Comprehensive Exam

 
Master’s in Forensic Psychology Comp Exam
Need this by Wednesday November 25th at 1pm PST
MAFP Comp Exam
Master’s in Forensic Psychology

Here is the comp exam requirements: ****In this paper we do not diagnose and or prescribe anything as we are a forensic health expert but we are not licensed. You can suggest and say that because Ana’s is presenting with signs of depression that meet the definition of depression in the DSM-5, it could be suggested that Ana may be depressed, but that would need further follow up by a licensed psychologist.
Answer questions in body of paper – each question must start on a new page!

Case Vignette for Comprehensive Examination
Please read the vignette carefully. Based on information provided in the vignette, please compose a well-written and organized response to each of the questions that follow:
Offense Identification:
A citizen summoned police to a city park. The police made the following report:
Ana had spent the afternoon at the park and fell asleep at a picnic table. When the time came to close the park and lock the park gate, a Parks & Recreation worker shook her shoulder to wake her. She yelled and swung a knife at him, grazing his abdomen. She then continued swinging the knife and yelled, “Let me go! Get off of me! Get off of me!” She then became confused, began sobbing, and was easily subdued. Ana was charged with assault. She was then quiet and cooperative. However, she did not want to discuss matters related to her arrest. A urinalysis tested negative for drugs and alcohol.
Psychosocial History: Ana is 35 years old. Having been born in the U.S., she is a U.S. citizen. Ana’s mother returned with her to Mexico when Ana was a small child—three years old. Ana was then raised in Mexico by her single mother. She has two older brothers, an older sister, and a younger sister. Finances were always strained, and her mother worked extra hours whenever possible. As a child, the oldest brother often watched after her while her mother worked. As a preteen, she became withdrawn and depressed. Then, at fifteen years old, she says that a friend of her brother raped her. Her brother laughed at her and nobody believed her, and the friend continued to be a frequent guest at the home.
Ana graduated from high school and got a job in a factory. As she got older she expected to marry, but she was unable to find any man who interested her. Since she continued to be depressed and withdrawn, few showed any interest in her either.
At age 22, Ana fell in love with a female coworker. This was contrary to her religion and her depression deepened. She did not act on this attraction, and tried to stay away from the woman. At age 25, she fell in love with another woman, and felt that she was happy for the first time in her life. When the two women were caught kissing, neighbors beat them both. The women then took an apartment together in another part of town. However, neighbors there eventually became suspicious that the relationship was romantic. One evening, two men from the apartment building arrived at her apartment with another man. Ana was alone. The men gang-raped her, taunting her that she should learn how to have the “right” kind of sex. She was afraid to report the rape to the police. She and her partner moved again, and again were socially rejected and taunted by their neighbors.
Ana and her partner, who is a Mexican national, decided to move to the U.S. in hopes of greater tolerance. In their first neighborhood in the U.S., they became frightened when they believed that they were again being treated with open hostility. They responded by moving to their current residence in another new town, where they have now lived for three years. Ana has worked at a series of low-paying jobs here, and she is currently unemployed. She has trouble focusing on her work, and employers have considered her a marginal worker. Her partner is employed as a grocery cashier, and was at work at the time of Ana’s assault. Ana often falls asleep at odd times—such as on this day in the park—because her nighttime sleep is disrupted by nightmares.
Ana has no record of previous criminal activity or violence. She was referred to the mental health department because of suicidal preoccupations, nightmares, withdrawn behavior, and ongoing irritability toward others in jail. Ana has shown little motivation in therapy and says that it is useless.
Task Identification
You are being asked to conduct a pre-trial psycholegal evaluation of Ana for the court to which she is initially assigned. You are to act as a forensic mental health evaluator and produce a written report addressing the questions, below. The report will be submitted to the appropriate supervisor and presented to the court.
Behavioral Observations
When the forensic evaluator meets with Ana, she seems sullen and hopeless about her situation, and states that it does not matter what happens to her in court because she is a sinner and will be punished for eternity anyway. She answers questions, but offers nothing unless asked and does not seem invested in collaborating in the procedure or helping herself. Her psychosocial history was gathered with some resistance on her part, and only after patient prodding and support.
Based on the vignette provided, please compose a well-written and organized response to each of the following questions. When writing your responses, please:

