Because the standards for forensic evaluations must be high, KKJ uses a team approach when conducting most forensic evaluations. This article will explain the reasoning behind this approach and suggest best practices for a team-based model of forensic evaluations.
Importance – Why Do Forensic Evaluations Matter?
Forensic evaluations are used in many types of legal cases (including custody, capacity, and criminal responsibility), and courts overwhelmingly issue decisions that align with the conclusions of those evaluations (e.g., Zapf, Hubbard, Cooper, Wheeles, & Ronan, 2004). Given the major impact on the lives of those involved, high standards are required. The American Psychological Association (APA) and the Association of Family and Conciliation Courts (AFCC) have both published extensive guidelines, including specific procedural recommendations, for diagnostic and forensic evaluations to ensure evaluators adhere to the most ethical and effective practices (see APA, 2010; APA, 2020; AFCC, 2022).
The Problem of Bias
However, despite specific guidelines, forensic evaluations are not immune to the many sources of bias that affect human cognition and behavior. Neal, Lienert, Denne, and Singh (2022) conducted a systematic review of studies measuring bias in forensic mental health experts and found evidence of some form of bias in 82.4% of those studies. The authors note that this finding is unfortunate but also unsurprising, as forensic evaluations involve human judgments, which are prone to many well-known and predictable errors, often referred to as cognitive biases. Research has identified over 200 possible biases that affect our beliefs, decision making, behavior, and memory. An examination of cognitive biases is beyond the scope of this article, but general examples include evaluators over-emphasizing information that is more available/memorable, relying on stereotypes or implicit beliefs, ignoring contradictory information, or becoming overconfident.
Importantly, research has consistently demonstrated that forensic mental health professionals can recognize biases in others but are less able to perceive bias in themselves, a meta-cognitive bias referred to as the “Bias Blind Spot” (e.g., Kukucka, Kassin, Zapf, & Dror, 2017; Neal & Brodsky, 2016; Zapf, Kukucka, Kassin, & Dror, 2018). Forensic evaluators also tend to believe they can “introspect” or think their way out of their own biases – a strategy shown to be quite ineffective (Neal & Brodsky, 2016). Again unfortunately, teaching people about bias appears to have little effect on their behavior (Forscher et al., 2019), and even attempts to teach forensic evaluators about the ineffectiveness of introspection have been unsuccessful (Zappala, Reed, Beltrani, & Zapf, 2017).
Potential Strategies to Combat Bias
Some strategies appear to hold promise for helping evaluators to reduce bias. For example, increased accountability and the need to justify a decision can help people recognize flaws in their arguments and thereby reduce the effects of some biases (Lerner & Tetlock, 1999).
“Considering the opposite” or considering possible alternatives may also be a helpful strategy when used systematically (Griffith, 2019), as is the use of simple statistical models to assess risk (Hanson & Morton-Bourgon, 2009). However, many forensic evaluations involve complex and unique issues, extensive collateral information, and varied sources of information – making it difficult to apply simple methods (Neal, Lienert, Denne, & Singh, 2022). Neal and colleagues (2022) suggest that “structural” solutions, involving systematic “processes, procedures, or rules” are likely to be the most effective strategies for forensic evaluators to combat bias (p. 110).
Effectiveness of Teams
While there is little research on the team approach to evaluations, there is ample research on the effectiveness of teams in a variety of workplaces and settings, including behavioral health teams in hospitals, corporate workgroups, and mission teams at NASA. Teams have become more common in most organizations and show superior decision making to individuals in some (but not all) contexts (Tannenbaum & Salas, 2020). Teams appear to make better decisions and produce better work than individuals in certain contexts: when the work is cooperative rather than competitive (Johnson & Johnson, 2012), when team members are competent and enjoy working on a team, when cooperative attitudes are promoted, and when team members feel safe to raise issues and speak up (Tannenbaum & Salas, 2020). Effective teams also tend to share views about their tasks, roles, and priorities. Without these contextual factors, the use of teams may not fit for all tasks or organizations. Interestingly, while teams may fall prey to their own types of biases (such as groupthink or group polarization), these biases have been well studied, and clear solutions have been recommended. Research on groupthink, for example, has shown that problems can be avoided by having leaders who are open to criticism and dissent, group members who are able to express contradictory opinions, and diversity in members.
The Team Approach as a Debiasing Strategy
Given the recommendation to combat bias via the structure of forensic evaluations, the team approach seems poised to offer some remedies. Researchers studying teams maintain that communication, thoughtful leadership, and diversity of members are key to success (Tannenbaum & Salas, 2020). These same factors also appear likely to serve as debiasing strategies when implemented as part of evaluation procedures. For example, a leader who promotes communication between all team members, encouraging everyone to speak up and share information, helps the evaluation team to consider all information available, not just that which is known or recalled by a single evaluator. Encouraging a discussion of alternative or dissenting views may remedy biases like groupthink but may also combat confirmation bias (focusing on information that confirms an initial hypothesis and ignoring contradictory information). Diverse team members (whether in experience, abilities, or demographics) offer many possible advantages to group work, but they may specifically help a team to combat implicit biases like stereotyping as well preexisting attitudes and beliefs about various issues and groups. As an example of the potential value of diverse team members to a forensic evaluation, Saunders, Faller, & Tolman (2013) studied the beliefs of child custody evaluators about domestic abuse allegations. While the study did not examine teams, the authors noted important differences in the beliefs of evaluators with different academic degrees (e.g., master’s level vs. doctoral); social workers, for example, were more likely than psychologists to recommend that
the victim of alleged abuse receive custody and the alleged perpetrator receive supervised visits, and the authors suggested that the social workers’ systems framework likely impacted their decision making. Again, this study was not about teams, but one interpretation of this finding is that having both social workers and psychologists on an evaluation team could lead to improved sharing and consideration of diverse viewpoints and potentially to a broadly informed, carefully deliberated decision.
KKJ’s Team Approach in Practice
In practice, an evaluation at KKJ is usually conducted by two or more evaluators, with a psychologist as a team lead. Master’s-level clinicians and/or another psychologist usually conduct initial interviews, administer testing, review records, draft reports, and provide project management such as scheduling. The lead psychologist generally conducts the primary interviews and key collateral interviews, interprets the testing, checks all record reviews, and edits and finalizes the report. Ongoing communication and information sharing in team meetings as well as peer consultation from other staff is considered key in the process. The lead psychologist is responsible for the final product and for any testimony, and this level of accountability is intentionally maintained to ensure the psychologist is motivated to justify and defend their ultimate conclusions.
Overall, team approaches to forensic evaluations seem to offer some potential remedies to bias. They may increase the availability of rival hypotheses and counterfactuals (a strategy recommended by Zapf & Dror, 2017), support peer review or build in peer consultation (recommended by Ballantyne et al. 2017), allow for the sharing of diverse opinions on cases, and offer alternatives to ineffective methods such as introspection. While more research on the team approach is needed, we at KKJ believe the team approach leads to improved decision making and a superior forensic evaluation when systematically implemented within a structure that consistently supports open communication, intentional leadership, and diverse perspectives.