drmargaret

I get told often that forensic psychology must be a very interesting field. People presume that I do crime scene investigation. I don’t. When “Quincy” was on television, people presumed I worked with dead bodies. I don’t.

Let me explain what the word “forensic” means for all you people who don’t want to look it up. It means simply “having to do with the law.” For those of you old enough to remember the television show, Quincy was a pathologist. A pathologist examines cells and tissues, and can determine illness. Therefore a forensic pathologist is someone who determines the causes of death for a court of law. Lots of people are involved in crime scenes. The stuff they show on television mixes up several types of professions for the purpose of making an interesting show. They are all investigating what happened. They are all doing it for law enforcement and ultimately for a court of law or for the police or district attorney. They are all therefore doing forensic work.

I’ve done several types of forensic work. I provided treatment to mentally disordered sex offenders as required by the courts. I provided testimony as an expert witness on several different types of cases in terms of how someone functions psychologically in different circumstances. I provided testimony in statements that were recorded legally as depositions on what the appropriate standards of care are in the regulatory community in terms of hospital treatment, note writing, standard of practice, and care for patients. Sometimes I talk to attorneys about medical cases that have an impact on cognitive functioning. Psychology is one of the professions that can test how the brain functions as it works to do tasks. We can measure how people think. There are lots of different ways to measure those thinking processes. Medical problems can cause some difficulties in thinking. Medical doctors can take pictures of the brain and can look at the structure and the the tissues and the chemistry and the blood flow. They can take MRIs and CT scans and PET studies and BEAM studies and lots of very pretty colored pictures. Psychologists, especially neuropsychologists, can tell people how their brains function. They can explain for the court the difference between normal brain functioning at the level of the thinking part of the brain, the cortex, and the abnormal brain at the same level. Forensic neuropsychologists do that for the courts.

Psychologists look at behavior. Forensic psychologists look at behavior as it applies to law. I saw a woman who had signed some papers. She couldn’t read well and was told to sign the papers by someone she liked and believed. The papers gave away the house she lived in. There was no question that she had signed the papers. There were photos of her at the bank signing the papers. There was a question of whether she understood what she had signed. She was not able to read the document in my presence. I gave her a reading test. She could read words at a fourth grade level. She could understand words at a fourth grade level. The document she signed was at an eighth grade level. It was not probable that she understood what she had signed.

Psychologists talk in probabilities. That comes from math. We use statistics to make decisions. If you flip a coin you have a 50% chance that it will come up heads and a 50% chance that it will come up tains if the coin is evenly weighted. You flip the coin 10 times and 9 times it comes up heads. The next time it is 50% likely to come up heads assuming it is evenly weighted. As you continue to flip the coin and continue to get heads you may start to doubt that the coin is evenly weighted. You may speculate that the coin is favoring to fall with the tail side down. Those speculations would prompt you to do research on the coin. You would be starting off to test your theory about the coin and your hypothesis that the coin wasn’t equally weighted. These kinds of data collection and hypothesis testing are what psychologists do. They do them on people, on situations, on animals, on lots of things. They make observations, they make hypotheses, they collect data, they do some research, they collect more data, they tell people what they find. Forensic psychologists tell people in law.

I do Social Security Disability Evaluations. It’s important work but nothing like crime scene investigation. People tell me what’s wrong with them. They have “allegations.” The allegations either make sense or they don’t. I’m limited to evaluating allegations in my field of psychology. Often people have allegations in other fields. They will tell me they have pain in their arms and legs. That’s going to be evaluated by someone else. I write down in my report what they tell me is wrong with them. That’s evidence. I do psychological testing. I determine a diagnosis. I write a little thing called a Medical Source Statement. I answer a few questions from the State of California on the person’s ability to do some specific tasks. Those answers are based on my test results and my opinion about how well they did in their effort. My report then goes either to their disability analyst to make a determination or to an Administrative Law Judge to make a determination. I don’t decide anything. I don’t treat anything. I don’t make any recommendations. So if someone tells me they graduated high school and they believe 1+1=6. I write that down in my report. I’ll check the allegations and the history to see if anything explains why they think 1+1=6. I’ll ask about treatment. I’ll ask a bunch of other questions. If they also tell me other stupid things, I might wonder if they realize I went to school for a very long time. I might suspect fraud. I don’t have all the history. The analyst or the Administrative Law judge can get more history. I might suggest they do that if I don’t have enough information in some areas.

I like the evaluation to be consistent. The tests usually are consistent across measures. People tell you what’s wrong with them. You find that. You write it up. Very simple. It’s not very complicated.

There’s stuff that’s complicated. Most of the tests are developed for people who can talk and hear and see and who speak English. When people come in who need translators or who can’t talk, or can’t see or can’t hear, there are adjustments that need to be made to insure that the testing is accurate and fair. I know a few words in a variety of languages so that helps quite a bit. The testing still should match the history and the allegations and the presentation. If it all comes together it’s all fine. When it doesn’t there’s lots of explanations needed.