Dr. Otto Competency Nuts & Bolts
Dr. Randy Otto, PhD, ABPP, is a faculty member in the Department of Mental Health Law & Policy at the University of South Florida, with adjunct appointments in the departments of criminology and psychology. Dr. Otto’s research, writing, and practice focus on forensic psychological assessment and he has co-authored several texts, including Psychological Evaluations for the Courts: A Handbook for Mental Health Professionals and Lawyers, the fourth edition of which will appear in early 2018, and Forensic Reports and Testimony: A Guide for Psychologists and Psychiatrists (2015). Dr. Otto recently served on the American Bar Association committee that revised that organization’s Criminal Justice Mental Health Standards, and he also chaired the American Psychological Association’s Committee on Legal Issues.
This video is a Q&A in regard to the following topics:
- How long should an evaluation should last?
- Is there an effect on the validity of psychological testing when 3rd parties are in the room during the administration?
- Sometimes examiners offer opinions that the examinee is “marginally competent.” Is that an acceptable opinion?
- It seems that some examiners focus on the examinee’s understanding of the legal process and spend less time considering the examinee’s ability to consult with counsel. What do you make of this?
- What is the difference between a rational understanding and factual understanding?
- How can delusional thinking affect a defendant’s competence?
- What about the issue of “parroting?” or the “veneer” or “patina” of competence? What are the implications of this for competence?
- Is it important for the examiner to discuss the facts of the case with the defendant?
- What about defendants from other countries, from other cultures? How might that impact assessment and consideration of competence to proceed?
- What about defendants with strong religious beliefs that seem to affect their case decision making? For example, a belief that God will protect them from tough penalties, or God will give the client a jury who is understanding?
- How much impairment is need to render a defendant incompetent? For example, what if the defendant is diagnosed with ADHD and has a hard time focusing on the case to the point that she wouldn’t be able to focus during trial…is that enough? What about depression/anxiety…the defendant keeps crying and she can’t stay on task during conversations with counsel…is that enough?
- Are there limits as you see it in terms of what we can expect from a defendant? Similarly, can we expect the courtroom players to change their behavior in any way to suit a defendant’s needs? I have seen multiple evals suggesting that a courtroom be “slowed.” Is that a realistic expectation?
Baker Act – Martha Lenderman, M.S.W.
Martha Lenderman, M.S.W., discusses Florida’s Baker Act. Lenderman is the former president of the Area Agency on Aging of Pasco-Pinellas, Inc. Lenderman was key in reforming the Baker Act in 1996 and drafted the Florida Administrative Rules governing the Baker Act.
Beyond Addictions & Personality Disorders – John Briere, Ph.D.
Survivors of trauma and early attachment disturbance are at elevated risk of a variety compulsive and self-endangering behaviors, ranging from suicidality and self-injury to substance abuse, indiscriminant sexual activities, and binge eating. Many of these difficulties are seen as symptoms of a personality disorder, behavioral addiction, or impulse control disorder. However, emerging research indicates that they are more accurately understood as coping/homeostatic responses to triggered childhood memories and inadequate emotional regulation capacities. Calling on his upcoming book Treating Risky and Compulsive Behavior in Trauma Survivors (Guilford), John Briere presents an integrated approach to self-endangering behavior. Based on new research, this treatment system directly targets memory/dysregulation dynamic, with interventions such as emotional regulation training; mindfulness, metacognitive awareness, and emotion surfing procedures; in vivo treatment of implicit memory activations; and harm reduction. A new treatment component, trigger management, increases client autonomy, resilience, and problem solving.
Trauma and Toxic Stress
Dr. Elizabeth Beck discusses how trauma and toxic stress affects an individual’s psychosocial development. Topics include exposure to violence, the impact of context, polyvictimization, how trauma becomes toxic stress, adverse childhood experiences (ACEs) and the use of juvenile victimization questionnaires, the biology of toxic stress, the effects of toxic stress, and how toxic stress can be used in mitigation.
How Physical Health Impacts Mental Functioning
In this fascinating and enlightening program, our guest speaker discusses medical conditions which mimic psychiatric illness. When finished with this training, workers should be able to identify potential medical illnesses that present with traditionally psychiatric symptoms and indicators. Takeaway: Physical health and mental health are inextricably linked.
