Ethical - PowerPoint Presentation

Slide1

Ethical Issues and forensic psychological practice using the DSM-5 Quadrant with Juvenile Fire Setting and Bomb Making

Ronn Johnson, Ph.D. ABPP

University

of San DiegoSlide2

OVERVIEW OF JUVENILE FIRE SETTING & BOMB MAKING…ETHICS OF COMPETENCEUnderstanding Juvenile Fire setting and Bomb Making

* Evaluating

One’s Self* Case Studies and Ethical Considerations*Q & A

AgendaSlide3
Slide4

Assessment of JFSB experiences for MH ProfessionalsIAFF and the JFSB National Data base effortCurrent status of JFSB and mental health programs nationally

ETHICAL Professional issues in JFSBSlide5

Why do we need an ethical assessment of mental health professionals competencies for JFSB?Slide6

ACA CODES OF ETHICS and Standards of Practice 2014C.2. Professional Competence

C.2.a.Boundaries of Competence

Counselors practice only within the boundaries of their competence, based on their education, training, super vised experience, state and national professional credentials, and appropriate professional experience…

Sources for Ethical

PRACTICES FOR MENTAL HEALTH PROFESSIONALSSlide7

1.04 Competence (a) Social workers should provide services and represent themselves as competent only within the boundaries of their education, training, license, certification, consultation received, supervised experience, or other relevant professional experience. (b) Social workers should provide services in substantive areas or use intervention techniques or approaches that are new to them only after engaging in appropriate study, training, consultation, and supervision from people who are competent in those interventions or

techniques

.National association of social work (NASW)Slide8

2.01 Boundaries of Competence (a) Psychologists provide services, teach and conduct research with populations and in areas only within the boundaries of their competence, based on their education, training, supervised experience, consultation, study or professional experience.AMERICAN PSYCHOLOGICAL ASSOCIATION (APA)Slide9

2.01 Scope of CompetenceWhen determining one’s competence to provide services in a particular matter, forensic practitioners may consider a variety of factors including the relative complexity and specialized nature of the service, relevant training and experience, the preparation and study they are able to devote to the matter, and the opportunity for consultation with a professional of established competence in the subject matter in question.  Even with regard to subjects in which they are expert, forensic practitioners may choose to consult with colleagues.

Specialty Guidelines for Forensic PsychologySlide10

Forensic vs. Clinical

Clinically, one accepts a juvenile’s description

of

the circumstances

Forensically,

accused

juveniles have

reasons to lie:

proclaim innocence

The devil made me do it

Which hat are you wearing?Slide11

Legal StandardsSlide12

StateArson is defined in the California Penal Code (CPC) 451 and 452.CPC451: A person is guilty of arson when he or she willfully and maliciously sets fire to or burns or causes to be burned or who aids, counsels, or procures the burning of, any structure, forest land, or property.

CPC452

: A person is guilty of unlawfully causing a

fire

when

he

recklessly

sets fire to

or

burns

or causes to be burned, any structure, forest

and or property.Slide13

Three forensic psychological Competency Questions

Why should licensed mental health providers be concerned about JFSB?

What does the research reveal about JFSB? What are the myths associated with JFSB?

.Slide14

FACTS ABOUT JFSB

More

than 50% of the individuals adjudicated for arson were under the age of 18 56,300 Reports from 2005-2009110 Civilian Deaths Annually

880 Civilian Injuries Annually

$286 Million in Damages Annually

Up to 96% of JFS Cases

I

nvolve the Intentional

S

etting of a FireSlide15

STATISTICS ON JFSB55% of all U.S. arson arrests are children under the age of 18. Almost half of these arrests are children ages 15 and under.

As many as 6.8% of juveniles arrested for arson are under the age of 10.

The crime of arson has the highest rate of juvenile involvement.Arson is the 2nd leading cause of all fatal home accidents.

Fire setting is the largest cause of home deaths among children.

Almost 34% of the victims of child-

­‐

set fires are the children themselves.

Caution: These federal statistics provided by FEMA may be low, because

m

any fires that cause only minor damage or injury often go unreported by Parents and agencies

.Slide16

Empirical support for JFSBPrevious involvement in fire-setting behavior was found to be the best single predictor of recidivistic fire-setting.

