that may have surfaced would include remaining objective knowing the client had to deal with a lifetime of trauma that has had a marked effect on her development and caused a hindrance in her maximizing her life potential.  Additionally, at the start of the project I maintained one perspective, but through the course of evaluations and as information was input, perception changed and the assessment became more objective than at the start.  A repeat offender, such as Ms. G faces harsher sentencing as the perception is “lessons are unlearned”.  However, in the case of Ms.  G, it appears that mental in compacities had been overlooked much too long.

Court Setting

It is vital to remain objective and only disclose exact answers when being questioned in court.  Having knowledge of the tests employed, their validity and reliability rates, as well as their generalization ability will prove an effective defense when testifying in court.  The posoibility of any potential bias and all efforts made to reduce personal bias should be disclosed.  Additionally, one should disclose any ethical dilemmas that may have risen during the course of the assessment.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

American Psychological Association. (n.d.). Ethical principles of psychologists and

           code of conduct including 2010 amendments. Retrieved from http://www.apa.

           org/ethics/code/principles.pdf

Argosy University. (2013). Case Vignettes. Retrieved from Argosy University, FP6020 A01 website.  Retrieved from http://vizedhtmlcontent.next.ecollege.com/pub/content/b4906a89-6b22-49c2-bf45-5035e900258e/AU_FP6020_M1_Case_Vignettes_C2.pdf

Combs,M. D., H. (n.d.). . Retrieved from https://depts.washington.edu/psyclerk/secure/mentalstatusexam.pdf

Drayton, M. (2009). The Minnesota Multiphasic Personality-2 (MMPI-2). Occupational Medicine, 59(2), 135-136. doi:10.1093/occmed/kqn182

Folstein, M.  F., Folstein, S.  E., White, T,. & Messer, M.  A.  (2010).  Mini-mental state examination, 2nd edition. Mental Measurements Yearbook, 20.  Retrieved from http://web.a.ebscohost.com.libproxy.edmc.edu/ehost/detail/detail?vid=3&sid=5cfedacc-e5c5-44f2-80f5-ec1b13f75c2a%40sessionmgr4009&hid=4201&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#AN=test.6474&db=mmt

Kalmbach, K. C., & Lyons, P. M. (2006). Ethical issues in conducting forensic evaluations. Applied Psychology in Criminal Justice, 2(3).  http://www.apcj.org/documents/2_3_Ethics_foren.pdf

Melton, G.B., Petrila, J., Poythress, N.G., & Slobogin, C. (2008). Psychological evaluations for the courts: A handbook for mental health professionals and lawyers. (3rd Ed.) New York; Guilford Press.

Miller, G. A. (1983-1997). The substance abuse subtle screening inventory – 3. Mental Measurements Yearbook, 15.  Retrieved from: http://web.b.ebscohost.com.libproxy.edmc.edu/ehost/detail/detail?vid=15&sid=d7ca3401-3038-405f-bb8d-4ad8608b0418%40sessionmgr102&hid=102&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#AN=test.1982&db=mmt

Murray, H.  A. (1935).  Thematic Apperception Test.  (Mental Measurements Yearbook, 8).  Retrieved from http://web.a.ebscohost.com.libproxy.edmc.edu/ehost/detail/detail?vid=3&sid=16555d4d-a5d9-4a6b-93bb-59fee2a81d8b%40sessionmgr4008&hid=4201&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#AN=test.4841&db=mmt

Poythress, N.  G., Nicholson, R.  N.,  Otto, R.  K.,  Edens, J.  F.,  Bonnie, R.  J.,  Monahan, J.,  & Hoge, S.  K.  (1999).  MacArthur Competence Assessment Tool-Criminal Ajudication (Mental Measurements Yearbook, 20).  Retrieved from http://web.a.ebscohost.com.libproxy.edmc.edu/ehost/detail/detail?vid=13&sid=4021c487-e4a6-4486-b8b0-840b9fc26eaa%40sessionmgr4006&hid=4201&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#AN=test.6528&db=mmt

