Forensic Psychology has received increasing media attention over the past several years, from Criminal Minds to Netflix’s Mindhunter and Law and Order SVU. But what exactly is it? What role do forensic psychologists serve? What even is a forensic evaluation? In order to answer these questions, we need to understand what forensic psychology is and is not, what types of populations are seen by forensic psychologists, what a forensic evaluation entails, and what kinds of risks or benefits are present in forensic evaluations. At the conclusion of this blogpost, we will also provide some information on our forensic services that we provide at FMWH as well as some guidance on how to determine if this type of evaluation may be right for your client or loved one.
TABLE OF CONTENTS:
Definition of Forensic Psychology and Role of a Forensic Psychologist
Types of Forensic Services
Forensic Evaluations: Risks and Benefits
Virginia Requirements to Become a Forensic Evaluator
Process for a Forensic Evaluation
Fairfax Mental Health and Wellness Forensic Services
Sources
DEFINITION OF FORENSIC PSYCHOLOGY AND FORENSIC PSYCHOLOGIST
Psychology Today defines forensic psychology as the intersection between the law and psychology. In practice, this can be applied to therapy or assessment. For example, a clinician may be providing forensic psychological services if they conduct anger management groups in prisons or conduct a competency evaluation for someone charged with a crime. In short, forensic psychology requires the presence of a psycholegal question. The psycholegal question refers to when someone’s psychiatric functioning could be impacting or is relevant to a legal process.
Forensic psychologists are licensed clinical psychologists who use their clinical knowledge to answer these psycholegal questions. Although specific training requirements may vary from state to state, these clinicians typically hold a doctorate in clinical psychology or medicine and have specialized training working within the legal system. Those who solely provide therapeutic and competency restoration services on the other hand, may hold a variety of clinical degrees (social work, counseling, psychology, etc.) and have specialized training in working within the justice system population. If you are a student or aspiring clinician, the APA has a short article discussing forensic psychology, potential employment opportunities within the field, and tips for education and training.
TYPES OF FORENSIC SERVICES
As you may have gathered so far, the role of forensic clinical work is diverse and thus, maybe a little confusing as to what services these specialized clinicians provide. Below are some examples of forensic services that are commonly completed by these mental health professionals though this list is not exhaustive:
Evaluations
Competency to Stand Trial (CST)
Mental Status at the Time of the Offense (MSO) or Insanity Defense
Violence Risk
Psychosexual Risk
Child Abuse
Child Custody
Immigration
Civil Commitment
Guardianship
Personal Injury/Workers Compensation
Therapy
Pre-trial mental health services in jail
Therapy with incarcerated individuals or those in secure psychiatric hospitals
Competency restoration
Risk/harm reduction
Family or Individual therapy with victims of:
Crimes
Domestic violence
Child abuse
Anger management
Consulting
Expert Testimony
Education
FORENSIC EVALUATIONS: RISKS AND BENEFITS
Risks: Like any evaluation, clinicians cannot “guarantee” that an evaluation will go a certain way. For instance, individuals who are undergoing a risk evaluation or an MSO evaluation may hope that the evaluation shows they should be released or that they should not be held responsible for their crime. However, evaluators are meant to be unbiased third parties whose goal is to uncover whether the individual meets certain legal criteria. So, they may not provide an opinion that aligns with the charged individual’s interests. In fact, the result of these evaluations could result in the extension of incarceration and delay release in order to protect the safety of the public. This risk cannot be totally avoided as this is a necessary consideration when deciding on someone’s eligibility for parole so we can reduce recidivism and potential harm. Recidivism refers to the rate at which someone reoffends after being released. The other potentially negative element of these evaluations relates to cost.
These evaluations can be costly and time-consuming. For example, self-pay rates for forensic evaluations may range from $250-$900 an hour depending on the complexity of the case, speciality, and expertise of the clinician. This can result in a total evaluation cost from $2000-$90001. This cost typically includes the time it takes for the evaluation process, report writing, and expert testimony in court if requested. Sometimes, for certain evaluations, the court may pay these evaluation fees. This usually occurs when an evaluation is ordered by the court rather than the individual or their attorney. The time that an evaluation takes largely depends on the availability of medical records, the functioning level of the individual, availability of other collateral information, complexity of the case, and whether the evaluator will be required to testify in court. For instance, some evaluations may require several interview sessions with the client as well as collateral interviews with the individual’s family, previous teachers, or employers. This is not an extensive list of potential risks which may vary by the individual case, but hopefully this overview provides at least some understanding of risk so that you can make the most informed decision.
