Forensic Report Writing - WordPress.com › 2019 › 05 › may-1… · 05/05/2019 · Forensic Report Writing The 41st Annual Forensic Centers Continuing Education Conference May

Richart L. DeMier, Ph.D., ABPP and Meredith Veltri, Ph.D., ABPP

May 10, 2019

Columbus, OH 1

Forensic Report Writing

The 41st Annual Forensic Centers Continuing Education Conference

May 10, 2019Columbus, Ohio

Rick DeMier, Ph.D., ABPP

and

Meredith Veltri, Ph.D., ABPP

Brief Overview of the Day

Foundational Ideas Research Findings Conceptual Models Elements of the Forensic Report Avoiding Jargon Matters of Style

Financial Disclosure

I may mention a recent book Rick would receive about $3.50 per book

sold


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A Short ReportThe Defendant is a danger to others (high risk of property offenses and above average risk of sexual offenses). The most appropriate place for treatment in light of his mental disorder and his light of his mental disorder and his potential threat to public safety is in a secure psychiatric facility. The defendant is not competent to refuse treatment, and he should be subject to involuntary treatment.

FoundationalIdeas

Foundational Ideas

Understand your role Be responsive to the psycholegal

questionP t d t th d l i Present data, then draw conclusions

Link your conclusions to the underlying data

Write so you can be understood Tell the truth


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A forensic report is what you think and

Foundational Ideas

what you think and why you think it.

How do you know ?

Foundational Ideas

what you know?

Show your work.

Foundational Ideas


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“The quality of our reports is often the most tangible and visible measure of our professionalism.”

– Appelbaum, K.L. (2010)

“The only time the expert is in complete control of the information that is and is not presented is when writing the report As a result it is when report. As a result, it is when writing a report that one can clearly meet ethical obligations.”

– Otto, R.K., (2009)

High Quality Forensic Practice and Exemplary Forensic Reports These two go hand in hand, but the

presence of one does not always predict the other

It may be impossible to disentangle the y p gquality of one’s practice from the quality of one’s written work

But for purposes of this workshop, we will presume that you already have a high quality forensic practice

This workshop focuses on report writing


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A Silly ArgumentArgument

Functions ofForensic ReportsForensic Reports

Communicating One’s Professionalism

The report is the first impression The report communicates the expert’s

commitment to comprehensiveness, clarity and objectivityclarity, and objectivity◦ Stands in stark contrast to testimony

May refer to report during testimony


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Framing the Questions

Considerable latitude No single “right” format Examiner can choose an approach that

b f h i i di d best frames the issues in dispute, and . . . Facilitates presentation of their work in a

persuasive manner

Communicating Efficiently

The report documents:◦ The focus of the evaluation◦ Assessment techniques used◦ Data gathered and considered◦ Opinions formedp◦ Underlying reasoning

Sometimes retaining attorneys do not want a written report, for these very reasons:◦ They do not want experts to communicate what they

did to opposing counsel, or◦ They do not want experts to commit to opinions

they formed.

Memorializing the Evaluation

Reports are far more likely to provide the bases for decisions than testimony

The report stands alone as the enduring and tangible evidence of the results of the evaluationevaluation

Wettstein (2005): “A window into the forensic evaluation”

Over time, examiners misremember or forget

The report commits to paper details that would otherwise be lost to memory


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Complying with Legal Requirements

Know legal requirements for reports in your jurisdiction

Ohio Administrative Code 5122-29-07

Forensic Evaluation Service:◦ An evaluation resulting in a written expert opinion regarding a

l l i f i di id l f d b i i l d i legal issue for an individual referred by a criminal court, domestic relations court, juvenile court, adult parole authority, or other agency of the criminal justice system or a Ohio Department of Mental Health and Addiction Services (OhioMHAS) operated regional psychiatric hospital.

