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Richard I. Frederick, Richart L. DeMier, Martha S. Smith (with Karin Towers)
Richard I. Frederick, Richart L. DeMier, Martha S. Smith (with Karin Towers)

Examinations of Competency to Stand Trial: Foundations in Mental Health Case Law (Second Edition)

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• 2014  334pp paperback   ISBN: 9781568871530
• This title appears on the American Board of Forensic Psychology (ABFP) suggested reading list

     Not a guide to conducting evaluations.  Instead, this updated and expanded second edition presents a highly detailed discussion of how the U.S. Supreme Court construes the legal issues affecting competence to stand trial evaluations. This text presents a level of comprehensiveness that is not covered in CST evaluation guides.
     Anyone involved in forensic evaluations or aspiring to become competent in forensic evaluations must read this text.  It prepares possible witnesses to competently address critical issues.
Here is a full review of the first edition by David Sweet, PhD. from 
The Journal of Psychiatry and Law:
Assessing a defendant's competency to stand trial is an area where mental health and law can overlap, but they can also disagree.  Those involved in the process, whether on the legal side or the mental health side, need to understand how each side approaches the issue.  More importantly, the mental health examiners must have a clear idea of what information is necessary for the judge to make a determination of competency.
     Examinations of Competency to Stand Trial
is intended to explain how the courts construe competency.  The authors make it clear in the introduction that this is not a "how to evaluate" book.  They want us to understand the thinking of the courts regarding various issues of competency.  It is hoped that this understanding will lead clinicians in the right direction when providing evaluative information to the courts.
     The book is divided into five sections: Standards of Competency, Thresholds of Competency Evaluations, Constitutional and Judicial Considerations, Incompetent Defendants, and Amnesia and Competency.  Each section includes a brief outlining the essential facts of the case, and then a discussion of the court's analysis and ruling.  The authors provide what they call Implications for Examiners at the end of each section.  This is an important area of focus because it helps the examiner see how the courts' rulings may be applied when the evaluation is conducted.
     Many of us have probably seen reports from examiners who describe the defendant well and provide a clear and supportable diagnosis but do not really address the issue of competency.  This type of report only wastes time and resources; it does not help the court make an informed decision.  As the authors point out, the Dusky v. United States decision made note of the importance of the need to have the clinician provide more than a diagnosis.  The court needs to hear from the clinician what the defendant can and cannot do relevant to the issues of competency.  This requires sound and accurately detailed information and a rationale for the opinion offered by the clinician.  The court needs to know not only if the defendant is mentally ill, but also the extent to which he is capable of consulting and working with his attorney and if he has an understanding of the legal process and can participate in his defense.

     The emphasis in competency evaluations, though, is on providing the data necessary for the court to rule, not on making a legal opinion.  Competency is considered to be a legal condition that reflects values of statutory and case law at a particular time and within a particular jurisdiction.  The clinician operating within a certain jurisdiction must be aware of the requirements of the law and how it is applied.
     The authors note that decisions from the Supreme Court make it less likely that there will be major differences among various jurisdictions.  However, state legislatures may create standards that are higher than federal standards, making it important for the evaluator to keep current on all appropriate laws within the jurisdiction in which he or she practices.  The clinician must clearly understand the language of the law to be able to communicate effectively with the court.
     One area I have found interesting in my experience has to do with the question of restoring the defendant to competency.  This is a critical issue for the court, and it requires the evaluator to give useful input in the form of prognostic statements.  At various points in the book, the authors discuss the need to explain to the court factors regarding changes in mental health states and the effects of medication on these states.  One would expect physicians to be better suited to discuss the biological aspects of medication.  On the other hand, all mental health experts in this field need to be able to provide information to the court about how medications can affect the functioning of the defendant.
    This book should be useful to attorneys as well as to mental health practitioners.  The more all those who handle competency cases - be they attorneys or mental health experts understand the process and the information needed to make the process work, the more likely it is that we will be able to work together and achieve the goal of understanding the key issues of competency to stand trial.  Understanding these important legal cases will result in a refinement of the process for all those involved."

This new revised edition includes seven more recent legal cases with rulings from the US Supreme Court.  It also contains a sixth section dealing with Adjudicative Competency in Juveniles.

This book is a companion text to Examinations of Criminal Responsibility: Foundations in Mental Health Case Law, which provided a comprehensive review of judicial decisions impacting issues in criminal competencies.