Benefits: Although there are some risks involved, there are also several benefits that may make these evaluations worthwhile for your client or loved one. These evaluations can help increase the chance for justice and safety of the community by upholding an individual’s constitutional rights and providing access to necessary mental health services. For example, civil forensic evaluations may result in compensation for injuries caused by the negligence of another person or entity. Criminal forensic evaluations can also allow individuals to qualify for specific mental health services while they are incarcerated that they may not normally receive. Other types of evaluations, such as competency assessment, ensure that an individual’s constitutional right to a fair trial is upheld by ensuring they are able to meaningfully assist in their own defense. Another way these evaluations protect constitutional rights is by helping to prevent cruel and unusual punishment for those who do not hold the capacity to understand the nature or consequences of their behavior (i.e., NGRI evaluations). Instead of jail, these individuals who meet NGRI criteria may instead be diverted to long-term psychiatric care where they are provided the support they need while ensuring the safety of them and the public. Other benefits may include (but are not limited to) appropriate placement of children, adequate treatment services for victims and families, support for those who can no longer care for themselves, and more. For more information on how this process could benefit your case specifically, you can also ask the appropriate attorney or provider for more information.
REQUIREMENTS FOR VIRGINIA FORENSIC EVALUATORS
In the state of Virginia, the law states that individuals who perform competency and MSO evaluations must be a clinical psychologist or psychiatrist, complete training approved by the Commonwealth, and provide evidence of competence in this area to the Commonwealth. There is separate training for evaluations conducted with adults versus juveniles. Clinicians who meet this criteria and desire to engage in Competency or MSO evaluations are then placed on a list of Virginia certified forensic evaluators. For other types of evaluations, such as civil, family court, or risk evaluations, individual clinicians may participate in specialized training which usually includes continuing education training and/or supervision from a licensed clinician with experience in that particular area.
THE EVALUATION PROCESS: WHAT TO EXPECT
As alluded to previously, each case will be unique in the complexity, needs, cost, and expertise required. Each evaluation will require a slightly different process depending on what type of evaluation is needed (e.g., civil versus competency versus risk, etc.). Below, we have included an example of what our process looks like at FMWH based on the evaluations that we currently offer (Competency and MSO).
Typically, these evaluations will begin with a court order or a request sent to an evaluator from the court or an individual’s attorney. Once this order or request is submitted to the clinician, we will determine if the clinician has the experience necessary to potentially take the case. If we believe we may be able to help, we will reach out to your individual attorney to set up a consultation appointment. During this appointment, we will assess the needs of the evaluation by discussing the client’s background, the type of evaluation requested, and the availability of records. Historical records are critical to assist the clinician in determining the relevant psychiatric history and features of their diagnosis (i.e., persistent versus episodic). They can also help the clinician determine how the individual has responded to treatment in the past and the level of support that may be required in the future. If the clinician feels they are a good fit for the case after this consultation, they will begin the official evaluation process.
Typically the evaluation will consist of an extensive interview with the incarcerated individual and any available collateral contacts who may be able to provide additional observations and verify historical information. This may include the attorney, spouses, family members, friends, former supervisors, and/or former treatment providers. Some cases may require multiple sessions to complete interviews depending on the condition of the individual, time constraints, and their setting (e.g., hospital versus jail). During these interviews, the clinician will attempt to ascertain the client’s relevant background history, their current symptoms, functional capacity, and their ability to meaningfully assist their attorneys. For MSO evaluations, the interview will focus more on the client’s functioning and condition around the time of the alleged offense. Some cases may require the use of specific testing measures that evaluate the person’s cognitive, academic, emotional, and behavioral functioning. Whether these measures are used largely depends on the type of case and the diagnostic history of the client. For example, if there is a history of reading problems, a clinician may give a reading achievement test to ensure that they can be given materials that require a certain level of reading fluency (e.g, some tests require an 8th grade reading level). Performance-based assessments may be used if there is a question of whether the person’s cognitive abilities, such as memory or decision making, may have contributed to the alleged offense. Once the evaluation portion is completed, the clinician will then create a report outlining their findings.
