MA Forensic Psychology

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AUO Comprehensive Examination

MA Forensic Psychology

NT 4.27.2017

Case Vignette for Comprehensive Examination

Please read the vignette carefully. Based on information provided in the vignette, please compose a well-written and organized response to each of the questions that follow:

Presentation of the Problem:

defendant’s name: Mr. Gary

current age: 27

Mr. Gary M was a 27-year-old Caucasian man who was referred to a state forensic hospital for an examination of his competency to stand trial, for evaluation of his mental state at the time of alleged criminal offenses (“MSO”), and for treatment recommendations. The exam was ordered by the judge at the recommendation of his defense attorney. Prior to the exam, he had been housed in a state prison on a pre-trial basis for seven months.

According to information forwarded along with Mr. M’s referral, he had been charged with numerous sexual offenses, including Sexual Exploitation of a Child, Rape, and Using a Computer to Unlawfully Depict a Child Engaging in a Prohibited Sexual Act. In part, the charges stemmed from alleged sexual contact between Mr. M and Miss Cheri Wilson, who was 11 years old.

Police received a report from a school counselor that Cheri disclosed that she had been touched by a man she called “Gary.” Police investigated and spoke with Cheri’s mother, Mrs. Wilson. She said that Gary, Mr. M, was a “family friend” and watched Cheri after school. A forensic interview of Cheri was conducted, but she did not disclose any sexual contact at that time. When Mr. M was interviewed, he stated that he was “best friends” with Cheri and that he “loved” her. No charges were filed at that time. At a later time, however, police received a report of an “older male kissing a young girl at a lake.” Investigation revealed that a witness had seen Mr. M “kiss Cheri on the mouth.” The witness said that the two of them “act[ed] like boyfriend/girlfriend.” The witness said that Cheri’s mother had apparently “witnessed the kiss.” Furthermore, she continued to allow Mr. M. to have unsupervised access to Cheri, and she later stated that she did not report M’s actions because she “didn’t want to get into trouble.”

Police interviewed Cheri. She indicated that Mr. M had touched her breasts and had kissed her on the lips. When police interviewed Mr. M, he admitted to touching her breasts, to placing his mouth on her vagina, to inserting his finger inside of her vagina, and to placing his penis inside of her vagina. Mr. M also admitted to taking pictures of Cheri with a digital camera. Police obtained Mr. M’s camera and computer and discovered images of Cheri unclothed and in sexually provocative positions. When police interviewed Cheri, she stated that Mr. M “would make her pose naked.” If she did not pose for him, she “would have to stand in the corner.” Finally, police searched Mr. M’s home and found that his computer contained “hundreds of child porn images.” Therefore, police charged Mr. M with 30 counts of Using a Computer to Unlawfully Depict a Child Engaging in a Prohibited Sexual Act.

Historical Information

Mr. M grew up in a rural community along with two brothers. When he was seven years old, his parents divorced. His mother later remarried. Mr. M reported a history of physical abuse at the hands of his step-father during his late childhood and adolescence. He indicated that his step-father had “choked” him on two occasions, that he had struck him “in the head,” and that he had hit him with “taped up paint sticks,” with “spatulas,” and with “wooden spoons.” Mr. Webber stated that he was told not to go to the nurse at school if he was feeling sick, so that no one would find out about the abuse. He also reported that his step-father would lock him in his room for extended amounts of time and that he had to “knock on the walls” in order to be let out to use the bathroom. Mr. M stated that at one point, someone notified authorities, but his parents “cleaned up the house” and removed the locks from the bedroom door.

Mr. M reported that he did fairly well in school, earning mostly As and Bs. Following graduation from high school, he joined the Army, where he served in active duty for over eight years. During that time, Mr. M completed two tours of duty, working as an infantryman and running supplies. He chose to leave the army toward the end of his third tour of duty because he wanted to attend college and wanted to start a family. He received an honorable discharge from the army and joined the National Guard.

Key Examination Findings

During an initial examination, Mr. M reported that he had been psychiatrically hospitalized on several occasions for self-injurious and suicidal behavior. He reported a history of alcohol use, but no use of illicit substances. Immediately prior to the exam, he had been placed on suicide watch in the infirmary of the prison. He had apparently taken an overdose of Tylenol. When asked to describe his mood, Mr. M said it was “between fear, anger and suicide…feeling depression.” He added that he was “thinking about Cheri, worried about her all the time.” He said that he missed her “too much” and that he loved her “more than anything.” His affect during the exam was labile in range, was anxious, irritable and depressed in quality, and was consistent with the content of his statements and expressions.