Roesch, R., Zapf, P. A., Golding, S. L., & Skeem, Jennifer L., (n. d.). Defining and Assessing Competency to Stand Trial. Retrieved from https://www.justice.gov/sites/default/files/eoir/legacy/2014/08/15/Defining_and_Assessing_Competency_to_Stand_Trial.pdf

Shapse, Ph. D., S. N. (2016). HG. Retrieved from https://www.hg.org/article.asp?id=5100

Standard
Ethics for Forensic Psychology, Uncategorized

Therapeutic Role vs. Forensic Role

Thesis

The coexistence of a therapeutic end forensic role is a topic of debate that pans into the ethicality of the practices.  The belief of Bush and colleagues emphasized that to be of benefit to the legal system and elicit ethicality one should develop a sense of divergence among conflicts of interest (Neal, 2010).  Shifting focus to maximize ethical potential avoids misconduct and enforceable disciplinary action and encourages positive ethicality in one’s profession (Neal, 2010).    Understanding the perception of why some practices are unethical appears as one of the most vital concepts of Bush, Connell, & Denney (Neal, 2010).  Although certain practices are clearly identified as unethical, there are gray areas remain that require the consideration of their implications and the possible repercussions of one’s chosen reaction to the practice (Neal, 2010).   Although the duties and roles of therapeutic and forensic specialists differ in legal issues, there lies the potential of overlap between the roles (Hugaboom, n.d.).   It is assumed a clinical therapist who indulges in a dual role as a forensic specialist may have a negative impact on the client, the legal issue, and the outcome of services.

 

Therapeutic Role

A clinician role includes the promotion of treatment void of harm by obtaining informed consent and maintaining confidentiality and privacy while functioning within the boundaries of competence (Greenburg and Schumann, 1997).  Clinicians are expected to abide by blurred guidelines when faced with legal proceedings that may require them to testify on behalf of their client, submit records, report suspicion of child abuse (Hugaboom, n.d.).  One of the most vital expectations of a clinical therapist is to maintain confidentiality of the client, but at times confidentiality is broken legally and ethically (Hugaboom, n.d.).  For instance, a therapist is expected to breach confidentiality in events of suspicion of physical or sexual abuse, self-harm or harm to others, and when a court action requires their testimony (Hugaboom, n.d.).  Non-compliance in these areas may result in charges including contempt of court (Hugaboom, n.d.).  Only when the information sought is considered privileged, not relevant to the court hearing, is it considered legal and ethical for the therapist to reject exposing the information to protect the client’s right of privacy and confidentiality (Hugaboom, n.d.).  The therapist must be involved in a professional relationship with the client, the information must be given to the therapist or assistant, and the information must not be released to a third-party by the client (Hugaboom, n.d.).  Most importantly, the legal confines of therapeutic roles lead to tough decisions such as testifying for or against a client and reporting potential danger (Hugaboom, n.d.).  Consequences for ethical decisions hold potential of confinement for contempt of court while decisions made for legality hold potential of decreasing trust and hindering the effective therapeutic – client relationship (Hugaboom, n.d.).  A clients best interest is always the priority, however, at times, crossing the gray area of legality and ethicality encompasses the possibility of  the therapist mistakenly leaking confidential information when not required which may lead to a loss of licensing (Hugaboom, n.d.).

Forensic Role

The forensic role is defined as one which practices explicitly with psycholegal issues, directly assisting in court, legal proceedings, correctional mental health facilities, and in an adjudicative capacity (American Psychology-Law Society, 2011).   A forensic psychologist should practice only in areas of expertise gained through education, training, and experience with fundamental knowledge in legal, factual, professional, and civic standards in the area of which they practice (American Psychology-Law Society, 2011).  The standards above give the forensic specialist the privilege of testifying as an expert witness allowing them to express personal opinion, but must be careful to render the highest standards of the profession and ensure their services are used responsibly (Hugaboom, n.d.).

