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PSY 495 Forensic Psychology
Terms in this set (82)
2005 Graduate UNC- BA, Psychology & Criminal Justice
2009 Graduate DU- MA, Forensic Psychology
2007-2008- Denver Juvenile Probation- Drug Court
2008-2010- Independence House Therapeutic Community
2009-2013- Contractor with Independence House completing mental health evaluations and treatment for Department of Corrections clients and Federal clients.
2011-current- Arapahoe County Human Services
What is Forensic Psy?
The professional practice by psychologists within areas of clinical psychology, counseling psychology, neuropsychology, and school psychology, when they are engaged regularly as experts and represent themselves as such in activities primarily intended to provide professional expertise to the criminal justice system.
Components of Forensic Psychology
1- The research endeavor that examines aspects of human behavior directly related to the legal process.
2- The professional practice of psychology within or in consultation with a legal system that encompasses both criminal justice and civil law and the numerous areas where they intersect.
Different Education Designations
Doctoral levels (psy D and ph D)
Advantages and Disadvantages of both
History of Psychology and Law
1906 Sigmund Freud cautioned the courts, that the courts and judges could be influenced by their unconscious processes. He also believed that his theory could be used to help understand criminal behavior and thinking.
1908 On the Witness Stand by Hugo Munsterberg. Brings attention to the human aspect of the criminal justice system, such as errors in memory, eye witness testimony issues, etc. While this was influential, it was rejected by the psychological community and law societies.
1908 Muller v. Oregon - "When the health of women has been injured by long hours, not only is the working efficiency of the community impaired, but the deterioration is handed down to succeeding generations. Infant mortality rises, while the children of married working-women, who survive are injured by inevitable neglect. The overwork of future mother's thus directly attacks the welfare of the nation (Muller v Oregon, 1908)." Opened the door to "social science" or psychological research and evidence being permitted in the court system.
1954 Brown v Board of Education- The writing of The Effects of Segregation and the Consequences of Desegregation: A Social Science Statement was utilized in US Supreme Court decision making progress.
From Different Walks of Life
Culture: "the set of attitudes, values, beliefs, and behaviors shared by a group of people, and communicated from one generation to the next."
Differing Goals, Methods, and Styles.
Psychology- understanding of human behavior. Who, what when, where, why.....dilemmas.
Law- Regulate human behavior/punish behavior that break the law, imposing justice, absolute truths, etc.
Laws- "the system of rules that a particular county or community recognize as regulating the actions of its members and may enforce by the imposition of penalties" Enforced by authority, court system, law enforcement, etc.
Empirical data produced by scientists
Advocacy versus Objectivity
Role and Carriers
Advisors- Trial Consultants, mentoring, teaching, private sector
Meeting with clients, conducting assessment, evaluations, therapy, and are working the field
Yochelson & Samenow explanation to criminal activity
• 1. The roots of criminality lie in the way people think and make their decisions.
• 2. Criminals think and act differently than other people, even from a very young age.
• 3. Criminals are, by nature, irresponsible, impulsive, self-centered, and driven by fear and anger.
• 4. Deterministic explanations of crime result from believing the criminal who is seeking sympathy.
• 5. Crime occurs because the criminal wills it or chooses it, and it is this choice they make that rehabilitation must deal with
Crime myths help use organize our views of crime and the criminal justice system.
Stereotype and labeling
Commonly accepted views of crime
Street crime is increasing
Street crime is more violent
Street crime costs more then corporate crime
Police officers are more likely to be killed on duty than other professions
Criminal are different then the rest of us.
Criminal Justice System Basics
Adversarial justice system
AKA Trial Consultants & Litigation Consultants
Participate in jury selection and deselection
The two roles attorney's take
Things to focus on: demographics, experience, and attitudes
Small Group Research: Focus Groups & Mock Trials
Community Attitude Research
Oral, written, and visual Strategy
Introduction to Offenders and Victims
What are offenders and why do we classify them as so?
What different types of offenders do we work with and in what types of settings?
What makes working with offenders rewarding and challenging?
When we say mental health, what are we referring to?
How to we know to look for mental health?
How do we assess and diagnosis mental health?
Are mental health and substance use connected?
What do we need to understand about substance use when completing assessments?
How do we assess substance use?
DSM 4 versus DSM 5
What do people know about the differences?
