Publications
Podcast Interviews
Episode 17: Let's Explore ACT Therapy with Dr. Michael Keesler
Mind Your Brain • By Candace Gantt + Alisha Sawant • Dec 15, 2020
Today, we will hear from Dr. Michael Keesler from Fox and Ferns Mental Health to learn about acceptance and commitment therapy (ACT). This year more than ever, we are in situations beyond our control. ACT helps us cultivate psychological flexibility so we can co-exist with our thoughts and emotions, both desirable or undesirable.
Presentations
Sustaining Emotional and Physical Intimacy Following Acquired Brain Injury
Presented for the Brain Injury of Association of Pennsylvania (BIAPA) 2020-2021 Educational Series
Columns and Blog Entries
Marriage and Relationships after Traumatic Brain Injury
…Although a relationship after traumatic brain injury faces new challenges, these are not insurmountable and - if navigated properly - can even bring a relationship closer…
Photo by Thao Le Hoang
How Martial Arts Training Helps Develop Executive Function Skills
…Consider, then, martial arts as a tool to train Executive Function. Whereas popular media often portrays martial arts as fast-paced and combative, the reality is much more complex. Most martial arts classes incorporate some combination of ritual, warm-up, stretching, cardiovascular training, strength training, footwork/stance drills, strikes and blocks, forms or katas, and sparring. For a 45 to 60-minute period that is a lot of task-shifting for participants - a major component of Executive Function.
Can Spending Time in Nature Improve Executive Function?
With spring’s arrival, parents and children are shaking off winter’s cabin fever and returning outdoors. On the one hand, it is no great insight to observe that we enjoy spending time outdoors in nice weather. But there may be more to this phenomenon than we all know intuitively. Indeed, a growing body of research now supports what many of us in the mental health community have long suspected. This is simply that our mental and physical well being actually relies upon interaction in and with nature.
Expert Opinion: Locking the Backdoor to your forensic evaluations
By the time I returned from grand rounds this morning, my patient had already arrived for neuropsychological testing. Our administrative assistant handed me a folder and said she had already prepared the test battery. I thanked her, but when I opened the folder I was surprised to see about 75 pages of medical records.
“Sorry, maybe I’m confused, is this an IME?” (independent medical evaluation), I asked.
“No, but there was an accident,” she answered.
“Ah,” was my reply. We exchanged a look. And we understood one another.
What I understood was that this case was going to be another ‘backdoor forensic evaluation’ (BFE) – as they’ve come to be called in some circles. To those unfamiliar, BFEs occur when patients undergo a treatment oriented evaluation (TOE) that will be billed to their health insurance, but there exists an expectation the evaluation findings and report will be material to a pending or in-progress legal proceeding.
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Books
Forensic Mental Health Assessment in Death Penalty Cases
Forensic mental health assessments in death penalty cases are on the rise due in part to the continuing growth of forensic psychology and psychiatry as professions, combined with several recent U.S. Supreme Court decisions. Forensic mental health professionals are now conducting assessments at every stage of death penalty proceedings, ranging from pre-trial evaluations to determine eligibility for the death penalty to evaluations conducted post-sentencing and closer to the date of execution. Yet there are surprisingly few comprehensive resources available for students interested in death penalty assessments, clinicians who conduct those assessments, and attorneys who work with forensic mental health professionals.
Forensic Mental Health Assessments in Death Penalty Cases fills this gap in the literature, providing an essential road map to the field for students and practitioners. Well-written and comprehensive, this book integrates the most up-to-date research with best practice recommendations, yielding a solid foundation of information related to capital punishment, death penalty litigation, and the role of forensic mental health professionals in death penalty cases. Vivid descriptions of influential court cases, a discussion of ethical considerations, guidance on conducting various types of forensic mental health assessments, and sample forensic reports illustrating best practices make up this important work. Current case law is covered in detail, alongside an important discussion of what remains unknown and directions for future research. This book is essential reading for students and professionals in the fields of mental health, criminal justice, and law, as well as for forensic practitioners who may not be familiar with the special requirements of death penalty cases. It is also an important resource for attorneys who work with forensic mental health professionals.
