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MacArthur Competence Assessment Tool for Clinical Research (MacCAT-CR)
by Paul S. Appelbaum & Thomas Grisso

MacArthur Competence Assessment Tool for Clinical Research (MacCAT-CR)

Your Price: $24.95
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Order Code :MACTCR
This instrument is not User Qualified and can be sold to any researcher doing research on human subjects.

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 studies have 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.

Review
"The MacArthur Competence Assessment Tool for Clinical Research has rapidly become the gold standard against which all other ways for assessing capacity to participate in research are measured.  Legally sound, psychologically sophisticated, and backed by an award-winning program of research, this clinician-friendly 'tool' can streamline and standardize what would otherwise be a time-consuming and unwieldy task.  Once again, Appelbaum and Grisso have given the field just what it needed, just when it needed it the most."
     -John Monahan, PhD, Doherty Professor of Law, University of Virginia

Table of Contents
PREFACE
INTRODUCTION
    I. CUSTOMIZING THE MacCAT-CR
        Understanding Section
        Appreciation Section
        Reasoning Section
        Expressing a Choice Selection
    II. INTERVIEW
        Content
            Understanding Section
  Appreciation Section
  Reasoning Section
  Expressing a Choice Selection
        General Procedures
            Timing
  Sequence
  Style
  Recording
  Duration
        Introduction
        Understanding Section
            Disclosure
  Inquiry
  Probe
  Redisclosure and Reinquiry
        Appreciation Section
  Inquiry
  Probe
        Reasoning and Expressing a Choice Sections
  Procedure to Establish Subject's Choice
  Logical Consistency
    III. RATING
        Understanding
        Appreciation
        Reasoning
        Expressing a Choice
REFERENCES
APPENDIX A: Sample MacCAT-CR Interview
        Understanding
        Appreciation
        Expressing a Choice
        Reasoning
        Final Choice
        Reasoning
APPENDIX B: MacCAT-CR Record Form
APPENDIX C: Subject's Capacity to Consent to Neurobiological Research
        Capacity to Consent to Research
            Standards for Determining Decision-Making Competence
  Empirical Studies of Decision-Making Capacity
      Understanding
      Appreciation
      Reasoning
        Guidance for Policy Makers
            Capacities Necessary
  Identifying Impairments
  The Role of IRBs
        Practical Guidance for Researchers
Conclusion
References

About the Authors
Paul S. Appelbaum, MD, is currently Elizabeth K. Dollard Professor of Psychiatry, Medicine, & Law, Columbia University Medical Center.  He was previously A. F. Zeleznik Distinguished Professor of Psychiatry; Chairman of Psychiatry; and Director of the Law and Psychiatry Program at the University of Massachusetts Medical School.  He is the author of many articles and several books on law in clinical practice including Almost a Revolution: Mental Health Law and the Limits of Change (1994), for which he was awarded the 1996 Manfred S. Guttmacher Award from the American Psychiatric Association and the American Academy of Psychiatry and the Law.  Dr. Appelbaum is the secretary of the American Psychiatric Association, past president of the American Academy of Psychiatry and the Law, and past president of the Massachusetts Psychiatric Society.  He has served as Chair of the Council on Psychiatry and Law and the Commission on Judicial Action for the American Psychiatric Society and was a member of the John D. and Catherine T. MacArthur Foundation Research Network on Mental Health and the Law.  He has received the Isaac Ray Award (1990) of the American Psychiatric Association for "outstanding contributions to forensic psychiatry and the psychiatric aspects of jurisprudence."  In 1996-1997, he was the Fritz Redlich Fellow at the Center for Advanced Study in the Behavioral Sciences.

Thomas Grisso, PhD
, is Professor of Psychiatry (Clinical Psychology) at the University of Massachusetts Medical School where his research, teaching, and clinical practice focus on forensic mental health evaluations and services.  He has authored and edited several books on evaluations for the courts and juvenile forensic issues, including Competency to Stand Trial Evaluations (1988) and Assessing Competence to Consent to Treatment (with P. Appelbaum, 1998).  He has also authored two assessment tools published by Professional Resource Press: Instruments for Assessing Understanding and Appreciation of Miranda Rights and MacArthur Competence Assessment Tool-Treatment (with P.S. Appelbaum).  Dr. Grisso is a diplomate of the American Board of Professional Psychology (Forensic), past president of the American Psychology-Law Society, a member of the MacArthur Foundation Network on Adolescent Development and Juvenile Justice, and the 1995 recipient of the American Psychological Association's Award for Distinguished Contributions to Research in Public Policy.
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