Elizabeth Smart testifies at competency hearing

Kidnap victim Elizabeth Smart provided dramatic testimony today in David Mitchell's long-anticipated competency-to-stand-trial hearing.

But Mitchell wasn't in the room to hear her. He was removed from the courtroom when he refused to stop singing a Mormon hymn, as he does whenever he comes to court.

Smart's testimony was ostensibly intended to establish that Mitchell was acting rationally in order to further his criminal conduct, rather than being motivated by religious delusions as the defense has maintained.

A "calm, poised, articulate" Smart testified that Mitchell was obsessed with sex and used religion to further his predatory goals. She described Mitchell as "evil, wicked, manipulative, sneaky, slimy, selfish, greedy."

But defense attorney Robert Steele said Smart's testimony hinted that Mitchell is delusional, according to coverage in the Salt Lake Tribune. Last week, he argued unsuccessfully that Smart should not be allowed to offer opinions about Mitchell's state of mind or motivations.

Mitchell has refused to submit to any psychological evaluations or diagnostic tests.

His wife and co-defendant, Wanda Barzee, has twice been found incompetent for trial and is undergoing forced treatment with antipsychotic medications. Her next competency hearing is scheduled for Oct. 23.

A transcript of Smart’s 100-minute testimony is online HERE.

The Polanski debacle: Polish schizophrenia?

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Intellectual competence and the death penalty

That's the title of a new blog some of you will be interested in. Produced by Kevin McGrew, director of the Institute for Applied Psychometrics, its focus is "psychometric measurement issues and research related to intelligence testing that may have bearing on capital punishment cases for individuals with an intellectual disability."

The blog is just a few months old, but it's already loaded with resources pertinent to capital litigation, including recent court cases as well as professional journals, associations, blogs, and experts. It's even got a poll you can take, indicating what topics you would like Dr. McGrew to tackle next. The professor clearly enjoys blogging, as he's already running at least two other IQ-related forums.

Clicking on the image at left will take you directly to the site, which today just happens to feature my blog.

Should forensic psychologists have minimal training?

Would you trust a "master's level dentist" to pull your tooth? Or a "bachelor's degree attorney" to defend you in court?

Not hardly.

Terminal master's degree programs in forensic psychology represent just this type of degradation in quality, says Carl Clements, a psychology professor at the University of Alabama, who argues that forensic psychology training should remain at the traditional doctoral or postdoctoral level.

But critics like Clements are spitting in the wind. Paralleling forensic psychology's breakneck growth and immense popularity, degree programs -- including many online, distance-learning options -- are sprouting up like mushrooms after a heavy rain. And just like mushrooms, they will be impossible to eliminate.

The field's perceived glamour, including the allure of the mythical profiler, has produced a bumper crop of impressionable young people willing to shell out cash for a forensic degree. Massive prison growth, along with prisoner's rights cases mandating mental health evaluation and treatment, have produced abundant jobs for psychologists.

Educational institutions have responded with alacrity. New training programs take a variety of forms, according to a survey in the current issue of Training and Education in Professional Psychology:

• PhD in clinical psychology with specialty track in forensic psychology (about 10 programs)
• PsyD in clinical psychology with forensic specialty track (about 10 programs)
• PhD in nonclinical (e.g., social or experimental) psychology with forensic or legal emphasis (about 10)
• Joint psychology-law degree programs (6)
• Master's degree in forensic psychology (12)
• Bachelor's degree in forensic psychology (John Jay College of Criminal Justice)
• Undergraduate psychology-law courses (increasingly common and popular)

In addition to all of these different degree options, more and more predoctoral internships offer forensic rotations. About 17% of APA-accredited internships now offer a major forensic rotation, with another 47% offering a minor rotation, according to the Association of Psychology Postdoctoral and Internship Centers (APPIC).

