The Roles of Forensic Psychiatrists and Psychologists: Professional Experts, Service Providers, Therapists, or All Things for All People?

Pham, Thierry H.; Taylor, Pamela J.

doi:10.1007/978-3-319-74664-7_10

Cited by 2 publications

(3 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Another concern with the post-trial forensic-psychiatric evaluations was that they were not always completed by third party experts with no relationship to the person under examination - thus potentially raising ethical dilemmas related to dual loyalty, which have already been discussed extensively in this context ( 9 , 10 , 41 ). Appelbaum ( 15 ) noted that it is acceptable for psychiatrists to perform forensic evaluation when there is no therapeutic relationship.…”

Section: Discussionmentioning

confidence: 99%

“…In such situations, patients believe that the purpose of risk-assessments is to further punish them, highlighting patients' opposite perspective (i.e., achieving freedom) as compared to that experts one (i.e., ensuring adequate evaluation). Another concern is that of dual loyalty: experts performing such assessments may in some rare cases also be the treating therapist ( 9 , 10 ), or reports written by the therapists may be consulted in the evaluations. Treating therapists' dual loyalty dilemma in the Swiss context have been discussed in recent publications ( 11 , 12 ).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Forensic-Psychiatric Risk Evaluations: Perspectives of Forensic Psychiatric Experts and Older Incarcerated Persons From Switzerland

et al. 2021

View full text Add to dashboard Cite

Background: Forensic-psychiatric risk assessments of persons in prisons aim to provide treatment for their mental health disorders to prevent risk of recidivism. Based on the outcomes of such evaluations, it is decided, for instance, whether the person can be released or be assigned to further treatment with or without privileges. A negative evaluation would mean that the assessed person must remain in prison or in a forensic institution until his or her mental health has improved to live safely in the community. This paper highlights the process of forensic-psychiatric evaluations and the challenges faced by the two parties directly involved in this process in Switzerland.Methods: Data for this manuscript are gathered using semi-structured one-to-one interviews. The study participants included a purposive sample of 41 older incarcerated persons under measures (i.e., mandated by court order to psychotherapeutic and psychiatric treatment), and 23 expert participants working in Swiss prisons or forensic institutions. We analyzed data using thematic analysis.Results: Study findings within four themes are reported. First we describe the standards and procedures that expert participants use to carry out adequate risk assessments and conditions under which they refuse to perform such assessments. Thereafter, we present expert participants' concerns associated with predictive risk assessments and highlight the need to be cautious in drawing conclusion from them. We then reveal older incarcerated participants' reports on the inconsistencies with the forensic expertise and their belief that these reports tend to be negative toward them. The final theme concerns older participants' experiences of how these evaluations negatively impact their lives and their perspectives of a different future.Conclusion: The study findings about forensic-psychiatric risk assessments point to the need for a clearer communication on how these evaluations take place and how decisions are taken based on them. As incarceration under measures denotes the necessity to continue therapy and reduce dangerousness, it is important that accused person understands his or her real progress, feel that the decisions are objective and justified, and are aware of the progress needed to achieve the goal of eventual release. Such clarity will not only be valuable for those under measures, but also the justice system.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Forensic-Psychiatric Risk Evaluations: Perspectives of Forensic Psychiatric Experts and Older Incarcerated Persons From Switzerland

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Moreover, as the referral by criminal courts guarantee treatment entry and participation, therapists might face resistance and lack of motivation because treatment is not requested by the patient [23]. Other important aspects that are specific to court-mandated treatment are the therapist's dual role to care and control [24][25][26][27], limited medical confidentiality [28][29][30][31], as well as coercion [32,33]. The precise impact of these aspects on psychotherapy process and outcome factors is unclear, but it is particularly important to understand their influence in court-mandated treatments [34].…”

Section: Introductionmentioning

confidence: 99%

What characterizes a good mental health professional in court-mandated treatment settings?: Findings from a qualitative study with older patients and mental health care professionals

Seaward¹,

Wangmo²,

Vogel

et al. 2021

BMC Psychol

View full text Add to dashboard Cite

Background Therapist-related activities and characteristics such as empathy and genuineness are factors that significantly contribute to psychotherapy outcome. As they play a role in psychotherapy more generally, it can be expected that they are equally important in the treatment of court-mandated patients more specifically. At the same time, these treatment settings come with specific challenges—e.g. due to coercion and control—and it could thus be that some therapist-related characteristics might have a different empathy on the therapy. This interview study sought to investigate service providers’ and users’ perspectives on therapist-related characteristics in the context of detention. Methods We conducted a qualitative interview study with 41 older incarcerated persons mandated to treatment, and 63 mental health professionals (MHP). The data analysis followed thematic analysis. Results Patients and experts both emphasized the importance of treating patients with respect by taking a humanistic approach, that is, condemn the deeds but embrace the person and display genuine interest in supporting patients with any issue or concern that is of relevance to them. Furthermore, interviewees underscored that the coerciveness of the therapy context required to incorporate patients’ wishes into treatment planning, recognize and respond to the patients’ needs, and allow some choice within the given framework. Such inclusive attitude was deemed critical to engage and motivate patients to participate in treatment. In addition, it was emphasized that feedback and advice by the therapists need to be concrete, detailed and applied to each person’s current situation. Lastly, patients questioned MHP’s qualification when they did not progress in therapy. Discussion Our findings indicate that some therapist-related activities and characteristics are of particular importance in court-mandated settings. These include genuine interest in the patient, a respectful and positive attitude, as well as the capacity to target sensitive issues in a directive but non-confrontational manner. Further research needs to identify specific expressions and behaviors that are linked to the aforementioned characteristics in the forensic context. Our study therefore contributes to much-needed empirical research on clinician and patient perspectives on therapist characteristics and activities in the treatment of court-mandated patients.

show abstract

The Roles of Forensic Psychiatrists and Psychologists: Professional Experts, Service Providers, Therapists, or All Things for All People?

Cited by 2 publications

References 12 publications

Forensic-Psychiatric Risk Evaluations: Perspectives of Forensic Psychiatric Experts and Older Incarcerated Persons From Switzerland

Forensic-Psychiatric Risk Evaluations: Perspectives of Forensic Psychiatric Experts and Older Incarcerated Persons From Switzerland

What characterizes a good mental health professional in court-mandated treatment settings?: Findings from a qualitative study with older patients and mental health care professionals

Contact Info

Product

Resources

About