Recidivists were noted

to have greater levels of interest in fire and fire-related activities Recidivists displayed more covert antisocial behaviors, and were more likely to be male and older than non-recidivists. Recidivists also reported poorer social skills and higher levels of family dysfunction than other

fire-setters

.

Kennedy, Patrick

J.;Vale

, Ellen L.

E.;Khan

, Sarah J.;

McAnaney

,

Andrea (2006) Factors

predicting recidivism in child and adolescent fire-setters: A systematic review of the

literature. Academic

Journal Academic Journal | Journal of Forensic Psychiatry Psychology,

Vol

17(1), Mar, 2006. pp. 151-164. Slide17

Competency self-audit for JFSB Slide18

Assessment of Competenciesunderpinning generic

clinical forensic skills

Competence with implementing culturally

responsive & evidenced based interventions

specific skills needed to

conduct a risk assessment and diagnosis

System competences (fire service, probation, schools, juvenile court, other providers)Slide19

FORENSIC MENTAL HEALTH COMPETENCY DOMAINS FOR JFSB

RISK ASSESSMENT

&

DIAGNOSIS

CORE SKILLS

FOR YOUTH WORK

LAWS & PUBLIC SAFETY

CULTURALLY

RESPONSIVE

INTERVENTIONSSlide20

Foundational Competency Domains: building blocks of what psychologists do:reflective practiceself-assessment

scientific knowledge

methodsrelationshipsethical and legal standards policyindividual Ethnoracial factorsinterdisciplinary systems

Rodolfa

et

al.,

(2005) Slide21

Functional Competency Domains Knowledge, kills and values necessary to perform the clinical forensic work requiredSlide22

Functional Competency Domains (cont.)Knowledge is typically gained through one’s formal education, readings, and other didactic experiences.

Skills

are developed through supervised clinical experiences during practicum and internship training as well as through ongoing clinical supervision and professional development throughout one’s career. Professional judgment should be developed through both, with ongoing efforts made to prevent any degradation of judgment, (emotional distress, mental

health difficulties, substance

abuse etc.)

Competence

and the lack

thereof should

not be viewed

dichotomously according to

the American

Psychological Association’s

(APA, 2002) Slide23

Guarding Against Threats to CompetenceMaintaining one’s clinical forensic competence is essential

Beyond

receiving additional training and updating one’s knowledge and skillsMust also guard against factors that may degrade one’s ability to exercise good judgment and effectively implement knowledge and skills as wellSlide24

Recent refereed scholarship in Police Psychology

± 5

Recent refereed Conference Presentations

In Police Psychology

± 4

Attendance at Police

Psychology Conferences

± 3

Articulation of Police

Psychology literature/

methods

± 2

Membership in Police Psych.

Assoc. or use of current Police Psych. Lit/Methods

± 1

Johnson, R. (In press) Journal of Forensic Research

Johnson, R. (In Press).

Journal of Forensic ResearchSlide25

Assessing One’s CompetenceReal knowledge is to know the extent of one's ignorance.

—Confucius

Why is it so hard for us to accurately gauge our proficiencies?How may we explain such poor self-insight? How can we ensure our percieved effectiveness is reality?Slide26

Dunning-Kruger EffectSlide27

Dunning-Kruger EffectDefinition: People with substantial deficits in their knowledge or expertise have difficulty recognizing their deficitsDouble Burden of Incompetence:

1.) Deficits in skill allow person to make more mistakes.

2) Same deficits lead person to be unable to recognize they are performing below their peers Slide28

Fig. 2. Perceived versus actual test score as a function of actual test performance.

Dunning D et al. Current Directions in Psychological Science 2003;12:83-87

Copyright © by Association for Psychological ScienceSlide29

Fig. 1. Perceived percentile rankings for mastery of course material and test performance as a function of actual performance rank.

