RATIONAL UNDERSTANDING IN COMPETENCY TO STAND TRIAL: A

156 Pages·2011·0.8 MB·English

RATIONAL UNDERSTANDING IN COMPETENCY TO STAND TRIAL:
A QUALITITATIVE STUDY AND DEVELOPMENT OF AN
ASSESSMENT INSTRUMENT

A Dissertation

Presented to the Faculty of
Antioch University Seattle
Seattle, WA

In Partial Fulfillment
of the Requirements of the Degree
Doctor of Psychology

By
Kenneth C. Cole, Jr.
September 2010
RATIONAL UNDERSTANDING IN COMPETENCY TO STAND TRIAL:
A QUALITITATIVE STUDY AND DEVELOPMENT OF AN
ASSESSMENT INSTRUMENT

This dissertation, by Kenneth C. Cole, Jr., has been
approved by the committee members signed below
who recommend that it be accepted by the faculty of
Antioch University Seattle at Seattle, WA,
in partial fulfillment of requirements for the degree of

DOCTOR OF PSYCHOLOGY

Clinical Dissertation Committee:

_________________________
Mary Wieneke, Ph.D.
Chairperson

_________________________
Catherine Koverola, Ph.D.

_________________________
Philip Barnard, Ph.D.

________________________
Date.

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© Copyright by Kenneth Cole, Jr., 2010
All Rights Reserved
iii
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ABSTRACT

RATIONAL UNDERSTANDING IN COMPETENCY TO STAND TRIAL:
A QUALITITATIVE STUDY AND DEVELOPMENT OF AN
ASSESSMENT INSTRUMENT

KENNETH C. COLE, JR.

Antioch University Seattle

Seattle, WA

Mental competency as a prerequisite for due process was established by the United States
Supreme Court‟s Dusky decision (1960). The Court mandated that a defendant must possess
reasonable levels of factual and rational understanding in order to competently participate in
the adjudication process. The precise definitions of competence were not included in any of
the Court‟s decisions regarding the concept of Competency to Stand Trial (CST). The
original purpose of this research was to contribute knowledge regarding the psychological
dimensions of CST and to suggest definitions of the psychological dimensions of CST and
the standardization of the CST evaluation process. However, a review of the existing
literature regarding CST revealed a significant omission in the current CST evaluation
process. Courts have not adequately defined the dimensions of rational capacity. In addition,
CST assessment instruments focus almost exclusively on a defendant‟s factual understanding
and take few steps to evaluate the defendant‟s rational capabilities. The research included a
qualitative analysis of seven hours of interviews with an incarcerated individual whose CST
was in question. That case study was initially designed to analyze for psychological
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dimensions of CST using a predominant CST assessment instrument. The case study revealed
that rational capacities are not a prominent part of current evaluation protocols and the impact
of rational incompetence on the CST assessment of defendants is minimal. As a result of
these discoveries the focus of the research was modified from a study of a broad-spectrum of
psychological dimensions of CST into a study specifically focused on identifying and
defining dimensions of rational understanding. In addition, the researcher developed a new
CST assessment tool explicitly designed to measure a defendant‟s capacity to rationally
understand and participate in the adjudication process - the Cole Rationality Assessment
Instrument (C-RAI). A small pilot study of the C-RAI is included. No examples of a similar
research approach for exploring the psychological dimensions of CST were found during the
review of the literature for this study and no other tools specifically designed to measure
rational competencies were located. The electronic version of this dissertation is at OhioLink
ETD Center, www.ohiolink.edu/etd.
Dedication

I dedicate this dissertation work to my family, who has patiently supported me
throughout this lengthy process. I especially want to express my feeling of enormous
gratitude to my wife Charlette, who was incredibly tolerant and an unwavering source of
encouragement and tenacity.

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Acknowledgements

I wish to thank my committee members who were more than generous with their
expertise and precious time. I would like to gratefully acknowledge Dr. Mary Wieneke,
my committee chairwoman for her countless hours of reflection, reading, and limitless
patience, and most importantly for her steadfast encouragement to me throughout the
entire dissertation process. My sincere thanks go to Dr. Catherine Koverola for agreeing
to serve on my committee and for challenging me to produce a meaningful contribution
to forensic psychology. I especially want to express my heart-felt gratitude to Dr. Philip
Barnard for his encouraging service on my committee, but also for his willingness to be
my mentor and role model of professional excellence in the practice of forensic
psychology.
I also would like to acknowledge the profound impact of Dr. Andy Benjamin
upon my entry into the world of forensic psychology at Antioch University Seattle and
his continued supportive mentoring since that time.
My special thanks to my daughters Corrin and Kaelyn, who helped during final
editing of the paper, and for the support and encouragement of my son Joshua and
daughter Jacqueline.
Finally, I want to acknowledge with deeply felt gratitude the immeasurable
influence of my mother and late father upon my life and work.

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Table of Contents
Page
Dedication………………………………………………………….….……….........iv
Acknowledgements.………………………………………………….….……….......v
List of Tables………………………………………………………….….…..….....vii
Introduction……………………………………………………………………….…..1
Purpose………………………………………………………………………………..2
Literature Review……………………………………………………………………..4
Background……………………………………………………………………….….65
Methods…………………………………………………………………………........66
Results …………………………………………………………………..……..…......75
Discussion……………………………………………………………………..…....107
Recommendations for Future Research……………………………………….…....116
References……………………………………………………………………...…...119
Appendix A: Legal References …………………………………………………....126
Appendix B: Definitions of CAI Content Areas and Psychological Dimensions….130
Appendix C: Pilot Study of the Cole Rationality Assessment Inventory (C-RAI)...132
Appendix D: Cole Rationality Assessment Inventory (C-RAI)……………………143

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List of Tables
Page
1. Items from the Competence to Stand Trial Assessment Instrument (CAI)……..76
2. Total Occurrences of 13 Content Areas in Participant Interviews………………77
3. Total Occurrences of Prominent Dimensions in Participant Interviews………...78
4. Results of Pilot Study of the Cole Rational Assessment Inventory (C-RAI)…..137

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Introduction
A fundamental American ideal is that all defendants have the right to a fair trial
while participating in an adjudication process. Mental competency as a prerequisite for
due process was established by the United States Supreme Court‟s Dusky decision
(1960), but the precise definitions of mental competence were not included in any of the
Supreme Court decisions regarding the psycholegal concept known as Competency to
Stand Trial (herein after referred to as CST) . Thomas Grisso (2003) suggested that the
psychological dimensions that make up CST have not been adequately identified and
defined and that the forensic evaluations utilized to measure CST have not been
administered in a standardized manner. In response to Grisso‟s observations this study set
out to explore the psychological dimensions of CST by conducting a case study of one
potentially incompetent defendant in the adjudication process. In this way the researcher
hoped to contribute useful information to the body of knowledge regarding the
psychological dimensions of CST, and to assist in establishing precise definitions of the
psychological dimensions of CST and the standardization of the CST evaluation process.
During the process of reviewing the existing literature regarding CST (i.e.,
relevant federal and state case histories, CST evaluation assessment instruments and
conceptual models of CST), the researcher discovered a significant omission in the
evaluative process of CST. In the United States Supreme Court‟s Dusky decision (1960)
the Court directed that defendants must possess two overall psychological capabilities in
order to competently stand trial; factual and rational understanding. However, the
literature review revealed that federal and state Courts have not clearly or adequately
defined the makeup of rational capabilities. In addition, past and current CST assessment
instruments focus almost exclusively on the defendant‟s factual understanding and spend