Couple of significant difference: Schizophrenia sub types, Bi Polar Disorder and NOS, Anxiety Disorders and Obsessive Compulsive Disorders
My Soap box
Mental Disorders Due to a General Medical Condition
Substance related disorders (alcohol abuse, dependence, etc)
Schizophrenia and other Psychotic Disorders
Mood Disorders (Major Depression Disorder)
Impulse- Control Disorders
Obsessive- Compulsive PD
General Medical Conditions
Diseases of the nervous system
Endocrine, Nutritional, and Metabolic Diseases and Immunity Disorders
Complications of Pregnancy, Childbirth
Psychosocial and Environmental Problems
Problems with primary support system
Problems related to the social environment
Problems with access to health care
Global Assessment of Functioning (GAF)
Scale from 0-100
100-90 is superior functioning in a range of activities, life's problems never seem to get of out hand, is sought out because of his/her positive qualities, and no symptoms.
60-50 Moderate symptoms (eg flat affect and circumstantial speech, panic attacks) or difficulty in occupation, social life, or school functioning.
10-0 Persistent danger of severely hurting self or others (recurrent violent behavior) or persistent inability to maintain minimal personal hygiene or serious suicidal act with clear expectation of death
Substance Dependence I
A maladaptive pattern of substance use leading to clinically significant impairment or distress, as manifested by 3 or more of the following, occurring at any time in the same 12 month period.
Tolerance, as defined by the following
A need for markedly increased amounts of the substance to achieve intoxication or desired affect
Markedly diminished effect with continued use of the same amount of the substance
Withdrawal, as manifested by either of the following
The characteristic withdrawal syndrome for the substance (ref to criteria A & B for the criteria sets for withdrawal from the specific substance)
The same substance is taken to relieve or avoid withdrawal symptoms
The substance is often taken in larger amounts of over a longer period than was intended
There is a persistent desire or unsuccessful effort to cut down or control substance use.
Substance Dependence II
A great deal of time is spend in activities necessary to obtain the substance, use the substance, or recover from its effects
Important social, occupational, or recreational activities are given up or reduced because of substance use
The substance is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance.
A maladaptive pattern of substance use leaving to clinically significant impairment or distress; as manifested by one or more of the following occurring within a 12 month period
Recurrent substance use resulting in a failure to fulfill major role obligations at work, school or home
Recurrent substance use in situation in which it is physically hazardous (driving under the influence
Recurrent substance-related legal problems (arrests for substance related issues)
Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance (arguments with spouse)
Characteristic Symptoms: 2 or more of the following, each present for a significant portion of time during a 1 month period
Grossly disorganized or cationic behavior
Social/occupational dysfunction- symptoms and impact occur across different domains of life
Duration- continuous signs of the disturbance persist for at least 6 months. The 6 months must include 1 month of symptoms.
Schizoaffective/Mood Disorder Exclusion
Substance/General medical condition exclusion
Relationship to a pervasive developmental disorder exlusion
Major Depressive Episode
(A) 5 or more of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1)depressed mood or (2) loss of interest of pleasure
(1) depressed mood most of the day
(2) markedly diminished interest or pleasure in all, or almost all activities that at one point were pleasurable.
(3) significant weight loss or gain
(4) insomnia or hypersomnia nearly everyday
(5) psychomotor agitation or retardation
(6) fatigue or loss of energy
(7) feelings of worthlessness or excessive or inappropriate guilt
(8) diminished ability to think concretely
(9) recurrent thoughts of death, recurrent suicidal ideation, without a specific plan, or a suicide attempt
(B) the symptoms do not meet criteria for a mixed episode
(C) the symptoms cause clinically significant distress or impairment in social, occupational or other important areas
(D) The symptoms are not due to a direct physiological effects of substance use
(E) symptoms are not better accounted for by Bereavement
(A) A distinct period of abnormality and persistent elevated, expansive, or irritable mood lasting at least 1 week.
(B) During the period of mood disturbance, 3 or more of the following symptoms have persisted (4 if the mood is only irritable) and have been present to a significant degree.
