Clinical relationships with forensic clients: A three-dimensional model

This paper considers the clinical relationship with clients in mandatory treatment. In several countries, clients found guilty of committing a sexual or violent offense (often resulting in a jail sentence) are obliged by law to meet a psychotherapist. This mandatory treatment occurs both during the time in jail and in the community. The clinical relationship with these clients is a complex process involving the therapist, the client, and the courts. In this paper we describe some common factors that can facilitate or hinder the therapist's work in this situation.     

Coercive uses of mandatory reporting in therapeutic relationships

Mandatory reporting legislation was enacted with little consideration of its consequences for ongoing therapeutic relationships. One consequence is the unanticipated and coercive uses of the law in mental health settings. Thirty therapists and 25 child protective service workers were interviewed about their experiences with mandatory reporting in therapy relationships. The interviews revealed unanticipated as well as coercive uses of mandatory reporting in therapeutic relationships, including prompting crisis in family systems to promote change, and using reporting or threats of it to enforce attendance and engagement in therapy. Therapists'd anger and view of reporting as a form of power or tool for social control also related to coercive uses of mandatory reporting. The special case of coercion in mandated cases resulting from mandatory reporting legislation is discussed as well.     

Power in relationships of women with depression

To identify marital power difficulties specifically associated with depression, twenty couples in which the female partner was depressed were compared on a range of interpersonal power variables with twenty healthy control couples and also with twenty couples in which the female partner had a disorder other than depression (specifically panic disorder with agoraphobia (PDA)). Couples in the depressed group had two features that distinguished them from couples in both the PDA and control groups and which were independent of relationship dissatisfaction. In the depressed group, both partners reported more physical assault in the year prior to the study and depressed women were more dissatisfied with their control of surplus spending money. Couples in the depressed group had a series of features that distinguished them from couples in both the PDA and control groups but which were due in part to relationship dissatisfaction. Depressed women were less committed to their relationships. Both partners in depressed couples reported more demand–withdraw transactions and less mutual constructive communication within their relationships. Depressed women reported more dissatisfaction with decision-making and greater dissatisfaction in childcare task distribution.     

Therapeutic techniques vs therapeutic relationships in child behavior therapy

The parents of 56 children who had received behavior therapy rated a number of variables, including the degree to which they viewed the therapeutic relationship versus the specific techniques used in treatment as important, the extent to which the child improved in therapy, and the child's present functioning. Therapists also provided ratings of clinical improvement. Even though parents gave the highest ratings for the importance of the relationship in therapy, the correlation between technique and clinical outcome was statistically significant while the correlations between the relationship and outcome was not. These statistical associations also held when therapists rated improvement. Also, therapists saw greater improvement in children than did the parents. Over-all, the results support the view that the relationship and techniques are interwoven and are both perceived as important factors in treatment.     

The relationships between child and forensic interviewer behaviours and individual differences in interviews about a medical examination

This study examined the interviewing process between professional forensic interviewers and their “mock” child witness. Fifty-eight preschool children participated in a medical examination, and were later interviewed by an experienced forensic interviewer (n = 15) about this event. Interviews were coded with mutually exclusive and exhaustive coding schemes that captured interviewers and child behaviours in a temporally organized manner. To evaluate the relationship between interviewers' and children's individual differences measured prior to the interview and the interview outcomes (i.e., questions asked, child interview behaviour), all child participants were tested with relevant cognitive and behavioural measures, and all adult interviewers were tested with personality measures. Results showed that leading questions were more often followed by simple assents and denial than expected. Interviewers did not remain consistent from question to subsequent question, but children's response type was predictable from response to subsequent response. Children's and adults' individual differences measured prior to the interview predicted some of the adults' interviewing behaviours and some of children's own response behaviours during the interview. Mediation modelling evinced that more self-controlled interviewers posed more recommended questions and elicited more assents with details from the children. We discuss the results in relation to established views of recommended interview practice and to theories of suggestibility.     

Power and affiliation motivation, stress, and abuse in intimate relationships

The associations among n Power, n Affiliation, inhibition, stressful life events, and infliction and receipt of psychological and physical abuse in intimate relationships were investigated in a sample of 48 male and 107 female college undergraduates. Results indicated that life events that were perceived as being negative were associated with both the infliction and the receipt of abuse for women but not for men. Individual personality characteristics determined the tactics used in resolving intimate interpersonal conflicts. High n Power was significantly associated with the infliction of physical abuse on their partners by men, but not by women. For women, n Affiliation and activity inhibition moderated the effect that stress has on the infliction of abuse. Highly stressed women with high n Affiliation and low activity inhibition were the most likely to inflict abuse. Length and status of relationship were also found to be related to abuse, with abuse occurring most often between more committed couples. Sex differences were found for the relation between infliction and receipt of abuse. That is, receipt of abuse was highly correlated with infliction of abuse for women but not for men, suggesting that when women strike out they are struck in return.     

Self-directed and other-directed aggressive behavior in a forensic sample.

