11 / 28
Page 67
International Journal of Emergency Mental Health and Human Resilience | ISSN: 1522-4821 | Volume 20
November 26-27, 2018 | Los Angeles, USA
Psychiatry, Mental Health Nursing and Healthcare
World Summit on
Applied Psychology, Psychiatry and Mental Health
International Conference on
&
Tipping the scales towards restorability: Integrating cognitive remediation therapy within a competency
restoration group curriculum
Amanda Giordano
Nova Southeastern University School of Clinical Psychology, USA
C
ompetency restoration can be a difficult and seemingly unachievable, legal mandate for many with severe and persistent mental
illness. As a result, a large portion of incompetent defendants remain suspended within the psychiatric hospital system for years
and are never able to return to the legal processes which rendered them there in the first place. At face value, instilling the knowledge
and understanding necessary to establish a patient’s “competence” appears to be a relatively straightforward task. Standard competency
restoration methods aim to teach information related to an individual’s specific case and the overarching legal and criminal justice
systems. The capacity to learn and comprehend such information relies on frequently used cognitive processes related to attention,
memory, reasoning, processing speed and executive functioning. However, studies on the neuropsychological deficits associated with
major psychiatric illnesses, such as schizophrenia, bipolar disorders and depression, indicate global dysfunction of these vital mental
abilities. Thus, legally incompetent individuals with severe mental illnesses often lack the very cognitive resources that they need for
competency restoration, subsequent hospital discharge and the resumption of their court case. Simply stated, typical competency
restoration methods, which include individual and group therapy, remain largely inadequate due to discrepancies between many
patients’ cognitive abilities and the mental requirements necessary to understand, conceptualize, recall and integrate legally required
knowledge. Therefore, treatments used with the severely mentally ill should not rely on intact cognition, and, instead, should seek
to mitigate its deficits. Cognitive remediation therapy (CRT) has emerged as a promising treatment approach for this population to
improve cognitive skills, social and vocational functioning and motivation. Despite overwhelming promise, CRT therapies have not
yet been used to address barriers related to competency restoration. Thus, this proposed poster will outline the underlying theory
and overall design of a group-based treatment manual that adapts competency restoration strategies and incorporates cognitive
remediation therapy (CRT) as an adjunctive form of treatment to promote better outcomes for legally incompetent defendants who
have been court ordered to receive competency restoration treatment at an inpatient psychiatric facility.
acgiord@gmail.comInt J Emerg Ment Health, Volume 20
DOI: 10.4172/1522-4821-C5-024