Forensic Track

This track provides specialized training in preparing interns to provide services where psychology and the law intersect. The intern will have the unique opportunity to conduct clinical assessments and treatments with a diverse population of clients with severe mental illness who are involved with the criminal justice system, including many with serious criminal charges. This track makes use of the following educational components: (A) providing treatment services as a member of an inpatient multidisciplinary team at East Central Regional Hospital (ECRH); (B) consultation services to treatment teams at ECRH by providing empirically-based violence risk assessments; (C) providing court ordered pretrial evaluations of competency to stand trial and criminal responsibility to inpatients at ECRH and outpatients found at various detention centers throughout our 33 county catchment area; (D) opportunities to observe and participate in civil commitment testimony; (E) participate in specialized weekly forensic seminars including Mental Health Law and Landmark Cases in conjunction with our postdoctoral fellows in forensic psychology. Training may include participation in mock trials. In the past our postdoctoral fellows have engaged in mock trial exercises with trainees and faculty from the Medical University of South Carolina.

Forensic Track Specifics. 

Purpose: The core purpose of the forensic track, which is part of the MCG-Charlie Norwood VAMC Internship is to produce professionally and racially/ethnically diverse psychologists who are well prepared to seek out careers in forensic psychology. We also strive to train future psychologists who can offer expert services to the courts, who call upon forensic experts to inform them on matters where psycholegal referrals arise. Finally, the Forensic Track strives to train future psychologists who are culturally aware and aspire to cultural competence when providing psychological services. Trainees will be given ample opportunities to provide both treatment and assessment services to clients from diverse cultural, socioeconomic, racial, and ethnic backgrounds.

Settings:         

• Forensic and civil units at ECRH
• Detention Centers and Jails through Outpatient Services at ECRH
• Augusta University Hospital and Clinics     

Forensic Track Faculty:

• Holly Tabernik, Ph.D., Licensed Psychologist, ECRH; Assistant Professor; Director of Internship Forensic Psychology Training
• Jessica Britt, Ph.D. jessica.britt@dbhdd.ga.gov - Assistant Professor Forensic – ECRH
• Cassandra Groth, Ph.D. cassandra.groth@dbhdd.ga.gov - Assistant Professor Forensic – ECRH
• Jason Henle, Psy.D., Forensic Director, ECRH; Assistant Professor
• Michael J. Vitacco, Ph.D., ABPP; ECRH; Associate Professor      

Emphasis Goals/Objectives of the Forensic Track:

1. To provide Interns with experience working on multidisciplinary treatment teams responsible for the day to day treatment and management of forensic inpatients. Interns will work with psychiatrists, nurses, social workers, and activity therapists to provide comprehensive treatment services for forensic inpatients at ECRH.
2. To train Interns to provide mental health treatment services to a diverse clientele who are involved with the criminal justice system. Treatment opportunities include restoration of competency to proceed to trial and Dialectical Behavior Therapy for patients who have difficulty with emotion regulation. 
3. Provide a background in theory and science related to forensic psychology. This goal is facilitated through attendance at two specialty seminars dealing with the intersection of psychology and the law.
4. To train Interns to conduct comprehensive evaluations of violence risk with forensic patients and potentially violent civil patients.
5. To train Interns in case conceptualizations of clients with a variety of diagnoses in inpatient and outpatient forensic evaluations.
6. Work with Interns to conduct forensically-related research suitable for presentation and publication in peer-reviewed sources. This can take place with a project the INTERN is currently working on or through the onset of a new research project that could include archival data.
7. To train Interns to conduct comprehensive forensic pretrial evaluations of criminal responsibility (insanity) and competency to proceed to trial. Conduct psychological assessments with forensic patients.

A primary training goal of the forensic track is for the INTERN to gain a high level of familiarity and comfort with conducting forensic psychological evaluations. Interns will also become proficient in working with a wide variety of individuals suffering from severe and persistent mental illness.  These evaluations include taking a thorough history, conducting a detailed mental status examination, conducting structured interviews related to the legal referral question, and making pertinent recommendations easily understood by the referring agency.  To this end, Interns will become familiar with the following clinical, forensically-related, and forensic instruments.

• Evaluation of Competency to Stand Trial-Revised
• Historical, Clinical, Risk-20
• Inventory of Legal Knowledge
• MacArthur Competence Assessment Tool for Criminal Adjudication
• Miller Forensic Assessment of Symptoms Test
• Minnesota Multiphasic Personality Inventory-Restructured Form
• Personality Assessment Inventory
• Psychopathy Checklist-Revised
• Test of Memory Malingering
• Validity Indicator Profile 
• Structured Interview of Reported Symptoms-2
• Violence Risk Appraisal Guide
• Wechsler Adult Intelligence Scales  

Measurable Outcomes for Emphasis Training in the Forensic Track:

1. Interns will work effectively and professionally as a member of the forensic service team at ECRH. This includes working with members of a multidisciplinary team devoted to the treatment and care of forensic patients placed at ECRH.
2. Forensic interns will have two long-term therapy clients over the course of their training year. Interns, in conjunction with their supervisors, will develop specific interventions that will be the focus of treatment. Some examples of this individual treatment may involve preparation for return to the community, individual psychoeducational work on issues related to competency restoration, or individual therapy to reinforce skills learned in DBT.
3. Interns will work comfortably and professionally as a consultant to treatment teams located throughout ECRH. The primary goal of this outcome is the completion of violence risk assessments that can assist treatment teams with appropriately placing our individuals.
4. Interns will demonstrate proficiency in treatment strategies related to patients with forensic issues. Treatments will include co-facilitating competency restoration and dialectical behavior therapy groups.
5. A key component of forensic emphasis training is the completion of pretrial forensic evaluations.

