| Competency Training within the Developmentally Delayed Treatment Program at College Hospital of Cerritos |
| Admissions (800)352-3301 |
When confronted with criminal charges against them, developmentally
delayed defendants are often found to be incompetent to stand trial. In fact,
across the U.S. almost one third of all admissions of developmentally delayed
criminal offenders to inpatient mental health facilities are for incompetence to
stand trial. Unfortunately, there is little research guiding these admissions
and for a large majority of these hospitalizations, these patients remain
hospitalized seeking restoration of their competency for years, until judicial
officers are forced to develop alternate plans for resolving the case.
College Hospital of Cerritos has developed a specialized program
individually tailored to the needs of the offender. As a full service psychiatric
hospital, a variety of services is available for those patients who are dually
diagnosed. Behavioral and emotional conditions often complicate the
restoration of competence process, prolonging the length of treatment before
returning to court to resume proceedings. Staff within the College Hospital
program includes training in psychiatry, forensic and clinical psychology,
social work, nursing, familial and behavioral systems, and behavior specialists
certified in applied behavior analysis.
A New Jersey state hospital has pioneered a comprehensive training tool
designed to help these patients who are found incompetent, but also have
special needs that complicate their return to court. The Slater Method is
ground breaking in that it provides detailed recommendations specially
designed for the developmentally delayed population. The training is
organized into different modules addressing the range of competency topics,
including understanding the charges against the defendant, knowledge of
courtroom personnel and proceedings, understanding how best to assist their
attorney in presenting a defense, as well as tolerating the stresses of
courtroom proceedings. These procedures are well suited for a highly trained
multidisciplinary staff such as College Hospital that address cognitive deficits,
but more importantly the behavioral challenges that interfere with competence
within the courtroom setting including passivity, angry outbursts, rebellion,
poor attention span, psychotic behavior, etc. With both adolescent and adult
developmentally delayed programs, individuals are treated within a setting
reflecting programming designed for their age groups. Another unique
advantage of the College Hospital program is the focus upon cultural
diversity. Staff at all levels receives training in cultural competence and have
multilinguistic skills to further maximize the opportunities for success with this
important population. Other areas that reflect a refinement of the Slater
method, including modifications reported in subsequent research in North
Carolina have also been incorporated in the College Hospital program.
Within the first weeks of training, all patients’ records are thoroughly
reviewed by the treatment team and specific recommendations that guide the
assessment process are completed. Often these patients have received
comprehensive evaluations prior to their admission. These assessments will
not be repeated, but inform the basis of the curriculum developed especially
for the patient. The treatment team develops a systematic understanding of
what deficits prevented the assessment of competence during the courtroom
proceedings and focus upon these issues. The College Hospital competency-
training program is effective with a diverse group of defendants ranging from
those patients with mild developmental delays with few behavioral or
emotional disorders to some patients with more severe cognitive and
psychiatric disorders. While defendants with less complex conditions may be
returned to court within the first few months, patients with more cognitive
deficits and psychiatric disorders are likely to require longer periods before
achieving restoration and a return to court. Of course, there are some
defendants who can be identified early in training that will have little likelihood
of achieving restoration.
During the next phase of training, the patient participates in a mock trial to
further uncover challenges that are likely to resurface during their return to
court. Specific deficits are assigned to different team members consistent
with their disciplinary expertise.
Patients experience multimedia resources that maximize the success of these
empirically developed approaches. Modules presenting specific challenges
for the patient are repeatedly presented using videotaped vignettes that must
be role-played illustrating varied stages of the trial.
Throughout the training, patients are staffed daily, assessing the patient’s
response to the curriculum, fine-tuning strategies to address resistance and
barriers to restoration. During the court proceedings approximating five to
seven months following admission, a mock trial will provide additional
information regarding the patient’s readiness to return to court. While
evaluations from clinical staff involved with restoration training are not
considered objective by the court, valuable information about the patient’s
performance during training is useful in assessing their readiness to return to
court. With the defendant’s (or the conservator) authorization, such
information is presented to court personnel, e.g. probation officers, defense
attorneys, etc., or as part of an objective court ordered competency evaluation.
College Hospital staff are dedicated to facilitate the earliest restoration of
competence and return to court possible for each patient. By employing
ethical empirically supported training strategies and state of the art curriculum
and multimedia resources, no efforts are spared in striving for a positive
outcome.
References
Stoops, R.; Hess, J.: Scott, T.; Tolan, J. Gailucci, G.; & Brierley-Bowers, P.
Training competency to stand trial in an individual with intellectual disability
and behavioral health concerns. Mental Health Aspects of Developmental
Disabilities. 10 (2).
