An integrated case formulation approach in forensic practice: the contribution of Occupational Therapy to risk assessment and formulation

Forensic services focus on risk reduction and extol the value of multidisciplinary working. Due to the complex relationship of personality disorder and risk, a multidisciplinary approach to risk assessment, formulation, management and reduction is essential. Occupational Therapists provide a unique perspective; however, current literature pertaining to the contribution of Occupational Therapy is negligible. This paper aims to initiate discussion of the value of Occupational Therapy contributions to risk assessment and formulation with personality disordered offenders. A new approach is described that integrates occupational adaptation and multiple sequential functional analysis to provide a structured framework for Occupational Therapy risk assessment and formulation. A single case report is presented to demonstrate the advantages of the approach for identifying offenders’ strengths and difficulties, predicting risk of reoffending, identifying offence paralleling behaviour and informing and evaluating efficacy of intervention, thereby supporting the aims of forensic practice settings to assess, manage, treat and reduce risk.     

The Uncritical Acceptance of Risk Assessment in Forensic Practice

Forensic psychologists are frequently asked to conduct evaluations of risk assessment. While risk assessment has considerable merit, recent applications to forensic psychology raise concerns about whether these evaluations are thorough and balanced. Forensic adult risk-assessment models stress risk factors, and deemphasize or disregard entirely the other side of the equation: protective factors. Mediating and moderating effects must also be considered. Moreover, base-rate estimates may produce erroneous results if applied imprudently to forensic samples without regard to their unstable prevalence rates or the far-reaching effects of settings, referral questions, and evaluation procedures. Psychologists are offered a preliminary list of relevant issues for evaluating the merits of risk assessment in their forensic practices.     

Red-teaming the panopticon* (mobilising adaptive change in secure and forensic settings)

In England and Wales, secure and forensic psychiatric institutions provide a high-cost, low-volume service that imposes significant restrictions upon detainees. Patients may be detained under the Mental Health Act in such settings for several years or even life, as they are deemed to present a significant risk to themselves or the public. Patients under s37/41 require the Home Office to approve any increase in their freedom. Best practice requires reoffending risk to be assessed before a patient is discharged. Evaluation of risk is an inexact actuarial science operating in a political arena, and research has indicated risk assessment tools have little positive predictive validity. There is concern amongst the wider psychiatric and judicial communities about the ethics of current practice. We examine these issues and consider means of improving risk assessment through red-teaming, increased collaboration between clinician and patient and a paradigm shift towards greater emphasis on patient self-agency.     

A risk-based approach to cognitive bias in forensic science

Over the past decade, the potential impact of cognitive bias in forensic science has instigated much discussion and debate between academics, scientists and those in the justice sector. Evidence of bias influencing subjective decision-making across a range of forensic disciplines has been described in the literature. Forensic service organisations are being urged to address cognitive bias in subjective decision-making by designing processes or procedures to limit access to (irrelevant) contextual information or reduce dependence on cognitive functions. Although some laboratories have implemented bias mitigating strategies, with varying impact on operational efficiency, there has been no systematic assessment of the risk posed by cognitive bias. Forensic Science SA assessed the potential impact of bias on forensic interpretations across multiple disciplines, using a risk management framework. This process proved useful in assessing the effectiveness of existing bias mitigating strategies and identified the latent level of risk posed. While all forensic organisations should seek to implement bias limiting measures that are simple, cost-effective and do not adversely impact efficiency, using a risk-based approach has contextualised the limited benefit of introducing resource hungry measures, as postulated in the literature. That is not to suggest that forensic organisations should dismiss the potential influence of cognitive bias but they need to strike an appropriate balance between risk and return, as they do with any business risk.     

Incorporating index offence analysis into forensic clinical assessment

Purpose. Assessment is a core skill of clinical and forensic psychology practice and forms the basis of all ongoing engagements with offender/patients. In forensic settings, assessment involves the systematic gathering of reliable data on the characteristics of offenders and the offences which they have committed in order to develop understanding of the dynamics of offending and relevant intervention strategies. However, whilst the assessment process is aided by various protocols, no such instrument appears to exist for the assessment of an offender/patient's index offence. This paper presents a draft ‘index offence analysis guide’ designed by the present authors for this purpose and which has been piloted on prisoners and patients in secure settings. Argument. Evidence suggests that for various reasons, many clinicians do not routinely review crime scene data while working with offenders. However, this practice is arguably questionable, because how can decisions about admission, amenability to treatment, risk of reoffending, and discharge be made if there is limited awareness of what the offender/patient has done? The present authors argue that knowledge of the index offence is important to understanding the offender and suggest this can be obtained using a guide such as the one presented here. This is illustrated with an anonymous case. Conclusion. Index offence analysis should be a core task of any forensic clinician engaged in the assessment of offender/patients as it can provide a better understanding of crime scene actions and offence motivations. This can help guide treatment planning and improve risk assessments.     

