The Importance of Clear Referral Questions in Forensic Psychological Evaluations

By: Kathyrn Grier, MLIS and Amy James, PsyD

Forensic psychological evaluations are conceptually and procedurally different from solely clinical evaluations. Although both require adequate referral information regarding the scope of the assessment and information sought from the assessment, a forensic psychological evaluation is designed to answer specific psycholegal questions posed by the referral source. Referral sources may include, but are not limited to, the court, an attorney, a child welfare agency, or an employer.

Because the evaluator’s role is to address legally relevant issues, the scope of the evaluation and referral questions are some of the most important components of the evaluation process. A clear referral question identifies the referral sources’ concerns and questions, which assists the evaluator in determining the methodology, data to be collected, and helps the evaluator remain objective and within appropriate professional boundaries. Without a clearly defined question or series of questions, the evaluator may be tempted to infer the purpose of the evaluation, which increases the risk of evaluator bias, improper methods, and irrelevant or incomplete opinions.

The most common issue in forensic referrals, court orders, and court appointments, is vague requests such as “comprehensive psychological evaluation.” While this phrase may appear thorough, it provides little to no direction regarding the actual legal issue to be addressed. In clinical and forensic practice, the evaluator is not tasked with simply “evaluating the person.” In clinical practice, the evaluator must assess a specific presenting problem or cluster of problems and rule in or out various diagnoses and treatment considerations. In forensic practice, the evaluator must answer a legally relevant question using reliable psychological methods.

For example, an order or request for a “comprehensive psychological evaluation” does not identify the actual issue in question. Is the concern parental capacity, trauma-related impairment, substance abuse, cognitive limitations, risk of violence, mental health stability, some combination of these, or something else? Without clarification, the evaluator may collect unnecessary information while failing to address the primary concern.

A more effective referral question would be:

“Assess the parent’s psychological functioning, including risk and protective factors relevant to their ability to safely and independently care for the child.”

Similarly, referrals such as:

“Evaluate competency” or “evaluate capacity” are overly broad because they fail to identify the applicable legal standard. Competency or capacity may refer to competency/capacity to stand trial, represent one’s self, parent, waive Miranda rights, consent to treatment, or another legally distinct capacity. Each requires a different forensic framework and assessment strategy.

More precise referral questions would be:

“Assess the defendant’s competency to stand trial, including their ability to understand the legal proceedings and assist counsel in their defense.”

“Assess the parent’s capacity to care for their three children, one of which is medically fragile. Identify risk and protective factors for future instances of abuse or neglect, and identity any mental health diagnosis and symptoms and whether it impacts their parenting.”

“Assess the adult’s capacity to make medical decisions, live independently, and manage their finances.”

Clear referral questions also protect the neutrality of the forensic process. Forensic psychologists are not advocates for either party; their role is to provide objective, data-driven opinions that assist the decision-maker. Specific referral questions help prevent unnecessary or inappropriate lines of inquiry and reduce the likelihood that evaluators will overstep the intended scope of the evaluation.

When developing referral questions, referral sources should:

- Tie the questions directly to the legal standard or issue in question

- Define key terms when necessary

⁃ Avoid vague phrases such as “comprehensive psychological evaluation” without identifying the psycholegal issue to be addressed or explaining the concerns.

If a referral source is uncertain about how to frame the question, consultation with the retained evaluator before the evaluation begins can help ensure the assessment will provide meaningful, focused, and admissible information.