• Use APA (6th Edition, Second Printing) Style, with 1-inch margins, double-spaced, 12 font, with a reference list at the end.
• Write clearly and concisely.
• Cite appropriate, and especially current, literature (empirical and/or theoretical).
• Avoid all sexist idioms and allusions.
• Remember to demonstrate your multicultural competence where appropriate.

Psychological Theory and Practice

A. What assessments would you conduct to enhance your understanding of the client’s problems and how would your choice of assessment(s) inform your diagnostic formation and treatment planning? Assessments may include structured or unstructured interviews, valid and reliable assessment measures, and/or formalized assessment procedures that may be conducted by yourself or by someone else referred by you.

B. Provide your diagnostic impressions (based on the DSM-5) for this individual. In narrative form, please describe how the individual meets the diagnostic criteria for the disorder(s) chosen in addition to the differential diagnostic thought process that you used to reach your hypotheses. Be sure to include any additional (missing) information that is needed to either rule out or confirm your differential diagnoses.

Legal Theory and Application

A. Explain the background, current presentation, and behavior of the client utilizing theories of offender and/or victim psychology and personality/psychological theories to support your position. Do not simply restate the client’s presentation from the vignette. Instead, provide a theoretical-based discussion of the client’s behaviors as presented in the vignette.

B. Describe the psycholegal standards and/or definitions for each of the following: competence to stand trial, risk of dangerousness, and insanity.
Identify and describe one or more landmark case(s) for each standard (at least three cases total). Describe the elements or issues that a mental health professional usually focuses on when assessing a person’s adjudicative competence, risk and insanity, and any additional items that might be especially important to focus on in the provided vignette.
Research and Evaluation

A. Describe tests or assessment procedures you would employ to address the psycholegal issues of (competence to stand trial, risk of dangerousness, and insanity). You may refer to these from the Psychological Theory and Assessment Section “A” if you already covered them there. Discuss what the anticipated conclusions would be based upon information provided in the vignette.

B. Develop one empirically supported therapeutic treatment plan for the client in the vignette. Please make sure you summarize the empirical evidence with appropriate citations to support your treatment choice(s) in working with your client. Be sure to discuss the effectiveness and limitations in working with this particular client, including this client’s background, using the above treatment plans.

Interpersonal Effectiveness

A. What diversity factors, cultural considerations, or other demographic variables pertaining to this client would you take into account in rendering diagnoses, choosing assessment measures, forming case conceptualizations, and designing the treatment plan? Be sure to discuss cultural/diversity factors that could apply even if they are not explicitly mentioned in the vignette.

B. Your writing, use of citations, ability to form a logical argument, and proper APA Style, including the use of paraphrasing, will be evaluated as a measure of your interpersonal effectiveness. No response is required for “B”.
Leadership, Consultation, and Ethics
A. Describe how you would work within a professional treatment team to consult, triage, and treat this case. Include a description of the various members of the professional team with whom you would be likely to interact. Additionally, explain the roles and responsibilities of each member of the treatment team.

B. What are the ethical and legal dilemmas this vignette introduced? What would be your immediate steps and why? Please be specific and make sure that you describe your process of ethical decision making and the solutions/consequences to which this process might lead. Your discussion should be informed by the American Psychological Association’s Ethics Code as well as the Specialty Guidelines for Forensic Psychologists

