Juvenile Competency Training Conference October 18, 2013

Juvenile Competency Training Conference October 18, 2013
A Legal Professionals Guide to evaluating competency to proceed and likelihood of successful attainment with juveniles Ivan Kruh, Ph.D. Forensic & Clinical Psychology – Ossining, NY Also -- I am going to do my best to call this CTP since that is what you call it here in Utah. And Attainment rather that restoration. But know that they are equivalent! In Washington State, where I did most of my work in this area, it is called CST. In New York State, it is called “Capacity.” It is increasingly being referred to as “Adjudicative Competence.” Mouthful to say… Glad won’t have to today. I still slip back to CST – and may well today. Juvenile Competency Training Conference October 18, 2013

Nice to be here when everyone in SLC is in a well-deserved celebratory mode!!

Oxford University Press Series
Thomas Grisso, PhD

Competency to Proceed

Competency to Stand Trial
Criminal defendants must be able to meaningfully participate in the case against them. Yield defense decisions reflecting defendant’s wishes Promote accurate and just adjudications Retain the integrity and dignity of the court process Protects: The defendant being tried The state’s pursuit of fair and reliable adjudications Traditional Threats: Acute Psychosis or Mania Cognitive Disability (especially Mental Retardation)

Competency to Stand Trial USSC
Dusky v. United States (1960): …the test must be whether [the defendant] has sufficient present ability to consult with his lawyer with a reasonable degree of rational understanding – and whether he has a rational as well as factual understanding of the proceedings against him Godinez v. Moran (1993): [All c]riminal defendants – not merely those who plead guilty – may be required to make important decisions once criminal proceedings have been initiated. And while the decision to plead guilty is undeniably a profound one, it is no more complicated than the sum total of decisions that a defendant may be called upon to make during the course of a trial. DUSKY: Sufficient ability and reasonable understanding Does not require complete and fully unimpaired functioning. Present ability Explicitly a “current mental state question” Generally accepted to include the immediate future across the trial process Ability Want to identify individuals unable to function adequately Not simply unfamiliar with the process or choosing not to participate adequately. Factual vs. rational understanding More than a concrete, rote understanding is required And Both components are necessary. Godinez: Says that making decisions is an inherent component of being a competent defendant. No need to assess specific decisional competencies – competency to plead guilty – being competent to stand trial assumes decisional competence

Competence to Proceed – Utah Law
Juvenile Court Act (Chapter 6) 78A-6-105(30). Definitions. “Not competent to proceed” means that a minor, due to a mental disorder, intellectual disability, or related condition as defined, lacks the ability to (a) understand the nature of the proceedings against them or of the potential disposition for the offense charged; or (b) consult with counsel and participate in the proceedings against them with a reasonable degree of rational understanding. If we look at how CTP is defined in Utah law for juvie courts, see clearly based on Dusky. Adds the predicate requirement!

Competency to Proceed As a Forensic Concept
Four-factor general model summarizes most models Factual Understanding Basic, concrete knowledge of the legal process Rational Appreciation Accurate “beliefs” about what is understood about court Assisting Counsel Ability to participate with and meaningfully aid defense counsel in developing and presenting the defense Legal Decision Making Ability to consider legal alternatives and reach adequately contemplated legal choices One job of forensic mental health experts is to translate legal concepts into mental health concepts so that clinicians can assess them. “Forensic Mental Health” is the bridging of two different worlds – an idea we will come back to…. A number of different conceptualizations have been offered— I have found a general 4 factor model to be the most compelling and the most helpful in the hundreds of Juv-COMP evaluations Ive done. Lets look at each factor in turn.

Competency to Proceed Factual Understanding
Basic, concrete knowledge of the legal process Understands they are accused of a crime Understands what the alleged crime is Understands the court will decide guilt and innocence Understands the trial could result in punishment Understands what punishments are possible Understands the various ways one may plead Understands the roles of various participants at a trial Understands the basic process of a trial !!!!!DON”T GET INTO DIFFERENCES BETWEEN ADULT PROBLEMS AND JUVE PROBLEMS HERE DO IT AT THE END!!! Factual Understanding – Basic, concrete knowledge of the legal process e.g., Understands the court will decide guilt and innocence Understands what punishments are possible Understands the various ways one may plead Of course, youth less likely to have studied or been exposed to how courts work vs. adults.

Competency to Proceed Rational Appreciation
Accurate “beliefs” about what is factually understood about court Is able to manipulate the information that is factually understood Is able to contemplate the implications and significance of what is understood Is able to rationally apply that knowledge in one’s actual case-related situations Rational Appreciation - Accurate “beliefs” about what is factually understood about court Is able to rationally apply knowledge in one’s actual case-related situations adult defendants > most common threat = idiosyncratic and irrational beliefs resulting from psychotic delusions. e.g., a defendant who factually understands the role of the court personnel might nonetheless believe and act in court from the premise that, “Although defense attorneys are supposed to help the defendant, my defense attorney is a CIA agent and only the judge can save me from his plot to kidnap me.” Fails to appreciate (or to rationally apply) that which he understands about the role of the defense attorney and the judge. May happen this way in less common cases in which youth are psychotic. more common in younger defendants (or with limited cognitive abilities) > distorted beliefs rooted in concrete thinking, incomplete understanding of the process, and/or other factors (e.g., limited temporal perspective) that impair the ability to appropriately consider and apply information. Increased risk for over-generalizations, under-generalizations, confusion, immature presumptions, and frankly erroneous beliefs. e.g., a youth may be able to state that she is allowed to plead not guilty and may accurately define that term, but may believe that to plead not guilty when she knows that she committed the offense is not allowed “because it’s lying, and you can never lie in court.” Another e.g., Difficulty appreciating the role of defense counsel due to potential difficulty conceptualizing why their own authority eclipses that of an adult -- contrary to the usual social distinctions between children and adults that they face in most other aspects of everyday life.

Competency to Proceed Assisting Counsel
Ability to participate with and meaningfully aid the defense attorney in developing and presenting the defense Is able to understand and adequately respond to counsel’s questions during pre-trial consultations in a manner that provides relevant information for mounting a defense Is able to provide a coherent account of the facts of the alleged crime Is able to identify potential sources of relevant evidence and witnesses Is able to identify reasons for confronting opposing witnesses Is able to manage the stresses and demands of trial process Is able to follow and comprehend the testimony of other witnesses so to be able to alert counsel to any distortions of the facts Is able to provide testimony with relevance, coherence, and independence of judgment. Assisting Counsel - Ability to participate with and meaningfully aid the defense attorney in developing and presenting the defense e.g., Is able to provide a coherent account of the facts of the alleged crime Is able to understand and adequately respond to counsel’s questions to allow for mounting a defense Traditional threat – disorganization due to psychotic thought process Younger and/or cognitively-limited defendants may also be vulnerable > due to general cognitive underdevelopment. e.g., May believe that their primary role in court is simply to show up and avoid behaving inappropriately May misunderstand role of defense as advocate and withhold information from counsel for fear it will be used against them Further, skill limitations in memory, attention, tracking, processing, verbal reception and expression, interpersonal perspective-taking, rapport development with strangers, and time perception may each limit Assisting abilities.

Competency to Proceed Legal Decision-Making
Ability to consider process and weigh legal alternatives, and ability to reach and communicate adequately contemplated legal choices Is able to rationally decide how to plead Is able to rationally decide about going to trial Is able to rationally decide about accepting a plea offer Is able to rationally decide about testifying Is able to rationally decide about calling certain witnesses Is able to rationally decide about pursuing certain defenses Legal Decision Making: Ability to consider legal alternatives and reach adequately contemplated legal choices e.g., Is able to rationally decide about accepting a plea agreement offer Legal decisions are appropriately based on the advice of counsel, but they cannot be made by or altered by the defense attorney alone. Defendants must be able to engage their case with autonomy, self-interest, and rational expectations so that case decisions are not merely capitulation to the attorney’s ideas (Rogers & Shuman, 2005). Again, traditional threat is disorganized thinking and delusional beliefs – e.g., decide to take the case to trial because at trial it will be made known that the defendant is JC Youth and cog limited > skills deficits may interfere Juveniles – “I’ll take the case to trial because that’s what my mom told me to do.” “I’ll plead guilty because I want to go home right now.”

