Clinical Neuropsychology in the Criminal Forensic Setting

Although many neuropsychologists evaluate individuals who are involved in the criminal justice system, few references are dedicated to this topic. Forensic neuropsychologists Robert L. Denney, PhD, and James P. Sullivan, PhD, have attempted to fill this void by recruiting a team of neuropsychologists who practice in correctional, hospital, academic, and private office settings, to write a reference book for forensic mental health professionals. Although neuropsychological concepts may be challenging to grasp, this text is easy to read and maintains the reader's interest.

The book contains detailed discussions of ethics, summaries of landmark cases, and explicit guidelines for conducting mental health assessments in the criminal justice system. The authors describe the role of the mental health expert and the limitations of confidentiality and informed consent in forensic settings. Several detailed models of forensic informed consent contracts that can be tailored to fit any clinician's practice are offered as references. The authors address fundamental aspects of the field with substantial detail and skill. No one should claim to be an expert in criminal forensic mental health without a firm knowledge of the areas that are covered in this text. This is especially true of forensic mental health experts who proffer opinions about malingering. The authors describe the body of research on validity testing that should inform the interpretation of and testimony about relevant psychological testing data.

The initial chapters lay the foundation for understanding more challenging topics, including competency to proceed with trial, criminal culpability, criminality and violence, presentencing evaluations for defendants in capital cases, juvenile justice, neuropsychological assessment, expert opinions and testimony, and professional competence. The authors provide practical recommendations about forensic mental health practice. The advice about billing, travel, licensure exceptions, and negotiating the correctional environment and the sample forms are worth the price of the book. In addition, there is a discussion about cross-examination that contains pearls about how to prepare for cross-examination as well as an overview of how attorneys prepare to cross-examine expert witnesses; forewarned is forearmed.

As a psychiatrist who works in the criminal justice system, I was especially interested in reading about the differences between the criminal and juvenile justice systems. As with psychopharmacological studies, the research findings that inform adult treatment and rehabilitation may deviate substantially from the data that determine effective rehabilitative interventions for juveniles. The authors report the disturbing fact that in many jurisdictions, the lead judge may have an administrative role over the entire county's juvenile justice system (including the hiring of probation officers, detention personnel, and treatment staff). Also, studies indicate that 33 percent of juvenile confessions to violent crimes are false. The rate is higher in youths who are eventually exonerated by DNA evidence. These rates are significantly higher than those found in adults.

The authors' guidelines for assessing the knowing, intelligent, and voluntary waiver of Miranda rights are useful. Of course, much of the section pertains to the use of specific neuropsychological tests and their validity in criminal populations. However, rather than feeling excluded, I found the information helpful, since psychiatrists are familiar with many of the tools neuropsychologists use in such assessments.

The book contains a timely discussion of ethics in forensic mental health. An overriding guiding principle is captured succinctly in Chapter 9: “The expert is retained not to provide a specific opinion but to provide the truth. Whether the truth helps or hurts the case is irrelevant” (p 282). By design, the U.S. legal system is adversarial. Mental health professionals who practice within it are at risk of introducing bias into their assessments and testimony. The book sheds light on these potential pitfalls and reinforces a strong code of ethics that is similar to the American Academy of Psychiatry and the Law Guidelines for the Ethical Practice of Forensic Psychiatry.¹ Reiteration of such principles is the best protection against the inbred biases in this field.

A detailed review of the applicability of Daubert v. Merrell Dow Pharmaceuticals, Inc. (509 U.S. 579 (1993)) and Frye v. United States (293 F. 1013 (D.C. 1923)) offers clear assistance for experts regarding what constitutes scientifically reliable evidence that may be used to formulate an opinion. Landmark cases are reviewed when needed and referenced clearly throughout the text. Each chapter is followed by a comprehensive list of paper and electronic references.

The writing is of high quality and is consistent throughout the text. The authors and editors have succeeded in presenting complex material in a nonintimidating manner. This user-friendly text would be a valuable addition to the library of any mental health clinician.

• © 2011 American Academy of Psychiatry and the Law