To the 100% American writer: I started part of my paper. A case history must be included and you can blend this to meet your writing style and please add any information that I missed in the section: You will see the questions again in the below section.
Case History
The court has requested that a pre-trial psycholegal evaluation be conducted on Ana, a 35-year-old Hispanic female that has been charged with assault. It is reported that Ana had fallen asleep at a park bench and when the park employee went to wake by shaking her on the shoulder, she yelled and swung a knife at him grazing his abdomen. It was also reported that Ana yelled, “Let me go! Get off of me! Get off of me!” while she continued to swing the knife about. The report continues to describe Ana as becoming confused, crying and was easy to subdue. Once Ana learned that she was charged with assault, she became quite and cooperative but was not wanting to discuss the issues related to her arrest. Police ran a urinalysis test and Ana’s test showed negative results for drugs and alcohol.
Ana is a natural born citizen to the US but her mother moved the family back to Mexico when Ana was just 3 years of age. While in Mexico, Ana lived with her two older brothers, an older sister and a younger sister. Ana’s mother did not earn a large salary, so she would take on extra hours whenever the opportunity presented itself; therefore her older brother looked after Ana. In her preteen years, Ana became depresses and withdrawn. At the age of fifteen, Ana revealed to her brother that a friend of his had raped her. The brother did not believe Ana’s accusations. He actually laughed at her and continued to have his friend over routinely.
Ana was successful in graduating from school and went onto work in a factory. The expectation was that Ana would eventually find a man and get married but she never found a man that she was interested in so the marriage never materialized. Ana at this time continues to be withdrawn and depressed and therefore finding a suitable partner for her becomes even harder.
At the age of 22, Ana fell in love with a female co-worker but knew that this was not in line with her religious beliefs, so Ana did her best to avoid the female. Three years later at the age of 25, Ana fell in love with another female and reported that she was happy for the first time. When her and this female were caught kissing, the neighbors beat them both. Because of their relationship the women opted to move to a new apartment complex. In this new complex, neighbors became suspicious of their relationship and one evening, two men from the apartment complex and another friend entered into Ana’s apartment where she was alone. She alleges that the three men gang raped her all the while telling her that she should learn how to have the “right” kind of sex. Ana never reported the rape to the authorities, as she was too afraid too. The couple moved yet again but encountered the same treatment as they had at the last complex, where they were socially rejected and taunted by their neighbors. Eventually the pair decided to move to the US in hopes of finding a better life. In their first apartment, Ana and her believed yet again they were being targeted with open hostility and so they relocated to a new residence in which they still reside currently and have for the past three years.
Records show that Ana has no previous criminal activity and or violence. Because of Ana’s difficulty in dealing with other inmates, Ana was referred to mental health services because of her withdrawn behavior, suicidal preoccupations and nightmares. Once in therapy, Ana showed no interest and says that it is useless.

Psychological Theory and Practice
C. What assessments would you conduct to enhance your understanding of the client’s problems and how would your choice of assessment(s) inform your diagnostic formation and treatment planning? Assessments may include structured or unstructured interviews, valid and reliable assessment measures, and/or formalized assessment procedures that may be conducted by yourself or by someone else referred by you.
Assessments suggestions to use:
Mental Status Exam – always use this one
Beck Depression – matches for her depression
Suicide Risk Evaluation
CAI Competency Assessment Instrument or competency to stand trial
PTSD – nightmares, this is because she was allegedly raped twice and she reports that she was beaten for being gay – you will have to research an assessment for this.
Clinical Interview- talk about doing a clinical interview to obtain the assessments and gather information; please reference any and all past medical records if applicable, you can mention that you would interview family members if they were available.
I would also like to rule out a few disorders and or syndromes, this might work – Social Anxiety Disorder (Social Phobia) 300.23 (F40.10) according to the (DSM-5 2013) anxiety of social settings where scrutiny may occur, fears that he or she will act in a certain way that will show anxiety, social situations always provoke fear, the fear out of proportion of the actual situation etc. I included this diagnosis because Brine spoke of his reluctance to interact with his peers and also the fear of rejections of females in high school.
D. Provide your diagnostic impressions (based on the DSM-5) for this individual. In narrative form, please describe how the individual meets the diagnostic criteria for the disorder(s) chosen in addition to the differential diagnostic thought process that you used to reach your hypotheses. Be sure to include any additional (missing) information that is needed to either rule out or confirm your differential diagnoses.
I feel that Ana presents with symptoms of the below:
PTSD
Rape Trauma Syndrome / Rape Crisis Syndrome
Depression
Legal Theory and Application
C. Explain the background, current presentation, and behavior of the client utilizing theories of offender and/or victim psychology and personality/psychological theories to support your position. Do not simply restate the client’s presentation from the vignette. Instead, provide a theoretical-based discussion of the client’s behaviors as presented in the vignette.
This is where you can relate Ana’s background to her being raised in Mexico, she has religious beliefs but not sure what religion, but we know that being a lesbian was not acceptable where she was from. This is one of the hardest questions on the test.
Behaviors – female Hispanic, cultural issues, gay, religion, allegedly raped twice, withdrawn, depressed, trouble sleeping, nightmares,
D. Describe the psycholegal standards and/or definitions for each of the following: competence to stand trial, risk of dangerousness, and insanity.
Identify and describe one or more landmark case(s) for each standard (at least three cases total). Describe the elements or issues that a mental health professional usually focuses on when assessing a person’s adjudicative competence, risk and insanity, and any additional items that might be especially important to focus on in the provided vignette.
Durham vs. Unites States 214 F.2d 862 (1954) / Competency to Stand Trial (CST)
Dusky v. United States -362 U.S. 402 (1960).
I’ve listed two very popular landmark cases, please find a third.

