The Psycholegal Assessment

AuthorR. Ian Hector
Pages11-23
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CHAPTER 2
The Psycholegal Assessment
R. Ian Hector
I. INTRODUCTION
A forensic psychiatrist serves as consultant to a wide variety of parties and agencies, takes on many dis-
tinct roles in the course of his psycholegal consultative practice, performs evaluative tasks in a number
of settings, and subsequently appears to oer ndings and recommendations in the (generally) public
arena of courts and other tribunals. In contrast, the clinical or treating psychiatrist works to establish a
therapeutic alliance with patients with the primary purpose of improving their health.
e psycholegal assessment, an assessment undertaken for forensic purposes, is done relying on the
same general methodology as that used in the standard medical and psychiatric assessment. e medical
model is the template; however, the essence and purpose of forensic work will likely aect the extent to
which the medical model is relied upon and the manner in which it is used.
As a creation of the legal system, forensic evaluation oen, if not invariably, needs to go well beyond
the parameters of information gathering consistent with the medical model to pursue information that
will assist in the determination of a legal rather than a medical issue (Melton et al., 1997). e princi-
pal distinction between the forensic and the treating psychiatrist providing an assessment is that the
psycholegal assessment has at its core the provision of opinions on issues germane to legal, administra-
tive, or employment-based concerns. Diagnostic and therapeutic issues are generally of importance only
as they relate to the legal issues.
II. THE ROLE OF THE FORENSIC PSYCHIATRIST
A. Distinguishing the Forensic Examiner from a Treating Clinician
e clinician or therapist is the person providing treatment with the medical goal of curing or amelior-
ating illness. In sharp contrast to the focus of the psychiatrist in a therapeutic encounter, the forensic
clinician does not, by denition, concern herself with the patient’s well-being, although as a medical
practitioner she inevitably has some concerns in this regard. e focus of the forensic psychiatrist re-
tained to provide a psycholegal assessment is in essence more objective: the focus is on gathering infor-
mation to address specic questions, questions that are relevant to a specic legal matter and have less to
do with the general well-being of the individual being assessed.
e role of the psychiatrist functioning as treating doctor does not translate directly into the role of
the forensic psychiatrist: “Having observed the patient only from the vantage point of a treating clinician,
I have no objective basis for rendering an expert opinion, with a reasonable degree of medical certainty,
on a legal as opposed to a clinical question” (Strasburger et al., 1997). Whether court-appointed or party-
retained, psychiatric experts do not ordinarily have a doctor/patient relationship, in the usual sense,

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