The Quality of Forensic Psychological Assessments,Reports, and Testimony: Acknowledging the Gap Between Promise and Practice

During the past decade, the field of forensic psychological assessment entered a period of standard setting, reflected in the publication of specialty guidelines for practice and in the proliferation of educational opportunities, training programs, and credentialing and certification procedures for forensic examiners. Representing significant efforts to advance the quality of psychological assessments in legal contexts, these developments foreshadow the promise of forensic assessment. During this same time period, new evidence emerged regarding the quality of forensic practice. This article reviews this evidence and evaluates current practice against the promise of forensic assessment. Forensic reports appear to be of higher quality than those described by commentators in the 1970s and early 1980s; nevertheless, the level of practice falls far short of professional aspirations for the field. The review identifies significant areas of weakness that demand the attention of professional organizations, accrediting agencies, educators, lawmakers, practitioners, and consumers.The truth is what is, not what should be.--Lenny Bruce     

论司法鉴定机构的公益性建设

从属性上分析。司法鉴定应当是政府着力提供的一种公共服务,具有公益属性,作为司法鉴定依托的司法鉴定机构应该以公益性建设为主导的价值方向。为侦查服务的侦查机关内设鉴定机构具有天然的公益性,但实践中出现的一系列问题也使其公益性出现偏位．从而引起人们对其公益性的质疑。在全国人大常委会《关于司法鉴定管理问题的决定》指引下的司法鉴定机构建设过程中,应该避免社会司法鉴定机构走向市场化的竞争域,从而保障鉴定意见这一法定证据的公正性、客观性和中立性。从现行鉴定体制出发,以建设国立司法鉴定机构为向导,使司法鉴定机构走向公益性的良性发展道路．是所要探讨的一个核心问题。国家级司法鉴定机构的公布,标志着我国司法鉴定机构公益性建设的开端．以此为契机,应认真思考公益性建设的进路。     

The forensic examination of structural fires in Victoria,Australia: Decision-making processes and impact on judicial outcomes

There is a body of published research that has evaluated the contribution of forensic science to the criminal justice system, but many disciplines of forensic science remain unexplored in this regard. The aim of this study was to examine the contribution that forensic fire examination services provide to criminal investigations and court processes in arson cases. Forensic fire examination services differ in a number of ways to the disciplines covered in previous research on the impact of forensic evidence on justice outcomes. Forensic fire examinations involve a combination of scene examination and laboratory analyses, and the results can provide critical evidence of whether an incident that has occurred is a criminal offence (i.e. whether a fire has occurred as the result of an act of arson). Forensic fire examination is also a discipline that has faced challenges and undergone development in recent decades regarding its scientific basis and the issue of contextual bias. In this study, data were collated for 273 structural fires that were examined by the forensic fire services in Victoria, Australia. In this jurisdiction, scene and laboratory forensic services are delivered within short time frames with a focus on providing impartial scientific and investigative services to assist criminal investigations conducted by police. The current dataset was highly skewed in terms of criminal justice outcomes and was not suitable for conducting the planned statistical analyses. Nonetheless, the pattern of findings obtained suggested that the inclusion of forensic evidence which supported the prosecution of arson may be associated with an increased likelihood of suspects being charged and defendants found guilty. Examination of the decision-making process of the forensic fire examiners has provided insight into the variety of evidence that is considered by forensic experts in reaching the important conclusion about the origin and cause of structural fires.     

