The journal of the American Academy of Psychiatry and the Law
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J. Am. Acad. Psychiatry Law · Jan 2007
Practice GuidelineAAPL Practice Guideline for the forensic psychiatric evaluation of competence to stand trial.
Competence to stand trial is a legal construct used to identify those criminal defendants who have the requisite mental capacity to understand the nature and objective of the proceedings against them and to participate rationally in preparing their defense. This Practice Guideline has described how psychiatrists should evaluate individuals concerning their competence to stand trial. The Guideline describes acceptable forensic psychiatric practice for such evaluations. ⋯ At a minimum, a psychiatrist's opinion about adjudicative competence should reflect an understanding of the jurisdictional standard and of how the defendant's mental condition affects competence as defined with the jurisdiction. The psychiatrist's report should clearly describe the opinion and the reasoning that leads to it. Psychiatrists who provide mental health expertise concerning adjudicative competence give trial courts information needed to assure that defendants can appropriately protect themselves and that criminal proceedings will be accurate, dignified,and just.
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J. Am. Acad. Psychiatry Law · Dec 2015
CommentCommentary: Coming Full Circle--Psychoanalysis, Psychodynamics, and Forensic Psychiatry.
Drs. Simopoulos and Cohen argue that knowledge of one's unconscious processes improves the forensic psychiatrist's capacity to manage complex forensic situations and to generate forensic formulations and opinions that are demonstrably more valid and reliable, much like competence in cultural assessment and formulation. In practice, the challenges posed by the application of these principles in forensic settings are far outweighed by the potential benefit. ⋯ The same may not be true of psychodynamic assessment and formulation. Although much can be learned from supervision, case seminars, conferences, and reading, such knowledge does little to foster awareness of one's unconscious processes that by definition operate outside awareness and thus contribute to the vitiating effect of bias. To date, the only method whereby psychiatrists can effectively come to appreciate their own unconscious processes in action is arguably through their own analysis conducted in the course of training in analysis or psychodynamic psychotherapy.
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J. Am. Acad. Psychiatry Law · Jan 2014
No duty to warn in California: now unambiguously solely a duty to protect.
In 2013, legislation went into effect clarifying that the Tarasoff duty in California is now unambiguously solely a duty to protect. Warning the potential victim and the police is not a requirement, but a clinician can obtain immunity from liability by using this safe harbor. In situations in which a therapist believes warning might exacerbate the patient's risk, however, alternative protective actions can satisfy the duty to protect. ⋯ Legislation was enacted in 2007 as an attempt to clarify the requirement, but the revised immunity statute at the time retained the phrase 'duty to warn and protect', which perpetuated the now-eliminated confusion. Correctly understanding the California law is important to avoid having the restored flexibility eroded again by belief in a nonexistent duty to warn. The Tarasoff duty originated in California, but since many other states later established similar duties, the developments in California may have national implications.
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J. Am. Acad. Psychiatry Law · Jan 2002
Practice Guideline GuidelineAAPL practice guideline for forensic psychiatric evaluation of defendants raising the insanity defense. American Academy of Psychiatry and the Law.
The insanity defense is a legal construct that excuses certain mentally ill defendants from legal responsibility for criminal behavior. This practice guideline has delineated the forensic psychiatric evaluation of defendants raising the insanity defense. The document describes acceptable forensic psychiatric practices. ⋯ The psychiatrist's analysis and opinion should be clearly stated in the forensic psychiatric report. It should be noted that the role of a psychiatric expert witness in the criminal justice system is predicated on the law's interest in individualizing the criteria of mitigation and exculpation. Forensic psychiatric analyses and formulations of opinions are, therefore, subject to change as the legal guidance changes.
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Psychiatrists who publish case reports are required to seek informed consent from their subjects on the basis of the ethics-related obligation to maintain patient confidentiality. Academic journals have developed editorial standards to fulfill this obligation. ⋯ This article outlines the ethics of informed consent in published case reports for general and forensic psychiatry and offers recommendations for forensic case study publishing. The authors suggest changes in the current requirements stated in The Journal for publication of case reports.