During the competency portion of the exam, Mr. M demonstrated an adequate factual understanding of court processes and of the roles of those involved in his court case. He also showed a good understanding of his criminal charges and the potential consequences of conviction. However, Mr. M expressed a strong desire for punishment. He stated that he believed an appropriate consequence for his actions would be for him to “get rid of his sexual organs” or to “cut off” his “fingers.” To those ends, he reported that he has recently injured his genitals with an ink pen. Additionally, Mr. M reported a strongly held belief that those involved in the court proceedings are biased, that “They’re all against” him. He further went on to say that it “doesn’t matter what” he “says” and that he “pretty much gave up.” He relayed a mixed level of confidence in his attorney, indicating his belief that she will get “paid either way,” regardless of the outcome of his case. He was uncertain of the extent to which she would work in his best interests.

Exam Questions

Based on the vignette provided above, please compose a well-written and organized response to each of the following questions. When writing your responses, please:

  • Use APA (6th Edition, Second Printing) Style, with 1-inch margins, double-spaced, 12 font, with a reference list at the end.
  • Write clearly and concisely.
  • Cite appropriate, and especially current, literature (empirical and/or theoretical).
  • Avoid all sexist idioms and allusions.
  • Remember to demonstrate your multicultural competence where appropriate.

Psychological Theory and Practice

  1. What assessments (general and specific) would you conduct to enhance your understanding of the client’s problems and how would your choice of assessment(s) inform your diagnostic impression and treatment planning? Assessments may include structured or unstructured interviews, valid and reliable assessment measures, and/or formalized assessment procedures that may be conducted by yourself or by someone else referred by you.
  1. Provide your diagnostic impressions (based on the DSM-5) for this individual. In narrative form, please describe how the individual meets the diagnostic criteria for the disorder(s) chosen in addition to the differential diagnostic thought process that you used to reach your hypotheses. Be sure to include any additional (missing) information that is needed to either rule out or confirm your differential diagnoses impressions.

Legal Theory and Application

  1. Explain the background, current presentation, and behavior of the client utilizing theories of offender and/or victim psychology and personality/psychological theories to support your position. Do not simply restate the client’s presentation from the vignette. Instead, provide a theoretical-based discussion of the client’s behaviors as presented in the vignette.
  2. Describe the psycholegal standards and/or definitions for each of the following: competence to stand trial, duty to warn, and insanity.

Identify and describe one or more landmark case(s) for each standard (at least three cases total). Describe the elements or issues that a mental health professional usually focuses on when assessing a person’s adjudicative competence, risk and insanity, and any additional items that might be especially important to focus on in the provided vignette.

Research and Evaluation

  1. Describe tests or assessment procedures you would employ to address the psycholegal issues of (competence to stand trial, risk of dangerousness, and insanity). You may refer to these from the Psychological Theory and Assessment Section “A” if you already covered them there. Discuss what the anticipated conclusions would be based upon information provided in the vignette.
  1. Develop one empirically supported therapeutic treatment plan for the client in the vignette. Please make sure you summarize the empirical evidence with appropriate citations to support your treatment choice(s) in working with your client. Be sure to discuss the effectiveness and limitations in working with this particular client, including this client’s background, using the above treatment plans.

Interpersonal Effectiveness

  1. What diversity factors, cultural considerations, or other demographic variables pertaining to this client would you take into account in rendering a diagnostic impression, choosing assessment measures, forming case conceptualizations, and designing the treatment plan? Be sure to discuss cultural/diversity factors that could apply even if they are not explicitly mentioned in the vignette.
  2. Your writing, use of citations, ability to form a logical argument, and proper APA Style, including the use of paraphrasing, will be evaluated as a measure of your interpersonal effectiveness. No response is required for “B”.

Leadership, Consultation, and Ethics

  1. Describe how you would work within a professional treatment team to consult, triage, and treat this case. Include a description of the various members of the professional team with whom you would be likely to interact. Additionally, explain the roles and responsibilities of each member of the treatment team.
  2. B.What are the ethical and legal dilemmas this vignette introduced? What would be your immediate steps and why? Please be specific and make sure that you describe your process of ethical decision making and the solutions/consequences to which this process might lead. Your discussion should be informed by the American Psychological Association’s Ethics Code as well as the Specialty Guidelines for Forensic Psychologists
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