Research and Evaluation
C. Describe tests or assessment procedures you would employ to address the psycholegal issues of (competence to stand trial, risk of dangerousness, and insanity). You may refer to these from the Psychological Theory and Assessment Section “A” if you already covered them there. Discuss what the anticipated conclusions would be based upon information provided in the vignette.
D. Develop one empirically supported therapeutic treatment plan for the client in the vignette. Please make sure you summarize the empirical evidence with appropriate citations to support your treatment choice(s) in working with your client. Be sure to discuss the effectiveness and limitations in working with this particular client, including this client’s background, using the above treatment plans.
A therapeutic treatment plan that I think may work for Ana is – a residence care facility, including group and individual therapy. Would need to research meds used for PTSD that might be prescribed by a psychologist (in this paper we do not prescribe and or diagnose anything)
Interpersonal Effectiveness
A. What diversity factors, cultural considerations, or other demographic variables pertaining to this client would you take into account in rendering diagnoses, choosing assessment measures, forming case conceptualizations, and designing the treatment plan? Be sure to discuss cultural/diversity factors that could apply even if they are not explicitly mentioned in the vignette.
B. Your writing, use of citations, ability to form a logical argument, and proper APA Style, including the use of paraphrasing, will be evaluated as a measure of your interpersonal effectiveness. No response is required for “B”.

Leadership, Consultation, and Ethics
A. Describe how you would work within a professional treatment team to consult, triage, and treat this case. Include a description of the various members of the professional team with whom you would be likely to interact. Additionally, explain the roles and responsibilities of each member of the treatment team.
In this section you can list everyone that you would be involved with: Social Worker, court personnel, attorney, licensed psychologist and any other person…
B. What are the ethical and legal dilemmas this vignette introduced? What would be your immediate steps and why? Please be specific and make sure that you describe your process of ethical decision-making and the solutions/consequences to which this process might lead. Your discussion should be informed by the American Psychological Association’s Ethics Code as well as the Specialty Guidelines for Forensic Psychologists
Might be able to use this information:
Per the American Psychological Association, Ethical Principals of Psychologists and Code of Conduct (APA 2002 & 2010) 2.01 – Boundaries of Competence, the expert will provide services, teach, and conduct research with populations and only in his area of expertise. This code states that the expert that has been retained to give testimony can only give his opinions regarding his area of expertise and it is based of their education, training and experience. The Specialty Guidelines for Forensic Psychology (SGFP) code 2.03 – Representing Competencies, the forensic practitioners adequately and accurately inform all recipients of their services, about relevant aspects of the nature and extent of their experience, training, credentials, and qualifications, and how they were obtained. It is also important for the psychologist to maintain credibility and adhere to code 1.01 (APA 2002 & 2010) – Professional Responsibility, making sure that the information they represent is not misused in anyway and or misrepresented.