Competency to Proceed – Utah Law
Juvenile Court Act (Chapter 6) 78A (7). Juvenile Competency. In conducting the evaluation and in the report determining if a minor is competent to proceed as defined in Subsection 78A-6-105(30) the examiner shall consider the impact of a mental disorder, intellectual disability or related disorder on a minor’s capacity to: (a) comprehend and appreciate the charges or allegations; (b) disclose to counsel pertinent facts, events, or states of mind; (c) comprehend and appreciate the range and nature of possible penalties, if applicable, that may be imposed in the proceedings against the minor; (d) engage in reasoned choice of legal strategies and options; (e) understand the adversarial nature of the proceedings; (f) manifest appropriate courtroom behavior; and (g) testify relevantly, if applicable. Point out here that the Utah Juvenile statute breaks down CTP a bit differently. Identifies 7 factors that must be considered by examiners. But if you review these 7 factors I think it is easy to see how they relate to the four factors I just presented. A – Factual Understanding and Rational Appreciation B – Assisting Counsel C – Factual Understanding and Rational Appreciation D – Legal Decision Making E – Factual Understanding and Rational Appreciation F - Assisting Counsel and/or Legal Decision Making G – Assisting Counsel

Competency to Proceed & Juveniles

Competence to Proceed & Juveniles
During the era of “rehabilitative” juvenile justice, incompetence irrelevant Reforms of the 1960s and 1970s Kent v. US (1966) In re Gault (1967) In re Winship (1970) McKeiver v. Pennsylvania (1971) Breed v. Jones (1975) Reforms of the 1980s and 1990s Response to public outcry against juvenile violence. Deterioration of rehabilitative ideal. Deterioration of special protections. Growth of retribution traditionally reserved for adult system. In modern juvenile justice, respondents face more serious sanctions and are afforded due process rights Competence becomes relevant If a person’s ability to defend themselves is severely compromised by MI, seems unfair to try them -- as if we are trying them in absentia. Although this need long recognized in CJS, not true in JJS When JJS was non-adversarial, legal counsel not used, and based on pure rehab goals, no need to worry about competency to defend oneself With the new JJS we work within now -- the process is more adversarial, respondents do more often mount defenses against the charges, and quite punitive outcomes are at stake. CST has become relevant. Like adults, juveniles should not be tried if they are unable to defend themselves

Differentiating Competent & Not Competent Youth
Factors that differentiate across studies: Age Under 12 – Very High Risk 13-15 – Elevated Risk 15 and above – Similar to Adults Intelligence Mentally Retarded – Very High Risk Borderline IQ – Elevated Risk Low Average and Above – Similar to Adults Academic Functioning Special education placement and poor Achievement Test scores Grades and Retention not related Mental Health Problems Findings less consistent Mental Health: Relation of mental health diagnosis; mental health treatment, current mental health symptoms depends on sample/methods Diagnoses – less consistent findings Several studies have found behavior problems – ADHD; hostility; etc. predicts Less well investigated at this point Will discuss in a little more detail in a little bit

Differentiating Competent & Not Competent Youth
Factors that do not differentiate: Experience with Legal System Race Gender Socioeconomic Status Nature of Instant Charges Court of Jurisdiction (Juvenile vs. Criminal)

Red Flags for Problems with Juvenile Competency
Youth seems: Easily Confused Detached and/or Indifferent Severely Depressed Hostile and/or aggressive Inattentive and/or Distracted Oppositional and/or Defiant Immature and/or Infantile Youth demonstrates: Poor Memory Difficulty communicating information Difficulty understanding attorney Disorganized speech Peculiar statements Responding to internal stimuli Chaotic and/or bizarre behavior !!!!!!!!!!!!!!!!!!!CONSIDR SKIMMING!!!!!!!!!!!!!!!!!!!!!!!!! Here are some things to look for… So, when should attorneys carefully consider a referral for a competency evaluation? Remember – red flags are issues to consider – the identification of a red flag does not, in and of itself mean a referral is necessary!

Situational Red Flags for Problems with Juvenile Competency
Limited contact with &/or trust of attorney Alleged fact pattern is complex Evidence against the youth is unclear Hearings are likely to be lengthy Hearings are likely to involve many witnesses Case likely to require use of a complex defense Testimony by youth is likely to be necessary Plea bargaining is likely Many examiners and attorneys alike don’t appreciate that competency is specific to THIS respondent involved in THIS case! Does the child accused of hitting his teacher in anger in front of another teacher require the same ability as a child accused of raping... No. But NOT because, simply, the charges are differently serious. But because each is likely to require a different level of functioning. Alleged fact pattern is complex Evidence against the youth is unclear Ability to provide coherent fact account Hearing(s) likely to be lengthy Attention/concentration skills Hearing(s) likely to involve many witnesses Ability to track proceedings and confront witnesses Hearing(s) Respondent likely to pursue a complex defense Testimony by respondent likely Plea Bargain likely Decision-making/reasoning ability

Evaluations of Competence to Proceed
Conceptualizing the Process

Competency To Proceed Evaluation Model (Grisso, 2003)
The Functional Question What competency-related deficits exist? The Causal Question What are the causes of the deficits? The Contextual Question How will the deficits impact this examinee in their case? The Conclusory Question Are the deficits adequately impairing to meet the legal test? (Is the examinee not competent?) The Remedial (Attainment) Question Can the deficits be remediated within the legal time-frame? How? Now that we have a better understanding of the functions that are needed to be competent, let’s talk about how the evaluation is conducted Good to keep this model in mind throughout the evaluation process. Let’s look more closely at how we answer each question.

The Functional Question
What competence-related deficits exist? Summary of abilities and deficits Purely descriptive: What the respondent actually knows, understands, believes, and can do Identifies consistencies and inconsistencies

The Causal Question What are the causes of the deficits?
Forming and testing hypotheses Connection between identified deficits and examinee’s clinical/developmental problems Potential causes of deficits include: Clinical causes (i.e., symptoms of mental disorders) Developmental causes (i.e., developmental delay or immaturity) “Nonclinical” causes, (i.e., feigning/motivation, evaluation conditions, visual/auditory deficits that interfere with reception of information, lack of experience and acquired information) Typically not considered a reason for a finding of incompetence Developmental in red. Many jurisdictions consider developmental factors. Utah does not. I considered taking all mention out completely. But at the end of this presentation we will discuss these developmental issues. So – want you to know where and how they get considered in states that allow for it as a predicate. So put in red.

The Contextual Question
How will the deficits impact this examinee in their case? Having a deficit does not equal being incompetent Primary contextual factor: Specific demands of the respondent’s case Secondary contextual factor: Caretaker influence Caretaker influence: Minor weaknesses might be managable with a highly supportive and functional family. Minor weaknesses might yield major problems with an interfering and dysfunctional family.

The Conclusory Question
Are the deficits adequately impairing to meet the legal test? (Is the examinee incompetent?) Must begin with a presumption of competence Are the deficits significant enough to warrant an incompetency finding?