Complying with Legal Requirements

Each forensic evaluation report shall include:◦ Expert name and qualifications

◦ Name of the court or agency that referred the person

◦ Legal or referral question

◦ Identifying information including relevant clinical, social, criminal history (emphasis added)history (emphasis added)

◦ Duration and location of interview

◦ Description of collateral information

◦ Psychological/psychiatric data that addresses the legal issue

◦ Opinions and recommendations

Complying with Legal Requirements: OAC

Report shall be in non-technical terms and reasonable detail

Data shall be pertinent to the legal or referral question

Relevant collateral described to fullest extent possible

Opinions shall not be based entirely on self-report when collateral is available

Reports shall contain sufficient information to substantiate conclusions

Special caution for self-incriminating statements, information about those not being evaluated, or other material of a sensitive, personal nature not related to the issue for which the evaluation was requested


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A Note About Relevance…

Ohio Rules of Evidence, Rule 401:◦ “Relevant evidence” means evidence having any

tendency to make the existence of any fact that is of consequence to the determination of the action more or less probable than it would be without the evidence.

A data point is relevant when it leads you toward or away from an opinion

Committing to Opinions

While writing, the examiner must◦ consider all the information made available◦ identify key pieces of data◦ resolve or explain inconsistencies in data◦ form opinions that are relevant to the matter

This could be done without writing, but ... The very process of writing requires the

examiner to synthesize and integrate data and opinions, and rectify and explain inconsistent and contrary data.

Anticipating Testimony

Forensic reports provide the foundation for later testimony

Attorneys often look to the forensic report as the “starting place” for developing their as the starting place for developing their examinations of the expert

Even with careful preparation of testimony, the attorney is still likely to rely heavily on the structure of the report to shape the structure of anticipated testimony


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ResearchFindingsFindings

Data

Data


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aka:The SkeemThe SkeemDissertation

Skeem and Golding, 1998

Skeem and Golding identified three fundamental deficits in competency reports:◦ Failure to address competency-related

abilities◦ Failure to describe reasoning◦ Failure to use “forensically relevant

methods of assessment”

Skeem and Golding, 1998Failure to address competency related abilities

Most reports discussed foundational abilities, but not “the higher-order decisional capacities that lie at the heart of the ‘rational’ language of the Duskyof the rational language of the Duskystandard”

Doing so requires a contextual approach


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Skeem and Golding, 1998Failure to describe reasoning

Examiners’ conclusions can be organized into three categories◦ Defendant’s psychopathology◦ Competency-related abilities and deficits◦ Competency-related abilities and deficits◦ The link between the impairments and the

legally relevant deficits

Skeem and Golding found these crucial connections to be variable and poorly substantiated

Skeem and Golding, 1998Failure to use forensically relevant methods

Many reports used traditional clinical methods to answer psycholegal questions

Even when forensic assessment Even when forensic assessment instruments were used, none of the reports in the sample “detailed a concrete relationship” between test results and the relevant psycholegal abilities

Skeem, Golding, Cohn, & Berge, 1998 Experts coded reports to reflect report

content in 11 global psycholegal domains and 31 nested subdomains

When a defendant was considered impaired in a domain, experts judged the degree to which the report’s author linked the ppsychopathology to the identified deficit

Descriptions of the relationship were coded along an ascending hierarchy◦ Absent (no description)◦ Implied (by examples or quotes)◦ Asserted (without support)◦ Substantiated (with specific supporting data)


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Skeem, Golding, Cohn, & Berge, 1998

Found adequate description of reasoning regarding clinical findings . . .

. . . but poor description of reasoning regarding psycholegal conclusions◦ 34% of reports described no relationship p p

between impairment and psycholegal abilities◦ 36% asserted a relationship existed without

providing support for that contention◦ Only 12% discussed competency-related

abilities in the context of the specific demands of a defendant’s case

Practical Implications of Literature

An essential element of forensic reports is the description of the functional abilities of the person being evaluated, and the explicit link between clinical findings

d th h l l f l tiand the psycholegal referral question Ultimate Issue Issue: A red herring

ConceptualModels


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Grisso's Six Principles(Grisso, 2008)

1) Let the forensic question drive, guide, and limit the content of the report◦ To do this, you must understand what makes the

report forensic, and how it differs from other types of clinical reports


2) Report what is necessary – Do notreport what is not necessary◦ Decide what is relevant to the psycholegal

question◦ Be able to justify inclusion and exclusion on the

basis of relevance◦ The amount of detail necessary will vary


3) Sequence and describe information in a way that makes sense to the reader◦ Arrange information in a manner that will be Arrange information in a manner that will be

easy to follow◦ Adjust the structure of a report as necessary to

accomplish this◦ Use language your audience will understand◦ When writing, think about potential testimony