“A very intriguing and insightful approach to educating psychologists and other mental health professionals regarding the intimate ‘thinking’ of our nation’s judges.  Highly readable and yet surprisingly comprehensive.  An excellent compilation of judicial reflections, historical while extraordinarily current.”
     -Pat DeLeon,
former President of American Psychological Association, and former President of the American Psychology-Law Society (Division 41 of APA)

“Examinations of Competency to Stand Trial provides forensic evaluators and attorneys with the basic legal tools necessary to understand the nature and scope of competency evaluations in the criminal process.  The book contains easy-to-read versions of the most important legal cases on competency to stand trial and plead guilty, together with helpful commentary about their implications.”

     -Christopher Slobogin
, Stephen C. O’Connell Professor of Law, University of Florida Fredric G. Levin College of Law

“The volume covers several critical issues, such as thresholds for competency examination, the way Courts respond to treatment of defendants found incompetent to stand trial, and the relevancy of amnesia to competency to stand trial.  Each section has a conclusory part call ‘Implications for Examiners,’ which is concise, coherent and ties together the case law presented in that section.  The volume does an outstanding job of informing clinicians about the Court’s perspective so that clinicians doing forensic work can understand this perspective in order to better perform their evaluations and reports.  This is an outstanding, creative and thoughtful, yet completely user-friendly volume.”

     -David L. Shapiro
, Associate Professor of Psychology, Center for Psychological Studies,
Nova Southeastern University, Ft. Lauderdale, FL

Table of Contents
Introduction to the Volume
Section 1 - Standards of Competency
Introduction to Section 1
Youtsey v. United States
Dusky v. United States

Wieter v. Settle

Implications for Examiners

Section 2 - Thresholds for Competency Examinations

Introduction to Section 2

Kenner v. United States
Pate v. Robinson

Drope v. Missouri
Seidner v. United States

Implications for Examiners
Section 3 - Constitutional & Judicial Considerations

Introduction to Section 3
McDonald v. United States
Medina v. California
Cooper v. Oklahoma
Godinez v. Moran
Indiana v. Edwards
North Carolina v. Alford
United States v. Greer

Implications for Examiners
Section 4 - Incompetent Defendants

Introduction to Section 4
Riggins v. Nevada
United States v. Brandon
Sell v. United States
United States v. White
United States v. Valenzuela-Puentes
United States v. Evans
Jackson v. Indiana
United States v. Duhon

Implications for Examiners
Section 5 - Amnesia & Competency

Introduction to Section 5
Wilson v. United States
United States v. Swanson
United States v. Borum
United States v. Stevens

Implications for Examiners

Section 6 - Adjudicative Competency in Juveniles

Introduction to Section 6
In re Causey
G.J.I. v. State of Oklahoma

In the Interest of S.H.
Implications for Examiners
A: Legal Citations
B: Relevant Clauses & Amendments to the United States Constitution

About the Authors
Richard I. Frederick. PhD, ABPP,
 received his doctorate in clinical psychology from Oklahoma State University in 1986. He is Board Certified in Forensic Psychology by the American Board of Professional Psychology, and serves as National Chair of  Examinations and President of the American Board of Forensic Psychology and is Co-Chair of the Continuing Education of the American Academy of Forensic Psychology. After retiring from the U.S. Navy with rank of Captain in 2008, he later also retired from the U.S. Department of Justice.  He is in private practice in Springfield, Missouri.

Richart L. DeMier, PhD, ABPP,
earned his doctorate in clinical psychology at the University of Wisconsin-Milwaukee in 1994.  He is Board Certified in Forensic Psychology by the American Board of Professional Psychology, and he serves as an examiner for applicants for board certification.  He practices clinical and forensic psychology at the US Medical Center for Federal Prisoners in Springfield, Missouri.  At that facility, he conducts forensic evaluations of federally charged criminal defendants from all federal jurisdictions, and for 10 years, he served as the director of the U.S. Medical Center's APA-accredited internship program.

Martha Smith, PsyD, received her doctorate in clinical psychology at the Indiana State University in 2008 and completed a postdoctoral fellowship in forensic psychology at the University of Massachusetts Medical Center in 2009.  She is currently employed as a psychologist at the Center for Forensic Psychiatry in Saline, Michigan.  She conducts forensic evaluations at the facility and provides treatment to to a forensic population.

Karin Towers, PhD, JD, 
is a psychologist in Massachusetts.

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