Ethics Case #3For this case, please read the case history below. In this scenario you are a forensic expert on violence risk assessment in adults. You often testify in courts about future risk of violence and are deemed by the courts as an “expert witness.” You have been asked to consult with the school related to this case and future dangerousness. As you read the case below, consider what ethical concerns you may have, particularly related to the specialty guidelines for forensic psychology and competence, and how you might resolve these issues. Name: Michael Jones DOB: 12/14/01 Relevant Background information: Michael Jones is a 13-year-old adolescent who currently resides in Washington. He is a 7th grader in the SOAR classroom at the Middle School. SOAR is a special education classroom that provides both individual and group instruction to students with disabilities. He spends his time at school between two classrooms in which he receives individual and group instruction. In addition, he attends specials, lunch, and recess within the building with the rest of the student body. Michael currently receives these services due to a primary diagnosis of Intellectual Impairment and a secondary diagnosis of Communication Impairment. In the past, he was also diagnosed with Autistic Spectrum Disorder, but records and reports from his mother indicate that he no longer meets criteria for the disorder. Michael received a neuropsychological evaluation in September 2012 which noted him to have delays in cognitive, language, academic, visual–spatial, and adaptive skills, placing him in the mild end of intellectual disability. Michael was also noted to have difficulties with working memory, cognitive flexibility, and impulse control. He was diagnosed with Intellectual Disability and Attention Deficit/Hyperactivity Disorder. Michael’s IEP notes a communication impairment in addition to his intellectual disability, which affects his academic functioning. He is noted to require significant individual support when he is in classes outside of the SOAR program. There is also a noted concern related to difficulty making appropriate choices in relation to friends, and being easily manipulated into making the wrong decisions. He is noted to have difficulty understanding concepts related to relationships and dangerous social situations. According to the school, Michael has had several incidents which have caused concern related to sexually inappropriate behavior. The first incident occurred in approximately June 2014 when Michael grabbed the buttocks of a peer-mentor. According to the school, this occurred on a school bus in which Michael was trying to touch a female mentor despite her telling him it was inappropriate. He was eventually able to do so when the peer sat down, and Michael placed his hand under her buttocks. A second, more serious incident occurred in approximately November 2014. In this incident, while in the classroom, Micha ...

1. Ethics Case #3For this case, please read the case history below.
In this scenario you are a forensic expert on violence risk
assessment in adults. You often testify in courts about future
risk of violence and are deemed by the courts as an “expert
witness.” You have been asked to consult with the school
related to this case and future dangerousness. As you read the
case below, consider what ethical concerns you may have,
particularly related to the specialty guidelines for forensic
psychology and competence, and how you might resolve these
issues.
Name: Michael Jones
DOB: 12/14/01
Relevant Background information:
Michael Jones is a 13-year-old adolescent who currently resides
in Washington. He is a 7th grader in the SOAR classroom at the
Middle School. SOAR is a special education classroom that
provides both individual and group instruction to students with
disabilities. He spends his time at school between two
classrooms in which he receives individual and group
instruction. In addition, he attends specials, lunch, and recess
within the building with the rest of the student body. Michael
currently receives these services due to a primary diagnosis of
Intellectual Impairment and a secondary diagnosis of
Communication Impairment. In the past, he was also diagnosed
with Autistic Spectrum Disorder, but records and reports from
his mother indicate that he no longer meets criteria for the
disorder.
Michael received a neuropsychological evaluation in September
2012 which noted him to have delays in cognitive, language,
academic, visual–spatial, and adaptive skills, placing him in the
mild end of intellectual disability. Michael was also noted to
have difficulties with working memory, cognitive flexibility,

