Evaluations of capacity to waive Miranda rights: a survey of practitioners' use of the Grisso instruments

Minimal information is available regarding the frequency with which practitioners conduct evaluations of capacity to waive Miranda rights or what approaches they use in doing so. Grisso's Instruments for Assessing Understanding and Appreciation of Miranda Rights are the only published instruments designed specifically to assist practitioners in these evaluations. The instruments have been criticized for limited normative data in the test manual and the minimal guidance offered for interpreting results. A survey of practitioners was conducted to determine the nature and frequency of the use of these instruments. Of 401 respondents, 91% were engaged in forensic practice, and 26% had conducted evaluations of one's capacity to waive Miranda rights. Of those conducting Miranda evaluations, 44% had used Grisso's Miranda instruments. Practitioners' responses regarding the ways the instruments are used are reported. Suggestions are offered for informed practice, and related strengths and weaknesses of the instruments are identified.     

Focus groups in psychological assessment: enhancing content validity by consulting members of the target population

A review of articles in Psychological Assessment reveals that many researchers develop instruments without the benefit of consultation with members of the target population. To the extent that researchers do consult the target population, most fail to bring consultation in early enough to inform the identification and specification of key constructs. Moreover, this consultation typically takes the form of one-to-one interviews. The authors' goal in this article was to elaborate on the importance of population consultation as part of content validation and to critically evaluate the potential of one method of consultation, focus groups, to inform multiple stages of instrument development. The authors suggest that this method holds promise for enhancing the content validity of instruments and, ultimately, the validity of research findings.     

A Survey of Behavior Analysis and Behavioral Consultation Courses in School Psychology: Implications for Training School Psychologists

All 216 doctoral and specialist level school psychology training programs were mailed a seven question survey to determine how much behavioral consultation and behavior analysis course work school psychology students are offered. One hundred and twenty-eight surveys were returned, yielding a return rate of 58.26%. The results indicated that almost all programs offer didactic courses in consultation (98.79%) and behavior analysis/behavior modification (91.52%). The percentage of practicum devoted to behavioral consultation and behavior analysis/modification was considerably less (about 25% for each) than other subject areas. The results are discussed within the context of training needed to meet the needs of practitioners in the areas of behavioral consultation and behavior analysis/behavior modification.     

A Balancing Act—Telehealth Cancer Genetics and Practitioners’ Experiences of a Triadic Consultation

Telehealth is increasingly used for outreach service in cancer genetic counseling; however what occurs during the consultation and the roles practitioners adopt is largely unknown. Fifteen practitioners participated in semi-structured interviews that explored their roles within telehealth, compared to face-to-face consultations, and the relationship between practitioners during telehealth. As they were not physically present with the patient, most participants felt that telehealth altered the genetic clinician’s role to one of a ‘visiting specialist’. Genetic counselors described undertaking multiple roles during the telehealth process. Two models of interaction were observed. The medical model reduced the interaction to a dyadic consultation by having the genetic counselor off-screen and included minimal clinician meetings and supervision. The triadic co-facilitation model incorporated a high level of information exchange, counselor autonomy and included the counselor onscreen. The co-facilitation model offers a useful framework for telehealth genetic counselling, offering complementary roles between practitioners and efficient service delivery.     

The question of method in ethics consultation

This paper offers an exposition of what the question of method in ethics consultation involves under two conditions: when ethics consultation is regarded as a practice and when the question of method is treated systematically. It discusses the concept of the practice and the importance of rules in constituting the actions, cognition, and perceptions of practitioners. The main body of the paper focuses on three elements of the question of method: canon, discipline, and history, which are treated heuristically to outline what the question of method in ethics consultation fully involves.     

Discriminating Against “Organ Takers”

This paper offers an exposition of what the question of method in ethics consultation involves under two conditions: when ethics consultation is regarded as a practice and when the question of method is treated systematically. It discusses the concept of the practice and the importance of rules in constituting the actions, cognition, and perceptions of practitioners. The main body of the paper focuses on three elements of the question of method: canon, discipline, and history, which are treated heuristically to outline what the question of method in ethics consultation fully involves.     

Implementing scientific practices through case studies: Examples using home-school interventions and consultation

Integrating scientific methods into school psychological practice is an essential tenet of effective service. In this article, we present two related examples that demonstrate methods by which to conduct high-quality intervention and consultation case studies with integrity. The present case studies utilized home note and consultation-based interventions to improve task completion and accuracy in mathematics for primary grade students who had demonstrated performance difficulties despite adequate intellectual ability and academic skills. Two sets of case studies were conducted. One involved the use of a home-school note implemented by parents and teachers in conjunction with a self-instruction manual. The second set of case studies used the home note and manual instituted in the context of behavioral consultation with parents and teachers. Both interventions (home-note-only and home note with consultation) increased math completion and accuracy in underachievers. Levels of performance were stable and differences between baseline and treatment conditions were statistically significant for consultation students only. Treatment integrity, maintenance of treatment gains, and consumer acceptability were also stronger in the consultation case studies. The implications for practitioners and future research are explored.     