The Remediation (Attainment) Question
Can the deficits be remedied within the legal time-frame? How? Interventions to alleviate problems causing the deficits Classic model = medication to reduce clinical symptoms Unmedicated Psychotic Disorder Unmedicated child with severe ADHD Less useful with many disorders Pervasive Developmental Disorders Language Disorders Most common intervention used with youth = EDUCATION

The “Ultimate Issue” Issue
Ultimate Issue = the court’s legal question Is the youth competent to proceed? Is there a substantial probability that the minor may attain competency in the foreseeable future? Ultimate Issue Issue = unresolved debate about whether forensic clinicians should answer it. Against For Answering is the domain of the judge because the answer is a legal, social, moral matter – not clinical The court is aware any opinion is only advisory. Some laws forbid these opinions Many laws allow and many judges demand these opinions Current science is not precise enough to answer these questions Science has advanced so that reasonable answers can be given UI opinions -- Where law and MH run into problems. The ultimate legal question is a LEGAL QUESTION. Not a clinical or scientific one. Legal perspective Will the adjudication process be unfair if deficits prevent respondent from meaningfully participating? Have to keep in mind that scientists try to answer the question differently that judges— We have no scientific ways to determine fairness – so we look at cases where past judges have found it to be unfair, and try to compare our cases to that. Empirical perspective How do respondent’s abilities compare to others who have been found competent and incompetent to stand trial? Also: Courts want issues to be Black & White; mental health evaluations often identify Grays. Many prominent scholars train to NEVER give UI opinions. Others say can when the issues are crystal clear -- the legal criteria & the repsondent’s meeting of them. When board certified clinicians were asked of UI opinions should be given in 2003, 1/3 said always; 1/3 said never; and 1/3 said acceptable but not mandatory.

Evaluations of Competence to Proceed
The Evaluation Process Now let’s turn to what examiners do to collect the data and analyze the data to answer these questions.

Overview of Data Collection
Target relevant domains Historical/Developmental Context Current Mental Status Current Case-Related Functioning Obtain reliable information by emphasizing: manualized and structured checklists/interviews corroboration for obtained data psychological tests (when applicable and feasible) multiple interviews (when applicable and feasible) Use a flexible approach Manualized checklists and interviews – aide memoire; helps us to develop an internal barometer Corroboration: allowing for verification or disconfirmation of hypotheses Multiple sources: talk about them in a bit Flexible Battery: For one youth who has been a ward of the state and has no adult in his life with detailed historical information, you may spend a lot of time asking about Hx. For a youth who is a poor historian because they are young or they have a PDD, and you know there is an involved parent you will speak with, may spend much less time on basic Hx information.

Data Collection Third-Party Information Sources (Records & Interviews)
Teachers & School Officials Mental Health & Medical Providers Social Service Representatives Probation Officers & Detention Officials Defense Attorney Caregivers Psychosocial History Symptom Observations to inform diagnosis Observations relevant to competence Potential influence upon competence Recommendations for data sources (Records & Interviews) An essential feature of good forensic evaluations is heavy use of third-party information sources. Enhances validity and reliability: Provides information that occurred outside of the current case. Obtains the opinions of people less vested in the outcome of the current case (caregivers a clear exception Main goals – Put together a clear Psychosocial History, which includes the youth’s development Obtain any information about recent or even current functioning to assess diagnoses. Example of School: Daily functioning in a more structured and verbal-based setting Ability to learn novel information Previous psychological evaluations Individualized Education Plans Caregivers: Assess caretakers’ abilities to advocate, support youth, or refrain from impairing youth’s capacities Should never be conceptualized as possibility of caregivers compensating for youth’s incapacities Constitutional requirement that defendant alone can waive rights (must be autonomous) - Parents cannot decide for youth - Parents may only advise 2. Caretakers’ relation to youth may reduce effective guidance Good parenting principles can he harmful Emotional reactions may interfere (guilt, anger, fear) Caretakers may have conflicts of interest, leading to influence not youth’s best interest May have relationships with other suspects in the case, or with the victim May have an interest in child being removed from own custody May have financial conflict of interests (e.g., how much time away from work will this take?)

Data Collection Interview of Youth STATUS
Clinical and Developmental Interview Notification of Rights Psychosocial History Symptom History/Diagnostic Information Current Mental Status Competence Interview Direct Observation of Relevant Functioning Functional Interview of Competence Abilities Structured Interviewing Case-Specific Interviewing Current Mental Status Observations across the interview – eg/ posture; motor behavior; affect; speech Focused MSE questions: basic cognitive functioning – memory, abstraction; fund of general info. STATUS The purpose of mental status exams Identify mental and emotional features related to mental disorder

Data Collection Structured Interview of Competency Abilities
Tools Designed for Adults Some have been studied with juveniles: Fitness Interview Test – Revised (FIT-R) MacArthur Competency Assessment Tool – Criminal Adjudication (Mac-CAT-CA) Some have been recommended for use with juveniles: Competency Assessment Screening Tool for Mentally Retarded Defendants (CAST- MR) Problems with using with juveniles: Some content inapplicable to juvenile court Not designed to address developmental impediments Appreciation Reasoning Ability to Learn Specialized Content: Some content because the functioning of juvenile court is different than criminal court (if a juvie case) No jury trials Probation Officers as case workers Some content because research has shown youth have particular difficulty Nature of legal rights !!!!!!!!!!!!!!!!!!!!!!!!!!!!!DO NOT DETAIL THE BELOW!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! Appreciation 1. Application Not enough to just ask to define – need to ask to apply – abstract skill – may be able to offer rote definition, but not know how to apply it in practice. “If you testified in your case, what would your attorney want your testimony to prove? What about the prosecutor?” “If someone tells a lie about you in court, who should you tell? Why?” JACI 2. Developmental vs Psychotic With psychosis, looking for the interference of delusional content With youth, looking for the interference of immature ideas, concepts, abstraction, reasoning skills I never want to go to detention – I heard they torture you there and don’t feed you. Must always tell the judge you did it if you did because lying is wrong and not telling is as bad as lying Reasoning Also different issues: With adults, mainly cognitive: Hold information in memory; consider strengths and weaknesses of various options; reach an adequately reasoned decision; articulate that decision With youth, increasining evidence of psychosocial factors that can impair reasoning Autonomy (aka Conformity & Compliance) - ability of a youth to be self-reliant, independent, and autonomous in their decision-making so – compliance with authority figure; or with peers Attitudes Toward & Perceptions of Risk – Ability to imagine negative outcomes; assess their likelihood; appropriately assess aversiveness Time Perspective - ability to appropriately consider both long-term and short-term implications of their decisions and actions Temperance - ability to maintain emotional and behavioral control; esp. modulate their impulsivity in their decisions and actions Teaching Much more common – and important part of eval with juveniles Need approaches that allow for great deal and flexibility of teaching and re-assessing. Is it enough to teach and immediately re-ask? Maybe re-ask at the end of the interview? Maybe re-ask at a second interview?

Data Collection Structured Interview of Competency Abilities
Juvenile Adjudicative Competence Interview (JACI) Past Experiences with Court Framing and Context Nature and Purpose of the Trial Understanding & Appreciation Items + Flexible Capacity Checks Roles of Participants Assisting Counsel Reasoning and Decision Making Reasoning Items Participating at the Juvenile Court Hearing Behavioral Observations Nature and seriousness of offense; nature and purpose of trial; possible pleas; penalties Roles of pros, def, prob, judge (jury) Assisting def + plea agreements Decisions about having a defense lawyer; assiting the lawyer; how to plead; plea bargain Ability to attend; maintain self-control; testify

Data Collection Psychological Testing (as relevant and needed)
Of Youth Completed by Caregivers (or others) Intellectual Functioning (esp. Abstraction Skills) Memory & Learning Abilities Attentional Abilities Current Mental Health Problems / Symptoms Developmental Functioning / Level Response Style Testing. AS RELEVANT AND NEEDED. Important to understand. All surveys of expert CST evaluators have yielded opinion that testing is not necessary in many CST evaluations. Why? There are few tests that assess the abilities relevant to CST The deficits are so clear from basic interviewing (e.g., psychosis; severe MR) that testing will not add anything. The impairment is so severe that obtaining valid testing is unlikely. There is recent testing conducted in other contexts – which offer the benefit of potentially higher effort, greater validity? (except can’t always vouch for other examiner….) Strongest argument for testing is probably for assessing response style – but, no great tests for youth! – Word Memory Test. Maybe SIRS? The use of a standard test battery is unnecessary and rarely recommended. If you see a psychologist that uses a test battery – especially a vast test battery – and especially assessing things that seem irrelevant to CST they are likely unable to shift from how the conduct general clinical evaluations, or they are padding their charges. Intellectual functioning (especially abstraction skills) WISC-IV WJ-TCA-III WASI Memory & learning abilities WRAT-4 WRAML-2 Other neuropsychological abilities (e.g. attention) CPT BRIEF K-SNAP Mental Health Symptoms CBCL-2/BASC-2 MMPI-A Developmental Functioning Adaptive Functioning Vineland-II ABAS BASC-2 Psychosocial Functioning RST-I Response style General MMPI-A BASC-2 Memory & Effort TOMM WMT Psychosis SIRS