2. and impulse control. He was diagnosed with Intellectual
Disability and Attention Deficit/Hyperactivity Disorder.
Michael’s IEP notes a communication impairment in addition to
his intellectual disability, which affects his academic
functioning. He is noted to require significant individual
support when he is in classes outside of the SOAR program.
There is also a noted concern related to difficulty making
appropriate choices in relation to friends, and being easily
manipulated into making the wrong decisions. He is noted to
have difficulty understanding concepts related to relationships
and dangerous social situations.
According to the school, Michael has had several incidents
which have caused concern related to sexually inappropriate
behavior. The first incident occurred in approximately June
2014 when Michael grabbed the buttocks of a peer-mentor.
According to the school, this occurred on a school bus in which
Michael was trying to touch a female mentor despite her telling
him it was inappropriate. He was eventually able to do so when
the peer sat down, and Michael placed his hand under her
buttocks.
A second, more serious incident occurred in approximately
November 2014. In this incident, while in the classroom,
Michael and a male peer, who is more limited than Michael,
went behind a partition. When teachers noticed they could not
be seen and went to check on them, it was observed that the
peer had his pants down. The peer later told school personnel
that Michael had asked him to pull his pants down, saying “Do
it! Do it!” and that he had told the peer that is was a “secret
game.” Directly following this incident Michael also grabbed
the buttocks of a female student in the hallway outside his
classroom and was talking about this behavior.
In another incident in February 2015, Michael reportedly

3. brushed up against a female peer who was using a water
fountain. Staff report that he brushed up against her once and
when there appeared to be no issue with it, he again brushed up
against her in a sexual manner.
In addition to these specific incidents, the school reported that
he has made multiple questionable sexual comments. It is
indicated that he often takes conversation to a sexual level and
will say things such as, “It feels really good when I have my
pants down”; “It’s much better when you have your pants off”;
or “Do you sex girls?” It is also reported that he is fascinated
with a particular girl and has told others that he has sex with
that student every night.
Michael is also reported to stare for inappropriately long
intervals at females, particularly at their chest area, on a regular
basis such that it makes students and teachers uncomfortable.
The school reported that all behavioral incidents have occurred
when there has been less supervision or when he is in a
transitional time such as walking to specials or to the bathroom.
They indicate that the acts, at times, appear impulsive when an
opportunity presents itself. Also, he has also targeted
individuals who might be more easily victimized. Overall, the
school reports significant concern about these behaviors.
The school reported that currently he has staff watching him 1:1
throughout the day, though this is often difficult as he does not
have an aide directly assigned to him. Staff reported concern
over the inconsistency with using different aides, as some are
less familiar with him, and Michael has been described as
“sneaky.” They reported that he appears to be fully aware that
these behaviors are not acceptable and knows the rules, though
he has little understanding for how these behaviors might
impact others. The school has given him direct feedback related
to all of these behaviors, both in the moment and more
extendedly after the incidents. Monitoring sexually

4. inappropriate behavior is part of his daily plan at the school, via
a behavioral chart that Michael has signed by his teachers.
Specifically, it is a checklist that Michael carries with him that
gives him reminders to not have physical contact with others
and to not stare inappropriately at female peers or teachers.
Staff also indicate that Michael has a difficult time talking
about these things. They report that he often “shuts down” and
does not have the cognitive ability to report anything useful
regarding the reasons for his behaviors. Michael sees the
adjustment counselor at school to assist in working on these
issues.
In regard to peer relationships, the school reported that he has
relatively poor social skills. They reported that he likes to tell
jokes and clearly seeks friendships, but that he has difficulty
developing relationships. They reported that he has one friend
in his classroom who appears to be higher functioning and is
nice to Michael, but often appears uncomfortable with
Michael’s social level. The school also reported concerns that
he does not understand what is real from what is not real as a
result of his spending a large amount of time playing violent
video games in the past. They report that they recommended
that he play different games at home. The school also noted
decreased empathy and some possible impulse-control
problems, though they also indicated that he is able to delay
gratification. They noted no mood or behavioral outbursts at
school.
Michael’s school reported some concerns related to sexual
abuse and sexual perpetration outside of school in Michael’s
history. The school indicated that Michael’s younger cousin
(age 3), who also lives within the school district boundaries,
made allegations in early 2015 that Michael had touched her
“private parts and put his penis inside of her private parts.”
These claims resulted in charges being filed and DCF
involvement after the school district filed a 51A report.