Why men with hair loss go to the doctor

Consultations, motives, experience, and attitudes were explored in 201 men with alopecia androgenetica who had two years before shown interest in hair treatment using minoxidil. During the past two years, one-third consulted a professional on account of hair loss. General practitioners were consulted by 60% and other professionals by about 75%. The main motive for the consultation was hair treatment, which was offered to half of the consulting subjects. Medical professionals were generally considered to be more suitable than other professionals for consultation on minoxidil treatment. The perceived chance of the treatment being successful and the amount of hair problems experienced seemed more important factors for consulting than the views on the suitability of a professional or the extent of baldness. There were indications that subjects who consulted both general practitioners and other professionals had also more general problems.     

Cultivating ethics consultation: commentary on "The development of a clinical ethics consultation service in a community hospital

Conclusion: Simpson's article [in this issue, p. 124-130] provides us with needed data about the development and utilization of an ethics consultation service in a community hospital. It makes clear, however, how much further we have to go in developing guiding standards for practitioners and institutions. We need to learn much more about the effectiveness of ethics consultation in meeting well-defined goals and producing desired processes and outcomes before standards for credentials and accountability have a sound empirical basis.     

Psychoanalytic thinking in primary care: The Tavistock Psychotherapy Consultation model

This paper describes the conceptual underpinnings, structure and operations of a novel service, the City and Hackney Primary Care Psychotherapy Consultation Service – a service set up partly with the aim of addressing the needs of patients who present with ‘medically unexplained symptoms’. As part of the Tavistock and Portman NHS Trust, this service moves its clinical base, staff members and daily work, as well as the foundations of psychoanalytic thinking that define the Trust's work, into the heart of a community, and provides psychoanalytically informed clinical practice and consultation to patients and general practitioners in the City and Hackney, one of London's (and the UK's) most deprived and ethnically diverse boroughs. The authors describe the psychoanalytical underpinnings of the model, the design and structure of the service, patient demographics and preliminary outcome data, as well as an example of consultation work with general practitioners. The authors propose that psychoanalytic applications have a place in primary care and that psychoanalytic thinking can help general practitioners and patients alike, even when the clinical interventions offered are not solely based on psychoanalytic technique or therapeutic approaches. The paper concludes with thoughts about the model, its origins and its future.     

Sentence completion tests: a review of the literature and results of a survey of members of the Society for Personality Assessment

Test usage surveys consistently find that sentence completion tests (SCTs) are among the most popular personality assessment instruments used by practitioners. What is not noted is which SCTs practitioners are using, why these tests are so popular, and whether practitioners are using formal scoring. We surveyed a random selection of 100 members of the Society for Personality Assessment. With a 60% return rate on a single mailing, we found that most psychologists who use incomplete sentence tests use the Rotter (1951) Incomplete Sentences Blank with children (18%), adolescents (32%), and adults (47%). Most practitioners said they do not read stems aloud and record answers themselves, and even fewer said they use formal scoring. The most common reasons for using an SCT are (a) to use it as part of an assessment battery (41 endorsements), (b) to determine personality structure (18 endorsements), and (c) to elicit quotable quotes (17 endorsements). Implications for practitioners and training suggestions for academicians who prepare future psychologists are noted.     

Single session email consultation for parents: an evaluation of its effect on empowerment

This study evaluated the effect of single session email consultation (SSEC) on empowerment of parents. Practitioners in a control group (n = 19) received no training and practitioners in an experimental group (n = 21) were trained to use empowerment-oriented techniques in online consultation. Parental empowerment was measured (n = 96) through a questionnaire based on the Family Empowerment Scale before and after receiving advice from a trained or a non-trained practitioner. Parents showed a significant increase in the subscale of self-confidence (Cohen's d = 0.33). Study findings lend support to the feasibility of SSEC as a brief intervention to improve self-confidence of parents. A training for practitioners did not influence the outcomes.     