Differences

A therapist creates a trusting professional treatment for a length of time while to deal with issues that may be hindering some aspect of life for the individual (Heltzel, 2007).  On the other hand, a forensic psychologist meets with the client a few times, just long enough to conduct an evaluation after a crime is committed and the client is the accused (Hugaboom, n.d.).  A forensic evaluation is less time consuming and not as in depth of those that may be completed by a therapist (Hugaboom, n.d.).  Due to the forensic specialist not developing an on-going relationship he or she can more easily determine objective reality whereas a therapist, who creates a relationship of trust, empathy and understanding focuses on subjective thought (Hugaboom, n.d.).  However, both therapeutic roles and forensic roles require the elicitation of informed consent to the client (American Psychological Association, n.d.).  In the therapeutic role, confidentiality and privacy are supported unless the therapist suspects the client capable of harm to themselves or someone else, or potential child abuse (American Psychological Association, n.d.).  However, the forensic professional is responsible to emphasize to the client all information obtained in regards to legal purpose will be divulged, and only information exposed that does not relate to the specific case will be protected (American Psychology-Law Society, 2011).   The last point implicates the potential of the client to expose more information to a therapist rather than a forensic specialist who is at leisure to expose and have information used against them.

Contrast

Some argue a short, initial assessment constitutes the gathering of enough information to make an ethical objective opinion about the client, but this though may be rejected as the consideration of why therapy was sought and now the need for a forensic assessment stands (Hugaboom, n.d.).  As a clinician testifying in a legal matter, he or she must implicate the risks involved with a dual relationship including the possibility of breaking trust as information must be divulged in regards to the legal matter (Hugaboom, n.d.).  It is also imperative that therapist create a wall separating the forensic role from the therapeutic role and never incorporating the two roles together (Hugaboom, n.d.).  Additionally, in the event a professional relationship is severed and a forensic role is incorporated, the therapist must depict the ways objectivity may be affected and disclose any conflicts of interest that may arise (Hugaboom, n.d.).  Psychologists are encouraged to utilize scientific and professional knowledge in all practices, assessment tools should be chosen according to appropriateness for the specific issue and prevent misuse of the instrument while identifying any limitations of the chosen tool (Hugaboom, n.d.).

Others believe that allowing a clinical therapist to testify as an expert witness may cause harm due to the consequences the professional and client may face (Hugaboom, n.d.).   Often times, the therapist does not hold enough knowledge about forensic matters causing testimony to be discredited as research has indicated clinical therapist’s predictive ability of future violence to be compatible to that of a high schooler (Hugaboom, n.d.).  Competency of therapists is essential in providing ethical treatment and assessment.  When the professional does not have the competence to conduct justifiable professionalism congruent to the ability necessary, ethical codes of the APA are breached (Greenburg & Schuman, 1997).   Often, legal ability is not met by clipnical therapists such as the ability to render a client legally incapacitated as per the recognition of consequence that may derive from impulsive actions (Hugaboom, n.d.).