(1) inflated self-esteem or grandiosity
(2) decreased need for sleep (feels rested after 3 hours of sleep)
(3) More talkative than usual or pressure to keep talking
(4) Flight of ideas or subjective expereince that thoughts are racing
(6) Increased in goal-directed activity (either socially, at work or school or sexually or psychomotor agitation)
(7) Excessive involvement in pleasurable activities that have a high potential for painful consequences (spending lots of $)
(c) the symptoms do not meet criteria for a mixed episode
(D) the mood disturbance is sufficiently severe to cause marked impairment in occupational functioning or in usual social activities or relationships with others or requires hospitalization
(E) symptoms are not sue to substance use
Major Depressive Disorder
(A) at least one presence of a Major Depressive Episode
(B) not better accounted for by Schizoaffective Disorder
(C) Has never had a manic episode
Difference between Major Depressive Disorder and Dysthymic Disorder
Bipolar I Disorder
Has had both a Major Depressive Episode and a Manic Episode
Difference between Bipolar II (recurrent Major Depressive Episodes with Hypomanic)
Difference between Bipolar and Cyclothymic Disorder
Antisocial Personality Disorder
(A) There is a pervasive pattern or disregard for and violation of the rights or others occurring since age 15, as indicated by the following
(1) failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest
(2) deceitfulness, as indicated by repeated lying, using of aliases, or conning others for personal profit or pleasure
(3) impulsivity or failure to plan ahead
(4) irritability and aggressiveness, as indicated by repeated physical fights or assaults
(5) reckless disregard for safety or self or others
(6) Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations
(7) Lack of remorse as indicated by being indifferent to or rationalizing having hurt, maltreated, or stolen from others
(B) the individual is 18 years of age
(C) There is evidence of Conduct Disorder with onset of age being before 15.
(D) The occurrences of anti social behaviors is not exclusively during the course of Mania with a person who has Schizophrenia.
What is the difference between Projective Assessment and Objective Assessment?
Two different ways assessments are given:
Given by clinician
Read and completed by client
TAT (Thematic Apperception Test)
MMPI-II (Minnesota Multiphasic Personality Inventory-II)
MCMI (Millon Clinical Multiaxial Inventory-III)
WAIS-IV (cognitive assessment), WRAT, WISC
The MacArthur Competence Assessment Tool
Validity Indicator Profile
Need to perform an intelligence assessment
MMPI - CARB (Computerized Assessment & Response Bias)
TOMM (The Test of Memory Malingering) - Recognition Memory Test
Substance Use Assessments/Screeners
ASAP II (Adolescent Substance Abuse Profile)
AdSAP (Adult Substance Abuse Profile)
Mental Health Assessment
BDI (Beck Depression Inventory)
GAIN Short Screener
Modified Mini Screen
Actuarial- based purely on the assessment and the assessments comparison to norms.
VRAG (Violent Risk Appraisal Guide) - LSI
SORAG (Sex Offender Risk Appraisal Guide) - STATIC-99
PCL-R (Psychopathy Checklist-Revised)
Structured- clinician considers multiple factors/assessment and made the risk determination.
HCR-20 (Historical Clinical Risk) -SAVRY (Structure assessment of Risk in Youth)
SVR-20 (Sexual Violence Risk)
Beck Suicide Scale
What information do you need to know in addition to the assessment?
When do you hospitalize (liability & safety contracting)?
Pros and Cons
Pros and Cons of standardized assessments
Answers are already given
No ability for elaboration
Language and cultural components
Reading and comprehension abilities
Clinical judgment- good and bad
Pros and Cons of Projective Assessment?
Prone to cultural and time period biases
Administration error or interpretation
Treatment wise people
Pros and Cons of clinical interviews?
How good are we at reading people?
Assessment more reliable
Assessments & Diagnosis
PCL-R- Psychopathy Checklist or Hare Psychopathy Checklist
Anti Social Personality Disorder
Lack of remorse or guilt
Shallow emotional response
Grandiose self worth/Narcissistic
Ice Man & Others
Ice Man Video reactions
John Wayne Gacy
Eric Harris and Dylan Klebond (1999)
Duane Morrison (2006)
Seugn Hui-Cho (2007)
Adam Lanza (2012)
James Homes (2012)
John Houser (2015)
Introduction to Treatment
Self-Help Groups (AA, NA, etc)
Pros of Group Therapy
Lower intensity of treatment
Cons of Group Therapy
Make up of the groups
Rotating group members
People's fear to open up
Cognitive Behavioral Therapy
Dialectical Behavioral Therapy (DBT)
Cognitive Behavioral Therapy
Cognitive-behavioral therapy is an action-oriented form of psychosocial therapy that assumes that maladaptive, or faulty, thinking patterns cause maladaptive behavior and "negative" emotions. (Maladaptive behavior is behavior that is counter-productive or interferes with everyday living.) The treatment focuses on changing an individual's thoughts (cognitive patterns) in order to change his or her behavior and emotional state.
a type of psychotherapy in which negative patterns of thought about the self and the world are challenged in order to alter unwanted behavior patterns or treat mood disorders such as depression.