The report is the end goal of the evaluation process. It is a written presentation of the clinician’s findings and opinion on the psycholegal question. This report is generally sent directly to the court or the individual attorney depending on who hired the evaluator. For example, if the evaluator was privately hired by the attorney to conduct an MSO evaluation, the report is typically sent directly to them. Competency evaluation reports are generally always sent directly to the court. Thus, feedback is not given to the examinee and information provided by the client is not protected by normal practitioner-client privilege. This is different from typical clinical assessment in that general clinical practice gives the examinee the right to privacy from outside entities. Since in forensic evaluations the client is usually the court or attorney, this privilege is granted to them and not the examinee. Once the report is sent, it is the court’s job to make the final decision on the individual’s competency or guilt. Although the clinician may offer an opinion on whether they meet certain legal criteria, they do NOT make the final decision. This is the job of the judge or jury depending on the type of criminal proceeding. In some circumstances, the court may request the evaluator to provide their expert opinion by testifying in front of the judge and/or jury. The evaluator will then present their findings to the court and will be subject to questions and cross examination by the attorneys.
This is all to say that, while there are similarities between most evaluations, the process will vary to meet the individual needs of the person. Thus, factors such as cost and time necessary will also differ on a case-by-case basis. Your clinician will be able to provide a general estimate and pricing sheet based on the needs of your case.
FORENSIC SERVICES WE OFFER
At Fairfax Mental Health and Wellness, Dr. Baloy currently provides criminal Competency and MSO (NGRI) evaluations for adult populations only (ages 18-50). She is also in the process of adding psychosexual risk evaluations, so please check our website for updates on this particular service. We do not provide services for juveniles, civil cases (i.e., custody, immigration, workers compensation, guardianship, etc.), or forensic therapy services. Please email frontdesk@fairfaxpsych.com or give us a call at 703-896-7628 for more information. If you are an attorney who is interested in hiring us for forensic assessment, please send an email with the type of assessment requested, a copy of the court order, location/county, deadline, age of the client, and your contact information so we can determine if we may be a good fit for your case.
REFERENCES
American Psychological Association (2014) A career in forensic and public service psychology. https://www.apa.org/education-career/guide/subfields/forensic/education-training
Department of Behavioral Health and Developmental Services Office of Forensic Services (n.d.). List of approved adult forensic evaluators. https://dbhds.virginia.gov/forensic-services/
Educational Requirements for Clinical Psychologists, 18VA125-20-54 §54.1-3600 et seq. (2021).
Evaluation of Sanity at the Time of the Offense; Disclosure of Evaluation Results, 19.2 §19.2-169.5 (2018).
Mauro, Marisa (2010, June 7). What is forensic psychology? Psychology Today. https://www.psychologytoday.com/us/blog/take-all-prisoners/201006/what-is-forensic-psychology
National Institute of Justice (2022, April 19). Predicting recidivism: Continuing to improve the bureau of prisons’s risk assessment tool: PATTERN. https://nij.ojp.gov/topics/articles/predicting-recidivism-continuing-improve-bureau-prisons-risk-assessment-tool#1-0
The Chicago School of Professional Psychology (2019). [Photograph of a person with handcuffs talking to a mental health professional]. https://www.thechicagoschool.edu/insightadmin/2019/06/InstightDigital_1404x766_5-traits-that-can-help-your-success-in-forensic-psychology_24.jpg
1 The following price estimates were gathered using price estimates provided by the following practices:
Blue Ridge Psychological Associates (n.d.). Fees and insurance. https://www.blueridgepsychva.com/fees#:~:text=Forensic%20Evaluation%3A&text=Fees%20are%20determined%20on%20a,complexity%20of%20the%20referral%20question
Kaylor, Leah (n.d.) Forensic evaluations. https://www.drleahkaylor.com/forensic-evaluations#:~:text=Depending%20upon%20the%20complexity%20and,$2%2C000%20to%20$9%2C000%20or%20more
Pine Rest (n.d.). Forensic psychiatry and psychological services. https://www.pinerest.org/forensic-psychiatric-psychological-services/