Academic Journal Manuscripts (Peer-Reviewed Publications)
The telephone effect: Overcoming initiation deficits in two settings
ABSTRACT: PURPOSE: Disorders of motivation substantially impair an individual's ability to communicate with their families, therapists, and doctors. One method of overcoming initiation deficits is by utilizing the telephone effect, which is the ability for individuals with severe motivation deficits to communicate more readily when speaking on a telephone. However, little is available in the extant literature on how this effect works or how best to integrate this into patient care. This article aims to provide the first report of a proposed mechanism underlying the telephone effect and the first published procedures for eliciting this effect. DESIGN: This is largely a review article that also contains descriptions of clinical procedures for eliciting the telephone effect with 2 patient populations: acute inpatients following brain injury and dementia residents. A case vignette is also provided. RESULTS: We propose that the telephone effect is the result of an interaction between the patient and environment, and occurs because of Gibson's (1979) law of affordances. The use of this theory provides an explanation of the behaviors often observed when attempting to elicit this effect (i.e., disruption of the effect when using a cellular phone). Moreover, we argue that this can, and does, apply to social interactions as well. CONCLUSIONS/IMPLICATIONS: The telephone effect is an understudied phenomenon that provides a means of improving care for individuals with disorders of motivation. Future directions include systematic research into the telephone effect and further investigation of the mechanism underlying this effect.
Red Flags in the clinical interview may forecast invalid neuropsychological testing
ABSTRACT: Objective: Evaluating assessment validity is expected in neuropsychological evaluation, particularly in cases with identified secondary gain, where malingering or somatization may be present. Assessed with standalone measures and embedded indices, all within the testing portion of the examination, research on validity of self-report in the clinical interview is limited. Based on experience with litigation-involved examinees recovering from mild traumatic brain injury (mTBI), it was hypothesized that inconsistently reported date of injury (DOI) and/or loss of consciousness (LOC) might predict invalid performance on neurocognitive testing. Method: This archival study examined cases of litigation-involved mTBI patients seen at an outpatient neuropsychological practice in Philadelphia, PA. Coded data included demographic variables, performance validity measures, and consistency between self-report and medicolegal records. Results: A significant relationship was found between the consistency of examinees’ self-report with records and their scores on performance validity testing, X2 (1, N = 84) = 24.18, p < .01, Φ = .49. Post hoc testing revealed significant between-group differences in three of four comparisons, with medium to large effect sizes. A final post hoc analysis found significance between the number of performance validity tests (PVTs) failed and the extent to which an examinee incorrectly reported DOI r(83) = .49, p < .01. Using inconsistently reported LOC and/or DOI to predict an examinee’s performance as invalid had a 75% sensitivity and a 75% specificity. Conclusion: Examinees whose reported DOI or LOC differs from records may be more likely to fail one or more PVTs, suggesting possible symptom exaggeration and/or under performance on cognitive testing.
How Media Exposure Relates to Laypersons’ Understanding of Psychopathy
ABSTRACT: While conceptualization of psychopathy has evolved, so too has the public's relationship with psychology changed. Concurrently, portrayal of psychopaths has made several shifts, both through nonfiction sources and in popular film and television. Psychopathic villains of the mid‐20th century have made space for a growing cast of protagonist psychopaths. This study examined whether a relationship existed between exposure to fictional psychopaths and how lay individuals conceptualize psychopathy. Specifically, this study explored conceptualization differences based on exposure to antagonist versus protagonist fictional psychopaths. Surveyed community participants supported earlier research suggesting mixed misunderstanding of psychopathy. Additionally, higher exposure to protagonist psychopaths was associated with higher endorsement of flattering distractor traits, reflecting a kind of romanticized psychopathy. These findings have legal, practical, and ethical implications, including the potential for biased jurors, confounded research about psychopathy's labeling effect, and questions about how psychologists should respond on an individual and systemic level.