5. According to the school, the charges against Michael were
ultimately dropped. Specifically it was indicated that although
he admitted to this behavior to his parents, he would not discuss
it with officials. Further inquiry into the matter by the school
resulted in them learning that Michael had been sexually abused
by his aunt (niece’s mother) in the past. He reported to the
school that his aunt had touched his private parts and made him
undress, that this occurred many times, and that she had told
him it was a secret. According to the school, this sexual abuse
occurred when Michael was in 2nd and 3rd grade. The school
indicated that Michael’s mother, Michelle, was aware of the
sexual abuse by his aunt and that this occurred while Michael
and his mother were living with her parents and the aunt due to
a marital separation. According to the school, Michelle’s
parents threatened to kick her and Michael out of the house if
she reported the sexual abuse against Michael, which is why it
was never reported.
Ethics Case #2For this case, please read the case history below.
In this scenario you are a forensic psychologist performing a
risk evaluation on an adolescent offender. You have been hired
by the student’s school to complete the evaluation. As you read
this scenario and develop an understanding of the patient,
consider what ethical concerns you may have, particularly
related to the APA guidelines and specialty guidelines for
forensic psychology as they relate to informed consent. In your
assignment, be sure to address issues related to the age of the
patient and how you would achieve informed consent. In
addition, please answer the following questions:1. What would
you do if consent is denied and the school would still like you
to complete an evaluation?2. What if you have consent;
however, the patient presents with a concern related to his
competency (i.e., he is acutely psychotic and/or has a
significant intellectual disability)?

6. Psychodiagnostic Assessment
Name: Jim Smith
DOB: 1/10/2000
Age at Testing: 16 years 2 months
Reason for Referral:
Jim was referred for assessment by the school for a
psychodiagnostic assessment secondary to some legal issues
that occurred in this summer. Specifically, Jim was arrested for
possession of incendiary devices. The school is seeking
recommendations regarding Jim’s psychological needs.
Relevant Background information:
Jim Smith is a 16-year-old adolescent n who currently resides in
a juvenile residential facility, where he has been since his arrest
in July. According to records, Jim was charged with two counts
of Possession of an Incendiary Device, Chem/Bio/Nuclear
Weapon; one count of Possession of Hoax Incendiary Device,
Chem/Bio/Nuclear Weapon; and one count of Unlawful
Possession of Fireworks. These charges are in relation to a
search of the family home, in which police found spent
explosive devices, 22 BB and pellet guns, animal parts, and
digital evidence that Jim may be preoccupied with Nazism. He
is currently being held at the Department of Youth Services
(DYS) detention facility while he awaits trial in Juvenile Court.
Prior to this arrest, Jim’s school conduct report notes seven
incidents at school between 10/22/2013 and 05/11/15. These
incidents include bumping into a boy on the playground with
several peers; destruction of property in the school bathroom;
refusing to work; using a teacher’s email to send an email to
another school staff member which included the phrases “Aayy
nigger” and “fuck you”; making inappropriate comments about
another student’s sexual orientation, religious beliefs, and
cultural background; and drawing swastikas on his lunch tray.

7. These actions resulted in five days of in-school suspension and
five days of out-of-school suspension cumulatively.
In October 2015, a thorough neuropsychological evaluation and
risk assessment was completed for the courts. In this evaluation,
Jim was found to have intellectual abilities in the high-average
to superior range. He was noted to have intact encoding of
verbal information, planning, organization, and working-
memory skills. He demonstrated a mild weakness in sustained
attention and notable impairment in processing speed, impulse
control, and mental flexibility. In addition, the evaluation
identifies that Jim has clear symptoms of Autism Spectrum
Disorder.
Several school personnel were interviewed who are familiar
with the current incidents and have also known Jim in the past,
particularly in middle school. School personnel generally
describe Jim as withdrawn, aloof, giving a poor effort in school,
and having academic issues. They also reported consistently
that Jim presented with anxiety and depression. He was noted to
stutter, shake, and appear anxious often. He was also noted to
have minimal friends prior to the last year. In the past school
year, Jim was reported to have started hanging out with two
boys and began expressing anti-Semitic and anti-gay
viewpoints. He was reported to have bullied some students,
made swastikas, and sent an inappropriate email from a
teacher’s account. These behaviors all appear to be in
conjunction with the aforementioned other two boys. The school
reported that neither Jim nor the other boys seemed to grasp the
seriousness of their behaviors, and continued to get into trouble
from time to time. All school personnel denied any concerns
about an Autism Spectrum Disorder.
Outside of school, Jim’s parents described him as being fairly
“odd” as he got older. They indicated that he would frequently
get obsessed with things, such as melting metal, but that the