Wall, B.S.; Krupp, B.H.; and Guilmette, T. (2003) Restoration of competency to
stand trial: A training program for persons with mental retardation. Journal of
the American Academy of Psychiatry and Law, 31, 189-201.
delayed defendants are often found to be incompetent to stand trial. In fact,
across the U.S. almost one third of all admissions of developmentally delayed
criminal offenders to inpatient mental health facilities are for incompetence to
stand trial. Unfortunately, there is little research guiding these admissions
and for a large majority of these hospitalizations, these patients remain
hospitalized seeking restoration of their competency for years, until judicial
officers are forced to develop alternate plans for resolving the case.
College Hospital of Cerritos has developed a specialized program
individually tailored to the needs of the offender. As a full service psychiatric
hospital, a variety of services is available for those patients who are dually
diagnosed. Behavioral and emotional conditions often complicate the
restoration of competence process, prolonging the length of treatment before
returning to court to resume proceedings. Staff within the College Hospital
program includes training in psychiatry, forensic and clinical psychology,
social work, nursing, familial and behavioral systems, and behavior specialists
certified in applied behavior analysis.
A New Jersey state hospital has pioneered a comprehensive training tool
designed to help these patients who are found incompetent, but also have
special needs that complicate their return to court. The Slater Method is
ground breaking in that it provides detailed recommendations specially
designed for the developmentally delayed population. The training is
organized into different modules addressing the range of competency topics,
including understanding the charges against the defendant, knowledge of
courtroom personnel and proceedings, understanding how best to assist their
attorney in presenting a defense, as well as tolerating the stresses of
courtroom proceedings. These procedures are well suited for a highly trained
multidisciplinary staff such as College Hospital that address cognitive deficits,
but more importantly the behavioral challenges that interfere with competence
within the courtroom setting including passivity, angry outbursts, rebellion,
poor attention span, psychotic behavior, etc. With both adolescent and adult
developmentally delayed programs, individuals are treated within a setting
reflecting programming designed for their age groups. Another unique
advantage of the College Hospital program is the focus upon cultural
diversity. Staff at all levels receives training in cultural competence and have
multilinguistic skills to further maximize the opportunities for success with this
important population. Other areas that reflect a refinement of the Slater
method, including modifications reported in subsequent research in North
Carolina have also been incorporated in the College Hospital program.
Within the first weeks of training, all patients’ records are thoroughly
reviewed by the treatment team and specific recommendations that guide the
assessment process are completed. Often these patients have received
comprehensive evaluations prior to their admission. These assessments will
not be repeated, but inform the basis of the curriculum developed especially
for the patient. The treatment team develops a systematic understanding of
what deficits prevented the assessment of competence during the courtroom
proceedings and focus upon these issues. The College Hospital competency-
training program is effective with a diverse group of defendants ranging from
those patients with mild developmental delays with few behavioral or
emotional disorders to some patients with more severe cognitive and
psychiatric disorders. While defendants with less complex conditions may be
returned to court within the first few months, patients with more cognitive
deficits and psychiatric disorders are likely to require longer periods before
achieving restoration and a return to court. Of course, there are some
defendants who can be identified early in training that will have little likelihood
of achieving restoration.
During the next phase of training, the patient participates in a mock trial to
further uncover challenges that are likely to resurface during their return to
court. Specific deficits are assigned to different team members consistent
with their disciplinary expertise.
Patients experience multimedia resources that maximize the success of these
empirically developed approaches. Modules presenting specific challenges
for the patient are repeatedly presented using videotaped vignettes that must
be role-played illustrating varied stages of the trial.
Throughout the training, patients are staffed daily, assessing the patient’s
response to the curriculum, fine-tuning strategies to address resistance and
barriers to restoration. During the court proceedings approximating five to
seven months following admission, a mock trial will provide additional
information regarding the patient’s readiness to return to court. While
evaluations from clinical staff involved with restoration training are not
considered objective by the court, valuable information about the patient’s
performance during training is useful in assessing their readiness to return to
court. With the defendant’s (or the conservator) authorization, such
information is presented to court personnel, e.g. probation officers, defense
attorneys, etc., or as part of an objective court ordered competency evaluation.
College Hospital staff are dedicated to facilitate the earliest restoration of
competence and return to court possible for each patient. By employing
ethical empirically supported training strategies and state of the art curriculum
and multimedia resources, no efforts are spared in striving for a positive
outcome.
References
Stoops, R.; Hess, J.: Scott, T.; Tolan, J. Gailucci, G.; & Brierley-Bowers, P.
Training competency to stand trial in an individual with intellectual disability
and behavioral health concerns. Mental Health Aspects of Developmental
Disabilities. 10 (2).
Wall, B.S.; Krupp, B.H.; and Guilmette, T. (2003) Restoration of competency to
stand trial: A training program for persons with mental retardation. Journal of
the American Academy of Psychiatry and Law, 31, 189-201.
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