Psychological assessment as a therapeutic intervention in patients hospitalized with eating disorders.

As most psychologists are aware, there are many difficulties associated with the assessment and treatment of hospitalized individuals with eating disorders and their family members. Problems such as denial or minimization of the eating disorder, lack of motivation for change, treatment resistance, and lack of insight are common, and techniques that can diminish or eliminate these challenges are sorely needed. This article describes the clinical utility of therapeutic assessment, which is a nontraditional, collaborative approach to psychological evaluation, as an early step in overcoming assessment and treatment difficulties encountered in this population. Case examples are provided to illustrate the assessment method as a brief intervention. Possible mechanisms underlying the therapeutic effects are also discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological effects on surviving family members of seeing the deceased person after forensic autopsy.

In medicolegal autopsy, it is essential to consider the emotions experienced by relatives of the deceased person. This study examined the psychological effects on surviving family members of seeing the deceased person’s body after forensic autopsy. Participants (n = 359) were surveyed by means of a questionnaire designed to measure posttraumatic symptoms; 62 participants had been involved in traumatic events related to the bereavement (trauma-involved group), and 297 participants had not (no-involvement group). Statistical analyses using structural equation modeling (SEM) showed that the model implying a significant difference between these groups was better fitted, than that implying no difference. The trauma-involved group showed a higher score for posttraumatic symptoms than the no-involvement group (Ms = .32 and .00, respectively). However, there was a negative correlation in the trauma-involved group between seeing the deceased person after forensic autopsy and posttraumatic symptoms (r = ?.43), but there was no correlation (r = ?.01) in the no-involvement group. Furthermore, factor structure for posttraumatic symptoms in bereaved people showed that treatment focused on avoidance behavior would be most effective Japan. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Third party presence during criminal forensic evaluations: Psychologists' opinions, attitudes, and practices.

If you are a psychologist who conducts forensic evaluations, how would you respond to an attorney's or family member's request to be present or to videotape the evaluation? Your answer may be impacted by legal, professional, ethical, and practical issues as addressed in legal and mental health publications. However, there is a dearth of empirical attention, and even the opinions and practices of psychologists in this arena are unclear. The present article addresses the need for empirical data on third party presence by surveying forensic clinicians' perspectives on the topic. A total of 160 forensic practitioners (41% response rate) provided information on their attitudes and practices pertaining to third parties in an evaluation. Overall, most clinicians believe third party presence can negatively impact an evaluation, yet most have conducted examinations under such conditions. The article concludes with speculation as to the impact of third party presence, a call for research and professional standards, and specific guidelines for psychologists who may struggle with these complex issues. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Guidelines for child custody evaluations in family law proceedings.

Family law proceedings encompass a broad range of issues, including custody, maintenance, support, valuation, visitation, relocation, and termination of parental rights. The following guidelines address what are commonly termed child custody evaluations, involving disputes over decision making, caretaking, and access in the wake of marital or other relationship dissolution. The goal of these guidelines is to promote proficiency in the conduct of these particular evaluations. This narrowed focus means that evaluations occurring in other contexts (e.g., child protection matters) are not covered by these guidelines. In addition, the guidelines acknowledge a clear distinction between the forensic evaluations described in this document and the advice and support that psychologists provide to families, children, and adults in the normal course of psychotherapy and counseling. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Integrating family routines and rituals with other family research paradigms: Comment on the special section.

The articles in this special section represent cutting edge research on family routines and rituals. This comment discusses how this work may inform and be informed by other family research. This includes studying how routines develop, are maintained, and reorganize as well as how they influence individual outcomes through effects on socialization, security, and adaptation to stress. Applications of research on family routines to enhance prevention and treatment are also discussed. New directions for the study of family rituals are discussed, including how ritual events may have long-term effects on family interaction through discontinuous changes in relationship expectations of family members. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ethical and professional considerations in divorce and child custody cases.

The provision of psychological (e.g., psychotherapy, coparenting, mediation, collaborative divorce, child custody evaluation) services for families of divorce are growing specialties for many clinical and forensic psychologists. However, practice in domestic relations psychology, such as divorce and custody assessment and testimony, is a high-risk venture for incurring ethics complaints and law suits. The lead article and the three commentaries that follow enumerate the various roles practitioners might play, clarify how each role requires specific skill sets that may be outside one’s particular competence and necessitate additional training, describe how countertransferential issues arise, urge meticulous record keeping, discuss some of the subtleties of confidentiality and the releasing of information, describe how transparency in clarifying expectations leads to a lowering of contentiousness, and provide tips for divorce and forensic practice. The special challenges associated with psychologists being tempted to move beyond their role on a case and those of particularly high-risk situations (e.g., complaints of child abuse or domestic violence) are also discussed. Suggestions are offered to help psychologists better serve the public while taking steps to better inoculate themselves from complaints. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Family routines and rituals--The importance of family functioning: Comment on the special section.