Reconciliation of Roles

Research by Hugaboom implicates the difficulties that may arise from a clinical therapist delving into a dual relationship and taking on a forensic role.  It is found the potential error that may occur from a clinician indulging into a forensic role may actually result in negative consequence for the client and therapist.  Clinical therapists may find it difficult to maintain the neutral role required by forensic professionals due to the interpersonal relationship created in the therapeutic setting.  Depleting neutrality may create a bias win judgement and an opinion based on subjective emotions rather than scientific and legal evidence derived from forensic assessments.    A forensic psychologist seeks minimal encounters with the client and does not edify the history or the much of the emotional attachment in the case at hand.  The forensic professional has a goal of deciding abnormal behavior and ability of the client to meet the social expectation or if there is an underlying issue such as insanity that may have led to the crime purporting the client incapable of standing trial or accepting consequence for actions. When subjective feelings become the driver in a testimony, the objective role is abandoned and the potential of information vital to the issue being withheld increases.  Additionally, the confidentiality and privacy laws were enacted as a protection to clients receiving services.  However, a clinical therapist remains at risk to abort these protections either accidentally or due to the need of the legal issue.  Forensic professionals are not expected to adhere to such strict guidelines allowing them to abort confidentiality when necessary to the case.  It appears that if a clinical therapist entertains dual roles with a client, there is too much risk involved and the client, who is to be protected, is open to more harm.  Although the therapist has more in depth information that may hold more evidence of the cause of behavior, it seems that taking a subjective standpoint defies the clause of sound judgment made in a court hearing.  It is believed subjective testimony may create emotion with those involved rather than a scientific and knowledge based judgment.  For the above reasons, a dual role should not be taken by a clinical therapist.  However, if services were requested at the close of the legalities, the forensic professional would have the ability to subjectively approach treatment based on the objective assessments and opinions from the legalities.

 

References

American Psychological Association. (n.d.). Ethical principles of psychologists and
code of conduct including 2010 amendments
. Retrieved from http://www.apa.
org/ethics/code/principles.pdf

American Psychology-Law Society. (2011). Specialty guidelines for forensic
psychology
. Retrieved from https://www.apa.org/practice/guidelines/
forensic-psychology.pdf

Greenberg, S. A., & Shuman, D. W. (1997, February). Irreconcilable conflict between therapeutic and forensic roles. Professional Psychology: Research and Practice, 28(1), 50-57. Retrieved from http://www.healtorture.org/content/irreconcilable-conflict-between-therapeutic-and-forensic-roles

Heltzel, T. (2007). Compatibility of therapeutic and forensic roles. Professional Psychology: Research and Practice, 38(2), 122-128. doi: 10.1037/0735-7028.38.2.122

Hugaboom, Denise (n.d.). “The Different Duties and Responsibilities of Clinical and Forensic Psychologists in Legal Proceedings.” The Review: A Journal of Undergraduate Student Research 5 (2002): 27-32. Web. [accessed:  October 10, 2016]. Retrieved from <http://fisherpub.sjfc.edu/ur/vol5/iss1/4&gt;

 

Neal, T.M.S. (2010). Choosing the lesser of two evils: A framework for considering the ethics of competence for execution evaluations. Journal of Forensic Psychology Practice,10, 145-157. doi: 10.1080/15228930903446724

 

 

 

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Ethics for Forensic Psychology, Uncategorized

Case Study: Parole Assessment for Violent Sexual Predator

“Inmate X has a long history of violent behavior, which has resulted in his current imprisonment. While incarcerated, he has been a model prisoner. Inmate X has now been scheduled for a parole board hearing. Upon reviewing Inmate X’s central file, the warden believes that the inmate is still a dangerous individual who should not be granted parole despite his record of no institutional infractions. Accordingly, the warden requests that Dr. R evaluate Inmate X using psychological tests. The warden would like information about the inmate’s personality relating to his continued threat to public safety, and he would like this evaluation to be performed without the inmate being informed of its purpose because he believes Inmate X might otherwise refuse to participate in the evaluation” (Weinberger & Sreenivasan, 1994, pg. 164).

 

Evaluation

The Specialty Guidelines for Forensic Psychology advises practitioners to inform clients of the nature and parameters of possible services including the objective of the examination and who will have access to the information attained, as well as limitations of privacy and confidentiality (American Psychology-Law Society, 2011).  Although the inmate has a history of violent behavior, the incarceration period is void of infarctions potentiating future violations implying all rights of the individual remain intact.  According to Weinberger and Sreenivasan, exceptions to informed consent exist when extenuating emergency circumstances may arise such as the potential compromise of others or self-safety (1994).  It is unethical for a psychologist to act on an insinuation of the warden when the behaviors appear to be null.  The cornerstone of psychology is informed consent and confidentiality (Weinberger & Sreenivasan, 1994).  Breaking either, jeopardizes professional identity and the interpersonal relationship of client and provider and therefore, both must be protected through adherence to ethical codes and guidelines (Weinberger & Sreenivasan, 1994).

