Case Vignette

Current Offense:
Genevieve was arrested and jailed for the crime of Aggravated Mayhem €” an act causing permanent disability or disfigurement and is done with the specific intent of causing injury and with indifference to the well-being of another person.
Genevieve is a 36 year old, ethnic Samoan Polynesian police officer, a lieutenant, who has been on work-related disability leave (Workman’s Compensation) for the past nineteen months. This injury occurred after she was pushed off a second story roof by an armed robbery suspect whom she was chasing and attempting to apprehend. She suffered a dislocation of two lumbar vertebrae and developed a chronic pain syndrome for which she has been prescribed massive dosages of Vicodin. Her physicians have considered installing a morphine drip for her pain. Additionally, she has been prescribed the MAO Inhibitor, Nardil, for intractable dysphoric symptoms that emerged four months after her work-related accident.
On the day of her arrest Genevieve was being driven in her personal vehicle to her medical and psychiatric appointments by her spouse, Elizabeth, who is the 62 year old African American, County Sheriff, when a car of youth drove by and yelled at Genevieve and Elizabeth, Get off the road, you (bleep)ing dykes! Elizabeth drove up the youth’s car to get the license number. The youth’s car then slammed on its brakes leading Elizabeth to rear-end the car. The driver, a young Hispanic male, jumped out of his car and ran to Elizabeth’s driver’s window. Genevieve hit her head hard on the side window; then she jumped out of her car, screaming Get away from me, you devil!! Next, she ran around her car, kicked the youth in the groin, pulled out her penknife and sliced across both eyes of the youth causing him severe and permanent damage. Elizabeth called the local police, and Genevieve was arrested and taken to the local jail.
When she arrived at the jail and was processed, Genevieve manifested pressured speech and flight of ideas, €“ shouting nonsense statements, whirling around, hugging and kissing the jail staff, and trying to walk on her hands. She was subdued, restrained and transported to the county hospital locked forensic inpatient unit where she was medicated with neuroleptics and has remained in partial remission until this date.

Psychosocial History:
Genevieve was born and reared in American Samoa in a moderately large village composed entirely of her family and extended family. She was the youngest of eleven children. Genevieve immigrated as a U.S. National to the U.S. mainland when she was 16 with her two next older brothers, the youngest of whom had been accepted to a Big 12 university on a football scholarship. The older brother of the two, 28, set up household for the brother and Genevieve. The younger brother entered the local university and Genevieve entered high school. The older brother has a PhD in nuclear engineering from Oxford University and teaches at the local university.
Genevieve’s early childhood was chaotic and rife with violence. Her father was a late-stage alcoholic and perpetrated severe battery upon his wife and his sons for many years. He was killed in an auto accident when Genevieve was eight years old. Her mother, currently 68, is in recovery as an alcoholic and developed a Bipolar II disorder and a chronic concussion syndrome from her husband’s beatings when she was 36. After several years of untreated and unmanageable manic episodes, the mother is finally on medication and living with her oldest daughter.
Genevieve was protected by her mother and siblings from most of her father’s violent behavior although she was very withdrawn until her father’s death after which time she began to excel at school and strongly engage with her friends. She was an excellent track and field athlete specializing in field events of the javelin and shot put.
When Genevieve moved to the US at age 16 with her brothers she entered high school as a sophomore, older than most of her classmates. As the sole Samoan in her school, she was treated with both awe and trepidation by her schoolmates. She again became withdrawn yet overcame them by her athletic abilities. She won the state championship in the shot put as a junior and senior. She began dating a member of the school’s football team, a Hispanic fullback, but that yearlong relationship broke up after her unreported and unshared with anyone date rape experience. This boyfriend was the only intimate relationship in Genevieve’s life to this point. Genevieve graduated from high school at 19 and entered a local state college with a criminal justice major in which she excelled.
As a senior, Genevieve participated in a field placement in the local county sheriff’s office where she met Elizabeth, a deputy sheriff and 26 years Genevieve’s senior. The two began dating when Genevieve graduated from college. Elizabeth was divorced with three children and had always considered herself bisexual; Genevieve came out as a Lesbian. The two moved in together and lived as partners until they were married in Massachusetts two years ago. The two have experienced a moderate intensity of homophobia at their workplaces and local communities.
Genevieve applied to the local police department and was hired as a patrolwoman and quickly moved up the ladder to her current rank of lieutenant that she has held for the past six years. Genevieve enjoyed law enforcement in the field.
Task Identification:
You are being asked to conduct a pre-trial psycholegal evaluation of Genevieve for the court to which Genevieve is initially assigned. You are to act as a forensic mental health evaluator and produce a written report addressing the questions, below. The report will be submitted to the appropriate supervisor and presented to the court.