Data Analysis & Forming Opinions
The Functional Question What competence-related deficits exist? The Causal Question What is the cause(s) of the deficits? The Contextual Question How will the deficits impact this examinee in their case? The Conclusory Question Are the deficits adequately impairing to meet the legal test? (Is the examinee incompetent?) The Remedial (Attainment) Question Can the deficits be remediated within the legal time-frame? How? Now we return to the five questions and can use the data that was collected to answer these questions

Evaluations of Competency to Proceed
Assessing Likelihood of Successful Attainment Notice that I say “Assessing Likelihood of Successful Attainment” Again, the legal question is different “Is there a substantial probability that the minor may attain competency in the foreseeable future” Clinical question vs Legal Question

Pursuing Attainment Requires Likelihood of Success
Jackson v. Indiana 406 U.S. 715 (1972): “…a person charged by a State with a criminal offense who is committed solely on account of his incapacity to proceed to trial cannot be held more than the reasonable period of time necessary to determine whether there is a substantial probability that he will attain that capacity in the foreseeable future. If it is determined that this is not the case, then the State must either institute the customary civil commitment proceedings that would be required to commit indefinitely any other citizen, or release the defendant. Furthermore, even if it is determined that the defendant probably soon will be able to stand trial, his continued commitment must be justified by progress toward that goal.” The reason why success needs to be likelu is rooted in the USSC decision in Jackson v Indiana Keep in mind this was in reference to an adult model – if ITP, results in involuntary hospitalization. Court was preventing indefinite detention based on ITP.

Competency to Proceed – Utah Law
Juvenile Court Act (Chapter 6) 78A (8). Disposition on finding of incompetency to proceed – Subsequent hearings – Notice to Prosecuting Attorneys If at any time during the attainment period the court finds that there is not a substantial probability that the minor will attain competency in the foreseeable future, the court shall terminate the competency proceeding, dismiss the delinquency charges without prejudice, and release the minor from any custody order related to the pending delinquency proceeding, unless the prosecutor informs the court that commitment proceedings pursuant to Title 62A, Chapter 5, Services for People with Disabilities, or Title 62A, Chapter 15, Substance Abuse and Mental Health Act, will be initiated… Jackson was a protection of civil liberties issue Interesting that Utah encoded it for juveniles in ALL attainment cases – whether or not there is a deprivation of civil liberties. Can see arguments in both directions.

Types of Attainment Interventions
Pharmacological The “Psychotic Adult” Model Goal: Remission of symptoms causing deficits Less Straightforward with Childhood Disorders Psychotherapeutic Less Common Model with Adults May augment or replace pharmacology There is a literature – should be consulted However: Target in literature is not competence Let’s begin by thinking about the type of attainment interventions that are possible. Pharmacological: Target the symptoms causing deficits with medications. The traditional approach with psychotic adults. Fairly straightforward and frequently successful. Less straightforward with childhood disorders – ADHD, Anxiety/Dep, etc. Medications to target psychiatric symptoms Psychosis (rapid) ADHD (rapid) Depression (less rapid) PTSD (long term) Medical Disorders (e.g., hyperthyroidism) (???) Many symptoms minimally responsive to medications Cognitive weaknesses Language Dysfunction Pervasive Developmental Disorders Often complicated by previous treatment Many medications tried and did not improve functioning Many medications already being prescribed Psychotherapeutic: Target the symptoms causing deficits with psychosocial interventions. Consider treatment literature for the disorder or symptoms causing deficits …but remember: Successful Attainment Does Not Require: Complete remission of relevant symptoms Complete cure of relevant disorders Only adequate improvement to be Competent. Even in adult world ITP defendant is psychotic Goal is not necessarily to make him not psychotic, but to have skills to be CTP. May well overlap – but may not.

Types of Attainment Interventions
Educational The “Mentally Retarded” Adult Model Goal: Teaching of skills to alleviate deficits Widely Applicable with Youth Types of Educational Curricula: Traditional Training Curricula Didactic Psychoeducation Criticized for focus on memorization of facts 21st Century Training Curricula Multi-Modal and Active-Learning Techniques Systematic and Explicit Instruction Focus on Development of Specific Skills Abstraction ~ Communication ~ Social Skills Educational: Education often a component of Attainment efforts even with psychotic adults, but classically used with cog limitations With adults, research suggests moderately effective. Applicable in cases beyond MR > milder IQ deficits, LD, weaknesses in communication, memory, executive functioning. And of course, developmental-based interference. Historically, educational programs have focused on rote repetition of facts. No research on efficacy with these curricula with youth. However, both experts and courts have agreed that rote memorization of facts is less adequate than ability to meaningfully participate. Goal for the future is more sophisticated approaches: TO TARGET UNDERSTANDING: Multimodal interventions; active-learning techniques > yield deeper process of the information than “chalk-n-talk” Simulations; mock trials; case studies; stories; games; courtroom visits My Cousin Vinny Systematic and Explicit Instruction – From special education literature Knowledge and skills are broken down into smaller subcomponents and re-linked after they are mastered Begin with frequent use of prompts and visual aides – over time, prompts and aides are reduced and eliminated. Enhancing the development of focused skills. Abstraction skills with Cognitive Acceleration (see Adey & Shayer, 2002). Initial Instruction on vocabulary and concepts Problems are offered that challenge their thinking Problems are solved in small groups – encouraged to reflect on their thoughts as they solve. Some evidence it works in general pop with general skills – typically requires 1-2 years of instruction! Communication Skills Training – brief interventions (e.g., Lamb, Bibby & Wood, 1997 – a 12-week program) Social Skills Training – (Spence, 2003 – modeling, role-playing and rehersal; feedback; self monitoring; social problem solving; self-regulation) Very little of this out there and no research on it specific to CST attainment. Training to target knowledge weaknesses Curricula have been developed Rote repetition to over-learn and memorize facts Use of other methods to deepen understanding Multi-modal presentations & active learning techniques Target Factual Understanding Training to target skills deficits (communication; decision making; social) Just beginning to be contemplated (Viljoen & Grisso, 2007) No available curricula

Clinical Literature Juvenile Competency Remediation
Certain sources of deficits decrease the likelihood of successful attainment: Disorders That Are Less Responsive to Treatment Intellectual Disabilities Autism Disorders That Require Long-Term Interventions Posttraumatic Stress Disorder Receptive & Expressive Language Disorder Delayed Development Young Age Grisso, 2005 Otto et al., 2006 Schouten, 2003

Clinical Literature Juvenile Competency Remediation
Certain types of deficits decrease the likelihood of successful attainment: Factual Understanding deficits generally more remediable Appreciation, Assisting, and Decision-Making deficits generally less remediable Grisso, 2005; 2013 Peterson-Badali & Abramovitch, 1993 Viljoen & Grisso, 2007 Viljoen & Roesch, 2007 Understanding – Overlearning through repeated exposure has decent likelihood of success even with lower functioning youth Appreciation, Assisting, Decisionmaking – Fostering the development of higher order cognitive abilities (e.g., better abstraction) is highly challenging. This is NOT to say impossible – just more challenging!