Yet with all of this rapid growth, there is no consensus as to what training models and curricula are adequate in order to prepare students for real-world forensic practice. With that in mind, David DeMatteo of Drexel University and colleagues are proposing a set of core competencies for doctoral-level forensic psychology training curricula. At minimum, they say, students should get training and experience in the traditional areas of substantive psychology and research methodology, along with specialized advanced training in:

• Legal knowledge
• Integrative law-psychology knowledge
• Ethics and professional issues in forensic psychology
• Clinical forensic psychology

Aren't all of these areas already integrated into current forensic psychology degree programs?

Again, not hardly.

Reviewing the curricula for the roughly 35 [as of his review] doctoral or joint-degree programs with training in forensic psychology, DeMatteo and colleagues found* only three programs that included all four components. For example, only about 40% offered courses falling under "legal knowledge." More alarmingly, only three programs reported offering courses specifically addressing ethical and professional issues in forensic psychology.

So, will all of the self-described forensic psychologists emerging from these newly minted degree programs be able to find work in the field? I predict that those who travel the traditional path of postdoctoral specialization will fare the best. Those with terminal master's (or even bachelor's) degrees will be restricted to lower-level occupations such as correctional counselor or social services case manager. While they may meet the demands of the prison industry for warm bodies with letters after their names, these practitioners certainly won't be called as experts in court.

But there is a greater danger in these bare-bones forensic training programs. Not only do they offer false promises to students, but they sacrifice the intensive clinical training, including experience working with severely mentally ill populations, that is a key foundation for forensic work. The lack of adequate training in the law and in ethics will likely cause even more disastrous outcomes when these professionals take on forensic cases.

I know, I know. I am just spitting in the wind, too. Financial exigencies always win out.

Related resources:

What's it take to become a forensic psychologist?

*SOURCE: David DeMatteo, Geoffrey Marczyk, Daniel Krauss & Jeffrey Burl (2009), Educational and training models in forensic psychology. Training and Education in Professional psychology 3 (3), pp 184-191. Request from the author HERE.

Court roundup: Lots of action this week

In addition to the high-profile competency hearing in Iowa that I blogged about yesterday, this week featured lots of other legal happenings of relevance to forensic psychology. Issues included:

• The Zoloft defense
• Repressed memory
• Transsexual prisoners
• Child pornography sentencing

Here are some highlights, with links so you can read more if you are interested:

"Zoloft made me do it"

In a New York trial that is drawing national attention, a defendant is blaming a 2006 attack on his girlfriend on symptoms of withdrawal from the antidepressant Zoloft.

To bolster his defense, Brandon Hampson is expected to call Dr. Stefan Kruszewski, a Harvard Medical School graduate. Dr. Kruszewski testified at a pretrial hearing that Zoloft can cause "significant side effects," including agitation, aggression and grandiosity.

It's going to be yet another case of dueling experts: An associate clinical professor at Harvard is expected to testify that "Kruszewski's opinion is not generally accepted by experts in the field and was based on flawed research methods," according to an article by Vesselin Mitev in the New York Law Journal. In an unusual payment arrangement, Pfizer (the drug's manufacturer) will compensate Dr. Douglas Jacobs $7,500 for his testimony.

The trial harkens back to a rash of cases in which violence and suicidality were attributed to the effects of Prozac. Severe side effects from withdrawal from other antidepressants such as Paxil are well documented.

Transsexual prisoner rights

In a history-making ruling in the United Kingdom, a preoperative male-to-female transsexual has won the right to be housed in a women's prison. The prisoner, known only as "A," will have to be housed in segregation. "A" is serving a life sentence for killing a boyfriend and trying to rape a woman.

Under the ruling by a judge on London's High Court, holding "A" in a men's prison is a breah of human rights under the European Convention on Human Rights.

The Telegraph of UK has the story. My March 2008 post on transgender prisoners is here.

Repressed memories under assault

The infamous priest Paul Shanley of Boston, one of the central figures in the clergy sex abuse scandal, is back in court challenging his conviction by claiming that theories of repressed memories are not reliable or valid.

Shanley was convicted after a 27-year-old man claimed the priest had regularly raped him when he was just six years old, but that he blocked out the memories for two decades until he saw media reports about the clergy scandal unfolding in Boston.