国外法医临床学发展史

法医临床学是法医学的重要分支学科,正处于蓬勃发展阶段。研究法医临床学的发展史,对明确其定义和实践范畴,维护司法公正,具有重要意义。本文将从“简介、历史溯源、18世纪之后的法医临床学发展、现代法医临床学、世界法医临床学司法实践现状和结语”六个部分介绍法医临床学在国外,尤其是英国的发展历史,促进我国法医临床学的学科建设和发展。     

试论民营司法鉴定机构的发展——兼论“南天”、“太太”经验的借鉴

全国人大常委会《关于司法鉴定管理问题的决定》实施以来,民营司法鉴定机构得到蓬勃发展,在法院和司法行政机关不再设立司法鉴定机构,以及侦查机关的司法鉴定机构不得面向社会的情况下,民营机构的出现具有积极意义。经过几年来的实践,有的做大做强,有的还在为生存而挣扎,民营司法鉴定机构面临挑战。民营司法鉴定机构的发展需要关注。     

法医学尸体检验职业防护指南(建议稿)

法医工作者的职业暴露风险极大,案件现场及尸体上的有毒有害物质、高致病性微生物以及利器、骨折等因素均可能给法医带来身心伤害甚至生命危险。随着经济社会发展,法医的工作环境已经较过去显著改善,但是针对个人防护的重视程度仍需提高。近年来公共卫生事件频发,给法医职业防护带来新的挑战,迫切需要借鉴生物安全领域的先进技术和防护理念,以满足新形势下法医工作的需要。本指南立足当前法医职业防护的实际需求,从暴露风险、防护分级、应急处置等角度阐述,希望能为制定法医职业防护相关标准提供参考,以指导法医工作者开展个人防护工作,为提升法医职业化水平和身心健康提供帮助。     

法医学鉴定标准的现状与问题

司法鉴定标准化是一个世界性的司法话题,伴随我国司法改革的实施和政府对标准化工作的重视,我国将迎来建立法医学鉴定标准体系的黄金时代。然而当前我国法医学鉴定标准却存在标准少、质量参差不齐、更新缓慢、标准制定的科学性不足等问题,导致司法鉴定工作与实践脱轨,很多鉴定项目缺乏鉴定标准。为此,作者建议,正确认识法医学鉴定标准的法律地位和存在的错误,致力于法医学鉴定标准化。     

Use of the Rorschach in forensic settings for treatment planning and monitoring

Forensic psychiatric patients exhibit complex clinical issues that are neither readily understood by staff nor necessarily responsive to traditional psychotherapy or treatment milieu approaches. Individualized treatment planning identifies treatment needs and matches them to treatment services, thereby increasing the opportunity for a positive therapeutic outcome. The nature of the Rorschach, particularly that it bypasses volitional resources, enables observation and quantification of personality processes, making the Rorschach uniquely suited for treatment planning in forensic settings. In this article, the authors review relevant Rorschach literature, address the importance of incorporating Rorschach data into the assessment process, and discuss how Rorschach data fit into a thorough assessment that includes historical, clinical, dispositional, and contextual information. The authors offer two case examples to illustrate how Rorschach data are integrated in forensic treatment planning.     

The Impact of Māori Cultural Values on Forensic Science Practice in New Zealand

Abstract:  Forensic science aims to serve society by advancing justice. It is accepted that some actions taken by the state in the interests of advancing justice, such as postmortem examinations, may impinge on values held by members of groups within society. Such actions have the potential to cause cultural offense. It is important that forensic scientists are aware of these issues and that as a profession we should take actions, where possible, to reduce any potential offense and consequently reduce unnecessary distress. This paper examines the impact of these issues on forensic practice in New Zealand, and, in particular, in relation to the cultural values of Māori, the indigenous people of New Zealand. Interviews and workshops were used to identify forensic practices involving a risk of cultural offense. Particular issues were identified in regard to crime scene attendance and examination, postmortem attendance and sample storage, disposal, and return. This paper describes the response developed by the Institute of Environmental Science and Research Limited (ESR) to address these issues, including a cultural awareness training package and reference brochure.     

Forensic mental health assessment in France: Recommendations for quality improvement

The quality of forensic mental health assessment has been a growing concern in various countries on both sides of the Atlantic, but the legal systems are not always comparable and some aspects of forensic assessment are specific to a given country. This paper describes the legal context of forensic psychological assessment in France (i.e. pre-trial investigation phase entrusted to a judge, with mental health assessment performed by preselected professionals called “experts” in French), its advantages and its pitfalls. Forensic psychiatric or psychological assessment is often an essential and decisive element in criminal cases, but since a judiciary scandal which was made public in 2005 (the Outreau case) there has been increasing criticism from the public and the legal profession regarding the reliability of clinical conclusions. Several academic studies and a parliamentary report have highlighted various faulty aspects in both the judiciary process and the mental health assessments. The heterogeneity of expert practices in France appears to be mainly related to a lack of consensus on several core notions such as mental health diagnosis or assessment methods, poor working conditions, lack of specialized training, and insufficient familiarity with the Code of Ethics. In this article we describe and analyze the French practice of forensic psychologists and psychiatrists in criminal cases and propose steps that could be taken to improve its quality, such as setting up specialized training courses, enforcing the Code of Ethics for psychologists, and calling for consensus on diagnostic and assessment methods.     

