User:Ree73/Forensic Psychology

'''note from Tess: Rose, can you fix the citations you added to the live page that refer to the Melton book? Melton book was already cited on that page (citation # 4 should be cited, not add #45 - fix please thank you! - also, I made some wording and formatting changes.  Notably, I also edited the unstructured assessment section that claimed that this type of evaluation is very common.  There is also this page -''' Risk assessment that probably should be referenced (and/or maybe some of the content that was added to the forensic psych page should be integrated there instead).

Risk assessment
Risk assessment evaluates how dangerous an individual is, or could be, and the risk of them re-offending, also referred to as recidivism. Risk assessments affect the possibility of an inmate receiving parole or being released from prison and are also used in sentencing. In fact, imposition of the death penalty often requires a consideration of "future dangerousness," which risk assessment can play a vital role in. Although there are many advocates for the use of risk assessment in sentencing, sometimes referred to as "evidence-based sentencing," as a method for reducing mass incarceration in the United States, there are others who question whether risk assessments are accurate enough to be relied upon when making these consequential legal decisions. Risk assessment, as with any attempt to predict future behavior, is very difficult, especially because "risk" isn't always defined the same way in different legal settings, there is a wide research literature on risk assessment, but the information is varied and sometimes contradictory, and bias can play a role in risk assessment. It is also difficult to assess the accuracy of risk assessment and for individual clinicians to receive feedback on their risk assessment decisions. Making a false negative decision in the real world (i.e., labeling someone who is actually high-risk as low-risk) tends to have more visible consequences than making a false positive decision (i.e., labeling someone who is actually low-risk as high-risk), and clinicians might never even find out that the latter assessment was incorrect. This risk imbalance in making these types of errors can bias clinicians away from making low-risk classifications. In experimental validation studies, risk assessment accuracy is typically measured using area under the ROC curve (AUC), a statistical method which indicates the likelihood that a random high-risk offender would be classified as higher risk than a random low-risk offender.

Types of risk assessment
There are several different methods of risk assessment, the main five of which are unstructured clinical assessment, anamnestic assessment, structured professional judgment, actuarial assessment, and adjusted actuarial assessment.

Unstructured clinical assessment
Unstructured clinical assessment is a very common form of risk assessment in which the forensic examiner or clinician decides both what information to use and how to use it to determine risk, based on their clinical judgment. The information used in these types of assessments tends to come from in-depth interviews with the examinee, as well as collateral interviews with known personal contacts, the results of psychological testing, and historical records. Because these assessments, though frequently used, rely so heavily on the individual clinician's judgment, the interrater reliability for this method of assessing risk tends to be low. According to most research on predictive validity, unstructured clinical assessment is less accurate at predicting risk than other, more structured methods (though there have been some issues raised with the evidence supporting this claim ). Regardless, unstructured clinical assessment is still one of the most commonly used methods of assessing risk.

Anamnestic assessment
Another type of risk assessment is anamnestic assessment, which is a form of clinical risk assessment that is focused on risk factors specific to the individual being examined. This type of risk assessment tends to be used for assessing violence risk, and relies heavily on an examinee's past history of violent behavior to identify risk factors for that individual behaving aggressively again, rather than risk factors for violence in general. Because these risk assessments are based on clinical interviews and tailored to the individual in question, they can be useful for determining ways to reduce an individual's violence risk, but they suffer from the same limitations as general unstructured clinical assessment in terms of interrater reliability.

Structured professional judgment
Structural professional judgement (SPJ) is similar to unstructured clinical assessment in that the examiner still makes the final decision about risk, but it is more structured because these tools give the examiner specific, empirically-based factors to focus on when assessing risk. Because of the more structured nature of these assessments, the interrater reliability of risk assessments done using these tools tends to be higher than that of those done using completely unstructured clinical assessment. Many argue that the accuracy of assessments done using SPJ tools is equal to or higher than the accuracy of actuarial assessment, while preserving some of the flexibility that is notable about clinical judgment. Additionally, because most actuarial risk assessment tools are based on static (or unchanging) risk factors, SPJ tools tend to be better at identifying dynamic risk factors (which can be changed), and thus can be more useful in treatment settings than actuarial assessments. An example SPJ tool for assessing violence risk is the HCR-20, which stands for History, Clinical, and Risk management. An example actuarial tool for assessing sexual recidivism risk is the Sexual Violence Risk-20 (SVR-20).