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4) Separate facts from inferences and opinions◦ Facts can be verifiedFacts can be verified◦ Inferences and opinions reflect what is suggested

by the facts at hand◦ The inferences and opinions should be clearly

linked to the facts which support them

Fact/Inference Example It may be a fact that, after police were called to

a domestic dispute during which a husband held a knife to his wife’s throat and accused her of helping the CIA poison his food, she stated she wanted him removed from the home and jailedA i f h h f d f h An inference that the woman feared for her safety is supported by this fact

A conclusion that the man met the criteria for involuntary hospitalization is a psycholegal one, supported by such facts and inferences

Inferences and opinions should be clearly linked to the facts which support them


5) Explanations involve showing why you think what you think◦ A large part of forensic work is education –

that's the natural role of an expertthat s the natural role of an expert◦ It is incumbent on the examiner to be as

transparent as possible◦ Help the reader see through your eyes◦ Connect the dots – How, specifically, did you get

from the facts to the conclusions?


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6) Explain your rejection of other possible opinions and conclusions◦ Demonstrate that you were alert to, and actively

id d l i h hconsidered, alternative hypotheses◦ Explain why your data best supports your

conclusion◦ Explaining rejected ideas is an essential part of

the process of arriving at an opinion◦ Be transparent in your thinking

Structure of theF i R tForensic Report

It’s like a Rorschach


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Structure of the Report Grisso: Let the forensic question drive,

guide, and limit the content of the report For a report to be effective, there needs

to be an organizational structure that imposes coherence on the work as a imposes coherence on the work as a whole

There should be some reasonable logic to the sequence in which information is presented

There are several proper ways to structure a report

Melton et al. on Structure “Factual information and descriptive

material based on clinical observations and other procedures should be presented separately from the theoretical and inferential formulations h l k h l l d h l l that link the clinical data to the legal

referral question, with the former presented first.”

“This organization allows the clinician to ‘build’ a case, organizing the investigative data in a manner that invites the reader to reason along with the author.”

You are a Tour Guide


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Structure of the Report

Be free to vary the structure of your report as necessary to enhance the effectiveness of your communication◦ A very short report might not require y p g q

headings◦ In a complicated case, consider a section

early in report which summarizes opinion◦ Subheadings can make long reports less

cumbersome

Templates – AdvantagesCan help ensure the inclusion of all

necessary informationCan structure and guide reportsCan be especially useful for

d i th i k th t i t t reducing the risk that important information will be left out of a report

Can also guide decisions about how to sequence the presentation of information

Templates – Disadvantages

Can become beholden to template

Can decrease the amount of th ht th t i t d i i thought that goes into decisions about presentation and sequencing of information

May increase risk of inclusion of irrelevent information


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Elements of the F i R tForensic Report

Common Elements Referral Information Notification Sources Historical Information Behavioral Observations/Hospital Course Psychological Testing Diagnostic Formulation Response to Specific Psycholegal

Questions

Referral Question

This is the place to clearly state the

forensic purpose of the report

What is the psycholegal question?

How did it come to pass that somebody p y

wanted to know what you thought?

What legal standard did you employ in

responding to the question?◦ Cite statute if appropriate


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Referral Question

Include some identifying information◦ Name◦ Age◦ Case NumberH h d d?◦ How much do you need?

Cite the relevant statute or psycholegal standard

Notification

Understand the difference between consent and assent

Describe your explanation of the notification process, as well as the defendant's responsedefendant s response

ORC 2945.371 (J) No statement that a defendant makes in

an evaluation or hearing under divisions (A) to (H) of this section relating to the defendant's competence to stand trial or to the defendant's mental condition at the time of th ff h d h ll b d i t th the offense charged shall be used against the defendant on the issue of guilt in any criminal action or proceeding, but, in a criminal action or proceeding, the prosecutor or defense counsel may call as a witness any person who evaluated the defendant or prepared a report pursuant to a referral under this section.


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However… ORC 2945.39 Expiration of Maximum Time for Treatment for

Incompetency (2) On the motion of the prosecutor or on its

own motion, the court may retain jurisdiction over the defendant if, at a hearing, h f d b h f h f ll b l d the court finds both of the following by clear and

convincing evidence: (a) The defendant committed the offense with which the defendant is charged. (b) The defendant is a mentally ill person subject to court order or a person with an intellectual disability subject to institutionalization by court order.

