Trauma and Psychological Injury: Practice, Clinical, Legal, and Ethical Issues

Psychologists need continuing education in areas pertinent to their practice. The area of psychological injury and law presents issues and conundrums that need careful ongoing evaluation for appropriate clinical practice, adherence to ethical standards, and functioning in the legal context. In this article, we prepared a series of vignettes that illustrate these difficulties in the practice, clinical, legal, and ethical spheres related to the area of psychological injury and law. The vignettes, together with accompanying commentaries, are meant for use in workshops, and they aim to educate, stimulate, and provoke. Furthermore, the article has been written with the aim of interaction with readers, in that we seek commentaries from readers both for purposes of publication and use in workshops.     

Psychological Injury and Law: An Integrative Model

This article briefly reviews the literature on three areas of psychological injury, post-traumatic stress disorder, chronic pain, and traumatic brain injury, preparatory to presentation of an integrated biopsychosocial and forensic model of multifactorial causality. The model is the first in the field to (a) cover in one model the three types of psychological injury, (b) while including a full range of causality factors relevant to forensic psychology (such as pre-event, event-, post-event, and unrelated factors), and (c) while addressing the relevance of biopsychological and stress as a cohering factors in all conditions. (d) The model emphasizes the importance of individual differences, for example, in causality of symptom presentation. (e) The model acknowledges that in individual evaluations, psychologists need to consider threats to validity, response biases, and possible malingering, and verify whether pre-event factors fully explain post-event presentation.     

Psychological Injury and Law: Special Issue Epilogue

To conclude the special series in the issue, which marks the end of the first volume of the journal, Psychological Injury and Law, the epilogue highlights its major goals and contributions. The special issue takes the field in more diverse directions. It demonstrates the multiple research and practice foci that are emerging in the field and its interdisciplinarity, from the law and forensics to practice and treatment. The field needs to view the person in context and not from one side or the other of the adversarial divide.     

Psychological Injury and Law: Defining a Field

This article elaborates definitional and conceptual issues relevant to the field of psychological injury and law. It reviews the literature in the major areas that mark the field—law, forensic psychology, disability, and assessment/malingering. To meet admissibility requirements of testimony in court, psychologists and other mental health professionals need to maintain a comprehensive, impartial, and scientifically informed approach to assessments based on a state-of-the-art knowledge, such as made available in this journal.     

Psychological Injury and Law: Assumptions and Foundations, Controversies and Myths, Needed Directions

Psychological injury and law is a fast-developing field that is constructing a set of foundational assumptions and core knowledge guiding its science and practice. At the same time, it is marked by controversies, functions in an adversarial legal system and related systems, and is bedeviled by myths. I present a list of 25 basic assumptions, core knowledge, controversies, myths, and needed directions. With well-designed conceptualization and research on critical issues, the assumptions and core knowledge base in the field of psychological injury and law can continue to improve in quality, reducing its controversies and myths, and moderating the impact of the adversarial nature of the legal system and related systems in which it must function.     

Psychological Injury and Law: Editorial on Practice Criteria

The area of psychological injury and law is one that is interdisciplinary, requiring knowledge in multiple areas. Psychologists should acquire the necessary background knowledge before working in it. At the same time, many clinicians encounter these types of cases. Credentialing bodies in states and provinces should consider establishing criteria for working in the area of psychological injury and law. Working groups in each jurisdiction can be established to help create these criteria. The journal Psychological Injury and Law (PIL) and its parent society, the Association for Scientific Advancement in Psychological Injury and Law (ASAPIL), can actively help the field of practicing psychology meet the objectives of this proposal.     

Landscapes of the Law: Injury, Remedy, and Social Change in Thailand

Sociolegal theorists since Weber have postulated that state law operates by interacting with and responding to nonstate legal orders. This article, examining conceptions of injury and compensation in Thailand, analyzes two ways of mapping law onto the landscape. The first is associated with state law and legal institutions established at the turn of the twentieth century. The state legal system imagines space from the outside in, drawing a boundary line and applying law uniformly throughout the jurisdiction it has enclosed. A second type of mapping, which has been more familiar over the centuries to ordinary Thai people, imagines space from the inside out. Nonstate legal orders are associated with sacred centers and radiate outward, diminishing in intensity and effectiveness with distance. This article, based on extensive interviews with injured persons and other actors and observers in northern Thailand, examines the interconnections between these two ways of imagining the landscape of law. It suggests that recent transformations of Thai society have rendered ineffective the norms and procedures associated with the law of sacred centers. Consequently, state law no longer interacts with or responds to nonstate law and surprisingly plays a diminished role in the lives of ordinary people who suffer injuries.     