This diverse collection of papers highlights routines and rituals in family life. Just as individual family members bring unique styles and perspectives to the family table, to be incorporated into a family framework, so do each of these papers present rich and varied research questions, designs, and measurement strategies that enrich our understanding of family routine behavior patterns and ritual meanings. This series adds to our conceptualization of family routines and rituals within a systems perspective highlighting: 1) families are comprised of multiple levels that operate individually; interact with each other; and as a whole, reveal properties distinct from separate parts; 2) families tend toward stability in meaningful patterns of functioning; and 3) family functioning has meaning for individual outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Compatibility of therapeutic and forensic roles.

An article by S. A. Greenberg and D. W. Shuman (1997; see record 1997-02162-009) has been prominently referenced as an authoritative document making the argument that "explicit ethical precepts" (p. 50) are violated when a therapist provides expert forensic testimony. Greenberg and Shuman (1997) claimed that psychologists attempting to do so are engaging in an "irreconcilable conflict between therapeutic and forensic roles" (p. 50). Their arguments are challenged here and shown to conflict with established ethical standards and guidelines for forensic psychologists. The current author discusses serious potential negative ramifications to the public interest and the profession of psychology if state boards of psychology adopt the position of Greenberg and Shuman as a basis for the discipline of psychologists both treating patients and providing expert testimony. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evaluating process in child and family interventions: Aggression prevention as an example.

This article reports on 2 studies designed to develop and validate a set of measures for use in evaluating processes of child and family interventions. In Study 1 responses from 187 families attending an outpatient clinic for child behavior problems were factor analyzed to identify scales, consistent across sources: Alliance (Satisfactory Relationship with Interventionist and Program Satisfaction), Parenting Skill Attainment, Child Cooperation During Session, Child Prosocial Behavior, and Child Aggressive Behavior. Study 2 focused on patterns of scale scores among 78 families taking part in a 22-week preventive intervention designed to affect family relationships, parenting, and child antisocial and prosocial behaviors. The factor structure identified in Study 1 was replicated. Scale construct validity was demonstrated through across-source convergence, sensitivity to intervention change, and ability to discriminate individual differences. Path analysis validated the scales' utility in explaining key aspects of the intervention process. Implications for evaluating processes in family interventions are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Finishing well: Aging and reparation in the intergenerational family.

Reviews the book, Finishing well: Aging and reparation in the intergenerational family by Terry D. Hargrave and William T. Anderson (see record 1992-98532-000). The purpose of this book is to help older people and their families complete life in a more satisfactory way through contextual family therapy. The essence of the contextual approach is to resolve family relationships by building trust and commitment in the family through redressing the imbalance of entitlements and obligations within the family. In this review, the dynamics of family relationships are described and the stages of family therapy as detailed in the book are summarized. In the book, the authors focus on the importance of forgiveness and describe the technique by which they promote forgiveness between family members. According to the reviewer, the book is well written because the therapeutic techniques are clearly illustrated with examples from therapy cases. This book can be enthusiastically recommended to all therapists engaged in therapy with older people, and to those doing family therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evaluating parents in child protection decisions: An innovative court-based clinic model.

Providing relevant, timely forensic evaluations is challenging because of the differing worlds of mental health and law. In this study, the authors evaluated an innovative, court-based clinic model for improving acquisition and use of clinical information in juvenile court in a 3-year pilot project prior to wide-scale implementation. The authors investigated the extent to which 170 evaluations of parents in the child protection division met criteria recommended in the forensic literature by comparing reports across four groups categorized by source (inside or outside court; part of pilot project or not). Findings suggested greater use of recommended practices and more timely, consistent reports by the pilot clinic. The findings provide preliminary support for the model and guidance for improving forensic evaluations in child protection. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Unresolved controversies concerning psychopathy: Implications for clinical and forensic decision making.

At some point in their careers, clinicians who work or consult in forensic and correctional settings will almost certainly encounter individuals who exhibit psychopathic personality features. Because of the widespread use of this disorder to inform legal and clinical decision making, psychologists should be exceedingly familiar with the relevant research literature on this topic before venturing into these settings. This article reviews the empirical bases of several clinically relevant claims and assertions regarding psychopathy and concludes that many areas of research are decidedly more equivocal in their findings than is commonly perceived. Although there is much to be gained by assessing psychopathy in various contexts, clinicians need to be cautious about drawing overzealous and empirically questionable conclusions about an important disorder that also has great potential for abuse. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The power of Filial Relationship Enhancement therapy as an intervention in child abuse and neglect.

Identified variables that influence intervention in child abuse and neglect and proposes a constructive approach that can help these children and their families change. This is a difficult and complex societal problem, and it is difficult to tease out the specific elements that are responsible for the frequency of its occurrence. The family context is often recognized as having a significant influence. Filial Relationship Enhancement, using an improved family context to support gains, has a long history of research and practice to support its efficacy to intervene in difficulties that impede optimum functioning in children. Filial Relationship Enhancement helps parents learn to conduct weekly child-centered play therapy sessions with their own children at home. This article presents the basic assumptions and the rationale for considering the potential power of this approach. It also describes a program of intervention incorporated by a child protective unit of a county agency. Using informal measures, outcomes are described as well. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Assessment of sexual abuse allegations in child custody cases.

