Effect of an Individualized Treatment Protocol on Restoration of Competency in Pretrial
Forensic Inpatients
L. J. Bertman, J. John W. Thompson, W. F. Waters, L. Estupinan-Kane, J. A. Martin and
L. Russell,
Journal of the American Academy of Psychiatry and the Law
31(1): 027-035, 2003.
In this study, we evaluated the effectiveness of individualized treatment on restoration of competency
in patients adjudicated incompetent to stand trial. Treatment groups included deficit-focused
remediation (six individual sessions and four group sessions; n = 8), legal rights education
(control group; six individual sessions and four group sessions; n = 10), and standard hospital
treatment (control group; four group sessions; n = 8). There were no significant baseline
differences among groups. All groups differed significantly on competency measures obtained before
and after testing. The deficit-focused remediation and the legal rights education groups both
demonstrated significantly higher post-treatment scores on competency measures than the standard
hospital treatment group. Both groups demonstrated approximately 50 percent more improvement
on the competency measures than the standard hospital treatment group. There were no significant
differences between the deficit-focused remediation and legal rights education groups on post-test
competency scores, suggesting that focus on individual deficits may not be a useful treatment
strategy. Results demonstrate, however, that more frequent legal rights education is a worthwhile
endeavor in treatment of incompetency.