Empirical Literature Juvenile Competency Remediation
Studies of time-frames Very brief interventions are rarely successful Cooper, 1997 Viljoen, Odgers, Grisso, & Tillbrook, 2007 Four-Month to Six-Month Period seems Essential: Most youth ordered for attainment successfully attained by 6 months If did not attain by 6 months, likelihood of success drops markedly McGaha et al., 2001 Warren et al., 2009 Brief Interventions: 1-hr videotape. Cooper, Quick correction of responses a la MacCAT-CA, Viljoen et al

Empirical Literature Juvenile Competency Remediation
~ 70% Returned to Court Competent Success may depend on: Source of deficits: Mental Illness % Intellectual Disability % Both % Age: Younger Adolescents % Middle Adolescents % Older Adolescents % McGaha, Otto, McClaren & Petrila, 2001 Warren, DuVal, Komarovskaya, Chauhan, Buffington-Vollum & Ryan, 2009 70% deemed competent – actually, 71% and 72%, respectively Older adolescents less likely to be made competent than Middle. Why? More likely to have MR or serious MI. McGaha, Otto, McClaren & Petrila (2001) N=471; all Florida juveniles found IST from 5/1997 – 8/2000 and referred to their “Attainment” program Did not include juveniles tried as adults nor juveniles charged with misdemeanor level offenses. Restoration time period: 5-6 months, average. Warren et al. (2009). n = 563; the first Virginia youth ordered to the Virginia Juvenile Competency Program – 1999 – 2006. “…many young juveniles can be remediated in their competence-related abilities if they are provided developmentally tailored educational processes provided in the context of a consistent relationship with trained restoration counselors who meet with youth multiple times a week…” “…when the youth suffers from mental retardation, at times combined with severe mental illness, the impact of the interventions is far more limited…” Warren, DuVal, Komarovskaya, Chauhan, Buffington-Vollum & Ryan, 2009

Breaking Down the Remedial (Attainment) Question
What are the specific functional deficits? Factual Understanding Rational Appreciation Assisting Counsel Legal Decision Making What are the sources of those deficits? A treatable mental disorder Weak cognitive skills (normal &/or pathological) Weak psychosocial skills (normal &/or pathological) What types of interventions are most likely to help each deficit? Psychiatric Interventions Psychotherapeutic interventions Educational Interventions How long is intervention expected to require for each deficit? How did youth respond to training efforts during the evaluation? How has youth responded to similar interventions in the past? What does empirical and clinical literature suggest? As with all good treatment plans, restoration services should use a “matching paradigm.” Interventions should be matched to the problem that is being targeted THE FINAL QUESTIONS AFTER THOSE ON THE SLIDE: How does the timeframe match with statutory requirements What is the likelihood of successful attainment of each deficit? What is the overall likelihood of successful attainment?

Attainment Opinions Opinions based on clinical judgment
Legal professionals must know Evaluators must remember Opinions only as good as the reasoning/rationale Multiple deficits may require multiple estimates Prediction can quickly become complex Evaluator opinions are best understood as reasonable, but limited, guidance “I don’t know” may not be a cop out. Legal determination Evaluator opinion Substantial Likelihood vs. Probability of Success Opinions are based on clinical judgment – very little research to guide the formation of opinions. Court needs to be aware of this. Evaluators need to remember this – Everyone must be open to the possibility that the opinion is wrong. Across my career I have been surprised in both directions. You will be too! Different response probabilities: “Whereas the youth’s Understanding deficits may be remediable through education, the Appreciation deficits seem unlikely to respond to attainment efforts.” Allows the court to use its own threshold of the importance of each deficit. Maybe the court sees an unattainable deficit as not critical! e.g./ Inability to testify – maybe the court is clear that testimony of the youth will not be needed. Remember the legal threshold for pursuing attainment in Utah is “substantial likelihood that the minor may attain competency in the foreseeable future” Court gets to decide what that threshold means. Courts are often reluctant to forfeit the opportunity to adjudicate without clear evidence that remediation is unsuccessful. Grisso (2013) noted that a finding that a youth is unremediable at the initial hearing is very rare nationally – usually will wait til first revie

Appropriate Attainment Setting
Detention Only if youth’s risk to community or potential to abscond warrants it Psychiatric Hospitalization Only if treatment of clinical issue typically warrants it Some Unique Scenarios Vast Majority of Youth Treatable in Community LRAS: Hospitalization is necessary only when the youth’s mental health status is that which would require hospitalization in other contexts. Detention is necessary only when the youth’s level of risk to the community or potential to abscond warrants it. Unique scenarios: Youth with ID whose home provides inadequate care and supervision may warrant placement in res facility for ID Youth with less severe mental health issues who may warrant day treatment or even residential Two available studies of juvenile attainment services in Florida (McGaha, 2001) and Virginia (Warren, 2009) found vast majority can be served on an outpatient basis. Virginia – 100% in community Florida – 50% only in community; 28% combo of res placement and community; 22% only in a res placement. 5% served at some point in detention. Tell story of situation in Washington – ALL restoration done on an inpatient basis Rip kids from home supports Place them in a setting with youth with severe psychiatric problems – contagion. Utilize highly expensive resources when not necessary.

Services When Attainment Not Successful
Civil Commitment Title 62A, Chapter 5, Services for People with Disabilities Title 62A, Chapter 15, Substance Abuse and Mental Health Act Child/Person/Family In Need of Supervision A minor who is a habitual truant from school Referral to Mental Health System A dilemma everywhere in the country Since JJS has become (for better or worse) a key provider and clearinghouse for MH services – what to do when the JJS loses jurisdiction due to IST? Some juveniles will still need services – residential placements (long or short-term), psychiatric hospitalization, connections to appropriate community providers. Nearly all states provide for civil commitment to be considered when IST – provides help for the most imminantly dangerous. Highly important – but doesn’t totally solve the problem. What other states ae doing: Allow case to be referred for CHINS/PINS/FINS. – keep youth under court jurisdiction in its child protection capacity. Typically, must meet typical standards. Some states have added Not Competent as part of the standard so ALL not competent juveniles are eligible. Other states have mechanisms for court to refer youth to mental health system and then let go of case: Favored in places that have highly functional child mental health system. MHS better at determining services that are needed than court. Keeping court in role of supervising services increases likelihood of youth ending up back in delinquency system

The “Development Dilemma”
What should be done with youth who need to “grow up” to become competent? Courts torn on how to handle Some courts allow dismissal of charges Some with prejudice Some without prejudice Some courts continue for extended period, allow the youth to grow up, and revisit after Unique complexity of these issues in Utah As Grisso has said, trying to develop Appreciation skills in a youth who has not yet developed abstraction skills is a bit like trying to get an infant to learn to walk before it has begun to sit up or crawl. UTAH: Developmental Immaturity is not recognized as a basis for IST. Still, some youth found IST will have Developmental Immaturity as a contributing factor. e.g., 12-yo with severe untreated ADHD It may be that if the ADHD is successfully treated, the youth will still function poorly re CST because of young age. BUT, since young age is not recognized, this youth is now legally CST. That is, now that the legally recognized predicate for IST has been resolved (the ADHD), there is no longer a legally recognized predicate. So – competent! Becomes much more complicated when we think about more stable, less treatable clinical concerns. 12-yo who has BIQ. Both are contributing. Really no way to tease out where, exactly, the impariments from BIQ end and the impairments from young age begin. Don’t see much option beyond considering “impairments due to a complex and difficult to specify interaction of young age and BIQ” The Utah statute has set up dilemmas like this – and it may take actual cases and possible even appellate cases to resolve.

Why Are The Experts Dueling?
1. Differences in Answers to Evaluation Questions. 2. Differences in Quality of Evaluation. 3. Different Interpretations of Legal Ambiguities Hopefully you now know how to consider the evaluation questions and can see where two evaluators may have gone in different directions with analysis. Of course, another possibility is that one or both of the evaluations was not done at high quality – will discuss some ways to assess. A third possibility that you should be aware of is that every juvenile CTP evaluation is finding a way to manage ambiguities in the legal issues.