However… ORC 2945.39

(B) In making its determination as to whether to retain jurisdiction over the defendant, the court may consider all relevant evidence, including, but not limited to, any relevant g ypsychiatric, psychological, or medical testimony or reports, the acts constituting the offense charged, and any history of the defendant that is relevant to the defendant's ability to conform to the law.

NotificationMore detail is better Poor: “The limits of confidentiality were

explained.” Better: “The nature and purpose of the

evaluation were explained, as were the limits of confidentiality. The defendant acknowledged those issues and appeared to understand them”those issues and appeared to understand them.

Even Better: “I explained the nature and purpose of the evaluation were explained, as well as the limits of confidentiality. The defendant attended to the explanation and asked relevant questions. He demonstrated his understanding of the information by explaining it in his own words at various points throughout the evaluation.”


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Future Use of Forensic Reports Federal government and many states have

rules about how competency and sanity reports may or may not be used

Most preclude their use as evidence of guiltB f f d h l d◦ Bifurcation of death penalty proceedings

This is an important component of informed consent

However, few reports indicate whether this component was explained

Notification inDeath Penalty Cases Go overboard in terms of a detailed

explanation Carefully explain the potential uses of the

report, including the potential for you to p , g p ybe called at sentencing, should the defendant be found guilty.

Example: “Although his statements cannot be used to prove the case against him, I explained there is no similar protection against the use of his statements at sentencing, should he be convicted, if he were to raise his mental state as an issue.”

Defendant’s Response

Many reports indicate that informed consent was obtained, but they do so in a very perfunctory manner:◦ “The defendant consented to proceed.”

What is often missing is an adequate description of◦ The defendant’s reaction and understanding◦ An explanation of your conclusion that it was

sufficient◦ How do you know what you know?


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Sources of Information Include all sources◦ Interviews◦ Collateral contacts◦ Psychological testing◦ Documents reviewed◦ Documents reviewed

Organization is key Level of detail is a matter of style◦ Some people count time and pages◦ But there are reasonable arguments for not

doing so

Include Missing Sources

Document sources of information you requested or tried to access, albeit unsuccessfully

This demonstrates good faith and gappropriate practice

This documents that efforts were made to perform a comprehensive evaluation

Acknowledge any resulting limitations of opinions

Implications for Credibility

Be transparent and identify the sources of key data upon which opinions rely

The reader of the report can then make an independent judgment about the credibility p j g yof the expert’s factual foundation

The reader of the report can determine the amount of weight to be afforded to opinions based on that foundation


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History

“Including in the report pejorative or embarrassing information that is irrelevant to the legal issue may demonstrate a completeness of the interview but it does so at the cost interview, but it does so at the cost of the client’s dignity.”

– Griffith et al., 2010

“Just the facts, Ma'am”

Historical section is a place for reporting factual information.

Be specific about the source of your facts. Attribute as much as possible to the source.

Impressions of others are appropriate for the historical section: “Clinicians at the state hospital described him as entitled and narcissistic.”


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Why are histories overinclusive?

Concerns about appearing comprehensive That is how we are trained Legal mandates; concerns about admissibility

of the opinionof the opinion Institutional policies

Behavioral Observations

Even more so than the background information section, the behavioral observations section lays the foundation for your conclusions regarding current mental status and diagnostic formulation. What did you see during the evaluation that led you to your conclusions?

Behavioral Observations

Behavioral observations are especially important in establishing malingering when the defendant's inconsistent behavior supports that conclusion.


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Psychological Testing

Psychological testing is an easy area to fill with jargon Jargon: A few words used to represent very complex

ideas “Significant elevation,” “Supplemental validity scales”Significant elevation, Supplemental validity scales

People other than psychologists sometimes ascribe magical power to “test results”

People believe psychologists can use testing as an x-ray of the mind to reveal a person’s most carefully guarded desires, motivations, deceptions, and other secrets

Psychological Testing

Present the rationale for each test and describe its function◦ Brief discussion of the purpose of each

testA k l d li i f h ◦ Acknowledge limits of each test

◦ Be mindful to test security Write a rationale for the tests you

chose in a manner that is accessible to legal professionals

To do this, you need to understand the tests you are using

Psychological Testing Should you offer test by test descriptions or “integrate” all test data?