Some other information to help with this paper: Just some random notes and yet again, the questions are listed below:
Comp Exam Notes
Answer questions in body of paper – each question must start on a new page!
Psychology Theory & Practice
Past records – need consent
Clinical interview
Mental Status exam – give reasons why this assessment is needed. Cite the mental status exam and cite why you are choosing it for your specific scenario. You can also write about test assessments that would not work and list why they would not.
Suicide risk evaluation –
Testing: any test you use, cite this test and discuss pros and cons of this assessment for your scenario
Beck Depression inventory
Substance abuse if applicable – not applicable
Briefly summarize history – may include interviewing spouse if relevant
Additional psychological testing – make sure to do baseline assessment testing i.e. How often does he subject think about suicide?
Be prepared to speak about cultural differences. i.e gay, different race, or whatever the difference is, speak about it. The SPFG, you can cite this guide and cultural issues
**she seems ill, to establish a baseline of current functioning the treatment team is going to do…
Differential diagnosis – i.e – I thought it was this, but after reviewing this, I know believe that this fits because of this reason.
Legal Theory & Application:
A) Cognitive behavior or social learning theory – how could one learn to do this erratic behavior?
Positist Theory – actions learned from parents
Once you have identified the theories, tie it back into the vignette
Clinical symptomology – forensic involvement of the client – theoretical formulation tied back into vignette
Positive theory does not always explain but it is ….. cite the theory and the reason it did not apply
B) Application – Psycho legal
Tarasoff , Dusky, McNaughten, Durham – then explain the elements to help your defense
Standard and definitions – describe elements and relate vignette
– At the current moment Jane Doe is acting so incompetent that she is not competent to stand trial. Further assessment is needed to accurately assess

Research & Evaluation
A) Forensic test assessment: procedures comp to stand trial – cite
Risk of dangerousness – VRAG, PCER
Sanity – RCREST – Rodgers Criminal Responsibility, anticipated conclusions & relate back to the vignette –language, cultural or whatever
Tie in treatment go back and refer to question. The theories of treatment.
Triage – be sure to elaborate on all answers, provide reasons why. Explain how assessment – Jane Doe is still erratic, need to consult psychiatric doctor, her pain level is still at x, she may need meds, follow with medical doctor, psychological crisis interrogation – may need to consult social worker- follow up care. Want to see improvement from her baseline assessment. Assess an appropriate treatment plan, ie. Therapy
Relapse prevention plan –
Interpersonal Effectiveness
A) Factor or cultural consideration, American Soman, lesbian according to the APA guidelines cite what you can and relate back to vignette. Gender, age, disability, sexual orientation, identity development, demographic location. According to APA no bias should exist
Leadership, Consultation and Ethics
Attorney, clinician, medical pain meds – Stabilize, address pain, work on discharge if applicable.
State how you would work on interdisciplinary team – find source and cite. Also cite APA code that speaks to working with other professionals
Informed Consent
Site ethics code here – rights of others – you can use the Bush Decision making model in tis section, make sure to cite
Potential problems – applicable laws, consultation to protect, always seek consultations
The below are suggestions from one of my instructors:
With insanity or other situations you will not be able to address all possible laws, since they do change somewhat by state. You should however be prepared with a few key landmark cases as they apply to the case study discussion such as M’Naughten and Durham. You can find some relevant cases at:
https://www.aapl.org/landmark_list.htm
Ah, I see now. Yes, most every case will have different people to interact with. Some will be one-time debriefings or interviews, while others will be ongoing. It depends on the actual case. For example, for CST, you would be consulting with witnesses and attorneys, while on the treatment side, you may be interacting more with the psychiatrist, physician etc. The team work may evolve over time also from the initial assessment roles through the ongoing treatment. See also the rubric page 11 for some more ideas.

