Psy. D., Antioch University, 2023, Antioch New England: Clinical Psychology

This is a mixed-method study exploring Designated Forensic Psychologists' (DFPs) experiences with the violence risk assessment (VRA) of individuals diagnosed with dementia. DFPs (N = 23, 69.6% female, 87% White) completed an online survey investigating the frequency of VRA and dementia, potential change in VRA method in response to dementia, application of existing VRA instruments, and perceived benefit of tailored guidelines and VRA instruments. Most in this sample (84.2%) endorsed cases involving VRA and dementia that typically comprised 5% or less of lifetime cases. The presence of dementia had a variable impact on the approach to VRA, and thematic analysis revealed that changes in method were related to the clinical interview being impacted, the need for objective cognitive assessment, and increased reliance on collateral records or informants. Sixty-three percent reported using existing VRA instruments with perceived applicability to the population. However, many participants reported being less confident in their evaluations and an overwhelming majority reported perceiving benefit from the development of tailored guidelines or VRA instruments. These results shed light on the importance of future research to investigate the unique needs of this population concerning VRA.

Committee: Monique S. Bowen Ph.D. (Committee Chair); Jeffrey Burl Ph.D. (Committee Member); Kimberly B. Edwards Ph.D. (Committee Member) Subjects: Clinical Psychology; Psychology

Psy. D., Antioch University, 2019, Antioch Seattle: Clinical Psychology

The Washington State Supreme Court has strongly recommended that culture should be considered as a factor for multicultural defendants when questions regarding competency to stand trial have been raised and an evaluation is ordered by the Court. This represented a departure from prior decisions, which have ignored culture as a factor for consideration in such cases. Though culture had long been identified as a core pillar within clinical psychology, research in the sub-field of forensic psychology has shown a dearth in the literature regarding culture as a factor in forensic assessment. Despite the recent cases in Washington State, the criminal justice system generally remained silent on how to address culture, which led to a form of systemic cultural suppression. Given the dichotomy that exists at the intersection of the criminal justice system with psychology, forensic examiners have struggled in their efforts to address culture, which has become a nuisance variable. Using a grounded theory methodology, this study identified a spectrum of reactions that have risen from the attitudes and strategies forensic examiners have developed in their response to systemic constraints, bias, individual case and defendant characteristics. Furthermore, the identification of examiner reactions within the context of multicultural cases is a critical step towards developing best practice guidelines on how these cases should be addressed.

Committee: Jude Bergkamp Psy. D. (Committee Chair); Willaim Heusler Psy. D. (Committee Member); Maile Bay Psy. D., J.D. (Committee Member) Subjects: Psychological Tests; Psychology

Psy. D., Antioch University, 2018, Antioch Seattle: Clinical Psychology

The importance of culture as a reference point in clinical practices such as forensic psychology has been considerably valued yet poorly understood, especially in an age where precision and sophistication outlast cultural authenticity and patient-clinician relationship. This paper looks at the gaps and inconsistencies that exist in current forensic psychology research. The topic is introduced by delving into the understanding of the phenomenon of culture and its influences on our everyday conditioning. Aspects such as language, biological development, traditions, rituals, and narratives are emphasized as potent tools that drive individuals to create and mold culture according to needs and requirements of the moment. These elements are then used for signifying the inherent ways in which culture can result in both despair as well as positive enforcement, thereby being a powerful element of consideration in forensic assessment practice. The essential concept explored in this paper involves the clinicians' perspectives on the meaning of cultural values, norms and beliefs that shape the behavior of the patient. Through this exploration I attempted to understand how the clinical practice of forensic psychology can be made more authentic and less cold and calculated by consideration of cultural malleability. By using thematic analysis, I reviewed a large collection of the relevant literature in an attempt to understand the core concepts that drive clinicians in their cultural considerations. I emphasized attention to the malleable nature of culture and the intricate ways in which culture is related to biological, psychological, anthropological, and legal aspects of forensic psychology. The conclusions of the paper include specific considerations for creating a well-structured cultural consultation model, which emphasizes attention to aspects like clinical approach, patient's family of origin, current community, as well as biological and psychological conditions of the pati (open full item for complete abstract)

Committee: William Heusler PsyD (Committee Chair); Tedd Judd PhD, ABPP (Committee Member); Maile Bay JD, PsyD (Committee Member) Subjects: Clinical Psychology; Comparative; Criminology; Cultural Anthropology; Ethics; Forensic Anthropology; Law; Legal Studies; Mental Health; Multicultural Education; Psychology; Social Psychology

Psy. D., Antioch University, 2010, Antioch Seattle: Clinical Psychology

Mental competency as a prerequisite for due process was established by the United States Supreme Court‟s Dusky decision (1960). The Court mandated that a defendant must possess reasonable levels of factual and rational understanding in order to competently participate in the adjudication process. The precise definitions of competence were not included in any of the Court‟s decisions regarding the concept of Competency to Stand Trial (CST). The original purpose of this research was to contribute knowledge regarding the psychological dimensions of CST and to suggest definitions of the psychological dimensions of CST and the standardization of the CST evaluation process. However, a review of the existing literature regarding CST revealed a significant omission in the current CST evaluation process. Courts have not adequately defined the dimensions of rational capacity. In addition, CST assessment instruments focus almost exclusively on a defendant‟s factual understanding and take few steps to evaluate the defendant‟s rational capabilities. The research included a qualitative analysis of seven hours of interviews with an incarcerated individual whose CST was in question. That case study was initially designed to analyze for psychological dimensions of CST using the CAI, a predominant CST assessment instrument. The case study revealed that rational capacities are not a prominent part of current evaluation protocols and the impact of rational incompetence on the CST assessment of defendants is minimal. As a result of these discoveries the focus of the research was modified from a study of a broad-spectrum of psychological dimensions of CST into a study specifically focused on identifying and defining dimensions of rational understanding. In addition, the researcher developed a new CST assessment tool explicitly designed to measure a defendant‟s capacity to rationally understand and participate in the adjudication process - the Cole Rationality Assessment Instrument (C-R (open full item for complete abstract)

Committee: Mary Wieneke Ph.D. (Committee Chair); Catherine Koverola Ph.D. (Committee Member); Philip Barnard Ph.D. (Committee Member) Subjects: Criminology; Law; Legal Studies; Mental Health; Psychological Tests