Actuarial risk assessment
Actuarial risk assessment is a more objective method of risk assessment that involves structured tools and algorithms that combine certain risk factors to produce a risk score or rating. The algorithm tells evaluators both which factors to pay attention to and how to weigh and combine them to produce the risk score. The risk factors included in actuarial tools are empirically linked to violence or recidivism risk and tend to be more static (permanent, unchanging) than dynamic (changeable). Because actuarial risk assessment tools provide the most guidance and involve the least amount of clinician judgment, they tend to have higher interrater reliability and to be more accurate than unstructured clinical assessment. However, these types of assessment are less flexible, and their mathematical and algorithmic nature might make testimony based on them more difficult for jurors and laypeople to understand. Two example actuarial tools for assessing violence risk are the Violence Risk Appraisal Guide (VRAG) and the Classification of Violence Risk (COVR). An example actuarial tool for assessing sexual recidivism risk is the Static-99 Revised (Static-99R).

Adjusted actuarial assessment
Adjusted actuarial risk assessment is a combination of unstructured clinical assessment and actuarial risk assessment. In adjusted actuarial assessment, evaluators use an actuarial method to determine risk, and then adjust the score produced by the algorithm based on their own clinical judgment. This type of risk assessment is meant to make actuarial instruments more flexible and adaptable to the facts of a specific case; however, supporters of the actuarial technique tend to criticize this method as forgoing the main benefit of actuarial risk assessment -- the lack of subjectivity -- by reintroducing clinician judgment after a risk assessment score has been calculated.

Effectiveness
The evidence regarding the effectiveness of risk assessment (particularly established risk assessment tools) is mixed. According to a systematic literature review, professionals surveyed (including correctional staff, mental health professionals, and judges) have mixed opinions about the utility of risk assessment tools for risk management and treatment, and the evidence is also mixed regarding whether risk assessment tools are associated with reductions in violence and offending. Another systematic review and meta-analysis found some evidence that the use of risk assessment tools may reduce "restrictive placements," which could include pretrial detainment as well as post-conviction placements and potential release, but the effect was small and, after removing studies with a high possibility of bias do to confounding variables, not statistically significant. This same review also found that when these decreases in restrictive placements occurred, there was not a corresponding increase in recidivism; however, the evidence was low regarding the impact of risk assessment tools on recidivism generally and violent recidivism in particular. Moreover, a literature review found that even if risk assessment tools are effective, they may not be reaching their full potential to effect change because of implementation issues and issues applying risk assessment-derived recommendations to future risk management and treatment decisions.

Controversy
One issue that is particularly prevalent in discussions about risk assessment and the use of risk assessment in sentencing is its potential impact on racial disparities in criminal justice outcomes. Scholars and practitioners have argued that the use of risk assessment in sentencing may have no impact on racial disparities, increase racial disparities, and/or reduce racial disparities. Those who argue that risk assessment may have no impact on racial disparities tend to base their arguments on the assumption that sentencing decisions made by judicial intuition or sentencing guidelines based on prior criminal history are also prone to racial bias, so the alternatives to risk assessment in sentencing may not be much different with regard to racial disparities. Those who argue that risk assessment in sentencing reduces racial bias argue that, because race cannot constitutionally be included as a risk factor on any reputable measure of risk, the use of risk assessment tools decreases the weight people otherwise may give to racial factors in sentencing decisions. Those who argue that risk assessment in sentencing increases racial disparities, however, argue that because risk assessment tools (particularly actuarial tools) tend to be based on past criminal justice data, the use of these instruments to sentence future offenders may reproduce or even exacerbate existing racial disparities in criminal justice outcomes. Additionally, most legal scholars and laypeople are very opposed to the explicit use of race in risk assessment, but some argue that variables that are included in many risk assessment tools, including socioeconomic variables, employment, education, neighborhood quality, and criminal history, are so highly correlated with race that they serve as proxies for race in these instruments. Empirical research that has attempted to investigate the impact of using risk assessment tools on racial disparities has suffered from a lack of sufficient data. In a systematic review and meta-analysis that attempted to investigate the impact of different types of risk assessment on racial disparities in criminal justice outcomes, the authors were unable to find enough studies that actually measured this impact to draw clear conclusions, and other studies have also found limited or mixed effects of risk assessments on racially disparate outcomes.

Elizabeth's section begins here - Forensic psychological evaluations
'''[tess notes - Elizabeth, please enter these into the Forensic Psychology wikipedia page under the "Forensic Psychological Evluations" section. And put this under the "Forensic Assessments of Competencies" section. You'll have to work with the heading levels (and maybe will have to use bullet points like I put in the vio risk assessment for Rose's parts), but you can get this all up on this page and that would be great. Thank you for your work on this).''' (see e.g., the headings like below - maybe something like this).