8. things he wanted to do were logistically impossible. They
reported that he developed an obsession with voicing anti-
Semitic views in the past year. His parents note that he felt he
had freedom of speech and would frequently make defiant anti-
Semitic gestures or statements when encouraged to discontinue
expressing these views. They recounted that he got into trouble
at school on several occasions related to this behavior. He also
had run-ins with the police due to bullying a student in relation
to these viewpoints.
Despite these concerning viewpoints, his parents reported that
Jim is a good kid. They reported that they do not feel his use of
weapons and these viewpoints are related. They indicated that
they purchased the guns for him and that he and his mother
would target practice in the backyard regularly. Jim’s father
also reported that he caught his son mixing chemicals to make
an explosive device in their backyard and told him not to do it
again. Outside of this activity, his parents reported that Jim
preferred to keep to himself and spent much of his time on the
computer. He reportedly had two friends who were linked to the
current offenses.
Behavioral Observations and Mental Status:
Jim presented as oriented and cooperative with the evaluation.
He presented as fairly nervous and somewhat aloof initially. His
eye contact is sporadic; and his speech and mannerisms are, at
times, slightly awkward. He presented with good grooming and
hygiene. There were no remarkable motor concerns. His affect
was flat, and he reported a good mood. His speech was normal
in volume, rate, and tone. His thought content was goal
directed, coherent, and concrete with no tangential or loose
associations. He denied any current or recent suicidal or
homicidal ideation, intent, or plan. He denied any issues with
hallucinations or paranoia and did not present with any
symptoms of psychosis. Judgment and insight appeared

9. adequate.
Ethics Case #1For this case, please read the case history below.
In this scenario, you are a forensic psychologist working in a
correctional facility. Your role is as the treating psychologist
for this patient. You have been working with him for one year
and have developed a solid rapport with him despite his distrust
of others, particularly mental health professionals. You meet
with him for weekly therapy sessions. In this time, while he is
willing to speak with you, he avoids topics which he feels may
cause him to be forcibly medicated; and you have been unable
to get him to try psychotropic medications voluntarily.
Recently, the prison has decided to attempt to get a court order
to medicate the patient due to concern related to dangerousness
and increasing psychiatric instability. They would like your
cooperation in the court process. As you read this scenario and
develop an understanding of the patient, also consider what
ethical concerns you may have—particularly related to the
specialty guidelines for forensic psychology and multiple
relationships—and how you might resolve these issues.
INMATE NAME: DOE, JOHN
Reason for Referral
Mr. Doe was referred for this psychological evaluation due to
this the patient’s continued refusal to take psychiatric
medication, continued active psychosis, and history of risk to
others. This assessment was also conducted in order to get a
better understanding of Mr. Doe’s emotional functioning,
identify his strengths and weaknesses, provide suggestions that
may aid in treatment planning, and help determine risk factors
for his potential future violent behavior. He is currently being

10. referred for 402.10 commitment to CPC.
Legal History
Mr. Doe is serving his first bid for Murder 1, Burglary 1, and
Grand Larceny, with a life sentence. He is also accused of two
murders in Canada, which charges are still pending. In the IO, it
is reported that the patient first murdered two men in Canada
before crossing the border with one of the victim’s vehicles. Per
his parents’ report, the crimes in Canada were fairly graphic,
involved a knife, and one of the victims was almost decapitated.
In the U.S., it was reported that he shot a man in the back at his
hunting camp before tying him to a four-wheeler and dragging
him around. He then fled to the Mexican border in Texas. He
was apprehended by a Border Patrol officer after he was noticed
to have a rifle. Mr. Doe then assaulted the Border Patrol officer
and has pending charges in Texas for this assault.
Personal Profile and Relevant History
Mr. Doe was born on 03/05/81, with no known complications.
He had an unremarkable childhood, graduating high school in
1999. He was noted to have done well academically, had many
friends in high school, although not in junior high, and was the
co-captain of his high school football team. Records note a
history of depression in junior high school.
After high school, he attended Alpha University in Canada,
pursuing a degree in Engineering. He completed two years of
school and was involved with a fraternity and other similar pro-
social activities. He was noted to have had two girlfriends in the
past, one of whom he had a sexual relationship with. Mr. Doe
has one younger brother, Douglas, with whom he is very close.
He is also supported by his parents, Bob and Mary Doe. Prior to
Mr. Doe’s incarceration, he resided with his parents when he
was not hospitalized.
During the summer of 2000, Mr. Doe went to Taipei as an
English teacher. His parents reported that, when he returned