Forensic pathology then and now. Retrospect and reflections

The past half-century has witnessed significant progress and multiple, meaningful changes in the day-to-day practice of forensic pathology as it has in all other branches of laboratory and clinical medicine. Associated with the welcome advancing "scientific" aspects of our work have been gratifying changes in the professional status of our much misunderstood area of medical activity, the latter most vividly and convincingly represented by American Board of Pathology certification in Forensic Pathology and the appearance of such growing, vital, national professional organizations as the American Academy of Forensic Sciences and our National Association of Medical Examiners and the creation of such highly respected periodicals as the Journal of Forensic Sciences and our American Journal of Forensic Medicine and Pathology. Objective assessment of the foregoing accomplishments leads to the inescapable conclusion that forensic pathology has emerged from its previous role as the "invisible profession" and become a respected and productive branch of laboratory medicine.     

法医牙科学研究进展CSCD

法医牙科学是法医学与口腔医学的交叉学科,通过科学地收集、检测、评价牙科证据而为司法实践提供有法律效力的证明资料。本文从年龄推断,性别推断,种族、职业及生活习惯推断,个体识别,家庭暴力或虐待行为判定等方面对法医牙科学的应用现状进行综述,并对其未来应用进行展望,希望对法医牙科学体系进行不断的补充和完善,使其在法医学甚至司法实践中更好地发挥作用。     

The Criminogenic,Clinical, and Social Problems of Forensic and Civil Psychiatric Patients

Forensic psychiatric patients consume an increasing proportion of mental health resources in Canada and the United States. To inform mental health policy and practice, we compared the criminogenic, clinical, and social problems of forensic patients to those of civilly committed psychiatric patients in two Canadian studies. We predicted that forensic patients would score higher on criminogenic problems and lower on clinical and social problems than civil patients in two studies: one comparing 83 forensic and 189 civil inpatients on a clinician-completed form, the Resident Assessment Instrument--Mental Health, at an urban mental health center, and the second comparing 423 forensic and 178 civil patients assessed at different times using the Patient Problem Survey. The two studies were quite similar in their findings, despite differences in their samples, measures, and data collection methods. In both studies, forensic patients were similar to or lower than civil psychiatric patients in all criminogenic, clinical, and social problems. We conclude that forensic mental health services would benefit greatly by drawing from knowledge accumulated in the general psychiatric literature. This finding also supports the idea that many forensic patients can be appropriately diverted to nonforensic mental health services.     

On the added value of forensic science and grand innovation challenges for the forensic community

In this paper the insights and results are presented of a long term and ongoing improvement effort within the Netherlands Forensic Institute (NFI) to establish a valuable innovation programme. From the overall perspective of the role and use of forensic science in the criminal justice system, the concepts of Forensic Information Value Added (FIVA) and Forensic Information Value Efficiency (FIVE) are introduced. From these concepts the key factors determining the added value of forensic investigations are discussed; Evidential Value, Relevance, Quality, Speed and Cost. By unravelling the added value of forensic science and combining this with the future needs and scientific and technological developments, six forensic grand challenges are introduced: i) Molecular Photo-fitting; ii) chemical imaging, profiling and age estimation of finger marks; iii) Advancing Forensic Medicine; iv) Objective Forensic Evaluation; v) the Digital Forensic Service Centre and vi) Real time In-Situ Chemical Identification. Finally, models for forensic innovation are presented that could lead to major international breakthroughs on all these six themes within a five year time span. This could cause a step change in the added value of forensic science and would make forensic investigative methods even more valuable than they already are today.     

我国法务会计现状及其原因分析

法务会计是近年由英美法系国家传入我国的新事物。目前我国法务会计理论研究存在着种种误区,缺乏相应的法务会计制度性实践,法务会计人才培养也与市场需求脱节。法务会计不同于司法会计,它们根基于不同的司法体制和诉讼模式。法务会计的理论研究和实践探索必须立足于国情,与我国具体的诉讼、证据制度和司法行政体制相适应。