The Forensic Evaluation Process
| Procedures | Goals | Relevant General and Psychodynamic Concepts and Questions | |
|---|---|---|---|
| Preparation for a case | Initial consult with attorney(s), court-system | Determine basic nature of the case and medico-legal question | Determination of qualifications to provide forensic assistance |
| Request all appropriate documentation and collateral data | Determine whether referral to another forensic specialist is warranted | Discuss fee arrangement | |
| Countertransference: examine initial reactions to the case | |||
| Bias: given initial reactions, is impartiality feasible or would personal vulnerabilities and opinions impede objectivity? | |||
| Data collection | Interview with the evaluee | Obtain a full psychiatric database | Transference: how is the evaluee interacting? How does his current interactional style reflect his developmental history? Does he appear forthcoming or withholding? |
| Interview with any collateral sources where appropriate | Ensure that sufficient data are available to answer medicolegal question | Countertransference: what is my emotional response to the evaluee (anger, empathy, fear)? Is this a response to projected emotions, or is it idiosyncratic? Do I feel safe? Do I have unusually strong positive or negative feelings toward an evaluee? Is my interview with the evaluee deviating from my baseline or characteristic approach? | |
| Review documentation and request additional information if warranted | Developmental history: does the evaluee's narrative contain past loss, abuse, or psychological trauma? If so, how do these factors affect risk assessment? | ||
| Characteristics of the ego: strengths and weaknesses, defense mechanisms, relationship to superego | |||
| Quality of object relations: family and intimate relations | |||
| Characteristics of the self: self-esteem and self-cohesiveness, self-boundaries | |||
| Data analysis | Analysis of interview data | Ensure that focus remains on legal point in question | Countertransference: does the gathered data reflect a balanced approach to the case? Did I gather or include information that might disconfirm my impression of an evaluee? |
| Seek supervision if needed | |||
| Forensic report | Synthesis of the data | Provide a logical, integrated and objective assessment | Determine whether recommendations and clinical impressions reflect all data obtained during an interview |
| Discuss findings with consulting attorney | Ensure availability for expert testimony | Identify and acknowledge possible discrepancies or conflicting information that might alter report conclusions | |
| Forensic testimony | Presentation of the data | Assist the trier of fact in applying psychiatric expertise to a legal question | Determine whether a psychodynamic understanding of the case at hand assists the trier of fact in explaining a defendant's behavior |
| Provide formulation of the offense in a clear and coherent manner, without use of jargon | Educate court about relevant mental health concerns, including psychodynamic concepts, if relevant | Understand limitations and challenges of presenting psychodynamic concepts in court | |
| Anticipate challenges to testimony in cross-examination; acknowledge limitations of data | Countertransference: internal response to attorneys, judge and other court personnel in the courtroom; screen for signs of overinvestment in the case (e.g. remaining in court after testimony is complete) |