The MacCAT-CA and the ECST-R in Competency to Stand Trial Evaluations: A Critical Review and Practical Implications.

There is debate regarding the utility of standardized instruments in the assessment of competence to stand trial (CST). Though the field generally has a positive view of the second-generation nomothetic instruments available, the frequency of use falls far behind this favorable impression. The current paper reviewed two standardized instruments used in CST evaluations, the Evaluation of Competency to Stand Trial - Revised (ECST-R) and the MacArthur Competence Assessment Tool-Criminal Adjudication (MacCAT-CA). We first review the psychometric properties of both instruments, including a review of limitations. Next, we discuss the legal standing of both instruments, including a review of past admissibility challenges and a discussion of potential issues in cross-examination. Finally, we end with practical guidance for clinicians; namely, that these instruments are generally valid indicators of competence to stand trial and are likely to be particularly useful in cases where competence is ambiguous and the clinician would benefit from additional standardized data to make a clear clinical decision.

Analysis of the Written Policies of the 32 U.S. Archdioceses on the Prevention of Child Sexual Abuse.

The Catholic Church in the U.S. has been under concerted public pressure to improve its child protection policies. However, development of these policies has largely been left to the discretion of local dioceses with little central oversight. To determine the scope of current abuse prevention policies, we analyzed all 32 U.S. archdioceses' policies and practices for developing a safe environment and preventing child sexual abuse. Using a tool developed from a list of unique components selected from the policies of all 32 archdioceses, we compared policies and procedures across archdioceses. On a group level, we found policies to be inadequate. The average score for archdioceses in the general area of prevention was 40.7 (SD = 9.3) out of 102 possible points (40% of possible points) with few prevention policies conforming to basic best practices that would be expected of a youth-serving organization. The variation and inconsistencies across archdioceses reveal the need for the Catholic Church to establish more uniform standards for preventing sexual abuse. These standards should be grounded in evidence-based practices and expert guidance. We also discuss some key areas which warrant immediate attention in future policy-making.

Survey of the Written Child Protection Policies of the 32 U.S. Archdioceses.

Amid considerable public scrutiny, Roman Catholic institutions in the United States have been called upon to address underlying organizational conditions that may facilitate child sex abuse and establish effective policies for early intervention and prevention. The development of child protection policies has largely been left to the discretion of local dioceses with little in the way of central oversight. This study examined the 32 U.S. archdioceses' written policies on child protection and maintaining a safe environment. We found 14 distinct policies spread across the archdioceses which fit into four general categories or domains: (1) Prevention of Child Sexual Abuse; (2) Detection and Reporting of Abuse; (3) Response to Victims; and (4) Investigational Process and Response to Allegations of Abuse. Using a tool developed from a list of unique components selected from the better policies of all 32 archdioceses, we compared policies across archdioceses. On a group level, we found current policies to be inadequate. The average score for all 32 archdioceses was 100.9 out of 250 possible points or 40%. The range was 61 to 137 (SD 20.4). The variation and inconsistencies across multiple archdioceses within the U.S. reveal the need for the Catholic Church to establish evidence-based standards on appropriately and effectively addressing child sexual abuse within its dioceses. These standards should be based on empirically supported best practices and emerging consensus of experts on better practices for youth-serving organizations in relation to child abuse. This article points to parameters for consideration in developing such standards.