Dunning D et al. Current Directions in Psychological Science 2003;12:83-87

Copyright © by Association for Psychological ScienceSlide30

Conscious competence learning modelSlide31

Four Stages of Competency Awareness

Conscious Incompetence

“Awhaa Moment”Conscious CompetenceAware of learning Unconscious IncompetenceUnaware of deficits

Unconscious Competence

“Action becomes second nature”

Masterly LevelSlide32

How to Enhance Metacognition-Unskilled and Aware-

Good clinical supervision and Mentorship

Objective & Subjective performance reviewTrain, Train, Train!!!Slide33

JFSB DSM-5 Diagnostic Challenges

DSM Diagnoses

= symptoms cluster at the syndromal levelJFSBs can present with several sets of symptoms Diagnostically the goal is to assess (i.e., differential diagnosis) for a smaller & sometimes overlapping set of related symptoms that can assist with the clinical and forensic questions involved in a JFSB case.Slide34

Clinical Foundations of the DSM-5 QuadrantSlide35

Comorbidity in JFSB Cases:In general, it is advisable to adhere to the principle of parsimony when it comes to diagnoses. At the same time it is clinically & forensically relevant to remember that most

diagnoses are not mutually exclusive.Slide36

JFSB ComorbidityUsing multiple diagnoses requires understanding the clinical & forensic implications.Multiple diagnoses are not actually independent from each other.Slide37

JFSB Comorbidity• Having more than one DSM-5 diagnosisdoes not necessarily mean that there is more than one underlying pathophysiological process.

• The diagnoses are not entities but descriptive

building blocks, a way of communicatingdiagnostic information used to select clinical or forensic options.Slide38

DSM-5 Quadrant: DefinedFour (Quadrant) Primary Mental Health Disorders that Present with JFSB

Conduct

Disorder (CD)Autism Spectrum Disorder (ASD)Attention-Deficit / Hyperactivity Disorder (ADHD)Post Traumatic Stress

Disorder (PTSD)Slide39

DSM-5 Quadrant: Defined

ADHD

PTSD

ASD

CDSlide40

DSM-5 Quadrant: Defined

ADHD

PTSD

ASD

CDSlide41

DSM-5 Quadrant: Defined

ADHD

PTSD

CD

ASDSlide42

DSM-5 Quadrant: Prevalence

Conduct Disorder (CD)

JFSB are more likely to meet the criteria for CD than any other mental health disorder (Dolan et al., 2011; Kolko & Kazdin, 1988; Sakheim & Osborn, 1994) Juveniles exhibit more pronounced delinquent and hyperactive behavior (Del Bove & MacKay, 2011; Kafry, 1980; Ayoub et al., 2004)

Attention Deficit Hyperactivity Disorder (ADHD)

These juveniles exhibit high levels of antisocial behavior, criminal activity, and substance use problems

Tend to have more difficulty in school Slide43

DSM-5 Quadrant: Prevalence

Autism Spectrum Disorder (ASD)

Some behave in socially deviant and destructive ways (Barry-Walsh & Mullen, 2003)Fire-related crimes are frequently associated with higher-function ASD individuals

(Haskins & Silva, 2006)

Posttraumatic Stress Disorder (PTSD)

Impairs ability to tolerate stress

Greater accumulation of recent stressful life events

(Wilder, 2007)Slide44

FATJAM Parent InterviewFATJAM is an evidence based assessment and intervention approach

Cognitive behavioral framework and information collection

target protective and risk factors to reduce threatsParent interview portion examines:changes in child’s behavior, child supervision, school behavior, hx of abuse, firesetting behavior, previous arrests or involvement in juvenile justice systemSlide45

Case of The CasesSlide46

Case Study #1Early one evening, a boy (15) broke into his school with the intent of burning it. He started three separate fires in different locations to ensure that his effort would be successful. He left the school and waited. Nothing happened. Frustrated, he returned to the school, broke in a second time, and reignited the fires. This time his effort resulted in a multiple alarm fire which caused $3.5 million damage to the school building.

The boy lives in an upper-middle class neighborhood in a stable home environment. He lives with his biological mother and stepfather. His biological father is not really involved in his life, but all indications were that this was not an issue to him. No other significant family stressors were reported. However, it was indicated that his parents had poor parenting skills and judgment and would often allow him to come and go as he pleased. This lack of structure and clear expectations led to persistent school problems which resulted in his being reprimanded in school the day of the fire. The boy stated he was angry at his teachers and wanted to burn the school down.Slide47

Case Study #2A boy (15) admitted starting a fire by putting plastic bags, clothing, and boxes in a baseboard heater in a spare bedroom of his home. The resulting fire caused $60,000 damage to their single-family home.

