Despite the above case, which was done in two parts, my preference is to do the entire evaluation in one sitting. Fatigue works both ways. If I am well rested, I am usually able to remain focused longer than the plaintiff. I find that a fatigued examinee is not able to continue a charade and will eventually contradict themselves or talk in an uncensored way for the first time in the interview.
Most forensic psychiatrists use the criteria of DSM-IV in making their diagnosis. Unfortunately this text is not uniformly authoritative. One controversial area is the diagnosis of Post Traumatic Stress Disorder (PTSD). Most forensic psychiatrists believe that the DSM definition of "trauma," referring to any event that is considered life threatening, is overly inclusive. Another shortcoming is the fact that the other diagnostic criteria are subjective and are usually not seen during the evaluation. A crafty interviewee can easily the DSM-IV criteria and regurgitate them to the doctor. Obviously, there is a tendency to exaggerate because of secondary gain. One of the best ways of countering this is for the expert to know more than the litigant about how the symptoms of PTSD actually present themselves in daily life. For example, if the examinee says that she suffers from “flashbacks”, I ask her for a detailed description of one of her flashbacks or any other symptoms which she is endorsing. This is invariably followed by a loss of confidence and arrogance if there has been symptom magnification. It is disturbing how many professionals accept a litigant’s symptoms as fact. The key point here is that this approach to interviewing is meticulous and requires more time. It probably comes as no surprise that civil defense attorneys are more appreciative of this approach than their adversaries.
Find out how much of the psychiatrist's work has been for the plaintiff versus the defendant. Ideally, she should be doing work for both sides, but she probably has a preference. For example, I have found that I do more cases for the defense. This is based on my belief that plaintiffs should be compensated for genuine psychiatric disorders and not “normal human unhappiness.”
What percentage of his time is spent in doing forensic work versus clinical practice and/or other professional activities? Many attorneys prefer to retain experts who spend a considerable amount of time seeing patients, feeling that they have more credibility. I agree. Patient contact also allows for the continued development of skills in the detailed diagnostic interview, which is the essence of the psychiatric-legal evaluation. There is, of course, a fine group of academicians who limit themselves to forensic work.
Is your prospective expert board certified? In 1995, the American Board of Psychiatry and Neurology officially recognized Forensic Psychiatry as a subspecialty. From 1995 to 1997, a psychiatrist with significant experience in forensics could be designated as having "Added Qualifications in Forensic Psychiatry" based on experience alone and the successful completion of a challenging written examination. Since 1997, a psychiatrist must have completed a least a one-year fellowship in order to sit for the certification examination.
How much experience does she have? There is no magic number, but I would prefer someone with a minimum of ten years experience. I also believe that having some "life" experience makes for a better expert. If she has gone through childbirth, the death of a parent, divorce, a serious medical problem etc., she should have more empathy for the plight of the examinee.
Does he have an academic appointment? If so, is he active in teaching at this time in his career? If your probable expert is a teacher, this gives him more credibility and suggests that he may be more articulate in court than the average psychiatrist who spends more of his time listening to patients rather than talking.
What kind of appearance does she make? Everything else being equal, people who are taller, slimmer, good looking and well dressed have a distinct advantage in our society. Believe it or not, a blue suit and a conservative red tie supposedly convey power in a male expert.
Are his reports comprehensive and free of typos? If possible, try to review one of his reports. Of course, the opinion section is the most important part of the report. It should be well thought out and jargon free. If malingering is an issue in this case, is the expert willing to say it and how does he back up his opinion?
Talk to other attorneys to find out how this expert handles himself at depositions and in the courtroom. I have seen several experts who write superb reports but choke on the witness stand when forced to "think on their feet."
resource - http://www.rsostowskimd.com