Psychological Injury and Law: Editorial on Truth and Consequences, Psychologists and Attorneys

Psychology and law are established but evolving professions that need to communicate better with each other. In the interface of psychology and law in civil proceedings, such as in cases of psychological injury in tort, psychology can help in arriving at just and fair legal decisions that are appropriate in context. Professionals in the legal and mental health communities will find that the combination of the journal, Psychological Injury and Law, and its housing association, ASAPIL, function as a bridge between the two communities.     

Trends in Psychological/Psychiatric Injury and Law: Continuing Education, Practice Comments, Recommendations

This literature review of the major topics in the field of psychological/psychiatric injury and law is aimed at developing commentary for practice in the area. The field is a fast-developing one, with over ten major topics that it needs to integrate. In particular, the present review focuses current work on: law (evidence, tort); forensic psychology; assessment and testing; psychological injuries (posttraumatic stress disorder, chronic pain, traumatic brain injury, other); the APA DSM-5 draft (Diagnostic and statistical manual of mental disorders; American Psychiatric Association 2010); malingering; causality; multicultural considerations; disability; the American Medical Association (AMA) Guides to the evaluation of permanent impairment (Rondinelli et al. 2008); models; and treatment. At the end of each section of the article, practice comments introduce critical issues in applying the research to psychological work in the area. Whether undertaking tort evaluations, disability, and treatment plan assessments or treating individuals with psychological injuries, the professional needs state-of-the-art information in all the areas listed in order to remain scientifically informed, comprehensive, and impartial. The article concludes with recommendations for an integrated field in psychological/psychiatric injury and law, study in the field, research in its major areas, best practice policies, for example in assessment and treatment, and model building.     

Expert Testimony on Psychological Injury: Procedural and Evidentiary Issues

This article introduces psychologists to aspects of the legal process most pertinent to their role as expert witnesses in civil litigation. It summarizes the role of psychological evidence in the adjudication of common law tort claims, the structure of the court system, and the stages of the litigation process. It also explains the various roles a psychological expert may play during litigation and the implications of those roles for expert confidentiality and disclosure. The article then provides an overview of legal policy governing the admissibility of psychological expertise, especially as admissibility is affected by the “Daubert” standard applied in most North American courts.     

Psychotherapy for Psychological Injury: A Biopsychosocial and Forensic Perspective

This article reviews the predominant psychological approaches to therapy and other treatments in the field of psychological injury. Mostly, they concern cognitive behavior therapy and its variants. However, because of the simultaneous physical injuries or physiological effects that accompany these types of injury, practitioners should adopt an integrated biopsychosocial approach in treatment (Sperry, L., Treatment of chronic medical conditions: Cognitive-behavioral therapy strategies and integrative treatment protocols. Washington, DC: American Psychological Association, 2006; Treatment of chronic medical conditions: Cognitive-behavioral therapy strategies and integrative treatment protocols. Washington, DC: American Psychological Association, 2009). The paper presents a componential model of therapy that integrates the cognitive-behavioral, biopsychosocial, and forensic approaches. More research needs to be undertaken that takes into account the difficulties of conducting therapy with individuals who are expressing psychological injury. This will help in the quest to formulate evidence-based but flexible practice guidelines. The paper concludes with a model that may serve to scaffold the numerous psychotherapies that are available into a more coherent framework.     

Psychological Injury and Law: Introduction to the First Issue

In this introductory article to the special series of articles written to initiate the new journal, Psychological Injury and Law, I provide the background and impetus for this fast-growing area as a distinct field of scientific study. Professionals working in the area need to be aware of its diverse components, from evidence law and forensic psychology to disability and assessment, to its three core areas of Posttraumatic Stress Disorder and other distress, chronic pain, and traumatic brain injury, as well as issues such as malingering. I provide summaries of the articles in this special series that appear in this inaugural issue. The remaining articles of the special series of articles to introduce the journal are presented in the next two issues.     

