Issues In Forensic Psychology - Clinical Judgement

ISSUES IN FORENSIC PSYCHOLOGY
Clinical Judgement

It might seem reasonable to assume that the education, training, and professional experience of psychologists and psychiatrists confer expertise on their clinical judgments. In fact, however, this assumption is more often mistaken than not.
Additionally, professional identity is unrelated to the accuracy of clinical judgment. The judgments of psychiatrists, psychologists, and social workers are all equally unreliable because they commit the same kinds of errors.
To briefly belabor the obvious, the patients that psychologists and psychiatrists see in treatment exhibit problems more frequently than effective adjustment. This skewed exposure to maladjustment results in psychiatrists and psychologists developing an exaggerated sensitivity to psychopathology.
Unfortunately, psychologists and psychiatrists can see abnormality anywhere and everywhere despite the fact that they may be examining normal people. They frequently find evidence of maladjustment not because it really exists, but merely because they expect to discover it.
During their interviews, psychologists and psychiatrists often question patients in a manner that biases the information they obtain. Assumptions about a patient's drinking, marriage, or anger for example increase the frequency of questions directed at those topics - and asking enough questions allows psychologists and psychiatrists to find the answers they are seeking.
The expectations of psychologists and psychiatrists can lead them to believe that symptoms consistent with their diagnostic impressions were exhibited in an interview; when in fact, they were not.
Conversely, they are also less likely to recall symptoms that were actually present during an interview but inconsistent with their diagnostic impressions.
Therefore, psychologists and psychiatrists who testify relying on "my many years of clinical experience" deserve vigorous cross-examination.

If you are interested in issues related to clinical judgment, you may want to order any, or all, of the following publications authored by Dr. Campbell.

Challenging psychologists and psychiatrists as expert witnesses. Michigan Bar Journal, January 1994, 73, 68-72. (Order article #10, cost $10.00)

"Cross-Examining Psychologists and Psychiatrists as Expert Witnesses." This is a 79-page, single-spaced outline, containing 214 footnoted references. This outline is bound. (Order article #15, cost $59.00).

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