The Melton text: Psychological Evaluations for the Courts is my usual “go to” text. (ps recommend it if you don’t have it, but I’m not sure of the cost of it these days). There is not a separate section just on interactions, but as I mentioned, there are brief pieces dependent on the specific type of case (for example, child custody, or types of interactions on the court level etc.) I’ll keep looking around a bit, but have not seen a single article/book just on this topic, so much as sections discussing information sharing in certain contexts.
*CBT is certainly one of the most common treatment approaches, and a good base, but you have also learned several theories that specifically apply that approach to criminality.
*Good question about the assessment results. This is tricky. Do not insert any information or make things up. In real life it is very common to have incomplete information. Based on your diagnosis and the information provided you should be able to discuss in detail which diagnosis best fits (and exclude others since they do not). I would generally recommend staying away from Internet sources. They are a poor quality source without research backing. In general, if you had one or two it would not be bad, but if for example they were Wikipedia, for example, or something that gave you mis-information, it could be bad.
2005 Summary of laws and regulations related to the practice of psychology, penal and evidence code
And more notes:::
Triage & Assessment:
-Be sure to elaborate on all answers. Provide reasons why.
-Explain how assessment test measures what someone is diagnosed with. What aspects does it measure? What about its reliability and validity? Provide more description on reliability and validity. Is it standardized on certain groups (men, lesbians, Hispanics, etc.)? In other words, is it unique to a certain population? Be more specific and descriptive about the instruments you will be using. Explain HOW the test measures competency and insanity for that population.
-Explain WHY we are using that particular test, and what it is designed to measure.
-Show how the test works and why it’s valid.
-Discuss how assessment test will address any culture issues. Show awareness of culture issues.
-“What does the administration of the test look like?”
-Do not forget to include validity and reliability of each test.

Diagnosis:
-Make the distinctions between each diagnosis: if more than one diagnosis exists, then clearly distinguish each diagnosis, and the symptoms that make them 2 separate diagnosis (or 3, or 4, etc.). For example: what is the need for the additional diagnosis? In other words, can all the clients symptoms fit under the same diagnosis? If not, then why? For instance, if they have formal depression, and then later on you believe they have anxiety too, then what is the other symptom(s) that would cause them to quality for a diagnosis under anxiety as well?
-We cannot diagnosis, we can only make the suggestion: For example, instead of saying “Mel has depression”, say “According to the DSM-V, Mel qualifies for depression because…”. Then list the symptoms. But first, you must back this information up with the assessment tests that you plan to use, because the assessment test will render the diagnosis—not you. Ask yourself: “do we have enough evidence to diagnosis this person with this disorder?” Incorporate this answer into your paper. Only provide a diagnosis off what the assessment tests (that you provided) are able to measure.
-It is appropriate to use a R/O diagnosis (rule out), but only if we provide a reason for it.
-Only make a diagnosis using information provided in the vignette. We cannot make up or add any info.
-Remember, we cannot diagnosis off of assumptions. We have to test them first. However, we can still include it in our paper, and say something like “more research needs to be done on this”, or a “mental health professional needs to look into this”. For example, it’s ok to say stuff like “Alice may have a mood disorder, but more information is needed on her symptoms to come to this conclusion”.

Forensic Evaluation:
-Clearly articulate on HOW assessment tests will be used. Are they culturally appropriate? Any culture issues? How might the client’s charges be affected by competency issues? How might the client’s family history impact the court’s opinion of whether they knew right from wrong?

Treatment:
-Be sure to integrate culture. Address all clients’ acute symptoms
-Fully discuss interventions.

Other reminders:
-Don’t forget to discuss any immediate problems, such as a danger to one’s self, or a danger to someone else. Discuss what action should be taken.
-Try to include at least 1 quote used from each book in class.
-Each question must begin on a new page. Bold and centered headings.

WE ACCEPT