11. home for the fall semester, his mental deterioration began.
Records indicate that he was initially believed to be suffering
from a depressive episode during the fall/winter of 2000 to
2001. He reported using marijuana daily between August 2000
to August 2001. He was noted to have gone on a drug binge in
August of 2001, using cocaine, marijuana, ecstasy, and
mushrooms for approximately one week while on a trip to
Montreal with his fraternity brothers. Records from the family
indicate that he had his first admitted hallucination of fighting a
dragon at this time.
When he returned to school in fall 2001, he was further
isolating himself, and had also become paranoid. Records from
his family indicate that he was destroying and/or burying in the
woods his personal belongings, including taking all of his
clothes to a thrift store. He reported a need to “cleanse
himself.” His family reported that he decreased his food intake
to a half a piece of bread daily for the purpose of “ritual
cleansing,” and to examine/overcome the concept of “what is
need and what is want.” In September 2001, he locked himself
in his room for five days, turning off the lights, unplugging the
phone, TV, etc., and minimally drinking in an effort to “do well
with control and self-discipline.” Between August and
November of 2001, he lost 40 pounds. His family records note
that he fell into a deep depression, which continued to occur the
following years during the fall and winter months.
After Mr. Doe refused treatment and medication, he continued
to deteriorate. In October 2001, he was reported to be mute
often; and he overate to the point of physical pain. The patient
reported that he was punishing himself. His parents reported
that he often eloped to the woods for days at a time. He was
brought, involuntarily, by police to Canada Hospital on
11/02/01. Hospital records indicated that he eloped on 11/05/01,
was returned by his parents within hours, and subsequently
eloped again on 11/06/01. He was found a week later by police,

12. seeming to have lived in the streets for the duration of his
absence. At this time, it was noted that he was not showering,
for several weeks to months. Records indicate that he received
intravenous medication for approximately one month due to his
refusals to take oral medication. This was discontinued in
December 2001 when Mr. Doe agreed to accept oral medication.
His symptoms were noted to improve; however, he eloped on
01/14/02, and was not found by police.
According to his family, he then lived at home for the next few
years, continuing to exhibit bizarre behaviors including: outings
to the woods, sleeping with knives, having beliefs about a
“troop” being after his family, paranoia regarding vampires,
demonstration of poor hygiene including not showering or
brushing his teeth for one year, and further isolation. In 2003,
there was an episode noted in which he painted himself all
white, as well as everything in his room, indicating that he had
been enlightened. He then left the home to try to enlighten
others, but scared a homeless man and the police were called.
He was not charged with anything due to his parents’
intervention and their subsequent report of his mental condition
to police.
In March 2005, his parents reported that he unlawfully entered a
dwelling. His parents indicate that he was not intending to harm
anyone or steal anything, but that he was trying to get out of the
elements after spending time in the woods. He was hospitalized
at Canada Forensic Hospital in April 2005 due to unlawfully
entering a dwelling and resisting arrest. Records indicate that he
was found competent and capable of attending trial. His parents
reported that the case was dismissed due to his psychiatric
issues.
In July 2005, his family moved to another town in Canada.
Records from the family note that he began using marijuana
heavily again in the summer of 2005, often isolating himself