We overestimate our abilities to integrate data

A test by test approach allows you to A test‐by‐test approach allows you to inform the reader regarding what tests and results are linked to which data or interpretations

A test‐by‐test approach leaves the psychologist less vulnerable to reporting only data consistent with the opinion


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Psychological Testing Report any deviations from standard

assessment procedures . . .◦ . . . Especially when the deviation can affect

test validity◦ Transparency enhances credibility◦ Transparency enhances credibility

Acknowledge that test results do not translate into psycholegal opinions

Report all test results Frank and non-defensive discussion of

data contrary to one’s opinion enhances credibility

Psychological Testing Should you report scores? If so, which ones?◦ What is the context of the evaluation?◦ Are the scores important within that context?◦ Will the scores be understood by the reader?y

Test scores are jargon There does not seem to be a consensus in the field

Readers may ascribe inaccurate information to specific results

But some circumstances demand specific scores

Psychiatric Medications Psychiatric? Psychotropic? Neuroleptic? Identify◦ The type of medication (antidepressant,

antipsychotic, medication to address potential side effects)G ◦ Generic name◦ Trade name◦ Dosage

The antidepressant medication sertraline (Zoloft), 100 mg daily

Specifically note long-acting medication


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Diagnoses are Jargon

More important than a diagnosis is the rich description of the person’s cognitive, emotional, and behavioral functioning at and around the time of interestThi i h i f i h i f l This is the information that is of value to those who seek the assistance of a forensic examiner

A narrative description of an examinee’s clinical condition is likely to be much more helpful than a diagnostic label

Consider Alternative Hypotheses

In many cases, more than one diagnostic possibility is considered

Clinicians typically go through a process of considering differential diagnosesDi i di i ibili i ll Discuss competing diagnostic possibilities, as well as your reasons for favoring one over the others

Be transparent in revealing why you chose one particular diagnosis instead of another, especially when the issue is a close one

Response to Psycholegal Question

Ideally, there will be no surprises here Lay out your data first, then draw inferences Logically explain your interpretations and

opinionsopinions Make your thinking transparent◦ So the reader knows not only your opinion, but

also how you reached that opinion


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Psycholegal Opinions

Some reports explicitly acknowledge that the determination is a legal one.

Do you need to identify your opinion as an opinion? Or can this be assumed?opinion? Or can this be assumed?

There are reasonable arguments on both sides of this issue

Relevancy‐Focused Format

Inspired by Reid Meloy

Proposed by Terry Kukor for Netcare

More efficient reports

◦ Typically shorter – a consequence not a goal◦ Typically shorter – a consequence, not a goal Focused narrowly on referral question

Format is similar to a legal brief

Positive feedback from referral sources

Relevancy‐Focused Format: Major Sections Reason for Evaluation Notification Evaluation Procedures and Data Sources◦ Data requested but not obtained◦ Adequacy of the data◦ Reliability of the defendant (e.g., presence or absence of impairment in ability to report data)

Forensic Opinion Data and Findings upon which Forensic Opinion is Based◦ Each issue is addressed individually

Data Not Consistent with Opinion


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Relevancy‐Focused Format: Addressing the Issues State the Issue – What’s the question?

State the Opinion – What’s the answer?

Support the Opinion – What are the data?

Forensic Analysis What do the data mean Forensic Analysis – What do the data mean for the legal question?

Relevancy‐Focused Format: Supporting the Opinion Information organized by source

◦ Self‐report◦ Mental status/Behavioral observation

◦ Collateral information

◦ Psychological Testing/Forensic Assessment Instruments

Example: Issue: Evaluation of whether the defendant

has a severe mental defect Opinion: It is my opinion that the

defendant does/does not have a severe mental defect.

Data Considered: This opinion is based upon the following:◦ Self-reported History:◦ Mental Status:◦ Collateral Information:◦ Psychological Testing:

Forensic Analysis:


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WordChoiceChoice

First‐Person or Third‐Person?

Neither is incorrect Some people think third-person writing is

haughtier and harder to read Others think first-person writing is too Others think first-person writing is too

colloquial and thus unprofessional Find a style that is comfortable for you◦ But first-person language is strongly

recommended!


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Referring to the Examinee

Use of formal language is recommended: Mr., Ms., Dr., etc.