Basic Contents of a Good Report and Questions to Ask to Assess This
Includes identifying and referral information States legal questions to be addressed Did the examiner correctly understand the relevant law? Did the examiner correctly translate these to psychological issues? Identifies sources relied upon Did the examiner fail to consider any relevant data? Contains Valid and Reliable Facts Did the examiner adequately corroborate the data? Did the examiner employ appropriate and valid techniques, tests, and instruments to obtain the data? !!!!!!!!!!!!!!!!!!!!!!!!CONSIDER SKIMMING!!!!!!!!!!!!!!!!!!!!!!!!! Corroboration -- part of the dispassionate approach that clinicians turned forensics don’t appreciate

Describes the capacities relevant to the Competency to Proceed Did the examiner describe psychological capacities relevant to Competency to Proceed? Creates a connection between these capacities and Competency to Proceed Did the examiner offer a logical connection between the psychological capacities and opinions about Competency to Proceed? !!!!!!!!!!!!!!!!!!!!!COSNIDER SKIMMING!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Offers concluding opinions Did the examiner offer an Ultimate Issue opinion? If so, is the underlying rationale for this opinion made evident? Is it consistent with the facts? Did the examiner avoid an Ultimate Issue opinion? If so, is the underlying rationale for forming an opinion made evident? Is it consistent with the facts? Offers limits of the opinions Did the examiner explain his/her uncertainties about the concluding opinions? Did the examiner offer alternative explanations for the findings and the reasons they were rejected? !!!!!!!!!!!!!!!!!!!!!!!!!!!CONSIDER SKIMMMING!!!!!!!!!!!!!!!!!!

Legal Ambiguity Are the same degree of competency abilities required in juvenile court as in criminal court? The “Competent Adult” standard The “Competent Adolescent” standard The “Fundamental Understanding & Communication” standard The “Age-Peer” standard The “Flexible Bar” standard Fundamental Und & Comm > Require only concrete knowledge: e.g., the ability to be aware that defense is advocate without necessarily having the ability to apply that in court Most US jurisdictions have yet to take a stand on this: A few have: Adult Defendant Standard: Minnesota – In the Matter of the Welfare of D.D.N. 1998 Adolescent Defendant Standard:– Washington, D.C: In the Matter of W.A.F., 1990; Ohio: Ohio v. Settles, 1998; Michigan: People v. Carey, Ohio references “juvenile norms”

Should There Be A “Lower Bar” or “Flexible Bar” In Juvenile Court?
Grisso (1997) has argued that juvenile respondents need not function as well as adult defendants. Bar should be lower: 1) The juvenile system maintains some level of parens patriae philosophy despite the retributive turn in juvenile justice – they are there to help the child. 2) Juvenile dispositions are typically less severe than criminal sentences. 3) Juvenile dispositions are more likely than adult sentences to include educational and clinical interventions 4) Using the same bar as adults could render the court unable to order services for children who need it. Possible arguments in other direction: 1) Juvenile sentences may be less severe in direct comparison, but are they less severe in long-term outcome? (e.g., might it be that detention with separation from family/community and exposing to antisocial peers is more damaging than adult incarceration, even if its for a shorter time? These are formative years!) 2) Is the quality of educational and clinical services delivered in JJS settings of high enough quality to make it of benefit to the youth? 3) The bar in adult court is already very low. e.g. State v. Ortiz (1985) said that the ability to choose among alternative legal strategies is NOT a requirement for competency! 4) BOTTOM LINE: Courts have equated juvenile dispositions to adult sentences in terms of deprivation of liberty. Shouldn’t they then have same ability to avoid it? No statutes or case law to help us know the system’s beliefs about this. Yes: Juvenile dispositions less severe than criminal court Juvenile dispositions include rehabilitative services Juvenile Justice Systems still promote rehabilitative ideals No: Severity of dispositions is a relative term Juvenile Court should not substitute for an adequate social welfare/mental health system Criminal court bar is already very low

Relevant Research Judges, attorneys, and clinicians appear to use a “Flexible Bar” approach (Jones, 2004) Given vignettes varying functioning and charges More likely found incompetent with more serious charges The type of bar impacts % of youth found incompetent (Viljoen, Zapf, & Roesch, 2007) Administered competency screening instrument to youth (% Incmptnt) 14-15 (% Incmptnt) 16-17 (% Incmptnt) Adult- Norm 88% 73% 45% Adolescent-Norm 20% 6% 2% Basic Und. & Cmnctn. 80% 59% 33%

Legal Ambiguity Should the predicate requirement include a broader array of mental disorders in juvenile court than criminal court? Anxiety and Mood disorders Less Severe Cognitive Impairment Developmental Disorders “Soft” Neuropsychological Deficits Utah: due to a mental disorder, intellectual disability, or related condition as defined, What is to be considered a mental disorder? With adults, courts typically see only major mental illness (psychosis) or MR as bases for IST But w/ children, a broader array of disorders can cause major dysfunction Less Severe Cognitive Impairment Borderline Intellectual Functioning Developmental Disorders Asperger’s Disorder “Soft” Neuropsychological Deficits Attention-Deficit Hyperactivity Disorder Receptive and Expressive language disorders Learning Disorders Clinically apparent: Research beginning to demonstrate this is true:

Childhood Disorders and Competence
Studies have shown that other disorders may predict poor competency functioning in juveniles (Baerger et al., 2003; Ficke et al., 2005; Kruh et al., 2006; McGaha et al., 2001; Redlich et al., 2003; Viljoen & Roesch, 2005; Viljoen et al., 2005; Warren et al., 2003) Substance Abuse Disorders Learning Disorders Behavior Disorders Attention-Deficit/Hyperactivity Disorder Borderline Intellectual Functioning Some clinical disorders with obvious links not yet studied Pervasive Developmental Disorders Communication Disorders Different studies with different samples, different methodologies > inconsistent results Research beginning to demonstrate this is true: McGaha, McClaren, Otto, & Petrila (2001): among 471 juveniles found incompetent in Florida between May 1997 and August 2000, 70% were diagnosed with mental illness. Of the 349 youth with an Axis I diagnosis, 57% were diagnosed with Conduct Disorder, 37% with ADHD 35% with Mood Disorders, 17% with Psychotic Disorders 15% with Adjustment Disorder. Viljoen & Roesch (2005) – ADHD may have particular relevance with Appreciation and ability to assist counsel

Legal Ambiguity Should developmental immaturity be considered in juvenile competency determinations? Younger children at higher risk to be not competent (Grisso, 1997): Knowing, learning, and applying legal information Appreciating attorneys are advocates, even if guilty Communicating in the face of authority pressures Taking the perspective of others as to adequately explain Reasoning and decision-making about legal issues Research supports age-based deficits Only a few states have settled this by statute or case law Only six states clearly allow developmental incompetence, whereas 17 have laws that do not include developmental immaturity as an acceptable basis of incompetence in juvenile courts. Grisso has brought this issue to the forefront, beginning in 1997 with a review of developmental literature that explained why we should expect younger children to be less competent Since then, research has clearly supported this – in fact, age may be the most well-supported predictor of juvenile AdjComp Age differences have been shown in at least 12 studies across different measures of AdjComp – CST; GCCT; Mac-CAT, FIT-R; clinicians opinions across different populations – community; detained; delinquent; examinees Why this matters 90s trend toward charging younger adolescents Functional illogic of requiring MI/MR only

“The MacArthur Study:” (Grisso, Steinberg, Woolard, Cauffman, Scott, Lexcen, Reppucci, & Schwartz, 2003) Compared 927 adolescents and 446 adults on: MacArthur Competence Assessment Tool – Criminal Adjudication (MacCAT-CA) MacArthur Judgment Evaluation (MacJen) MacCAT: Youth 15 and younger performed more poorly Youth 15 and younger more likely to demonstrate level of impairment consistent with adults found incompetent 1/3 of all youth were significantly impaired 1/5 of all youth were significantly impaired MacJen: Youth 15 and under more likely to make decisions based on compliance with authority, focus on short-term consequences, and other more superficial reasons. Largest study of juvenile competency to date: MacArthur Network: Mac-CAT: Standardized and normed assessment tool for CST Hopefully discussed in CST talk Mac-Jen: A research measure designed for this study 3 vignettes and structured interview questions with objective response categories: 1) Responding to a police interrogation 2) Disclosing information to defense attorney 3) Responding to a plea agreement offer Scored for: 1) Readiness to comply with authority 2) Effects of immaturity a. Ability to identify risks b. Ability to identify long-term vs. short-term risks c. Resistance to peer influence With Mac-CAT (read slide): Ages 11-13: 1/3 in incompetent range Ages 14-15: 1/5 in incompetent range With MacJen: (read slide) Specifically – younger adolescents had more difficulty identifying risks to their decisions, as well as long-term risks. No differences in resistance to peer influence! Similar findings in a study we conducted at CSTC

“The MacArthur Study” Overall Impairment in COMPETENCE TO PROCEED (i.e., one or more scales)
Y-Axis is the percentage in the sample who had the deficits Juveniles were more than three times as likely as adults to show significant deficits. Juveniles were more than 2x as likely as adults to show them. However, juvenile were just about as likely as adults. These findings held across race, ethnicity, gender, SES, and geographical region.