Dialectical behavior therapy (DBT) is a form of psychotherapy that was originally developed by Marsha M. Linehan, a psychology researcher at the University of Washington, to treat people with borderline personality disorder (BPD).[ DBT combines standard cognitive-behavioral techniques for emotion regulation and reality-testing with concepts of distress tolerance, acceptance, and mindful awareness largely derived from Buddhist meditative practice. DBT may be the first therapy that has been experimentally demonstrated to be generally effective in treating BPD.] A meta-analysis found that DBT reached moderate effects. Research indicates that DBT is also effective in treating patients who present varied symptoms and behaviors associated with spectrum mood disorders, including self-injury. Recent work suggests its effectiveness with sexual abuse survivors and chemical dependency
a system of psychological theory and therapy that aims to treat mental disorders by investigating the interaction of conscious and unconscious elements in the mind and bringing repressed fears and conflicts into the conscious mind by techniques such as dream interpretation and free association.
Levels of Care
Why are there different levels of care
Why do we work towards the least restrictive setting?
Levels of care
Monthly Individual Sessions
Intensive Out Patient Services
Definition: the purposeful exaggeration or minimization of mental health symptoms for secondary gain.
Why do clients malinger?
What settings do we see this?
Each person will take a turn role playing a client. The other persons responsibility is to determine if the person is malingering or experiencing genuine mental health symptoms.
Violations of this includes
Inappropriate comments about a person's appearance, including flattery
Inappropriate conversation or enquiries of a sexual nature
Disrespectful or discriminatory comments or treatment
Inappropriate pet names
Failing to intervene in sexual harassment
Correspondence of a personal nature - text, phone, letters, email - that is unrelated to the staff member's role
Violation of this includes
Discussing personal lifestyle details of self, other staff or other clients
Not appropriate: "Hey, did you know Joe is from Cleveland and his sister lives in Seattle. He has 3 sisters and is the youngest."
What is appropriate
"hey, I use to fight with my sister and now that I am older, I realize that is a relationship that I need to work on. Maybe you can try and work things out with them."
"My mom and I use to fight, but as I got older I realized that she had a lot of important things to say - I would encourage you to listen to her."
Violations of this include
Unwarranted or unwanted touching of a child, personally or with objects
Corporal punishment (physical discipline, smacking etc)
Initiating, permitting or requesting inappropriate or unnecessary physical contact - massage, playing with hair, kissing, horseplay, tickling game
Inappropriate use of physical restraint
Violations of this include
Inviting/allowing/encouraging client's to attend the staff members house
Allowing client's to access a staff member's personal internet locations (social networking)
Attending client's homes or their social gatherings unless authorized for a specific purpose by a Manager (dropping a client off at home)
Being alone with a client outside of the staff member's responsibilities
Entering changing rooms/bathrooms without announcing yourself and for the reasons of safety only (client is not responding)
Violations of this include
Tutoring/educating/helping (outside of your duties)
Giving personal gifts or special favors
Sharing your food or drink with the clients (especially if its only certain clients
Singling the same clients out for special duties or responsibilities
Allowing certain clients to talk in transition, during silence, during room time, after bed time, during meds
Violations of this include
Adopting an ongoing welfare role that is beyond the scope of their position or that is the responsibility of another staff member that occurs without permission
Photographing, audio recording or filming when not authorized or without parental consent
Using personal equipment or money without approval
Laws and Reporting
Children's Protection Act 1993 - defines child abuse, mandates staff in education and care environments to report child abuse and neglect and requires all organizations providing this to comply with principles of child safe environments
Due to this law, every one at Jefferson Hills is considered a mandated reporter
Chain of Command - staff to milieu supervisor, milieu supervisor to Clinical Manager or Program Manager
Therapist - to Clinical Manager or Program Manager
Our Reporting Steps if this is a first report
Critical Incident report is generated
Person who it was reported to calls CPS to report incident
Person reported to writes description in Critical Incident
Supervisor or therapist contact necessary parties determined by CM or PM
Clinical Manager or Program Manger send Critical to licensing
Laws and Reporting
What is illegal:
Sexual contact with any client in our care
What is unethical (but not necessarily illegal):
Carrying on a romantic relationship or perceived romantic relationship with a client under our care
Writing inappropriate letters
Getting a PO box to send letters
Texting, calling, facebooking, twitter, instagram...
