Examining the effectiveness of an intervention designed for the restoration of competency to stand trial

Abstract

This study examined the effectiveness of the Fitness Game, an intervention created for the restoration of competency to stand trial. Of 28 participants who completed either the experimental or control intervention at Hawai'i State Hospital (HSH), it was found that both groups had significant pretest to posttest improvements on Understanding and Appreciation subsets of the MacArthur Competence Assessment Tool-Criminal Adjudication (MacCAT-CA). However, there was no statistically significant difference between the groups on competency measures, indicating that the Fitness Game was not significantly more effective at restoring competency than non-legal programming. In other words, individuals committed to a psychiatric hospital for care and treatment were as likely to improve as those receiving additional specialized competency restoration treatment.

Treatment for restoration of competence to stand trial: Critical analysis and policy recommendations.

“…Fitness Game. An examination of the Fitness Game (a board game used to teach individuals about the legal system according to eight criteria of competence suggested by Wieter v. Settle, 1961) as compared to a control condition (receiving a "Healthy Behaviors" board game or receiving "non-legal programming") was implemented (Mueller & Wylie, 2007). It included a total of 28 participants who completed either the experimental intervention (Fitness Game; n ϭ 21) or control intervention (Healthy Behaviors Game, a board game that covered content including symptom management, medication management, conversation skills, recreational activities, and substance abuse issues; n ϭ 17) at Hawaii State Hospital.…”

Ten Year Research Update (2001–2010): Evaluations for Competence to Stand Trial (Adjudicative Competence)

“…Subjects showed significant improvement from pre‐ to post‐treatment performance on the MacCAT‐CA across all three subtests as well as the total scores. Finally, Mueller and Wylie () found that when two restoration groups were compared – one that engaged in the Fitness Game (FG), a board game used to teach competency‐related information, and one that did not – both groups improved significantly on the MacCAT‐CA's Understanding and Appreciation scales, but with no advantage for the FG group compared with the control group.…”

Patient Characteristics and Outcomes Related to Successful Outpatient Competency Restoration

“…Although those are common practices, very little research has actually evaluated what type of treatment is effective in restoring competency (Mueller & Wylie, ; Noffsinger, ; Scott, ), particularly in the outpatient setting. Research examining traditional competency restoration programs has suggested that education about the legal process is an important component of the restoration process beyond standard inpatient hospitalization and treatment (Bertman et al, ; Siegel & Elwork, ), although others have failed to find similar results (Mueller & Wylie, ).…”

“…Most frequently, competency restoration treatment involves addressing an underlying psychiatric disorder, often with psychotropic medication, as well as remediating psycholegal deficits with education and information about the legal process (Gowensmith et al, ; Noffsinger, ; Zapf & Roesch, ). Although those are common practices, very little research has actually evaluated what type of treatment is effective in restoring competency (Mueller & Wylie, ; Noffsinger, ; Scott, ), particularly in the outpatient setting. Research examining traditional competency restoration programs has suggested that education about the legal process is an important component of the restoration process beyond standard inpatient hospitalization and treatment (Bertman et al, ; Siegel & Elwork, ), although others have failed to find similar results (Mueller & Wylie, ).…”