Legal Responses Judges are more likely to find youth incompetent when they (Cox et al., 2012) : Are younger Have features of psychosocial immaturity Few states make clear if immaturity-based incompetency is legally recognized (O’Donnell & Gross, 2012): 6 states allow 17 states do not allow This study investigated whether defendants’ ages and levels of psychosocial maturity would affect judges’ ratings of juveniles’ adjudicative competence in juvenile and criminal court. Three hundred forty two judges reviewed a forensic psychological report about a hypothetical defendant; only the defendant’s age (12–17) and maturity level (mature, immature) varied across reports. Results revealed a main effect of age, with older juveniles generally deemed more competent, and a main effect of maturity, with mature juveniles generally deemed more competent. No interaction was found. Results suggest that age and maturity play major roles in judicial determinations of juvenile competency.

Adolescent Development & Competence to Proceed
Adolescent Development is an area of struggle for juvenile justice. Seems odd – JJS designed specifically for youth. But adolescent development is SUCH a complex issue. For reasons I want to spend some time looking at – this is an issue that DOES NOT FIT WELL WITH LEGAL SYSTEM DESIRE FOR BLACK/WHITE DISTINCTIONS!

Adolescent Development: Basic Domains
Physical Development Neurological Development Emotional Development Cognitive Development Psychosocial Development Adolescent development occurs across a number of important domains. Most relevcant here are cognitive and psychosocial Closer look….

Adolescent Development: Cognitive Development
Verbal Fluency Information Processing Skills Knowledge Base/Experience Organization of Information Short- and Long-Term Memory Sustained Attentional Capacity Abstraction Skills Grasp the meaning of events Appreciate more complex concepts (e.g., a legal right) Apply learned information or past situations to new situations, Imagine consequences one has never encountered before (hypothetical situations) Reasoning and Problem Solving Clearly amongst the most important changes occurring in the transition from childhood to adulthood are cognitive abilities.

Adolescent Development: Psychosocial Development (Scott-Reppucci-Woolard & Steinberg-Cauffman Models) Autonomy/Conformity & Compliance Perceptions and Attitudes about Risk Temperance Perspective Taking Interpersonal Temporal Two groups of researchers have identified psychosocial factors that are particularly relevant to adolescent decision-making and, therefore, to many forensic evaluation contexts. The overlap between the models yields four main factors Theoretical sources of what is commonly called “poor teenage judgment” Autonomy/Conformity Compliance – Ability to think and behave in ways that are self-reliant, self-governing, independent & autonomous Ability to appropriately integrate the perspectives of others (parents; peers; authority figures) without being overly compliant or overly rejecting Perceptions of Risk – Process of assessing risk tends to be different among youth than adults Less aware of possible risks, underestimate likelihood of neg outcomes; underestimate impact of neg outcomes; place greater weight on positive outcomes (e.g., fun) and negative consequences of avoiding risk (e.g., peer rejection). Temparance - Ability to exercise restraint regarding emotional and behavioral impulses Immature temperance fosters impulsive decision-making Perspective Taking Interpersonal – Ability to take perspectives of other people When abilities immature, risk is higher for more self-serving decisions and ineffective communication about them Temporal– Refers to ability to appropriately consider both long-term and short-term implications of decisions and actions Youth tend to place greater weight on short-term consequences and discount long-term Yield less-adaptive decisions

Adolescent Development: General Features
Development is idiosyncratic Development is domain-specific Development is non-linear Development is progressive Development is interactional Now that we have a sense of the WHAT develops in adolescence – important to understand some general features of that development Idiosyncratic - Individual adolescents develop along different dimensions at different rates “Everyone grows at their own rate” Even in biological issues – significant differences in the onset and progression of puberty across children Domain-Specific - Typical development in one domain does not necessarily translate to normal development in another Youth vary significantly in the rates and timing at which they develop various characteristics and abilities. Just because a youth is physically mature, does not mean that they are cognitively mature or emotionally mature. Yet there are well-documented cases in which courts used physical development or social development as an indicant of all types of development Non-Linear – Development within any domain is a gradual, non-linear process, with stops and starts, spurts and delays, and even regressions Each domain is highly sensitive to environmental influences – e.g., death of loved one can cause social regression Development in a given domain is sometimes context-specific A child who is socially mature at home, but childish at school. Progressive – Development at one point is influenced by the quality of development at earlier points. A socially immature child is rejected by his maturing age-peers, which causes him to associate with younger children, which further impairs his social development. Or a child whose cognitive development is notable for verbal processing deficits – he can’t keep up with verbally presented information about how to attack academic problems in school, which impairs his general problem solving development. Interactional – Development in one domain can impact development in other domains They are in constant interaction with one another EXAMPLE: Interaction Between Biological & Social Development Boys with Early Puberty Greater: Confidence; Popularity; High Self-esteem Greater Risk: Academic Failure; Drugs; Sex; Illegal Behavior Take home messages: Development is complex – simple conclusions are often inaccurate conclusions. 67

Adolescent Development The Term “Immaturity”
Refers to incomplete or delayed development Incomplete Development: “Immature compared to adults” Delayed Development: “Immature compared to age-peers” Describes specific abilities or characteristics, not an overall condition of the youth Depends on actual functioning, not simply on age Can be expressed in degrees 1 2 3 4 – you hear this all the time – he’s socially immature. How immature? How impairing is it?

Development & Psychopathology
Diagnosis is different with youth Unique disorders Unique presentations of common disorders Diagnostic clarity is rarer Setting-specific problems Symptom overlap across disorders High comorbidity rates Interactions with normal development Developmental Psychopathology (Dante Cicchetti) Symptoms = Exaggerations of normal development Symptoms interact with development in complex ways Psychopathology is dimensional So far, we have been discussing the complexity of normal adolescent development. Of course, many of the youth passing through the JS have issues that go beyond interference in their normal development. Add in the issue of psychopathology and things get more complicated very quickly! DIAGNOSTICS Some Disorders are more commonly diagnosed among youth than adults (e.g., PDD; FAS; Language Disorders) Other Disorders have unique presentations in youth (e.g., prevalence of irritability in depression – arguments about Bipolar) Diagnostic clarity is often limited: True symptom overlap among disorders (anger and irritability in behavior and affective disorders; distractibility in attentional and depressive disorders) Much higher rate of comorbiidity of disorders among youth than adults – problems tend to cluster – e.g., PTSD and Depression – long Dx lists Interactions between symptoms of disorders and normal development Development can impact: the characteristics of disorders most appropriate label and conceptualization of problems – tantrums at 9 understood differently that tantrums at 15 impact Developmental Psychopathology: Symptoms of disorders result from adaptational compromises or failures in normal development Once they develop, these symptoms continue to interact with patterns of normal development – so stability and trajectory of problems not always clear Therefore, pathology is better understood as lying on a dimension between “normal” and “pathological” – no clear lines Classification systems can suggest a clear distinction between pathology and normality; typically a dimensional issue DSM and the “Medical Model”

