The Competency Restoration Handbook A Guide and Resources for Clinicians

In order for defendants facing legal charges in the United States to be able to move forward with the legal process, they must be competent to proceed with their cases. Defendants are presumed to be competent to make legal decisions, until someone calls their competency into question. Once the presumption of competency is questioned, their legal case is paused and the defendant is evaluated, so that the court can determine whether they are competent to proceed. If a person is not adequately knowledgeable about how the court system works, or too psychiatrically unstable to proceed with their case, their case gets put on pause and the defendant is ordered for "competency restoration." The Competency Restoration Handbook is a collection of foundational materials for competency restoration providers who work with adult pretrial defendants in the United States. The book begins with a description of the legal context related to adjudicative competence and an overview of foundational competency restoration practices. Following these foundational resources are chapters explaining how various clinical interventions can be adapted to help restore individuals to competency, and an assortment of practical tools (study guides, vocabulary-based games, and other hands-on activities) for use with defendants undergoing competency restoration. Covering empirically informed, theoretical, and creative approaches that can be individualized for each specific defendant, the book encourages and facilitates best practices in competency restoration. Readers are encouraged to adopt these interventions to address defendant-specific barriers to competency. The authors also encourage competency restoration providers to consider adapting other treatment modalities (i.e., particularly those which are empirically supported or newly developed) to facilitate competency restoration.

1 - Introduction to Adjudicative Competence
2 - Fundamentals of Competency Restoration in Practice
3 - Psychotropic Medications and Competency Restoration
4 - Competency Restoration for Defendants With Intellectual and Developmental Disabilities (the Slater Method)
5 - Cognitive Remediation (CogRem) and Competency Restoration
6 - Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) and Competency Restoration
7 - Religion and Spirituality (RS) and Competency Restoration
8 - Music Therapy (MT) and Competency Restoration
9 - Cognitive Behavior Therapy for Psychosis (CBTp) and Competency Restoration
10 - Dialectical Behavior Therapy (DBT) and Competency Restoration

Laura M. Grossi, PhD, ABSMIP, is a licensed clinical psychologist in the Commonwealth of Virginia. She is a forensic evaluator at Eastern State Hospital (Williamsburg, VA), and also works in private practice. She is board certified in serious mental illness (SMI) psychology, and has conducted more than 1,000 pretrial criminal forensic evaluations, with her work focusing primarily on evaluations of adjudicative competence and mental state at the time of the offense. She also serves as a direct supervisor for the postdoctoral fellow, as the Psychology Practicum Training Director, and as Chair of the hospital's Research & Review Committee.