Addiction severity index scores and urine drug screens at baseline as predictors of graduation from drug court
ABSTRACT: Graduation rates from drug courts are impressive and are often attributed to the delivered treatments. However, it is unclear whether graduation rates are bolstered by low severity of drug use problems upon entry into drug court. To address this question, this study examined the relationship between baseline substance use severity and graduation rates among 251 drug court clients. Results revealed that participants with subthreshold drug composite scores on the Addiction Severity Index (ASI) were significantly more likely to graduate than those scoring in the mild-to-moderate or severe range. Furthermore, results revealed that participants who provided a drug-negative baseline urine were significantly more likely to graduate than those who provided a drug-positive baseline urine. A binary logistic regression analysis revealed that ASI drug composite score, urine screen, race, and years educated were statistically significant predictors of drug court graduation.
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Empathy, acceptance of responsibility, and compelled testimony in juvenile transfer hearings: Legal context and empirical evidence
There are a number of decisions in which the court must decide whether juveniles can be rehabilitated. Such decisions include juvenile adjudication/placement, waiver, and reverse waiver. The criterion used by courts to consider rehabilitation amenability is typically phrased in a way similar to that described under Pennsylvania state law. In deciding whether a child may be decertified (reverse waived from criminal to juvenile court), the court can consider [numerous factors.] Empathy for the victims of the defendant’s offenses, and acceptance of responsibility for such offenses, may be considered by mental health and justice professionals working with that post-adjudicated youth. But rendering an expert opinion that describes the youth’s capacity for empathy or acceptance of responsibility, when that opinion in based in part on questions concerning the alleged offense, places the evaluator in an awkward position. To what extent can denial of culpability be used to infer limited empathy and acceptance of responsibility? How does the Fifth Amendment right against self-incrimination factor into these considerations?
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Training and Education-Related
Dissertation
Pop-Culture Psychopathy: How Media and Literature Exposure Relate to Lay Psychopathy Understanding
Psychologists’ conceptualization of psychopathy has gradually evolved over time, with interest peaking in recent decades. Concurrently, the lay publics relationship with psychology has changed from guarded skepticism to acceptance and even demand. The tie that binds psychology and the public has always been mass communication, both in news and popular media format. Reflecting changing trends, mass media has altered the way it objectively describes and popularly portrays psychopathy. Whereas psychopaths were consistently portrayed as villains in the mid-20th Century, today they comprise a growing cast of protagonists. It is currently unclear what effect, if any, these co-occurring changes have had on public understanding or perception of psychopathy. This research sought to explore that dynamic, and found a variety of interesting descriptive and statistically significant findings. Included among those is the finding that great misunderstanding of psychopathy, as a construct, exists in the minds of many lay individuals. Additionally, that misunderstanding might be positively slanted among individuals with high exposure to protagonist portrayals of psychopathy. Said another way, fans of television and movie protagonist psychopaths may conceptualize a kind of romanticized psychopathy. This signals important legal, practical, and ethical implications, including the potential for biased jurors, confounded research about psychopathys effect as a label, and questions about how psychologists should respond to this information. Many of this projects limitations are attributable to its largely exploratory nature, but are discussed at greater length. As for future directions for research, this exploratory investigation offers a foundation toward a psychopathy bias scale - a tool that could be utilized in research on the labeling effects of psychopathy.