Mental Health Issues Q&A
In this panel discussion, a wide array of experts discuss mental health issues in the context of the criminal justice system, including the role of neuropsychology in competency evaluations, the rational competency standard, the relationship between mental health professionals and attorneys, stress and criminality, and the insanity defense. Seated from left to right are Dr. Eric Mings, PhD; Dr. Jeffrey Danziger, MD; Dr. Alan Berns, MD; Dr. Jacquelyn Olander, PhD; Dr. Ryan Hall, MD; and Robert Wesley, Public Defender for the Ninth Judicial Circuit.
Telling Our Clients Stories Through Trauma
In order to litigate mental health, you must understand trauma. Dr. Denny LeBoeuf wants us to understand that trauma is dynamic and multi-faceted…and that the defense team needs to understand what the client is and has experienced. Understand childhood abuse and neglect and teach those in power that all traumatic events have psychological consequences.
Considering Culture for Reliable Mental Health Evaluations
In this training, Dr. Ricardo Weinstein emphasizes the importance of understanding and including cultural information (e.g., background, language, customs) in the mental health assessment. He discusses requisite procedures and guidelines for a proper legal defense.
Tools for Identifying Psycho-Legal Issues
Jails have become depositories for the mentally ill. Nationwide, more than 50 percent of inmates suffer from mental health issues. There are consequences for people who are suffering from mental illness while incarcerated, such as an increased risk in terms of fights, abuse, disciplinary action, and, of course, suicide. Understand that mental illnesses fluctuate on their own with or without the effects of medication.
What’s New in Psychotherapy – Josh Magro, LMHC
In this lecture, Josh Magro, LMHC, discusses the newest trends in psychotherapy, especially the use of neuroscience in validating theories related to childhood trauma, mindfulness, eye movement desensitization and reprocessing (EMDR), neurotherapy, and somatosensory therapy.
The Intersect Between Autism Spectrum Disorders (ASD) and Paraphilias: Ramifications in the Criminal Justice System
In this training, Dr. Eric Imhof, Psy.D., and Dr. Kim Spence, Ph.D., go into depth with Autism Spectrum Disorder (ASD) and Paraphilia. Beginning with an overview of ASD, the presenters will elucidate clinical differences in clients with ASD who engage in inappropriate sexual behavior versus clients with ASD and a comorbid paraphilic disorder(s). A particular emphasis will be placed on the diagnosis of Pedophilic Disorder and targeted suggestions will be offered to best educate the courts regarding the diagnosis and misperceptions related to risk and dangerousness. Best practices for assessment including differential diagnosis, risk assessment, identification of client needs, and how best to respond with comprehensive multi-disciplinary treatment planning will be discussed. The importance of a forensic team approach to include psychiatry, neuropsychology, and polygraphy will also be addressed. This training is intended for forensic evaluators, treatment providers, probation and parole, and law enforcement personnel.
Childhood Trauma: The Neurobiology of Adaption by Joanne Terrell, MSW, LCSW, PIP
This workshop begins with a discussion of the effects of personal and environmental violence on children, the effects of trauma on brain development, and the three ways trauma causes emotional and behavioral problems in children.
Post-Traumatic Stress Disorder
In this training, Nancy Rosado discusses post-traumatic stress disorder (PTSD). Rosado is the co-founder of Proyecto Somos Orlando, a retired NYPD sergeant, and a 9/11 first responder/survivor who was assigned the task of coordinating the long-term access to mental health care of other 9/11 first responders. Rosado received her Master’s in Social work from Fordham University.
Veterans with Trauma and PTSD: Considerations for Working with veterans in the Justice System – Sophia Dziegielewski
This workshop is designed to cover the practical implications when working with veterans in the legal system who have experienced trauma. Historically, awareness has been limited when working with veterans suffering from conditions such as PTSD, substance use disorders, and depression, as well as, medical conditions, such as TBI and chronic pain. Once the type of trauma is identified, helpful hints are provided to help professionals gain a better understanding of what the veteran is experiencing. Techniques to improve the interview and support mitigation are highlighted.
Forced Medications & Competency
The first video, produced by the AVID Jail Project, provides an introduction to the medical, legal, and ethical issues surrounding the practice of forced medications. In the second video, renowned law professor, speaker, author, and researcher, Elyn Saks lives with schizophrenia and shares her experience with the illness, as well as her educated (at Vanderbilt, Oxford, and Yale) opinions on mental health law.
Putting our Jargon into Your Jargon
John Philipsborn speaks about “Putting our Jargon into Your Jargon” and how we can communicate more effectively with the courts and understand recent advances in forensic mental health through case law.