Giving an address, sharing the time and date of a location you will be at, noting that you live in the same area/share the same Walmart
Spending too much time, whispering, being alone, singing lullabies to a specific client...
Gift giving - presents, fast food, souvenirs from a trip, personal items "you don't want anymore", anything you are spending your own money on
Special treatment - allowing one to do something that you won't allow another
Sharing too much information or someone else's information
Effects of violating client/staff boundaries
How you hurt the client:
Undermine the learning process for a client
Re-traumatizing and Victimizing
Loses trust in you
Other clients lose trust in you
Reinforcing maladaptive behavioral patterns
How you hurt yourself:
Undermine the professional reputation and confidence of the child care community
Formal write ups or other disciplinary action
Termination of Employment
Registered on Child Abuse and Neglect list
Criminal charges pressed
Working with kids one on one
What you can do to help yourself:
Make it Public:
Be visible, VERY VISABLE
Don't use personal email, text, websites to interact with young people
Allow others to hear what you are talking about
Make it authorized:
Parents/Manager/ Supervisor need to give consent
Any activities need to be authorized by Management
Make it timely:
Provide support during normal work hours
Do not conduct excessively long sessions - 15 minutes or less, as 15 minutes is a PC check in
Be mindful of transition, silence, bed time - do not meet with clients during this time, as it conflicts with program expectations
Speak with many different clients, not the same over and over
What to report
If you see:
Grooming behaviors (spending lots of time with one client, giving gifts, going into a closed door room, suspicious behavior
Any inappropriate physical contact (front hugs, back rubs, playing with hair, holding hands, sitting too close to each other)
Any inappropriate non verbal (winking, blowing kisses, silent motioning, double eyebrow raise, stop talking when others are around)
If you hear:
Any inappropriate conversation (sexual, personal, disclosure of either)
Another client states to you that a staff member is doing any other above
Anything suspicious (whispering, "ill talk to you later" while others are walking by, secret keeping
If you find:
Client and staff behind a closed door with no way to see them
Client and staff alone without authorization
Letters, texts, notes
Staff belongings, staff's full names on things, staff contact information
Personal information about a staff member in client's belongings
Competency to Stand Trial
Competence- references the defendants ability to assist in their own defense and understand the consequences.
Multiple Forms of Legal Competency
Waive Miranda Rights
Competency to Confess
Competency to make treatment decisions
Competency to execute a will or contract
Competency to manage one's finances
Why do we care?
Fairness to the defendants
Verdicts- entering pleas, enter into agreements, decisions around testimony, key elements, etc.
Faith in the system
Dusky v. United States 1960
United States Supreme Court set the following standard "...sufficient present ability to consult with his attorney with a reasonable degree of rational understanding and whether he has a rational as well as factual understanding of the proceedings against him"
Focuses on the time of trial, NOT the time of the event or crime.
2 aspects of Competency to Stand Trial:
One's ability to interact rationally with their attorney
Ability to understand how the court process works.
Ability versus willingness
Rules of Competency
Cooper v. Oklahoma 1996; Medina v California 1992;
Defendants are considered to be competent until proven until proven incompetent
Who has the burden of proof to prove the defendant incompetence?
What is the level of evidence: Beyond a Reasonable Doubt or Preponderance of the Evidence
Assessment Key Points
Not a legal or psychological concept.
1. Understand the current legal situation
2. Understand the charges against them
3. Understand the pleas available
4. Understand the roles of the judge, defense counsel, and prosecutor
5. Understand the possible penalties if they are convicted
6. Trust and communicate with defense counsel
7. Help in locating witnesses
8. Aid in developing a strategy for cross-examining witnesses
9. Act appropriately during the trial
10. Make appropriate decisions about trial strategy
Competency and Mental Illness
People who have severe mental illness, developmental delays and psychosis are often found competent.
2006- Warrant et al. examined over 800 competency evaluations in Virginia and of those, over 2/3 were found competent.
Competency and Mental Illness
Johnson v. Zerbst-1938
In order for a defendant to plead guilty, it must be done so with the, the plea must be entered into knowingly, voluntary, and intelligent.
Self representation and competency
Higher standard for the court to agree to someone represent themselves if the person has severe mental illness or competency issues.