Family courts frequently rely on the expertise of mental health professionals to assess allegations of sexual abuse within the context of child custody evaluations. Such evaluations are complex and require knowledge of techniques used in sexual abuse and sexual offender evaluations, as well as knowledge of child custody practices. Preliminary findings from a national survey of 84 psychologists indicated that respondents tend to adhere to the child custody guidelines of the American Psychological Association. However, few practitioners followed formal models, protocols, or guidelines when evaluating alleged victims or alleged perpetrators of sexual abuse in conjunction with child custody disputes. Implications for professional practice are discussed, along with a proposed comprehensive model for assessing sexual abuse allegations in child custody cases. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The efficacy of an online cognitive-behavioral family intervention in improving child behavior and social competence following pediatric brain injury.

Objective: To examine whether an online cognitive-behavioral intervention could improve child adjustment following traumatic brain injury (TBI). Participants: Thirty-nine families of children with moderate to severe TBI. Intervention: Families were randomly assigned to the online family problem-solving (FPS) group or to the Internet resources comparison (IRC) group. Main Outcome Measures: Outcomes included child behavior problems, social competence, and self-management/compliance. Results: The FPS group reported better child self-management/compliance at follow-up than did the IRC group. The child's age and socioeconomic status (SES) moderated treatment effects, with older children and those of lower SES who received FPS showing greater improvements in self-management and behavior problems, respectively. Conclusions: Findings suggest that an online cognitive- behavioral approach can improve child adjustment after TBI, particularly in older children and children of lower SES. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The practice of forensic psychology: A look toward the future in light of the past.

In a 1987 American Psychologist article, Tom Grisso summarized the state of forensic psychological assessment, noted its limitations and potential, and offered suggestions for researchers and practitioners interested in contributing to its future. Since that time, there have been many important developments in the field of forensic psychology, as well as in clinical psychology more generally, some of which were anticipated and recommended by Grisso, and some of which were not. Forensic psychology is now at a crossroads, and the specialty must make an effort to respond to current challenges if it is to aid in the administration of justice by assisting legal decision makers. The need to distinguish between and identify levels of forensic knowledge and practice, establish guidelines for practice, educate legal consumers, and devote more attention to treatment issues in forensic contexts is highlighted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Juvenile competence to stand trial evaluations: A survey of current practices and test usage among psychologists.

What is the current standard of practice for evaluations of juvenile competence to stand trial (JCST)? The present study surveyed psychologists regarding the practices used when conducting JCST evaluations. Respondents rated the importance of 17 elements that might be included in a JCST evaluation report. Of these elements, 7 were considered essential by 70% or more of respondents, with 9 additional elements rated as either essential or recommended. A majority of respondents felt that the use of psychological and forensic instruments was important. A list of tests used is provided, and the implications for the development of standards and policy are discussed to provide practitioners with additional knowledge that will help to further the state of the discipline. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Screening for feigned psychiatric symptoms in a forensic sample by using the MMPI-2 and the Structured Inventory of Malingered Symptomatology.

Fifty-five men undergoing pretrial psychological evaluations for competency to stand trial or criminal responsibility in the federal justice system were administered the Structured Interview of Reported Symptoms (SIRS), the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), and the Structured Inventory of Malingered Symptomatology (SIMS). On the basis of results from the SIRS, 31 were classified as honest responders and 24 as feigning. Significant differences between the 2 groups were found on all SIMS scales as well as on all tested MMPI-2 fake bad validity scales. The SIMS total score and the MMPI-2 Backpage Infrequency (Fb) scale had relatively high negative predictive power (100% and 92%, respectively). On the basis of this clinically relevant methodology, both tests have potential usefulness as screens for malingering. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Specialized practice in forensic psychology: Opportunities and obstacles.

In recent years, there has been a proliferation of the need for psychology practitioners to provide expertise to the legal system on a wide variety of topics. One of the difficulties for psychologists has been that the demand for such services has at times outstripped the capacity of the field to train practitioners to provide these services in a competent and ethical manner. Furthermore, many psychologists are not aware of the types of knowledge and training required to perform these services. This article describes the knowledge base and skills that distinguish the specialty of forensic psychology and the types of training required to practice in this field. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Consent, disclosure, and waiver for the forensic psychological evaluation: Rethinking the roles of psychologist and lawyer.

The duty to obtain consent from a litigant before beginning a forensic evaluation has fallen to the forensic psychologist. Guidelines, ethical standards, and commentators have made this assumed duty mandatory. Unfortunately, psychologists are not able to provide accurate and detailed legal information concerning the forensic evaluation. Only a person trained in the law would be qualified, and the litigant's lawyer has the legal duty to properly inform the litigant about the legal parameters of the forensic evaluation. This article discusses the psychological and legal aspects of consent for forensic evaluation and proposes a model in which both the lawyer and the psychologist collaborate in a process initiated by the psychologist to inform the litigant about the evaluation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)