A Video Life-world Approach to Consultation Practice: The Relevance of a Socio-Phenomenological Approach

This article discusses the [development and] use of a video life-world schema to explore alternative orientations to the shared health consultation. It is anticipated that this schema can be used by practitioners and consumers alike to understand the dynamics of videoed health consultations, the role of the participants within it and the potential to consciously alter the outcome by altering behaviour during the process of interaction. The study examines health consultation participation and develops an interpretative method of analysis that includes image elicitation (via videos), phenomenology (to identify the components of the analytic framework), narrative (to depict the stories of interactions) and a reflexive mode (to develop shared meaning through a conceptual framework for analysis). The analytic framework is derived from a life-world conception of human mutual shared interaction which is presented here as a novel approach to understanding patient-centred care. The video materials used in this study were derived from consultations in a Walk-in Centre (WiC) in East London. The conceptual framework produced through the process of video analysis is comprised of different combinations of movement, knowledge and emotional conversations that are used to classify objective or engaged WiC health care interactions. The videoed interactions organise along an active or passive, facilitative or directive typical situation continuum illustrating different kinds of textual approaches to practice that are in tension or harmony. The schema demonstrates how practitioners and consumers interact to produce these outcomes and indicates the potential for both consumers and practitioners to be educated to develop practice dynamics that support patient-centred care and impact on health outcomes.     

Teleconferencing model for forensic consultation, court testimony, and continuing education

A medical center-based forensic clinic that provides the necessary comprehensive consultation, continuing education, court testimony, and clinical services through an applied model of teleconferencing applications is addressed. Telemedicine technology and services have gained the attention of both legal and clinical practitioners, examining trends and models of health care for underserved populations, and identifying where consultation with a team of professionals may benefit service providers in rural communities. The contribution offered herein provides an understanding of the history of the development of the clinic, a theoretical model that has been applied to a clinical forensic program that employs telepsychiatry services, and the ethical and malpractice liability issues confronted in using teleconferencing services. This model is examined through a child and adolescent forensic evaluation clinic. The goals of this model are offered, as are a number of applications within the broad spectrum of services utilizing telemedicine. Finally, changing patterns are addressed in clinically based health-care delivery for criminal justice, social services, and forensic mental health.     

Collaborative Consultation and Program Evaluation

The article describes how consultants, working with school personnel, can use an action research approach to implement a program of value‐driven needs assessment. The presentation is focused on a collaborative consultation model of program evaluation. A case example illustrates the collaborative development of instruments for assessing the effectiveness of a school guidance and counseling program.     

Assessing Adolescent and Adult Attachment: A Review of Current Self-Report Measures

Increased interest in attachment theory among counseling researchers and practitioners has led to the development of several measures of attachment-related constructs. Following a brief overview of the theoretical foundations of attachment theory as conceptualized by Ainsworth (1989) and Bowlby (1988), the authors of this article review four self-report measures of adolescent and adult attachment. Many considerations for the selection and use of these instruments in future counseling research and assessment are discussed.     

Burnout in School Psychology

This study examined levels of bumout and relationships between burnout and selected personality characteristics and role expectations in a sample of school psychologists employed as practitioners in school settings. The results indicated that personality variables related significantly to burnout over and above demographic and work condition variables. Higher levels of burnout were associated with tendencies to be high in competitiveness and egocentricity and low in conscientiousness and extraversion. Professionals who reported higher levels of burnout indicated greater dissatisfaction with their professional roles, preferring to devote more time to consultation and counseling activities. The implications for research and practice are discussed.     

Video tape recording: A provocative tool for the school psychologist

The video-tape recorder (VTR) is one of the newest and most versatile instruments available for collection of assessment and research data. It has been used by a psychological consultant to the schools (a) to collect observational data in order to complete referral information and formal test data, (b) to facilitate multiple consultation, and (c) to provide models for test administration for teachers or paraprofessionals. Innovative and imaginative use of the VTR is encouraged.     

Validating Cultureand Gender-Specific Constructs

SUMMARY

Despite on-going calls for developing cultural competency among mental health practitioners, few assessment instruments consider cultural variation in psychological constructs. To meet the challenge of developing measures for minority and international students, it is necessary to account for the influence culture may have on the latent constructs that form a given instrument. What complicates matters further is that individual factors (e.g., gender) within a culture necessitate additional refinement of factor structures on which such instruments are based. The current work endeavors to address these concerns by demonstrating a mixed-methods approach utilized to assess construct validation within a specific culture; and in turn develop culturally-specific instruments. Qualitative methods were used to inform the development of a structured self-report by gaining detailed knowledge of the target culture and creating items grounded in interview and observational data. Factor analysis techniques and triangulation with qualitative analyses validated these findings. Previous work (Sarkar, 2003) suggested a number of gender-specific perceptions of mental health constructs within the target culture and these were investigated using additional mixed-method analyses. This article demonstrates an emerging mixed-method technique for developing culturally sound assessment tools, offers guidance on how to incorporate the overall approach in assessment, and provides a basis for thinking critically about the use of existing instruments when working with diverse populations.