Initial And Diagnostic Assessment Quotes

Helping a client with all those things is part of your job. But before you can begin-in fact, before that person walks through the door-you must prepare yourself. In many agencies part of your preparation will be reading some documentation on the client. That may be nothing more than a two-line summary of the problem the client has reported and a telephone number you can call to set up an appointment. On the other hand, if the case is being transferred to you, it may mean a huge file that includes a medical history, a psychiatric evaluation, a mental status exam, a biopsychosocial assessment by a previous clinician (or clinicians), that clinician’s progress notes, a report of psychological testing, a diagnostic code, and many other types of information. Whether it is one page or fifty, though, your response ought to be the same: What don’t I know that I need to know? Start making some written notes for yourself, beginning with those questions that you need to have answered before you call the client back to arrange an appointment. For instance, you may want further clarification of her current problem, if possible, so you can be sure she is coming to the right place. You may want to find out if anyone told her there is a fee charged. Or, if the case appears to involve more than one person, you may want to inquire about who should be included in the first interview. You should raise those questions with your supervisor or with the person who had the initial phone contact.

it is not uncommon for experts in DNA analysis to testify at a criminal trial that a DNA sample taken from a crime scene matches that taken from a suspect. How certain are such matches? When DNA evidence was first introduced, a number of experts testified that false positives are impossible in DNA testing. Today DNA experts regularly testify that the odds of a random person’s matching the crime sample are less than 1 in 1 million or 1 in 1 billion. With those odds one could hardly blame a juror for thinking, throw away the key. But there is another statistic that is often not presented to the jury, one having to do with the fact that labs make errors, for instance, in collecting or handling a sample, by accidentally mixing or swapping samples, or by misinterpreting or incorrectly reporting results. Each of these errors is rare but not nearly as rare as a random match. The Philadelphia City Crime Laboratory, for instance, admitted that it had swapped the reference sample of the defendant and the victim in a rape case, and a testing firm called Cellmark Diagnostics admitted a similar error.20 Unfortunately, the power of statistics relating to DNA presented in court is such that in Oklahoma a court sentenced a man named Timothy Durham to more than 3,100 years in prison even though eleven witnesses had placed him in another state at the time of the crime. It turned out that in the initial analysis the lab had failed to completely separate the DNA of the rapist and that of the victim in the fluid they tested, and the combination of the victim’s and the rapist’s DNA produced a positive result when compared with Durham’s. A later retest turned up the error, and Durham was released after spending nearly four years in prison.21 Estimates of the error rate due to human causes vary, but many experts put it at around 1 percent. However, since the error rate of many labs has never been measured, courts often do not allow testimony on this overall statistic. Even if courts did allow testimony regarding false positives, how would jurors assess it? Most jurors assume that given the two types of error—the 1 in 1 billion accidental match and the 1 in 100 lab-error match—the overall error rate must be somewhere in between, say 1 in 500 million, which is still for most jurors beyond a reasonable doubt. But employing the laws of probability, we find a much different answer. The way to think of it is this: Since both errors are very unlikely, we can ignore the possibility that there is both an accidental match and a lab error. Therefore, we seek the probability that one error or the other occurred. That is given by our sum rule: it is the probability of a lab error (1 in 100) + the probability of an accidental match (1 in 1 billion). Since the latter is 10 million times smaller than the former, to a very good approximation the chance of both errors is the same as the chance of the more probable error—that is, the chances are 1 in 100. Given both possible causes, therefore, we should ignore the fancy expert testimony about the odds of accidental matches and focus instead on the much higher laboratory error rate—the very data courts often do not allow attorneys to present! And so the oft-repeated claims of DNA infallibility are exaggerated.