Development-Based Threats to Competence to Proceed
Understanding Less exposure than adults Challenged by abstract concepts (e.g., rights) Appreciation Superficial understanding yields erroneous applications Demands beyond their own experience (e.g., role of defense) Assisting Counsel Information processing and organization weaknesses Social skill weaknesses Attentional weaknesses Legal Decision Making Psychosocial deficits yield poor decisions UNDERSTANDING Abstract Concepts: Problems with Legal Rights as an absolute and irrevocable protective legal entitlements. Youth may say, “I have the right to remain silent.” But if you ask them, can you get in trouble if you stay silent, they may say yes. Rational Appreciation - Accurate “beliefs” about what is factually understood about court Is able to rationally apply knowledge in one’s actual case-related situations Traditional threat: Delusion – “I know defense attorney helps me, but my defense attorney is an alien. Juveniles: distorted beliefs rooted in concrete thinking, incomplete understanding of the process yield overgeneralizations, undergenralizations, confusion, immature presumptions, and frank errors in understanding – “I know defense attorney helps me, but I know my PO much better.” May understand allowed to plead not guilty and understand that term – but may refuse to plead guilty even when the case against him is weak “because its lying and you get in trouble for lying” Difficulty with role of defense counsel > can’t understand why an adult stranger would advocate for them against other adults, why an adult would put aside their own views to advocate for a larger purpose, or why their own authority eclipses that of an adult. Many youth assume there are some situations in which defense would abandon assiting them and turn against them. Leads ti problems in Assisting. Next… Assisting Counsel - Ability to participate with and meaningfully aid the defense attorney in developing and presenting the defense e.g., Is able to provide a coherent account of the facts of the alleged crime Traditional threat: Disorganized, irrational thinking due to psychosis Juveniles: Immature development of cognitive skills to process and organize information and language skills to express information Difficulty taking the perspective of others – difficulty developing rapport Simple difficulty paying attention when consulting with counsel Legal Decision Making: Ability to consider legal alternatives and reach adequately contemplated legal choices Is able to rationally decide about accepting a plea agreement offer Traditional threat: Psychotic Reasoning – “I’ll take the case to trial so everyone can see I am J.C.” Juveniles – “I’ll take the case to trial because that’s what my mom told me to do.” “I’ll plead guilty because I want to go home.” Decisions may be based on immature reasons: Placing short-term gain over larger long-term gain. Making decisions based on wishes of parents; or expectations of peers Making decisions based on unrealistic assessment of risk – being found guilty; how bad detention will be, etc.

The Role of Legal Professionals in Enhancing Juvenile Competency
We tend to think about ways we can adapt the child to be better equipped to handle the legal process. Not enough attention is given to how the legal process can be adapted to facilitate the youth’s ability to navigate it!

What can legal professionals do?
Obtain training Youth Development Unique Challenges of Juvenile Defendants Developmentally-sensitive Communication In attorney consultations: Provide instruction Create a trusting relationship in which the youth is comfortable asking questions or noting confusion Enhance client involvement in trial preparation Demonstrate loyalty to client Engage in role playing CONSULTATIONS: Model Rules of Professional Conduct – Direct lawyers to “explain…matter[s] to the extent necessary to permit the client to make informed decisions regarding the representation.” Much of what is needed is better relationship building. Youth have no model for interacting with an adult in the manner expected within an attorney-client relationship. Many of the youth who become JJS involved have particularly weak relationship development and manintenance skills. Of course, this takes time which rubs up against modern caseloads. American Bar Association Juvenile Justice Center has been making recommendations for years about the problems of caseloads Mostly gone unattended to – or problem has worsened. Enhance involvement – youth learn best when they are active in the context they are learning about – involve them so they learn the mechanics of the process and the nature of the decisions they will need to make. Demonstrate loyalty – fight for youth’s confidentiality; take youth’s perspective over that offered by parents. Of course – attorneys cannot fully compensate for an incompetent youth – probably helps most with borderline cases.

In the courtroom: Slow things down Use simplified language Present testimony and arguments in simplified ways Include procedural steps that can help a participant structure and track what is happening Assess youth’s understanding on ongoing basis Provide summaries of what is occurring Have youth paraphrase legal concepts and processes Allow more time for decision-making in court Time to re-explain options and consequences COURTROOM: Interestingly, it has been pointed out that some criminal courts may be more conducive to youth participation than juvenile! This is because criminal court professionals often must accommodate the layman perspective of jurors. This is not an issue in juv court. Also, criminal courts must adhere to strict procedural trappings – opening and closing statements, swearing in witnesses one at a time, giving of testimony at set points in the process. Juvenile courts more likely to function with informality My experience in Washington: Against Ron Roesch – judge decided she could accommodate the youth’s deficits. Frequent breaks. Allow youth to raise hand and say she is feeling frustrated and needs a break Direct attorney to periodically offer youth summary of what was happening.

Resources: Buss, E. (1996). “You’re my what?” The problem of children’s misperceptions of their lawyer’s roles Fordham Law Review, 64, 1699. Buss, E. (2000). The role of lawyers in promoting juveniles’ competence as defendants. In T. Grisso & R.G. Schwartz (Eds.), Youth on trial: A developmental perspective on juvenile justice (pp ) Chicago: University of Chicago Press. Walker, A.G. (1994). Handbook on questioning children: A lingusitic perspective. Washington, DC: American Bar Association. COURTROOM: Interestingly, it has been pointed out that some criminal courts may be more conducive to youth participation than juvenile! This is because criminal court professionals often must accommodate the layman perspective of jurors. This is not an issue in juv court. Also, criminal courts must adhere to strict procedural trappings – opening and closing statements, swearing in witnesses one at a time, giving of testimony at set points in the process. Juvenile courts more likely to function with informality My experience in Washington: Against Ron Roesch – judge decided she could accommodate the youth’s deficits. Frequent breaks. Allow youth to raise hand and say she is feeling frustrated and needs a break Direct attorney to periodically offer youth summary of what was happening.

Forensic & Clinical Psychology
Contact Information Ivan Kruh, PhD Forensic & Clinical Psychology P.O. Box 1754 Ossining, NY 10562 PH: (845)

Legal Ambiguity In what ways should ‘interested adults’ play a role in the competency determination? Parents Are they always “interested adults?” Specialized Guardians ad litem Can provide emotional support, assist in communications with attorney, help ensure adequate legal representation. Can’t offer legal advice or make legal decisions Adults serve as proxy decision-makers for youths in a number of legal contexts (e.g., parenting decisions) Should adults serve such a role with juvenile defendants? Not aware of any statutes or case law fully on point: Interestingly, in WA a statute in our JJA requires a narrow application: Only for youth under age 12 Only for waiver of legal rights Parents MUST make waivers for children – keep in mind entering a guilty plea is a waiver! No attempt seen to apply this to AdjComp Jen Woolard doing resarch in this area

Relevant Research Survey of parent/child dyads during adjudication (Woolard, 2006) Many misconceptions: Believe defense can talk openly with parents about case 50% of parents 35% of youth Believe parent makes final decisions about the case 75% of parents Most younger juveniles; fewer older juveniles Observations of adult support persons during police interrogations (Medford, Gudjonsson & Pearse, 2003) : Passively observe Are unsupportive (incriminate the youth; challenge their account) There were many misconceptions about the role of parents in juvenile adjudications among these units. For example, many youth (35%) and parents (50%) believed that defense attorneys can communicate openly with parents about the youth’s case. Over 75% of parents believed that they play the role of final arbiter in their children’s cases when they disagree with their child. Younger youth tended to have similar ideas, but older youth increasingly believed attorneys are supposed to rely on adolescent defendants’ preferences.

Juvenile Competency Training Conference October 18, 2013

Similar presentations

Presentation on theme: "Juvenile Competency Training Conference October 18, 2013"— Presentation transcript:

Similar presentations

About project

Feedback

Log in

Auth with social network:

Juvenile Competency Training Conference October 18, 2013

Similar presentations

Presentation on theme: "Juvenile Competency Training Conference October 18, 2013"— Presentation transcript:

Similar presentations

About project

Feedback