The forensic report is central to the practice of forensic psychiatry. In many ways, the report reflects many of the skills of forensic practice: assemble and synthesize relevant information, perform a psychiatric evaluation, understand the evaluee's clinical condition, and tie clinical findings to the legal question posed. In this manner, Alec Buchanan and Michael Norko argue that “it is the skill at report writing that largely defines forensic practice” (p 1).
In their book, The Psychiatric Report: Principles and Practice of Forensic Report Writing, editors Buchanan and Norko set out to “express a comprehensive set of principles of writing the forensic report” (p 7). Winner of the coveted Manfred S. Guttmacher Award from the American Psychiatric Association and the American Academy of Psychiatry and the Law for an outstanding contribution to the literature of forensic psychiatry, the book delivers on the editors' goal.
The textbooks' 19 chapters provide both theoretical background materials for report writing and practical, skill-based information to guide report preparation. It is organized into three conceptual sections: Principles of Report Writing, Structure and Content, and Special Issues. Each section contains six or seven discrete chapters. Although there is some redundancy between chapters (e.g., report organization, examples of release of information forms), readers can review the material from cover to cover or examine chapters in no particular order.
The chapters cover various topics central to forensic psychiatric report writing. Authors with expertise in various aspects of report writing break down the topics into easily digested chapters. In the first section, general principles relevant to any forensic psychiatric report, including ethics, confidentiality, and record keeping, are discussed, and chapters give advice on clear and organized writing style. The chapter on confidentiality highlights the expert's obligations to the evaluee and agency commissioning the report and how the nature of confidentiality status can differ depending on whether the forensic evaluator is working for the prosecution or the defense in criminal matters. The author provides specific language to guide practitioners in the informed-consent process. Helpful to new practitioners are examples of release of information and privacy notification forms to be given to evaluees.
The second section provides practical information for preparing criminal and civil reports. The chapters are written as how-to guides to conducting particular types of forensic assessments. For each category of evaluation, the authors discuss report format, content, and subtopics that warrant particular attention. Each contributor uses a sequential structure for his report, but no specific report style is endorsed by the editors. The chapters each include a summary box with a proposed uniform sequential structure for the reports. Although these boxes reference text material specific to the report type being discussed, they could have been improved by being specific for each chapter. The authors of the chapter on civil litigation make specific mention of report vulnerabilities in cross-examination. On this subtopic, they artfully comment on common pitfalls in forensic report writing and how these pitfalls can be made evident during cross-examination.
The final section includes the more nuanced topics helpful to the seasoned practitioner. These topics include writing for federal courts, psychological testing, violence risk assessment, malingering, and criminal sentencing in the United Kingdom. The section on psychiatrist-administered psychological tests concisely reviews the caveats in using these tests in the forensic setting, such as the importance of using the standard test protocol and having a clear understanding of the limits and properties of any test. Another chapter on the concept of reasonable medical certainty aptly discusses the complexity associated with this concept and provides timely examples to illustrate some of the challenges that it poses for composing forensic reports.
Vitally important but infrequently discussed in the context of practical report composition are the impact of forensic reports on evaluees, establishing professional identity, and the expectations of the legal system. The introduction of the book deserves special mention for illuminating these related topics. Throughout the book, there is an emphasis on respect for the evaluee.
In summary, the written report is essentially the work product of forensic psychiatric practitioners. In contrast to many other resources on report writing, this book provides historical and background information, as well as clear practical guidance on specific types of forensic mental health reports. Accordingly, it is hard to find fault with the book. The editors have achieved their goal of providing an informative and comprehensive guide to writing forensic reports. The book is recommended to forensic practitioners who want a single text to serve as a reference and a guide to their report writing.
Footnotes
Disclosures of financial or other potential conflicts of interest: None.
- © 2013 American Academy of Psychiatry and the Law