Referring to the examinee by the first name seems inappropriately familiarpp p y◦ “Jeffrey” Dahmer, “Jodi” Arias

Use of first names with children is recommended◦ Shortly before the accident, Ms. Tompkins

graduated from kindergarten.

Word Choice Matters

Finding exactly the right word to convey your meaning can be worth the effort

Vary your words to maintain interest in the reportp◦ Avoid repetitive patterns◦ This can be challenging when struggling to

attribute all statements to sources◦ One possible solution is to organize by sources

Avoid Words with Prejudicial Connotations

Think about individual words and the connotations they carry◦ Admit◦ Deny◦ Deny◦ Maintain◦ Alleged◦ Refused


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Some Least Favorite Phrases

“appeared his stated age” “dressed in prison garb” “oriented times three” “suffers from” suffers from “rule out” “reasonable psychological certainty”

Reasonable Psychological Certainty

Some argue that the origin of this phrase is that it is a threshold issue◦ This is the degree of certainty required for the

opinion to be admissible

The trouble is its inclusion in reports and testimony as a matter of course

Consider Poythress’s 1983 article

Some of Lilienfeld’s least favorite words and phrases

Lilienfeld, S. O., Sauvigne, K. C., Lynn, S. J., Cautin, R. L., Latzman, R. D., and Waldman, I. D. (2015). Fifty psychological and psychiatric terms to avoid: A list of inaccurate, misleading, misused, ambiguous, and logically confused words and phrases. Frontiers in Psychology, Published online 2015 Aug 3. doi: 10.3389/fpsyg.2015.01100


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“Scientific thinking necessitates clarity, including clarity in writing.”

“An insistence on clarity in language forces d hi k d l d f ll students to think more deeply and carefully

about psychological phenomena, and serves as a potent antidote against intellectual laziness, which can substitute for the meticulous analysis of concepts.”

“Clear writing fosters clear thinking, and confused writing fosters confused thinking.”


Chemical imbalance Gold standard Acting outActing out And 47 more worth reading


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Trouble SpotAvoiding Jargong J g

Double Meanings Some words that mean one thing in

common usage and something far more exact and behaviorally grounded in psychology◦ Depression◦ Obsession

Report authors should recognize that unless the scientific meaning of such words is articulated, the readers will naturally resort to the meanings they know


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How to Avoid Jargon

Use plain English◦ Never use words like utilized or verbalized;

used and said will work just fine

When you must use technical terms, carefully define them

Explain terms and concepts in common-sense language and use examples

Plain English

• My mother never said, “Utilize your napkin!”• Parents do not instruct children, “Don’t

verbalize back!” My patient did not “demonstrate My patient did not demonstrate

tearfulness.” He cried. Pirates never made anybody “Ambulate the

plank.”

Explaining Technical TermsDevelop a repertoire of explanations for common terms

◦ Oriented◦ Form of

thought/Content of thought

◦ Delusions◦ Grandiosity◦ Paranoid Ideation◦ Affectg

◦ Tangential◦ Positive

Symptoms/Negative Symptoms◦ Hallucinations

◦ Affect◦ Suicidal Ideation◦ Suicidal Gestures


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Form and Content

Helpful way to explain elements of thought disorders. The form of one’s thoughts refer to how they think. Impairments in the form of thought include tangentiality, g g ycircumstantiality, disorganization, clanging, etc. Content of thought refers to what they think. This may reflect symptoms such as hallucinations and delusions.

Positive and Negative Symptoms

Psychotic symptoms are categorized as positive and negative. Positive symptoms refer to experiences that are present, but should not be, such as experiencing p ghallucinations or holding false beliefs. Negative symptoms refer to the absence of normal human experiences, such as the spontaneous production of thought or the experience of a full range of emotions.

Delusions

False beliefs which persist even in the face of contradictory evidence. For example, he appears to believe that his employer is a part of a vast and well-organized conspiracy intent g p yupon preventing him from becoming President of the United States.


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Trouble SpotIncriminating Evidenceg

Incriminating Evidence

There is a time to discuss the defendant’s statements about the offense-related behavior. That time is after the defendant has put his mental state at issue.p

Understand the risks associated with revealing this information prematurely.

