Guidelines for Forensic Report Writing: Helping Trainees Understand Common Pitfalls to Improve Reports

A forensic report is the primary work product of a forensic psychologist. The aim of a forensic report is to inform and influence the court. Unlike a clinical report, a forensic report influences the outcome of a legal conflict. This means that greater care must be taken in writing the report. The following errors (Grisso, 2010) were used to discuss best practices in forensic report writing: failure to answer the referral question, organization problems, language problems, mixed data and interpretation, inclusion of irrelevant data, over-reliance on a single source of data, improper psychological test use, failure to consider alternative hypotheses, and opinions without sufficient explanation. The purpose of this paper is to provide in one place all the information needed to improve forensic report writing, and to help the reader apply the literature using specific examples. Redacted report samples were collected from psychologists, graduate psychology trainees, teaching assistant experience, and clinical work. Identified errors in these samples were then corrected using the recommendations in the literature. Geared toward graduate psychology trainees, each section should serve both as a tutorial and as a brief checklist to help the reader avoid common pitfalls and assist in promoting better forensic report writing.

Leading With the Relationship: The Role of the Therapeutic Relationship in Motivational Interviewing

Motivational Interviewing (MI) is a brief evidence-based treatment that is most commonly used to treat addictive behaviors and to encourage diet and lifestyle changes and treatment adherence in health care settings. In recent years MI's use has been expanded to multiple other client populations in clinical psychology, as well as to other sectors, such as in education, and international non-profit work (Hettema at al., 2005). MI was inspired by research that demonstrated a high correlation between therapist application of the client-centered skill of accurate empathy and a reduction in drinking behaviors (Miller et al., 1980). MI contains both relational and technical components that are intended to operate synergistically. Despite a large body of research on MI treatment outcomes, variation in effectiveness has been found among studies, and the active ingredients of MI, particularly the relational aspects, are not well understood. As a result, the use of MI in many treatment settings is limited to the technical components of MI without a theory-based integration of the therapeutic relationship. This paper focuses on the contribution of the relational component to the effectiveness of MI, and explores the synergistic relationship between the technical and relational components of MI. A literature review of MI and the trans-theoretical literature on the therapeutic relationship is followed by two case illustrations. The paper concludes with recommendations for the field.

Acceptance and Commitment Therapy with Forensic Inpatients

This paper provides a preliminary exploration of the application of Acceptance and Commitment Therapy (ACT) within the context of a forensic hospital. ACT has a reputation for being a clinically flexible and empirically sound therapeutic intervention, which appears uniquely suited for forensic hospital settings. However, no research has been published to date on the use of ACT as a treatment for forensic inpatients. The ACT approach directly aims to help people let go of the unwinnable struggles to control symptoms of mental illness, and instead focus on constructing a "life worth living." ACT interventions can equip forensic patients with the values and flexible behavioral repertoires necessary to lead lives that are personally meaningful and satisfying and do not involve inflicting harm to others. The ACT model also attempts to minimize the therapist-patient hierarchy through an emphasis on the ubiquitous nature of human suffering. This approach can be particularly useful when working with marginalized, treatment-resistant patients. Continued research on the application of ACT with forensic inpatients is recommended.

Trauma Treatment in Forensic Settings: Clinicians' Perspectives, Barriers to Effective Treatment, and Suggestions for Clinical Practice

Between 30% and 90% of the prison population is estimated to have survived traumatic experiences such as sexual, emotional, and physical abuse prior to incarceration (Anonymous, 1999; Fondacaro, Holt, & Powell, 1999; Messina & Grella, 2006; Pollard & Baker, 2000; Veysey, De Cou, & Prescott, 1998). Similarly, information from the Bureau of Justice Statistics (as reported in Warren, 2001) estimated that more than half of the women in state prisons have experienced past physical and sexual abuse. Thus, given the astonishing number of inmates who appear to be victims of some kind of trauma, it seems likely that those who work with these inmates (e.g., prison staff, guards, and treatment providers) will in some way encounter challenges related to the inmates' trauma history. These difficulties may appear in any number of forms including inmates' behavioral outbursts, increased emotionality, sensitivity to triggering situations, and chronic physical or mental health needs (Veysey, et al., 1998). It is also likely that these individuals with trauma histories would benefit greatly from treatment while incarcerated. This treatment could be utilized to minimize symptoms of posttraumatic stress, decrease behavioral problems, and help the inmate function more effectively in society when released from incarceration (Kokorowski & Freng, 2001; Tucker, Cosio, Meshreki, 2003). Few studies have explored the types of trauma treatment that are effective with inmate populations or made specific suggestions for clinicians working in forensic settings (Kokorowski & Freng, 2001). Essentially, there appears to be a large gap in terms of the need for trauma treatment for inmates and the lack of literature addressing what to do about it. However, clinicians across the country seem to be quietly attempting to fulfill this need for trauma treatment with incarcerated populations. They are providing this greatly needed treatment every day. in the face of enormous challenges and often without recognition or the opportunity to share their valuable work with the larger community.

The Use of Therapeutic Assessment with Forensic Populations: Practitioners' Perspectives

Therapeutic Assessment is a semi-structured approach to collaborative assessment developed by Stephen E. Finn and colleagues. In Therapeutic Assessment, psychological assessment is used as a therapeutic intervention (Finn, 2007; Finn & Kamphuis, 2006). The Therapeutic Assessment model differs from traditional assessment with regard to procedure and the roles of both assessor and client. Therapeutic Assessment has yet to be explored in forensic settings, wherein assessors are required to take on a number of varying and conflicting roles. In the current study, five forensic psychologists completed a semi-structured interview to identify their perspectives of Therapeutic Assessment and its utility in forensic contexts. A phenomenological qualitative analysis of the interviews was conducted to derive themes about Therapeutic Assessment, forensic psychology, and the overlap between these two domains. General themes that emerged include (a) the role and the context of the practitioner's work with the forensic population; (b) the potential of using Therapeutic Assessment's paradigm in family law settings; and (c) the increased risk of harm when using Therapeutic Assessment with forensic populations. In addition to these themes, multiple respondents discussed components of collaborative/Therapeutic Assessment that they have found useful with this population. Finally, the implications of these results are discussed.

Intercultural Communication Between Forensic and Clinical Psychologists

While working in clinical and forensic psychology settings, a communication difficulty between the two professions became apparent. Forensic psychologists often appeared cold and callous from the clinical psychologist’s perspective, while clinical psychologists often appeared naïve or too client centered from the forensic psychologist’s perspective. I wondered if viewing each subfield of psychology as a culture could facilitate better communication through intercultural communication. Guided by Intercultural Communication in Contexts (Martin & Nakayama, 2010) in approaching intercultural communication between the two professions, I explored factors contributing to each profession’s cultural identities. Once this was established, I attempted to explore the different ways each culture could communicate more effectively. By recognizing and utilizing the strengths from each profession and understanding the possible pitfalls of one’s own, we may become competent in intercultural communication