The boy had a history of fire play and had been referred to the local juvenile

firesetter program three years before. At that time, he had started a fire in a closet because he wanted to be a firefighter. Later, the boy admitted to willingly causing the fire. His father had a chronic illness and it appeared that the boy had to manage household responsibilities that he resented. He did not feel that he was properly acknowledged for his increased responsibility. When asked about the incident, he stated that he was angry at his parents.Slide48

Case Study #3A girl (14) was expelled from school after she and a friend singed the hair of two other girls by using hair spray and a lighter to make a torch. The teenager frequently was in trouble at school. The investigator was very concerned about her lack of empathy and remorse for her violence against the two girls. The father stated he believed that his daughter was aware of what she was doing, and that she wanted to cause harm. He is frustrated and tries to monitor her behavior. She was referred for further evaluation.Slide49

Working With Ethics American Counseling AssociationAmerican Psychological AssociationNational Association of Social WorkersSlide50

American Psychological Association2.01 Boundaries of Competence (a) ...provide services, teach and conduct research with populations and in areas only within the boundaries of their competence… (e)…ensure competence of their work and protect clients/patients, students, supervisees, research participants, organizational clients and

others from harm

(d)…forensic roles, psychologists are or become reasonably familiar with judicial or administrative rules governing rolesSlide51

American Counseling AssociationA.4. Avoiding Harm and Imposing Values (a)…avoid harming their clients…or to remedy unavoidable or unanticipated harm.C.2. Professional Competence (a)…practice only within boundaries of their competence.

(b)…practice in specialty areas new to them only after appropriate education, training, and supervised experience...ensure competence of their work and protect others from possible harm.Slide52

National Association of Social WorkersSocial Worker’s Ethical Responsibilities to Clients 1.04 Competence (a)…provide services and represent themselves as competent only within the boundaries of education training

, license, certification, consultation received,

supervised experience, or other relevant professional experience. (b)…techniques or approaches that are new to them only after engaging in appropriate study, training, consultation, and supervision from people who are competent… Slide53

National Association of Social WorkersSocial Worker’s Ethical Responsibilities As Professionals 4.01 Competence (a)…accept responsibility or employment on the basis of existing competence or intention to acquire competence. Slide54

Basic ToolsSlide55

Assessment ConsiderationsDr. J-Could you throw in a couple good assessments here and maybe a risk related speal?Slide56

ConclusionSlide57

Questions?Slide58

References Dunning, D. (2011). The dunning-kruger effect: On being ignorant of one's own ignorance

.

Advances in experimental social psychology, vol 44. (pp. 247-296) Academic Press, San Diego, CA. doi:http://dx.doi.org/10.1016/B978-0-12- 385522-0.00005-6 Kruger, J., & Dunning, D. (2002). Unskilled and unaware--but why? A reply to krueger and mueller

(2002).

Journal of Personality and Social Psychology,

82

(2

), 189-192.

doi:http

://dx.doi.org/10.1037/0022-3514.82.2.189

Simons, D. J. (2013). Unskilled and optimistic: Overconfident predictions

despite calibrated

knowledge of relative skill.

Psychonomic

Bulletin &

Review, 20(3), 601- 607. doi:http

://dx.doi.org/10.3758/s13423-013-0379- 2 Williams, E. F., Dunning, D., & Kruger, J. (2013). The hobgoblin of consistency: Algorithmic judgment strategies underlie inflated self-assessments of performance. Journal of Personality and Social Psychology, 104(6), 976-994. Retrieved from http://search.proquest.com/docview/1346800649?accountid=14524 Slide59

ReferencesAmerican Psychological Association. (2015). Ethical principles of psychologists and code of conduct. Retrieved from http://www.apa.org/ethics/code

/

American Counseling Association. (2014). 2014 aca code of ethics. Retrieved from http://www.counseling.org/docs/ethics/2014-aca-code-of-ethics.pdf?sfvrsn=4National Association of Social Workers. (2015). Code of ethics of the national association of social workers. Retrieved from http://www.socialworkers.org/pubs/code/code.asp