Based on the vignette provided, please compose a well-written and organized response to each of the following questions. When writing your responses, please:
€¢ Use APA (6th edition, 2nd printing) Style, with 1-inch margins, double-spaced, 12 font, with a reference list at the end of each section.
€¢ Write clearly and concisely.
€¢ Cite appropriate, and especially current, literature (empirical and/or theoretical).
€¢ Avoid all sexist idioms and allusions.
€¢ Remember to demonstrate your multicultural competence where appropriate.
Psychological Theory and Practice
A. What assessment would you conduct to enhance your understanding of the client’s problems and how would they direct your diagnostic formation? In addition, what formal assessment procedures (conducted either by you or by someone you would refer to) would enhance your understanding of the problems and direct your treatment planning? Why?
B. Provide a possible multi-axial diagnosis (based on all five (5) axes of the DSM-IV-TR) for this individual. In narrative form, describe the differential diagnostic thought process that you used to reach your hypotheses. What additional information would you need for each of the possible diagnoses in order to confirm your diagnoses and rule out the others?
Legal Theory and Application
A. Describe the background, current presentation, and behavior of the client from a perspective that takes into consideration theories of offender and/or victim psychology and personality/psychopathology theories to support your position. (Do not simply restate the client’s presentation from the vignette. Provide a theoretical-based discussion of the client that will later help guide your suggested treatment approach. For example, if you were going to recommend Gestalt treatment, you would provide a theoretical formulation from a Gestalt perspective in this section).
B. Describe the psycho-legal standards and/or definitions for each of the following: competence to stand trial, risk of dangerousness, and insanity. Identify and describe one or more landmark case(s) for each standard (at least three cases total). Describe the elements or issues that a mental health professional usually focuses on when assessing a person’s adjudicative competence, risk and insanity, and any additional items that might be especially important to focus on in the provided vignette.
Research and Evaluation
A. Describe tests or assessment procedures you would employ to address these forensic issues (competence to stand trial, risk of dangerousness, and insanity) (you may refer to these from the Psychological Theory and Assessment Section A. if you already covered them there), and discuss what your anticipated conclusions would be based upon information provided in the vignette.
B. Develop one empirically supported therapeutic treatment plan for the client in the vignette. Please make sure you identify the name of the theory your treatment plan is based on and summarize the empirical evidence with appropriate citations to support your treatment choice in working with this client. Be sure to discuss the effectiveness and limitations in working with this particular client (including effectiveness/limitations in working with this particular client’s background using the above theories and treatment plans)
Interpersonal Effectiveness
A. What factors or cultural considerations would you take into account in rendering diagnoses, case conceptualization, and treatment planning? What other cultural factors may be salient for this client?
B. Your writing, use of citations, and proper APA Style will be evaluated as a measure of your interpersonal effectiveness. No response is required for B.
Leadership, Consultation, and Ethics
C. Describe how you would work within a professional team to consult, triage, and/or treat this case. Include a description of the various members of the professional team with which you would be likely to interact.
D. What are the ethical and legal dilemmas this vignette introduced? What would be your immediate steps and the rationale for implementing those steps? Please be specific and make sure that you describe your process of ethical decision making and the solutions/consequences this process might lead to.