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Challenges and Recommendations for Prisoner Neuropsychological Assessment

Vanderhoff, H.,, Jeglic, E.L., Donovick, P.J. Neuropsychological assessment in prisons: Ethical and practical challenges. Journal of Correctional Health Care  17(1): 51-60, 2011.

By Lori Whitten, Staff Writer, RTI International, Rockville, MD

Assessment of neuropsychological functioning of inmates-some of whom are mentally ill or cognitively impaired-can accelerate rehabilitation and ease inmates' transition back into the community. In this article, Holly , Ph.D., Elizabeth Jeglic, Ph.D., and Peter Donovick, Ph.D., draw on their experiences conducting clinical neuropsychological evaluations for inmates in high-security facilities to explore the unique ethical and practical challenges posed by these assessments. The authors offer recommendations and suggestions for psychologists, who provide neuropsychological evaluations for prisoners. NIC Vanderhoff iStock_000016133665Small1_purchased

Neuropsychological assessments include "clinical interviews and formal testing in the areas of sensory-motor processing, attention, motivation and emotion, language and spatial processing, learning and memory, and problem-solving abilities," according to the authors. Although such assessments are equally important for inmates and non-incarcerated clients, a wide range of ethical and practical issues arise for prisoners that are not in play for others.

For example, psychologists must clarify the nature of the relationship with the referring party -often correctional staff-and be mindful that the assessment results may have an impact on services to the inmate in the future. Clinicians providing evaluations should make every effort to preserve inmates' remaining rights to privacy and confidentiality. The reports they develop should include only the information necessary and relevant to the referral question.

Prisoners must provide informed consent, and psychologists must make inmates aware that they have the right to refuse to participate. The authors recommend that clinicians explain to inmates the reasons for the evaluation, the potential for release of information, to whom it may be released, and how the correctional system might use the results. The high prevalence of cognitive impairment and learning problems among this population, however, increases the risk of prisoners having diminished capacity to consent. In such cases, psychologists should get assent from the inmate, speak with referral source, and, if necessary, consult with legal counsel prior to assessment.

A major issue with assessment of inmates is that the average test scores (norms) for most evaluations have been developed from typical, non-prison populations, bringing their validity for inmates into question and making interpretation of results difficult. Incarcerated individuals differ in many important ways than those from which norms were developed-including the high prevalence of minorities, individuals whose first language is not English, lower cognitive ability and education, and multiple mental and intellectual problems. In the absence of norms for correctional populations, clinicians must weigh the potential benefits and costs of assessment, interpret results with great caution, and inform the parties asking for the evaluation of the limits of applicability of the results to the prison population.

Acting on assessment recommendations can be difficult with limited resources, time constraints, security issues, and concerns about differential treatment of inmates. Psychologists should consider the inmate's environment when developing recommendations for intervention. The authors suggest that clinicians discuss implementation of assessment recommendations with members of the facility's administration, frontline staff, and their supervisors. Explaining the reasoning for the recommendations and the ways that implementing them would benefit the inmate and staff may improve compliance with the intervention and overall understanding of the inmate's behavior. Although challenging, appropriate neuropsychological assessment can provide correctional professionals with a context for working with inmates and help guide rehabilitation efforts.

For more information, contact Elizabeth L. Jeglic, Ph.D., Department of Psychology, John Jay College of Criminal Justice, New York, New York, email:

Posted Fri, Mar 2 2012 12:49 PM by Tracey Vessels


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