Forensic Assessment:

• Proficiency will be demonstrated by the completion of a minimum of 8 pretrial forensic assessments, all of which will be signed by the intern and submitted to the court. These assessments will include competency to proceed to trial and criminal responsibility.
• On each case, the intern will be carefully supervised by a licensed psychologist. With supervision, the intern will be responsible for conducting the clinical interview, completing appropriate psychological testing, making clinical diagnoses, writing the forensic opinion related to the psycholegal question, and developing appropriate recommendations that can be effectively utilized by the court and legal system. Each intern will be given extensive formal supervision during the course of report writing. Supervision will include everything from the development of the psychosocial history to the formulation of the psycholegal opinion. Moreover, there are multiple opportunities for informal supervision during the report writing process.
• These evaluations will be comprehensive and require highly refined report writing skills. To that end, supervisors will work closely with the intern to ensure each report meets the exacting standards required of court-ordered reports.
• Over the course of forensic evaluations, there is a possibility the findings of the report authored by the intern and their supervisor will be disputed by one party, which would then involve the need to testify regarding the findings of the report. If this occurs, the intern, accompanied by their supervisor, would have the opportunity to offer expert testimony in the courtroom.

Forensic Consultation: Consultation is often a necessary component of the forensic psychologist’s work. In the forensic track, the intern will have the opportunity to provide two types of consultations.

•  The first type of consultation involves general psychological testing with forensic patients. Under supervision, the intern will perform psychological testing to provide information to the referring treatment team on common issues found with individuals undergoing forensic evaluations. Testing will generally be requested to assist with accurate diagnosis, including malingering, or to provide information on an individual’s intellectual and adaptive functioning.
• The second type of consultation involves conducting comprehensive risk assessments for referring treatment teams. These evaluations include the use of structured risk assessment instruments (e.g., VRAG, PCL-R, and HCR-20) and integrating the risk assessment information with extensive background information. These reports are often used to inform treatment teams on the individual’s violence risk, which in turn forms the basis for decisions regarding civil commitment. Often the individuals who are undergoing risk assessments have high profile crimes and the results of the risk assessment undergo a high level of scrutiny.  The intern will complete a minimum of 2 violence risk assessments .

Interns will demonstrate knowledge of common mental health diagnoses found with inpatient and outpatient forensic patients. Interns will gain knowledge about appropriate assessment techniques for these populations. Interns will learn how to appropriately apply the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition to mental health issues commonly encountered in forensic settings.

Educational Implementation Plan: The Forensic Track makes use of the following educational components in efforts to achieve the identified Goals/Objectives of this emphasis track:

1. For Forensic Track Interns, the preponderance of the clinical education experiences throughout the year will be completed at ECRH inpatient and outpatient forensic services. Activities will include traditional inpatient and outpatient evaluations of competency to proceed to trial and criminal responsibility, as well as consultation with forensic and civil inpatient units throughout the hospital regarding violence risk.
2. Throughout the year, interns will be involved in mental health interventions with forensic patients. These interventions include competency restoration treatment and involvement in dialectical behavior therapy. Forensic interns will co-facilitate both competency restoration and dialectical behavior therapy groups.
3. Interns will attend team meetings as a member of the multidisciplinary treatment team. This allows interns interactions with a variety of professionals all tasked with the care and treatment of forensic individuals. The team meeting will also provide the intern time to interact with forensic patients in a formal treatment setting.
4. Forensic interns will attend two weekly specialized seminars dealing with forensic mental health and the law. The Mental Health Law seminar occurs weekly and provides foundational information related to forensic psychology. Landmark Case Seminar also occurs weekly and reviews important state, appellate, and Supreme Court cases that provide the legal framework for conducting forensic evaluations and understanding forensic issues. Interns will be responsible for briefing a case each week and then sharing the case with postdoctoral forensic fellows and forensic supervisors. This is an opportunity for interns to learn how to read and understand case law, and to sharpen their presentation skills.
5. Forensic interns will engage in other specialized educational experiences as they are made available. Included in this are mock trials and a state-wide forensic conference that is held each year in the Atlanta area. These seminars will be attended in conjunction with the other seminars part of this APA approved psychology internship.
6. For research activities, forensic interns will be encouraged to devote their time to forensically-related research. Specifically, forensic interns will be encouraged to consider how their research may relate to public policy issues.