Competence to Stand Trial: Restoring Competence in an Inpatient Forensic Hospital Setting

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Davenport, Shelly
Washburn University
Psychology Department
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The following is a de-identified case study that describes how competency restoration treatment, psychiatric treatment, and assessments were used to assist Competency to Stand Trial restoration with a patient who has intellectual and psychiatric disabilities, in a state funded and forensic-focused in-patient residential hospital facility. Jack was a 20-year-old White male whose main struggles were with anger and impulsivity. His primary diagnoses were Attention Deficit/Hyperactivity Disorder, and Intellectual Disability. He has a secondary diagnosis of Other Specified Personality Disorder, and a differential diagnosis of Autism Spectrum Disorder. He was recommended by the unit psychologist for individual competency restoration treatment in addition to the group sessions he was assigned to as part of his more comprehensive treatment. Jack was assessed with an initial interview covering psychosocial history and mental status. Formal assessment instruments used included the Emotional Problems Scales (EPS), the Conners’ Adult ADHD Rating Scales (CAARS), and the Competence Assessment for Standing Trial for Defendants with Mental Retardation (CAST*MR). Individual competency restoration treatment sessions were based on and/or accessed from materials included in the Florida State Hospital CompKit manual (Florida State Hospital, 2011), and supplemented with available Mindfulness materials to increase coping skills and decrease impulsive behaviors. Included in this document is a transcript of a mock competency to stand trial evaluation that was the final session for Jack and designed to demonstrate his overall improvement as a result of the individual competency to stand trial treatment.
An Empirically Supported Treatment Case Study