What's the process & Stats
60-90% of people who are found incompetent are restored (Warren et al., 2006)
Bonnie G Grisso, 2000; nearly 60,000 competency evaluations are done a year; approximately 5% are for felony defendants, between 11-30% found to be incompetent.
Dismissal of charges
Forced Medications Riggins v. Nevada 1992- Due Process Rights
Sell v. United States, 2003- Forced medication permitted if inmate in dangerous to self/others & 1. such treatment was medically appropriate; 2. the treatment was unlikely to have side effects that would undermine the trial fairness and 3. such treatment was necessary to further a significant government interest.
Education and therapy
Juveniles and Competency
Transfers to adult court
Juveniles often lack intellectual maturity, which affects their ability to participate in their defense
The government is legally not responsible for providing citizens with medical or mental health care.
When the government retains custody of someone, the government then is legally obligated to provide certain services.
What services do we think are legally obligated?
Deshaney v. Winnebago Department of Human Services
This ruling establishes the basic principles that when the government maintains physical custody of someone then there is an obligation to "protect and preserve life including the treatment of serious medical issues and mental health issues."
Constitution & Case Law
Eighth Amendment & Fourteenth Amendment involves cruel and unusual punishment
Two cases have been brought to the US Supreme Court with inmates sighting the Eighth Amendment: Estelle v. Gamble & Farmer v. Brown
Estelle v. Gamble- Established that failure to comply with medical needs of inmates that could result in torture or a lingering death is not acceptable, however it added the standard that the petitioner must prove there was deliberate indifference.
Farmer v. Brown- defines deliberate indifference as a knowingly disregard.
US Supreme Court Cases sight "serious medical" and "serious mental illness."
There have been two different standards set by the court: obvious to the lay person & deemed by a medical professional.
What constitutes adequate care?
6 components in minimally adequate care (Ruiz v. Estelle 1983):
A systematic program for screening and evaluating prisoners must be in place to identify the inmates in need of mental health treatment.
Treatment must include more than segregation and close supervision
Treatment requires there be a trained mental health professional and there are enough mental health staff to identify and treat in an individualized manner those treatable inmates with serious mental illness.
There must be accurate, complete and confidential records of the mental health treatment process.
Prescription and administration of behavior-altering medication in dangerous amounts, by dangerous methods, or without appropriate supervision and periodic evaluations are unacceptable.
A basic program for the identification, treatment, and supervision of inmates with suicidal tendencies is a necessary component of any mental health treatment program
True or False People who are incarcerated are more likely to commit suicide then the general population.
True or False Most jail suicide occur within the first 24-48 hours after their arrest.
What is the leading cause of death in jails?
True or False: Suicide is the third leading cause of death in prisons, following AIDS and natural causes.
What do we think about these ideas?
Quote & Explanation
Some inmates are (or become) ill-equipped to handle the common stresses of confinement. As the inmate reaches an emotional breaking point, the result can be suicidal ideation, attempt, or completion. During initial confinement in a jail, this stress can be limited to fear of the unknown and isolation from family, but over time (including stays in prison) the stress may become exacerbated and include loss of outside relationships, conflicts within the institution, victimization, further legal frustration, physical and emotional breakdown, and problems of coping within the institutional environment.
Mental health support
Observation (Close Observation & Constant Observation)
Removal of dangerous items
Having a protocol that is consistently followed
Transferring suicidal inmates to the hospital when needed
Education and training for various correctional staff
Open communication from within the facility and also from arresting officers
CPR & first aid training
Suicide assessment is not a single event its an ongoing evaluation
Assessment identify current concern not future
Past history of attempts are strongly correlated with future attempts
Look at the whole picture: behaviors, sleeping patter, eating patterns, relationships with others, prior history, etc; don't just rely on their statements.
Communication with other staff, suicide risk is not something to keep secret
Work to eliminate any barriers
True or False: A therapist in a jail find out an inmate is making and selling weapons. Since there is no identified victim, the therapist does not have the ability to break confidentiality
True or False: Confidentiality rules change when a client is incarcerated.
True or False: If a client is in fear of being assaulted by another peer, the therapist is obligated to share this information with the corrections officers.
Reasons to Break Confidentiality
Presenting a reasonably clear danger of injury to self or to others
Presenting a reasonably clear risk of escape or the creation of internal discord or riot
Requiring movements to a special unit for observation, evaluation, or treatment of acute episodes
Requiring transfer to a treatment facility outside the prison or jail
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