13. behind the garage listening to rave music and “communicating
with the stars.” In November 2005, he was admitted to the burn
unit at a hospital after he burned his chest and back while
burning the clothes he was wearing. His family records note that
he was very psychotic during this episode and that the burns
were intentional. His family noted “lashing” marks, as though
he hit himself with a flaming article of clothing. Records
indicate that he left the hospital AMA, and peeled off and ate
all of his dead skin from the burns.
Records sent by his parents from his hospitalizations note Mr.
Doe being involuntarily admitted, with the last occurrence in
December 2005, due to being "acutely psychotic, delusional,
without any insight into his illness, with periods of agitation,
with high risk to act on his delusions if left untreated, with
potential of danger to his own safety or safety of others." It was
noted that he "presented with significant disorganization in
thought process with tangentially to loosening of association
with persecutory delusions believing his family and himself
being in life threatening danger including rape and murder. Up
until recently, in his hospital room, he was keeping lots of
garlic 'to keep demons and vampires away.' During most of his
interviews he has been quite agitated with verbal aggression and
body posturing and staring intently to intimidate others
especially nursing and medical staff. On many occasions he has
gestured to 'curse' the staff. He believes he has the ability to
curse people and make them suffer." Additionally it is noted
that, prior to this hospitalization, he "was brought by police,
after he had called two different police detachment units and
reported life threatening danger to his parents. His family
reported that he was extremely paranoid before his admission,
often sleeping with a knife. Mr. Doe reported having an
overwhelming 'intuition' or 'sense' that his parents were going
to be murdered and his mother raped. At the time, he eloped
from home, hitchhiked, he became insomniac, extremely
agitated, his behavior became very paranoid (e.g. carrying a

14. knife with him at all times, telling parents to take their lives if
an attack is going to be imminent). His parents feared that he
could act on his thoughts, e.g., 'he could attack us.'" He was
noted to have escaped in January 2006.
He was captured by police in January 2006 and returned to the
hospital. He was later transferred to the Canada Hospital. At
that time, he agreed to take Clozapine; and after his symptoms
diminished, he was released in July 2006. Records from the
family indicate that Mr. Doe was doing well and was believed to
be taking the medication until December 2006. During this time
when he was medication compliant, he was noted to be less
isolated, to have enjoyed some activities, and that the entire
family reported they had “a really great Christmas.”
In January 2007, he again began to isolate himself and become
depressed. He was noted as becoming very persistent in seeking
and using marijuana in early 2007. His family reported that he
listened to rave music on headphones, sometimes for 6-8 hours
straight. He was noted to laugh, scream, and make strange
noises, which appeared to be related to internal stimuli. In
March 2007, he was noted to present with grandiose delusions
of being the next Messiah, and having direct relations with God,
Jesus, and “the Archangel.” His family reported that he
regularly had conversations with these individuals. An incident
is noted in which he threw a book into a fire, then retrieved it
and placed it underwater, and then took it outside to the river.
According to Mr. Doe, he believed the book to have turned into
a demon and then into the Archangel (thus his need to save it).
He also believed that the river behind the family home was
sacred. He was noted to have gone to the river in the winter,
disrobe, and get entirely under the water, in order to “cleanse”
himself from demons.
Between March and May of 2007, he was noted to take multiple
cold showers throughout the day to “cleanse” himself, leave

15. food outside to “feed the spirits,” and holding his breath all day
long to “avoid letting demons enter him.” He was noted to not
be speaking and spending most of his day underneath a blanket
holding a knife. In April 2007, his brother moved from the
family home. In late April, Mr. Doe reported a desire to move to
Halifax, secured a room and a job, and moved there on
05/01/07.
The crimes occurred in the beginning of May 2007. According
to the patient’s own report, he went to a known location for
prostitution in Halifax. He reported being commanded there,
and that he was the “angel of judgment.” He reported getting
into a vehicle with a man and driving to a secluded location
where the man made sexual advances at Mr. Doe. Mr. Doe’s
reports indicate that he cut the man’s throat and that he believed
he was fighting the devil. He reported a similar experience
during his second crime, in which he waited for hours in a
known location for homosexual activity “while being tortured
by vampires.” He reported that he was prepared to leave when a
car drove up and “it was Satan himself.” He again reported
cutting the individual’s throat. Records note that he then fled by
car to the U.S. where he shot and killed another man, an act for
which the motive appears to have been to secure another
vehicle. He reported that he was told to do so by an angel.
According to Mr. Doe he was attempting to flee to Mexico “to
find safety in the forest.” He was apprehended at the Texas
border and returned to the county of his original crimes in the
U.S.
Since his incarceration, he has not taken any psychiatric
medications and continues to demonstrate psychotic processing.
He attempted suicide once at the county jail, in September 2007
by biting his wrist because he “believed that he was a spirit and
could walk through the wall.”
Mr. Doe is currently housed at Correctional Facility in General

