Seattle University Collaborative Projects - International Academy of ...

Gerben Meynen, Tilburg University (g.meynen@uvt.nl)The question of how criminal responsibility should be understood and implemented in forensicpsychiatric assessment is still unanswered. What capacities must agents possess in order to becandidates for moral or legal responsibility? Is free will relevant with respect to criminalresponsibility? Juth and Lorentzon (2010) proposed to replace the concept of free will with theconcept of autonomy and conceived the assessment of criminal responsibility in terms ofdecision-making processes. Hirstein and Sifferd (2010) argue that these processes are directed atprefrontal executive functions and call the set of executive processes “the legal self”. In thispresentation we discuss this “legal self” approach to criminal responsibility. What defines the“legal self”, and is this legal self concept of help in answering the question of criminalresponsibility in the practice of forensic psychiatric assessments? By presenting some casereports in which legal principles are implicitly directed at the executive processing capacities ofagents, we try to evaluate the clinical applicability of this “legal self” approach.68. Forensic PsychiatryChallenging DischargesJohn L. Young, Yale University (johnlmyoung@msn.com)Forensic inpatients do not necessarily share in the trend towards decreasing lengths of stayexperienced in civil mental hospital settings. The purpose of this presentation is to reflect onexperiences gained through focused efforts (some of them successful) to transfer patients from amaximum secure setting they no longer require. The obstacles to discharge are readilyunderstandable. Aside from legal requirements, they include difficult medical problems,challenging mental disorders, and imposing physical size and strength. Not uncommonly atransfer is arranged only to fail within a day or two, confirming the conviction that the patientcannot be discharged. Outside institutions play a crucial role; several organizations must beinvolved simultaneously. Long and frequent meetings cannot be avoided and it may be necessaryto revise plans midway more than once. Measures that can overcome these obstacles includeadministrative support and a critical mass of treating staff members willing to challenge somestrong socio-cultural influences. A great deal of patience is required to engage sufficientwillingness to repeat incrementally small steps in order to challenge prevailing assumptions.Creativity can help to support a gradual wearing away of physical and mental barriers. Therewards of success are immense for all concerned.The Applicability of Neurofeedback in Forensic PsychotherapyRon van Outsem, Bouman GGZ, Netherlands (ronvanoutsem@casema.nl)169