Forensic assessments of competences

 * Competencies in criminal cases
 * A multitude of competence issues may arise in criminal contexts. Matters of decisional competence require the defendant's ability to make decisions, and can become relevant at various stages in the criminal process. These include the competencies to consent to a search or seizure, exercise the right to remain silent, plead guilty, waive the right to counsel and represent oneself, and refuse an insanity defense and other mental state defenses. Additionally, defendants must be competent to testify, and to be executed and to participate in and waive appeals.
 *  Competence to consent to a search or seizure.  United States citizens are protected against unreasonable search and seizure by the Fourth Amendment of the U.S. Constitution. A person must be competent in order to consent to a search or seizure. This consent must be given voluntarily and without coercion from police. However, in Schneckloth v. Bustamonte (1973), the Supreme Court held that the suspect does not have to "knowingly" consent to search or seizure.

Competence to exercise the right to remain silent
The Fifth and Sixth Amendments respectively provide protection against self-incrimination and guarantee the right to due process. Confession evidence is often riddled with admissibility concerns related to the defendant's willingness to confess and their truthfulness in their confession. To be competent to waive the right to remain silent, defendants must do so knowingly, intelligently, and voluntarily. In other words, defendants must understand Miranda warnings, the consequences of waiving this right, and they must do so without coercion.

Some research has demonstrated that defendants do not understand their constitutional rights related to this competency, including Miranda warnings, posing an issue for the knowing and intelligent prongs of competence. Voluntariness may be also impacted by the defendant's suggestibility or if drug-use is involved. Suggestibility may be increased for defendants who are intellectually disabled or who are young.

Competence to plead guilty
The vast majority of criminal cases are settled without ever going to trial. Over 90% of criminal cases are resolved via a guilty plea. Defendants must be competent in order to plead guilty, and pleas must therefore be entered knowingly, intelligently, and voluntarily. The knowing prong of competence to plead guilty spans three dimensions. First, the defendant must understand the nature of the charge. The defendant must also possess an understanding of the penalties for the charge. Lastly, the defendant must understand the rights they waive by pleading guilty, including the right to remain silent and the right to a trial by jury.

In Godinez v. Moran (1993), the Supreme Court held that the standard for competence to plead guilty is the same level of competence to stand trial.

Competence to waive the right to counsel and to represent oneself
The Sixth Amendment of the U.S. Constitution allows defendants the right to represent themselves in criminal trials. The competence to waive the right to counsel and represent oneself requires that the waiver is knowing and voluntary. To be found competent to waive their right, defendants must understand the potential consequences of this decision.

In Faretta v. California (1975), the Supreme Court noted that defendants can be considered competent even if they do not understand the legal technicalities. In Godinez v. Moran (1993), the Supreme Court also noted that the standard for competence to waive the counsel and represent oneself requires only the same level of competence as the competence to stand trial.

Competence to refuse an insanity defense and other mental state defenses
Where there is question about mental status at the time of offense, the defendant may have the option to either raise or refuse insanity and related defenses. The competence to refuse this defense is characterized by the defendant's knowingness and voluntariness.

In Whalem v. United States (1965), the court held that trial judges have an obligation to raise an insanity defense on behalf of the defendant in the event that the defense is likely to succeed. This approach is based on the philosophy that those who are not morally responsible for their actions should not be punished. In contrast, the current majority view held in the case Frendak v. United States (1979), allows the defendant to decide whether they wish to refuse the insanity defense, given that they are competent to do so.

Competence to testify
Testimonial capacity or competence is an issue that may be relevant in both civil and criminal contexts, and it applies to any person who may be asked to testify in the case, beyond just the defendant. By default, individuals are presumed to be competent to testify. This assumption is codified in Rule 601 of the Federal Rules of Evidence.

Generally, judges have grounds to question a person's competence to testify based on five capacities, including 1) their ability to observe the incident, 2) to remember it, 3) to communicate their memory of it, 4) to distinguish between the truth and lies, and 5) to understand their obligation to be truthful in court.

Competence to be executed and to participate in and waive appeals
The Eighth Amendment of the U.S. Constitution bans cruel and unusual punishment, and therefore prevents the execution of those who do not understand their punishment, stemming from related common law ideology. To be found competent to be executed, inmates must understand the nature and purpose of the death penalty and understand why it is being imposed in their case.

Several psychological assessment instruments have been developed to aid in the identification of competency for execution. These include Ebert's Competency to be Executed Rating Instrument and Zapf and colleague's Interview Checklist for Evaluations of Competency for Execution. These tools assess the inmate's understanding that they are to be executed, their understanding of why they are to be executed, and their ability to assist legal counsel.