Fitness Interview Test

The Fitness Interview Test-Revised (FIT-R) is an instrument designed for use by mental health professionals in evaluations of competence to stand trial.

Designed as a structured clinical judgment instrument that guides evaluators through an assessment of the specific psycholegal abilities required of a defendant to stand trial, the FIT-R demonstrates reliability and predictive validity and is useful for screening out individuals who are clearly competent to stand trial.

Competence (or fitness) to stand trial is a well-established legal principle designed to ensure that criminal defendants have the ability to participate in legal proceedings. Defendants must be able to understand the charges against them, understand the possible consequences of legal proceedings, and communicate with their attorney. Defendants whose ability to participate competently in their trial is in question are typically referred for a forensic assessment, since mental health issues are central to the evaluation. If the court later determines that a defendant is competent, legal proceedings are resumed; if the defendant if found incompetent, the legal proceedings are suspended until competence is restored.

There are a number of forensic assessment instruments designed to assist in this process, and the FIT-R, a semistructured interview and rating scale, is one of them. While initially designed for use with adult defendants, research has also shown that it can be used to evaluate competence in juvenile populations. The current version is a revised and updated version of an earlier edition. A thorough review of pertinent U.S. and Canadian legislation is included in the introductory section of the FIT-R manual, and a brief review of research on fitness to stand trial is provided. However, the authors have noted that the FIT-R can be used in most common-law jurisdictions due to the similarity in legal criteria for competence to stand trial.

Administration of the FIT-R takes approximately 30 to 45 minutes. The instrument is intended to serve as a tool for assessing legal issues in concert with other methods of assessing additional clinical issues, including mental status and diagnostic considerations. The format follows a semistructured interview, ensuring that all legally relevant aspects of fitness criteria are addressed while allowing clinicians the flexibility to probe and further question the specific knowledge and abilities of the accused. Following the interview, the evaluator completes a rating scale in which the relative degree of incapacity for each of the items is evaluated. This semistructured format allows evaluators to conduct more uniform competence evaluations while still providing for flexible assessments.

The FIT-R comprises 16 items divided into three sections that parallel the Canadian and U.S. legal criteria for competence to stand trial. The first section, Understanding the Nature or Object of the Proceedings: Factual Knowledge of Criminal Procedure, examines a defendant’s understanding of the arrest process, current charges, role of key participants, legal process, pleas, and court procedures. The second section, Understanding the Possible Consequences of the Proceedings: Appreciation of Personal Involvement in and Importance of the Proceedings, examines a defendant’s appreciation of the range and nature of possible penalties, available legal defenses, and likely outcomes. The third section, Communication With Counsel: Ability to Participate in Defense, examines a defendant’s ability to communicate facts to a lawyer; interpersonal capacity to relate to lawyers; and ability to plan legal strategy, engage in the defense, challenge prosecution witnesses, testify relevantly, and manage courtroom behavior. Each section comprises a number of items reflecting the requisite psycholegal abilities required for competence in each area. An individual’s degree of impairment on each item is rated using a three-point scale (no impairment, possible/mild impairment, and definite/serious impairment), which is clearly explained and defined for evaluators. The evaluator then rates the accused’s degree of impairment in each of the sections. These ratings as well as an assessment of the defendant’s mental status are used by the evaluator to make an overall determination of the individual’s competence to stand trial. In scoring the FIT-R, the instrument does not rely on “cutoff” or “total” scores for making decisions about an individual’s competence, largely because the weight assigned to any one item will likely vary across individuals.

It is important to recognize that the FIT-R was designed to reflect the relative competence status of an accused individual at the time of examination, and it can serve neither a predictive nor a retrospective assessment function. Research has shown that few of the accused individuals ordered to undergo fitness assessments are found incompetent to stand trial. The FIT-R can be used as a brief screening instrument for assessing fitness, where individuals who score at an “unfit” or “questionably unfit” level will be referred for a more thorough evaluation. Research has demonstrated that it yields good sensitivity (the probability that the predictor variable is positive given a recommendation of unfit) and negative predictive power (the probability of a recommendation of fit given that the predictor variable is negative) when used in this way and that it can reliably screen out individuals who are clearly competent to stand trial, thereby reducing the number of individuals referred for more lengthy and costly assessments. The FIT-R can also be used as part of a more comprehensive fitness evaluation.

References:

  1. Grisso, T. (2003). Evaluating competencies: Forensic assessment and instruments. New York: Plenum Press.
  2. Roesch, R., Zapf, P. A., & Eaves, D. (2006). Fitness Interview Test-Revised: A structured interview for assessing competency to stand trial. Sarasota, FL: Professional Resource Press.
  3. Roesch, R., Zapf, P. A., Eaves, D., & Webster, D. (1998). Fitness Interview Test-Revised Edition. Burnaby, BC, Canada: Mental Health Law and Policy Institute.
  4. Viljoen, J. L., Vincent, G. M., & Roesch, R. (2006). Assessing adolescent defendants’ adjudicative competence: Interrater reliability and factor structure of the Fitness Interview Test-Revised. Criminal Justice and Behavior, 33, 467-187.
  5. Zapf, P. A., & Roesch, R. (1997). Assessing fitness to stand trial: A comparison of institution-based evaluations and a brief screening interview. Canadian Journal of Community Mental Health, 16, 53-66.

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