16. Population; however, he is on a unit that is largely populated by
inmates with serious mental illness. He does not speak often
about having a mental illness currently, but does indicate that
he had Schizophrenia in the past. He is known to sleep
minimally, is paranoid, and demonstrates strange mannerisms in
his speech and movement. Officers note that he is often fighting
imaginary people in his cell, particularly at night. His eye
contact is often poor and is threatening in nature. He currently
takes all meals in his cell so that he can spend more time
“meditating.” He has significant support from his family, whom
he calls on a regular basis. His family reports that he remains
psychotic and he believes that he is a higher religious being.
While he has had no disciplinary infractions during his
incarceration, he has needed officer intervention several times
to avoid any major trouble with other inmates. He remains
focused on not hurting himself or others as he is strongly
against forced medication and remains unwilling to do anything
to risk such.
He is receiving mental health services and carries a diagnosis of
Schizophrenia–Paranoid Type, and Personality Disorder NOS.
Behavioral Observations and Mental Status
Mr. Doe has been interviewed on multiple occasions since
January 2009; the following is a summary of his general
behavior and mental status.
Mr. Doe is a 35-year-old Caucasian male, who walks with a stiff
gait, similar to a military style. In addition, he is noted to
position himself when walking or seated such that no one is
behind him. Related to this, officers note that he will not let
other inmates hold the door for him and instead insists that they
walk in front of him. He was dressed in institutional clothing
and appeared in good hygiene. He is noted to have a goatee, and
his hair is styled with gel. He has not cut his hair since his
incarceration, although he grooms his facial hair regularly. Of

17. note, on one occasion he shaved lightning bolts into his facial
hair, claiming that “the earth made me do it.” He appeared his
stated age. He is oriented times three. There were no signs of
depression or agitation today, although he was noted during
initial interviews to appear more hostile, often with a
threatening yet avoidant glance at the interviewer (as well as
other staff). His eyes are often squinted, with his forehead
lowered as though he is almost trying not to make any eye
contact. When he meets the gaze of someone, he is often noted
to look away. Mental health records note that he believes that
“demons can see inside you through your eyes.”
In more recent meetings with this interviewer, the patient’s gaze
has become softer and less threatening. He consistently denies
suicidal or homicidal ideation, intent, or plan, and in fact
discusses at great length his desire not to demonstrate anything
similar to those ideas due to his fear of forced medication. His
affect is usually flat, except for a few moments when he
demonstrated some emotional response during an interview. The
most noticeable affective response was following Rorschach
testing when he demonstrated some anxiety, but also joked
briefly with this writer. He is generally calm during interviews,
although he is noted to be uncomfortable when the door is
closed, when there are unfamiliar people in the interview, or
when there is significant activity outside in the hallway. He
generally gets anxious at some point in most interviews and
requests to leave; it often appears abrupt and awkward and is
usually related to a topic he would not like to discuss. He has
never shown any signs of hallucinations or delusions during
interviews; however, he is noted by officers to appear to be
responding to such in his cell. Thought content is mostly
reality-based; however, it is extremely pseudo-philosophical in
nature. He is very difficult to follow due to his manner of
speech, difficulty responding directly to questions, and
tangentiality. He often becomes tangential but does always
return to the original question asked. He presents as intelligent

18. and is deliberate in his speech such that he does not reveal any
information that could be directly linked to psychotic
processing. When he nears this topic area he often stops and
states that he does not want to discuss that issue. During
testing, he readily attempted all tests and worked in an effortful
manner. He completed testing very rapidly, which will be
discussed further as it relates to specific testing. He
demonstrated no problems related to attention and
concentration. Speech was of normal rate and prosody. He had
many questions about his success and failure on the test, which
appeared reflective of decreased self-esteem.