Book Chapters
Vocal Health and Pedagogy: Science and Assessment, 3rd Edition
Music and the Brain
Neuropsychology is the science of brain-behavior relationships. Neuropsychologists are interested in understanding the neural or brain-related underpinnings of all forms of human behavior, including memory, problem solving, motor coordination, language, emotional functioning, and, more recently, musical behavior. With advances in functional neuroimaging techniques that allow us to view the brain at work, more is being understood about many aspects of music. These aspects include perfect pitch, musical imagery, the tune versus the lyric of music, memory for music, and our emotional responses to music. All of these topics will be covered, but first we will provide some general basic principles of how the brain works. We will then share what we have learned from individuals with acquired or inherited brain abnormalities that render their musical skills defunct or leave them intact. Last, we will present an overview of the rapidly changing landscape of music and the brain arising from advances in technology that are contributing to our knowledge base at an astounding rate…
APA handbook of forensic psychology – Vol I: Individual and situational influences in criminal and civil contexts
Capital Case Considerations
Over the nearly 40 years since the United States reinstated the death penalty in Gregg v. Georgia (1976), the involvement of forensic mental health professionals in capital cases has increased considerably. Forensic mental health professionals now routinely conduct assessments at every stage of death penalty proceedings. Some types of evaluations have long been a common feature of death penalty cases, other types of evaluations are less frequently conducted, and still others were developed after recent decisions by the U.S. Supreme Court. Given the obvious importance of mental health evaluations that are conducted in capital cases, evaluators who are - or wish to become - involved in these types of cases must have a thorough understanding of the legal and clinical issues inherent in capital cases.
The Handbook of Forensic Psychology, 4th Edition
Accessing the Law and Legal Literature
…Given the nature of [Forensic Mental Health Assessments], it is incumbent on the mental health professional conducting such an assessment to be familiar with the applicable law in the jurisdiction and the particular legal question at issue in the case. Indeed, Section 2.04 of the Specialty Guidelines for Forensic Psychology underscores the necessity for clinicians conducting FMHAs to possess knowledge and understanding of the legal and professional standards, laws, rules, and precedents that govern participation in legal proceedings…
…In this chapter, we present an overview of conducting legal research, with a specific eye toward mental health professionals who do not have any formal legal training. We begin by discussing the importance of understanding the law, particularly for those mental health professionals who conduct FMHAs. Then we provide an overview of the law in the United States, which includes a discussion of various sources of law and the structure of the state and federal court systems. Next, we describe specific methods for conducting legal research — highlighting both formal and informal approaches — using a variety of databases and research tools. We then discuss how to read and interpret the law, which is not an entirely obvious process. Finally, after discussing how to ensure that the law found through legal research is "good law," we conclude this chapter by describing effective ways of synthesizing the accumulated legal research.
Encyclopedia Entries
The Sage Encyclopedia of Criminal Psychology
Criminal Culpability
Criminal culpability refers to the degree to which individuals are held legally responsible for their conduct and distinguishes between those who are wholly or partially blameworthy from those who are blameless… click here to purchase access
Mitigation
In the U. S. legal system, mitigation (known also as mitigating evidence or mitigating factors) encompasses facts about a defendant’s background, character, and the circumstances of the offense… click here to purchase access
Ruiz v. Estelle (1980)
Ruiz v. Estelle is a significant case in U. S. jurisprudence regarding prison reform: It shaped modern-day practice and policy with regard to corrections management, prison reform, and judicial oversight… click here to purchase access
The Sage Encyclopedia of Abnormal and Clinical Psychology
Mild Neurocognitive Disorder
The diagnostic categories of major and mild neurocognitive disorders represent new conceptualizations of previously defined dementia and amnestic disorders in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)… click here to purchase access
Negligence
Negligence is a specific type of claim under the umbrella of tort law, wherein one party asserts that another has caused an injury and should be liable for damages in civil court… click here to purchase access
Secondary Gain
Secondary gain is the reward incentivizing an individual to be deemed medically, psychologically, or cognitively impaired…. click here to purchase access
The Corsini Encyclopedia of Psychology and Behavioral Science (4th Edition)
Sampling Error
Sampling error is the difference between the value of a sample statistic and the corresponding parameter in the population from which the sample was drawn… a chosen sample does not accurately represent the population from which it was selected… click here to continue reading through Google Books or purchase access