Coping in Psychological Injury: A Biopsychosocial and Forensic Perspective

This paper examines stress and coping from the perspective of psychological injury, which concerns injuries attributed to an event at claim. The paper explores current conceptualizations of stress and coping and includes discussion of resilience. In particular, the paper focuses on biopsychosocial approaches, given their relevance to the area of psychological in jury and law. The paper presents a model of coping that integrates biopsychosocial and forensic aspects. As part of the model, the author develops the concept of forensic appraisals, which are particular to the area of psychological injury and law. The paper discusses implications for practice and assessment.     

Psychological Injury and Law: A Biopsychosocial and Forensic Perspective

The articles in the present special issue on the area of psychological injury and law broaden understanding of the area by considering topics outside the range of the seven major areas that mark the field. In the articles in this special issue, common themes include: (a) having comprehensive, recent literature reviews, (b) presentation of models related to psychological injury and law in which existing models are integrated, (c) integration of biopsychological and forensic perspectives, and (d) consideration of development or change processes, and examination of causality. (e) All the articles discuss possible improvements to the DSM-IV; for example, there should be a separate, sixth axis pertaining to causality.     

Psychological Injury and Law: Journal Policy on Ongoing Debates

This journal, Psychological Injury and Law, has made it a policy to publish articles that are part of ongoing debates. They might not be subject to the standard review process and are published from the perspective that the reader should decide on the merits of the science and arguments presented and that rebuttals, as well, should be allowed in order to make the best scientific case possible. In response to queries, the journal editor describes in depth the review process undertaken for Butcher et al. (Psychological Injury and Law 1(3):191–209, 2008). The journal editor indicated to the reviewers of Butcher et al. (Psychological Injury and Law 1(3):191–209, 2008), that “we let opinions stand even if we do not agree with them, checking uniquely the methodology, data, and science underlying the opinion, and let the scholar writing the rebuttal deal with any differences of opinion, also by addressing methodology, data, and science.” Ben Porath et al. (Psychological Injury and Law 2(2), 2009) have written a rebuttal of Butcher et al., equally reviewed from this perspective.     

Erratum to: Trends in Psychological/Psychiatric Injury and Law: Continuing Education, Practice Comments, Recommendations

This literature review of the major topics in the field of psychological/psychiatric injury and law is aimed at developing practice in the area. The field is a fast-developing one, with over ten major topics that it needs to integrate. In particular, the present review focuses on current work on: law (evidence, tort); forensic psychology; assessment and testing; psychological injuries (posttraumatic stress disorder, chronic pain, traumatic brain injury, other); the APA DSM-5 draft (Diagnostic and statistical manual of mental disorders; American Psychiatric Association 2010); malingering; causality; multicultural considerations; disability; the American Medical Association (AMA) Guides to the evaluation of permanent impairment (Rondinelli et al. 2008); models; and treatment. At the end of each section of the article, practice comments introduce critical issues in applying the research to psychological work in the area. Whether undertaking tort evaluations, disability, and treatment plan assessments or treating individuals with psychological injuries, the professional needs state-of-the-art information in all the areas listed in order to remain scientifically informed, comprehensive, and impartial. The article concludes with recommendations for an integrated field in psychological/psychiatric injury and law, study in the field, research in its major areas, best practice policies, for example in assessment and treatment, and model building.     

Personality Disorder in Psychological Injury: A Biopsychosocial and Forensic Perspective

The present paper explores personality disorder from a biopsychosocial and developmental perspective, in particular, while considering forensic applications. It reviews criticisms of the current approach to classification, especially about its categorical in nature. Then, the paper focuses on the Five-Factor Model of personality dimensions and the attempts to relate it to understanding and assessing personality disorder (Costa and Widiger 2002). Developmental research is revealing that from early in life, temperament and personality seem to conform to a five-factor structure akin to the Big Five, although there are exceptions. Next, the paper examines the biopsychosocial model of personality and considers how personality disorder in the healthcare context affects treatment, relations with providers, and so on. Lastly, the paper examines Young’s (1997) stage model of development in relation to the Big Five and shows how the manner in which it deals with the development of the self may facilitate understanding of personality development and its disturbance. Recommendations and implications are considered.