Reports Denise Lavoie of the Associated Press:

Shanley's lawyer, Robert Shaw Jr., argues that Shanley deserves a new trial because the jury relied on misleading, 'junk science' testimony about repressed memories by prosecution witnesses. 'His conviction rests upon a theory that is false, that has not been shown to exist and has been rejected by the scientific community,' Shaw said. 'They needed repressed memories to normalize for the jury what was otherwise an extraordinary assertion - that he could be completely oblivious that this ever happened and then remember it 20 years later."

The appeal, to be heard by Massachusetts' high court, "is being closely watched by experts on both sides of the issue," Lavoie reports. "Nearly 100 scientists, psychiatrists and researchers have signed a friend-of-the court brief denouncing the theory of repressed-recovered memories. Another group has submitted a brief supporting the theory."

Judges protest child porn sentencing

Federal judges testified before a U.S. Sentencing Commission in Chicago about severe mandatory sentences for child pornography possession. Astonishingly, the punishment for watching a single video can be higher than that for raping a child repeatedly over many years, one judge testified.

The Wall Street Journal's Law Blog has coverage.

Rare chance to view dueling experts live

Accused coach killer's Iowa competency hearing

Courtesy of the Des Moines Register, we have a rare opportunity to watch two experienced mental health experts testify in court about competency to stand trial. The experts were the featured event in this week's highly publicized hearing for Marc Becker, the mentally disturbed man accused of gunning down esteemed Iowa football coach Ed Thomas in front of about 20 students this past June.
















Click on either image above to watch that expert's testimony. Dr. Michael Taylor's video (left) is about 79 minutes, the first 15 minutes of which are the testimony of a psychiatric nurse at the jail (manually move the time bar to 15 to start with Taylor). Dr. Dan Roger's video (right) lasts about 57 minutes.

The experts agreed that Becker is most likely schizophrenic. They differed vastly, however, on whether he evidenced symptoms of psychosis.

Testifying for the prosecution on Thursday, psychiatrist Michael Taylor said he found no evidence whatsoever of current psychotic symptoms. Dr. Taylor described the defendant as "a calm, relaxed, pleasant young man, well spoken, articulate, able to communicate clearly, able to joke."

"There's absolutely no hint in Mr. Becker's appearance or behavior that would raise any suspicion of any psychiatric disorder," Taylor testified.

On the other side of the aisle, defense-retained psychologist Dan Rogers described the defendant as "floridly psychotic," paranoid, and delusional. "He starts with a perfectly good thought and it just becomes filled with illogical concepts as he tries to proceed," he testified.

While the public may see this as an example of hired guns who will say whatever they are hired to say, an alternate possibility is that Becker presented differently to the two experts. Dr. Rogers evaluated Becker on two occasions, 32 days and 45 days after the offense. Dr. Taylor did not evaluate Becker until more than two months after the crime. By that time, Becker was being medicated with a high dosage of the antipsychotic Invega.

Becker appeared highly sedated in court, raising another competency issue: If his medication dosage is lowered so that he can stay awake in court, his psychosis will worsen, Dr. Rogers predicted.

Of note in this case is the informative, factually accurate coverage being provided by Jennifer Jacobs of the Des Moines Register. In Thursday's article, she quoted the illustrious Daniel Murrie of the Institute of Law, Psychiatry and Public Policy at the University of Virginia School of Medicine, talking about how uncommon incompetency findings are (only an estimated 20% of cases in which the issue is raised).

In her previous story, Ms. Jacobs quoted competency guru Thomas Grisso (of Evaluating Competencies fame) and cited recent empirical research on incompetency findings:

"Each year, about 7,000 defendants nationwide are involuntarily committed to public psychiatric hospitals for treatment intended to make them well enough to stand trial, according to a 2008 report in the American Journal of Forensic Psychiatry. About 78 percent are released in less than three months, according to a 2003 report by the Missouri Institute of Mental Health. Another 20 percent are released between three months and 12 months after committal, and 2 percent are released after 12 months."

After hearing from the two experts, Judge Stephen P. Carroll put the case against Becker on hold while he contemplates his competency ruling.

Hat tip: Luis Rosell