The warden’s request for a “covert” examination should not be cvilatarried out.  The warden is asking the professional to perform an analysis based on an inclination with a lack of current evidence substantiating the cause of an emergency based evaluation.  Despite the history, no validating circumstance warrants a breach of confidentiality in respects to the examination.  Although argument can be made about the safety of the general public upon release of the inmate and the “sabotage” of the examination if the prisoner is informed of the reasons for the evaluation (Weinberger & Sreenivasan, 1994), there must be justifiable cause for the completion of the examination when void of informed consent.  The vignette leads one to believe the warden is attempting to sabotage early release of the inmate based on history, not actual real-time life events that implicate a necessity to deny parole.

Non-APA Member

As a member of the APA, professionals are mandated to comply with the Code of Conduct outlined by the APA and failure to so do may result in professional sanctions, legal issues, and reporting to other state boards of the infarction (American Psychological Association).  A professional who is not a member of the APA should not perform the “covert” examination, despite the request and insinuation of the warden.  As a professional in the mental health field, one has the duty to uphold moral and ethical practices to avoid reduced justification of the intentions of the area of mental health.  Acting on a connotation implies a low level of value or respect for humankind in general, but in this vignette, for criminal offenders who hold potential for rehabilitation.  It is essential the professional conduct the examination to establish possible behavior for the future.  However, equally imperative is attaining consent for the evaluation, eliciting informed consent, and explaining the parameters of the assessment as the inmate has the right to justified evaluations.  Performing the evaluation would prove a biased outcome lacking empirically supported risk assessment measures compromising the standard of practice for violence risk assessment in the community negating validity and reliability (Board of Parole Hearings’ Revised Final Statement of Reasons 15 Ccr §2240, 2011).

Multicultural / Diversity Issues

Forensic Psychologists should utilize care when interpreting examination results.  In addition to considering the purpose of the assessment, various test factors that may affect judgment or accuracy must be considered (American Psychology-Law Society, 2011).  Test factors may include cultural, situational, linguistic, and personal factors in addition to cognitive ability (American Psychology-Law Society, 2011).  Despite indifferences that may occur in individuals raised in a single parent or adoptive home, race, ethnicity or gender affiliations, Ethical Codes are standards set to ensure fair and equal treatment for anyone receiving services (American Psychological Association).  The interpretations and perceptions of the assessments may differ among the diverse cultures, but professional standards do not change.  Understanding an inmate’s history and culture may lead to understanding the underlying cause of the criminal behavior and the beliefs and ideas one holds, but those factors should not cause the abandonment or adaptation of ethicality.  Considering the background of the inmate should be utilized solely for the purpose of identifying changes in behavior that may indicate risk for the future or prove rehabilitation success.

 

References

American Psychological Association. (n.d.). Ethical principles of psychologists and
code of conduct including 2010 amendments
. Retrieved from http://www.apa.
org/ethics/code/principles.pdf

American Psychology-Law Society. (2011). Specialty guidelines for forensic
psychology
. Retrieved from https://www.apa.org/practice/guidelines/
forensic-psychology.pdf

Board Of Parole Hearings’ Revised Final Statement Of Reasons 15 Ccr §2240. (2011). Retrieved from http://www.cdcr.ca.gov/boph/docs/revised_final_statement_reasons_original.pdf

Weinberger, L. E., & Sreenivasan, S. (1994). Ethical and professional conflicts in correctional psychology. Professional Psychology: Research and Practice, 25(2), 161-167. Retrieved from https://login.libproxy.edmc.edu/login?url=http://search.proquest.com/docview/614310220?accountid=34899

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