Fifty habitually aggressive men were assessed for self-directed aggressive behavior (SDAB) and other-directed aggressive behavior (QDAB). Subjects displaying SDAB were compared with subjects exhibiting exclusively ODAB. The former were found to engage in more frequent acts of verbal aggression, physical aggression against objects, and physical aggression against others, as well as in more severe acts of verbal aggression and physical aggression against others. They were also more likely to receive diagnoses of mental retardation, organic personality disorder, intermittent explosive disorder, or autism. Findings are consistent with the presence of a neurologically based behavioral dyscontrol in the SDAB subjects.     

Ethical issues in personality assessment in forensic psychology.

In this article we address several ethical issues of concern for psychologists who are engaged in personality assessment in forensic settings such as for courts or attorneys. The ethical issues reviewed include the role of the psychologist as an expert witness, matters of competence, informed consent, confidentiality, multiple relationships, and special issues related to billing. Emphasis is placed on how psychologists can provide useful information to the courts in a manner consistent with the American Psychological Association's Ethical Principles of Psychologists and Code of Conduct, the Committee on Ethical Guidelines for Forensic Psychologist's Specialty Guidelines for Forensic Psychologists, and the APA's Guidelines for Child Custody Evaluations in Divorce Proceedings. The practical recommendations made in this article are consistent with the APA's Ethical Principles of Psychologists and Code of Conduct.     

Values in forensic and correctional psychology

Although the practice of forensic and correctional psychology has been understood in relation to certain sets of values that have been articulated in codes of ethical practice or organisational mission statements, there has been little consideration of how the values of offenders can inform the rehabilitative process. In this paper the criminogenic nature of values is discussed and how these might be addressed in an intervention. It is concluded that an exploration of values is not only a necessary condition for successful rehabilitation, but also essential if ethical problems in working with offenders are to be avoided.     

Training and credentialing in forensic psychiatry

The increase in legal regulation of psychiatric practice, malpractice litigation, number of mentally ill in correctional settings and concerns about the sometimes embarrassing quality of expert witness testimony has led to an heightened focus on training and credentialing of psychiatrists who work in these areas. The past 20 years has witnessed a growth of professional organizations, journals, accredited training programs and board certification. The paper outlines the nature of these programs and some of the dilemmas for the profession in establishing formal subspecialties.     

Treatment and psychopathy in forensic settings

People commonly question whether highly psychopathic offenders are treatable. Little scientific research has addressed this question despite key developments in the last 20 years in two relevant areas: reliable measurement of psychopathy, and effective treatments for reducing criminal and antisocial behavior in offenders. One obstacle to progress is confusion about defining psychopathy; a necessary preliminary step to advancing intervention. After outlining the principal definitional issues, we review past and recent research on psychopathy and treatment, concluding that a handful of newer, well-designed studies suggest grounds for optimism about psychopathy and treatability. Although psychopathy characteristics—along with other indices of criminal risk—signal responsivity challenges, well-conceived programs for higher risk offenders can reduce recidivism in highly psychopathic offenders and appear to do so by reducing dynamic risk factors. There are no clear indications yet of whether PCL-psychopathic offenders differ from other high-risk offenders in their ability to respond to such treatments. The questions of whether psychopathy itself responds to treatment, and if so, what forms such treatment might take have not yet been addressed. We conclude by suggesting that advances will come from the use of more divergent measures of psychopathy, and in particular, dynamic measures of psychopathy traits that will allow us to document whether change is occurring.     

Power and gender influences on responsibility attributions: the case of disagreements in relationships

In a sample of 156 college students (74 men and 82 women), the authors examined the influences of power status and gender on responsibility attributions and resolution choices during disagreements in personal relationships. The participants read vignettes in which relationship partners disagreed; then the participants placed themselves in the situations depicted and reported their perceived responsibility and resolution choices. The participants were randomly assigned to 1 of 2 power-status conditions (you have/your partner has greater power in the situation). Power status was based on resource power (i.e., a monetary inheritance) or on perceived power (i.e., financial knowledge). The authors tested 2 alternative power-status hypotheses (justified benefits/rights and ability/accountability) and 1 gender hypothesis. The results supported both power-status hypotheses. In addition, the men's and the women's responsibility attributions and resolution choices (i.e., adhering to their own wishes or deferring to their partner's wishes) revealed differential dependence on the type of power held by the person with greater situational power. The authors suggest issues further research concerning how situational differences in socially based expectations (e.g., power status and gender) may affect conflicts within relationships.     

Training and credentialing in forensic psychology

The number of training programs in forensic psychology has grown considerably in the past 15 years. Numerous opportunities exist for individuals interested in pursuing careers in the forensic area. Interdisciplinary training in several forms is discussed: J.D. -Ph.D. Programs, specialist Ph.D. Programs, predoctoral internships, and postdoctoral fellowships. Continuing professional education, credentialing, and board certification in forensic psychology are also addressed. Despite the face validity of these various types of training and credentialing, little is known about their relative utilities.