The Macarthur Competence Assessment Tool Criminal Adjudication

Uses a vignette format and objectively scored questions to standardize the measurement of three competence-related abilities: understanding, reasoning, and appreciation.The eight understanding and eight reasoning items are based on a brief vignette that describes a hypothetical crime; the 16 items query about prosecution of the hypothetical defendant. This approach was designed to introduce legal issues in a way that distances the defendant from the specifics of his or her own case.The six appreciation items query defendants about their attitudes and beliefs concerning the legal process as it surrounds their own cases.Norms are based on the scores of 729 defendants; score ranges for three levels of impairment (none or minimal, mild, and clinically significant) are provided for each measured ability.Validated with three groups of criminal defendants with varying competence levels and mental illness treatment histories.

This is the definitive reference and text for both mental health and legal professionals. The authors offer a uniquely comprehensive discussion of the legal and clinical contexts of forensic assessment, along with best-practice guidelines for participating effectively and ethically in a wide range of criminal and civil proceedings. Presented are findings, instruments, and procedures related to criminal and civil competencies, civil commitment, sentencing, personal injury claims, antidiscrimination laws, child custody, juvenile justice, and more.

Adjudicative competence remains an important topic of research and practice in psychology and law. In the five sections of Adjudicative Competence: The MacArthur Studies, the authors present not only a summary of the research of the MacArthur studies on competence but also an examination of the underlying theoretical work of Professor Richard Bonnie. It is the first publication to encapsulate the scope and significance of both the studies themselves and Bonnie's contributions. There is no other source available that addresses this range of topics. Given its breadth and scope, this book will be a "must have" for forensic mental health professionals, an important volume for lawyers, and a vital academic reference work.

This book offers a conceptual model for understanding the nature of legal competencies. The model is interpreted to assist mental health professionals in designing and performing assessments for legal competencies defined in criminal and civil law, and to guide research that will improve the practice of evaluations for legal competencies. A special feature is the book's evaluative review of specialized forensic assessment instruments for each of several legal competencies. Three-fourths of the 37 instruments reviewed in this second edition are new.

The MacCAT-CR provides a structured format for capacity assessment that is adaptable to the particulars of any given research project. With the introduction of the MacCAT-CR, researchers enrolling human participants in their studieshave available for the first time a reliable and valid means of assessing their potential subject's capacity to consent to participation. The MacCAT-CR can typically be administered in 15-20 minutes. Beginning with project-specific disclosures to potential participants, the MacCAT-CR measures the four generally accepted components of decision-making competence: understanding, appreciation, reasoning, and the ability to express a choice. Quantification of subjects' responses permits comparisons across subjects and subject groups, and allows the MacCAT-CR to be used for not only for screening individual participants but also for conducting research on the characteristics of subject populations and for assessing the effectiveness of interventions designed to increase subjects' capacities.

The MacArthur Competence Assessment Tool for Treatment (MacCAT-T) is the product of an 8-year study of patients' capacities to make treatment decisions. It is a semi-structured interview that assists clinicians in assessing a patient's competence to consent to treatment. The process provides a patient with information about their medical/psychiatric condition, the type of treatment being recommended, its risks and benefits, as well as other possible treatments and their probable consequences. During this process, the MacCAT-T prompts the clinician to ask questions that assess the patient's understanding, appreciation, and reasoning regarding treatment decisions.The MacCAT-T Manual is a large-format, examiner-friendly field manual for conducting actual competency assessments. The MacCAT-T Record Form is well designed for recording, rating, and summarizing patient responses. The training videotape, Administering the MacCAT-T, demonstrates an actual administration of the test with discussion, comments, and annotations by Drs. Grisso and Appelbaum.The book, Assessing Competence to Consent to Treatment, describes the place of competence in the doctrine of informed consent, analyzes the elements of decision making, and shows how assessments of competence to consent to treatment can be conducted within varied general medical and psychiatric treatment settings. Includes numerous case studies.

Videotaped material is used for educational purposes in many areas of medicine. In forensic facilities, programs designed to restore competency to stand trial (CST) in incompetent, mentally ill defendants have utilized videotaped courtroom proceedings as learning tools. This pilot study reviewed the progress of incompetent defendants (N = 15) who participated in a program that utilized videotaped segments of the television crime-drama "Law & Order", among other techniques, to promote CST in individuals deemed unfit to stand trial. The authors hypothesized that participation in at least one cycle of the Competency Restoration Group (CRG)'s curriculum would be associated with improvement in the areas of understanding, reasoning and appreciation. In order to assess whether the group was beneficial to the patient's treatment goal of competency restoration, patients were screened using the MacArthur Competence Assessment Tool-Criminal Adjudication (MacCAT-CA) prior to starting the group and after completing a cycle of the group's curriculum. The Wilcoxon signed ranks test was employed to analyze the results from the pre-and post-group MacCAT-CA testing. The tests yielded significant (p