The 1991 Specialty Guidelines Forensic psychologists “exercise extreme

caution in preparing reports . . . prior to the defendant’s assertion of a mental state claim.” They “avoid including statements y gfrom the defendant relating to the time period of the alleged offense.” (VI.G.1)


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Professional & Other Public CommunicationsSpecialty Guidelines for Forensic PsychologySection 11.04

“Forensic practitioners are encouraged to limit discussion of background information that does not bear directly upon the legal y p gpurpose of the examination or consultation. Forensic practitioners avoid offering information that is irrelevant and that does not provide a substantial basis of support for their opinions, except when required by law.”

Estelle v. Smith451 U.S. 454 (1981)

The Supreme Court decision limits the use of competency evaluation results only to the competency issue

Incriminating evidence may well be produced during a competency evaluation

Avoid “fruits of the poison tree” in your report (and perhaps even in your notes)

Miscellaneous StuffStuff


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Changing Completed Reports Forensic examiners are sometimes asked to edit or

change reports they have already submitted. Attorneys make such requests for a variety of

reasons◦ Sometimes the request comes because of errors the

report writer made – ranging from typos to report writer made ranging from typos to misstatements of facts, such as dates or events◦ Sometimes the request is in response to concerns that

information in the report is unfairly prejudicial or otherwise inappropriate

But, some requests are an attempt to get the report writer to exclude facts or change opinions that are to the disadvantage of the requesting party

Changing Completed Reports Little has been written about this issue Relevant forensic practice guidelines do not

specifically address it However, be careful Such practice might violate the general ethical Such practice might violate the general ethical

obligations of objectivity and fairness These obligations preclude a report writer from

rewriting the report to exclude facts or opinions that are not helpful to the party making the request (almost always the retaining attorney)

Changing Completed ReportsChange the report if it contains errors

or data that are otherwise inappropriate (e.g., incriminating statements made by a defendant during statements made by a defendant during a competency examination, particularly sensitive irrelevant information)


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Changing Completed Reports In the interest of transparency,

document, in some way, that changes were madeA ti “fi l” t i h d Anytime a “final” report is changed, a copy of the first version should be retained – this provides a measure of transparency that is important in forensic settings

Appendix A:Flesch Kincaid Flesch-Kincaid Ratings

Flesch-Kincaid Ratings Flesch Reading Ease and Flesch-Kincaid Grade Level

ratings are a means to measure the reading level which corresponds to what you have written

Easily accessible via Microsoft Word Target ranges:◦ Flesch Ratings of 40-50◦ Flesch-Kincaid Grade levels of 9-11


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Flesch-Kincaid Calculations in Word

How to Enable Flesch-Kincaid Readability Statistics

Click the “Office” buttonCli k “W d Click “Word Options”


Select “Proofing”


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Your screen will look like like this. Let’s zoom in.


These two boxes must be checked


You cannot check Show readability

i i statistics unless Check grammar with spelling is checked


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Click “OK”

How to Use Flesch-Kincaid Readability Statistics

Click “Review”

Click “Spelling & Grammar”


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A box will appear titled “Readability Statistics” Let’s zoom in

How to Use Flesch-Kincaid Readability Statistics

Pay attention to the FleschReading EEase score

Pay attention to the Flesch-Kincaid Grade Level

The Formula for theFlesch Reading Ease Score


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Appendix B:Common ErrorsCommon ErrorsCommon report-writing errors among those applying for board certification

Common Errors Identified in Practice Samples Grisso, T. (2010). Guidance for Improving Forensic

Reports: A Review of Common Errors. Open Access Journal of Forensic Psychology Journal of Forensic Psychology.

Available at www.abfp.com/certification.asp under heading “Guidance for Improving Forensic Reports”

Common Errors Opinions without sufficient explanations – 56%◦ Major interpretations or opinions were stated

without sufficiently explaining their basis in data or logic (regardless of whether the report’s data could have supported or sustained the opinion)

Forensic purpose unclear – 53%◦ The legal standard, legal question, or forensic

purpose was not stated, not clear, inaccurate, or inappropriate

Organization problems – 36%◦ Information was presented in a disorganized

manner (usually without a reasonable logic for its sequence)


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Common Errors Irrelevant data or opinions – 31%◦ Data and/or some opinions included in the report

were not relevant for the forensic or clinical referral questions

Failure to consider alternative hypotheses – 30%D t ll d f lt ti i t t ti hil ◦ Data allowed for alternative interpretations, while report did not offer any explanations concerning how they were ruled out

