Method

In total, 81 experienced forensic mental health clinicians (primarily psychologists, with some psychiatrists) completed an online survey about their forensic practices and training experiences related to FASD and other NDDs. The sample was primarily drawn from the United States, (56%), Canada (27%), Europe (11%), and Australia and New Zealand (5%). In order to recruit a broad sample, the survey was distributed through professional association list serves, posted on websites advertising research opportunities, and circulated on various social media platforms. Clinicians with identified forensic mental health expertise were also contacted via email using publicly available information. The survey invitation described a study examining professional practices in forensic mental health clinicians, including those who worked with clients with NDDs. The invitation was designed to encourage the participation of a range of forensic clinicians with at least some practice experience working with this population to participate. All study procedures were approved by the University of Guelph’s Research Ethics Board.

A total of 156 individuals clicked on the initial survey link (Figure 1). Of these, 92% consented to participate, 81% met forensic practice inclusion criteria (e.g., a psychologist or psychiatrist who engages in forensic assessment or intervention), and 51% practised with clients who may have FASD or other NDDs. An additional 30% were removed due to drop-out or incomplete data (more than 25% of the survey was incomplete).

Figure 1. Sample details and inclusion criteria

Figure 1. Sample details and inclusion criteria

Figure 1. Sample details and inclusion criteria – Text version

Figure 1 presents information on the 156 individuals who clicked on the initial survey link. The image is of two columns of boxes.

The first box on the left is shaded in blue and says “included”. The box on the right is shaded in blue and says “excluded”.

Under the box that says “included” there is a box that says “Total initial responses n=156”. There is a line under the box directing readers directly down to another box that says “Consent & proceeded n=147 (92%)”

Between those boxes there is a line directing readers to a box in the right column (under excluded) that says “Did not proceed n=12 (8%), did not consent n=7, dropout n-5”.

From “Consent & proceeded”, there is a line down to a third box on the left that says “Forensic psychologist or psychiatrist n=129 (81%)”.

Between those boxes, there is a line directing readers to a box in the right column (under excluded) that says “Not eligible n=18 (11%), not psychologist/psychiatrist n=15, no assessment/intervention n=3”

From “Forensic psychologist or psychiatrist”, there is a line down to a fourth box on the left that says “Final sample n=81 (51%)”

Below the final box, there are two more boxes. A line runs from box 4 to the box on the left that says “Practice with FASD/NDDs n=75 (93%). A second line runs from box 4 to the box on the right that says “Does not practice with FASD/NDDs n=6 (8%)”

Between the box that says “Forensic psychologist or psychiatrist” and the box that says “Final sample”, there is a line directing readers to a box in the right column (under excluded) that says “Removed n=48 (30%), dropped out prior to inclusion question #2 n=25 (16%), ˃75% incomplete data n=23 (15%)”

The final sample included 81 forensic cliniciansFootnote 4 (Table 1). The majority (93%) had practice experience with clients who had NDDs broadly. Respondents were primarily psychologists with areas of practice including clinical and forensic psychology, and had substantial experience working as mental health practitioners.Footnote 5 Several forensic psychiatrists are also included in the final sample. Clinicians worked in various settings, including private practice, forensic/court clinics, and forensic mental health facilities.

Table 1. Participant demographic information
%
Age (years, M, SD) 47 (13)
Male gender 42
Highest degree
PhD 61
PsyD 23
MD 8
MA/MSc 6
Other 2
Field of practiceFootnote a of Table 1
Correctional/forensic psychology 63
Clinical psychology 55
Forensic psychiatry 9
Counselling Psychology 2
Other 2
Practice settingFootnote a of Table 1
Private practice 47
Forensic/court clinic 34
Inpatient forensic mental health facility 33
Academic setting 25
Outpatient forensic mental health facility 19
Jail, prison, or detention center 13
Non-forensic mental health facility 5
Other 5
Years of practice in current field (M, SD) 15 (11)
Geographic region
USA 56
Canada 27
Europe 11
Australia & New Zealand 5
Other 2
Professional membershipFootnote a of Table 1
AP-LS 66
CPA 25
IAFMHS 23
American Board of Forensic Psychology 14
American Academy of Forensic Psychology 11
Other 14
Source of forensic referralsFootnote a of Table 1
Judges/court-ordered 89
Public/private defense attorneys/lawyers 45
Prosecution/crown 39
Probation/parole officers 28
Other 13
Formal training for court
Graduate school 64
Developed expertise later 41
N/A; no formal training 3
Forensic diplomat (% yes) 16

Survey. The online survey was developed based on a review of other relevant practice surveys and consisted of five major sections (see Bibr, 2018; Brown et al., 2017, 2016; Caley et al., 2008; Coons et al., 2017; Cox et al., 2008). Participants first responded to forensic inclusion and practice questions, followed by a section characterizing their assessment and intervention practices with clients who have FASD and other NDDs. Participants then detailed their forensic training experiences focusing on FASD and other NDDs, and indicated whether additional training would be helpful. They also answered questions about their FASD-relevant knowledge, and lastly, provided demographic information.