Inadequate data – 28%◦ The referral question, case circumstances, or final

opinion required additional types of data that were not obtained or were not reported, and for which their absence was not explained in report

Common Errors Data and interpretation mixed – 26%◦ Data and interpretations frequently appeared together

in a section that reports data Over-reliance on a single source of data – 22%◦ An important interpretation or opinion relied wholly

on one source of data (often self-report) when corroborating information from multiple sources was corroborating information from multiple sources was needed

Language problems – 19%◦ Multiple instances of jargon, biased phrases, pejorative

terms, or gratuitous comments Improper Test Uses – 15%◦ Test data were used in inappropriate ways when

interpreted and applied to the case, or tests were not appropriate for the case itself

Appendix C:The Four C’sThe Four C s


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The Four C’s

The Four C’s of Effective Communication Source: Kwartner, P., & Boccaccini, M.T.

(2007). Testifying in court: Evidence-based recommendations for expert-witness ptestimony (pp. 565-588). In R. Jackson (Ed.), Learning forensic assessment. New York: Routledge.

Recommendations for testimony, but with applications to reports

The Four C’s

Credibility Clarity Clinical Knowledge Certainty Certainty

The Four C’s: Credible

Logical, informed, wise, educated, scientific (Knowledgeable)

Truthful, trustworthy, honest, dependable, reliable (Trustworthy)( y)

Self-assured, well-spoken, confident, poised, relaxed (Confident)

Kind, friendly, pleasant, respectful, well-mannered (Likeable)


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The Four C’s: Clarity

Experts who communicate in a clear, comprehensible, and non-technical manner are more persuasive than those using complex terms and jargon p j g

An example from medicine: Jurors prefer experts who use terms such as “cancer of the breast” compared to those who testify about “infiltrating ductal carcinoma”

The Four C’s: Clinical Knowledge Judges and jurors prefer expert witnesses who

focus on clinical, as opposed to scientific, issues in their testimony

This appears to be related to lay expectations about the process most “doctors” follow when

k d b lmaking decisions about people People expect doctors to meet with and talk to

patients, and resort to use of specialized tests or procedures only when necessary

Even when doctors use tests, people expect the doctor to make a clinical decision based on the test results

The Four C’s: Certainty The ability and willingness to draw firm

conclusions is a desirable quality in an expert Attorneys view tentativeness as the

characteristic they most dislike in an expertB t i l fi l i lik l t b But, excessively firm conclusions are likely to be viewed with distrust, given the limits and uncertainties inherent in nearly all areas of science

This is consistent with our obligation to acknowledge limits of our opinions


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Appendix D:Trouble SpotTrouble SpotCommon Grammatical Errors

Common Grammatical Errors

“At a basic level, misspellings, typographical errors, and poor grammar suggest carelessness, if not a lack of respect for the reader Submitting a report that has these reader. Submitting a report that has these faults could be compared to submitting an amicus brief that has ketchup stains on it.”

– Appelbaum, K.L. (2010)

Common Grammatical Errors

Confusing word pairs◦ Accept and Except◦ Affect and Effect◦ Compliment and Complementp p◦ Comprise and Compose◦ Discrete and Discreet◦ Inferred and Implied◦ There, Their, and They’re◦ . . . and many more


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Common Grammatical Errors Apostrophes◦ Use for possessives◦ Use for contractions (But only use contractions in quotations)

◦ Its and It’s The contraction of it is is it’s The possessive of it is its, with no apostrophe “The drawback of the test is its high false positive

rate. It’s a significant drawback.”

◦ Worst I ever saw: Red delicious’ apple’s

Common Grammatical Errors Tense Consistency An important consideration for forensic

reports Choose the appropriate tense deliberately Tense may appropriately varyTense may appropriately vary◦ Past tense for prior conduct◦ Present tense as indicated in quotations: “Patient is complaining about side effects of

medication.”

◦ Future tense for predictions Defendant will remain competent if . . . Suicide risk will increase in the event that . . .

Writing Resources

The Elements of Style by Strunk and White The Gregg Reference Manual Purdue OWL (Online Writing Lab) Grammar Girl Grammar Girl


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