Clinician Decision Making on Juvenile Transfer


The literature on clinicians’ decision-making and assessment of treatment amenability related to juvenile transfer is extremely limited. This is so despite the magnitude of such evaluations on the fate of youthful offenders. The findings of the current study have implications for both the legal and psychological communities. As previously noted, considerable changes within the juvenile justice system over the past few decades have led to legal proceedings that more or less resemble adult criminal trials, as the juvenile justice system has seemingly become more adversarial in nature (Ryba, Cooper, & Zapf, 2003). Following Kent v. United States (1996), the Supreme Court emphasized the need to balance the welfare of juvenile offenders with the interests of the state (Elrod & Ryder, 2011). While it is commonly acknowledged that a juvenile’s amenability to treatment is among the factors that are important to consider when determining whether a juvenile should be tried as an adult, the ways in which we might assess this matter remains less clear. A review of the extant literature reveals that few studies have attempted to empirically define treatment amenability, and none have examined what clinicians actually do when conducting an assessment of treatment amenability. The present study is one of the few studies that has attempted to address these gaps in the research. Furthermore, this study used an experimental design to expand on the related studies that do exist (i.e. Salekin et al., 2001; 2002), ultimately broadening the external validity of the research.

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The results of the study only partially supported the original hypotheses. First, when asked directly to make judgments regarding the treatment amenability of a juvenile offender, treatment availability did not appear to be a major determinative factor. Despite higher average ratings of treatment amenability assigned by clinicians in the treatment available condition, the difference was only slight. These ratings suggest that a juvenile’s perceived treatment amenability may not be entirely affected by legal definitions that include language regarding treatment options. At the surface, this finding mirrors the sentiment that it would be inappropriate for a clinician to base a juvenile’s level of amenability on a systemic issue such as resource availability. However, when considering the weighted scores specific to the 36-items clinicians reportedly considered when assessing the treatment amenability of the juvenile offender, “Realistic Chance for Placement in a Treatment Program” was identified as being the third most important item to consider, just behind “No or Limited Contact with the Legal System.”

One possible explanation for the seemingly discrepant information regarding the importance of treatment availability concerns the theoretical versus the practical. In theory, treatment amenability is a person-centered concept much like questions of competency. Despite the lack of a universally accepted description of treatment amenability, many of the psychological conceptualizations of this construct primarily emphasize the internal characteristics of the person being assessed. This sentiment is maintained irrespective of whether treatment amenability refers to the capacity to benefit from treatment or willingness to participant in treatment, two operational definitions presented in the literature. For example, issues pertaining to a juvenile offender’s intellectual ability, personality traits, and family dynamics, especially as they have influenced the juvenile’s attachment style, are subsumed under the aforementioned characteristics. Thus, in theory, focusing exclusively on functional and judgmental capabilities, protective factors, and pertinent contextual factors should be enough to hypothesize about one’s level of treatment amenability. That is, the assessing clinician might, with reasonable confidence, be able to make a relevant categorization (e.g. amenable vs. unamenable; moderately amenable vs. highly amenable). However, in practice, evaluations of treatment amenability are more or less concerned with judging the juvenile’s abilities against the demands of the situation (e.g. how best to benefit the juvenile charged with the offense and protect public interest).

As previously mentioned, several state statutes understand treatment amenability as referring to “the likely rehabilitation of the juvenile by use of facilities available to the juvenile court” (Heilbrun et al., 1997, p. 130). Arguably, the emphasis placed on resource availability contained in legal standards for waiver decisions closely aligns with notions of protecting public interests. However, in judging the juvenile’s abilities against the demands of the situation, the clinician has ultimately entered the territory of risk assessment. According to Brown and Singh (2014), risk assessments are concerned with predicting the probability of future offending in order to better allocate limited resources more effectively while protecting society at large. Recall findings from Brannen and colleagues (2006) study demonstrated that despite acknowledging the usefulness of amenability related information, information pertaining to dangerousness was most relevant to legal professionals. In understanding the fundamental goal of the forensic evaluation, it is likely that clinicians are aware of the merging of these distinct psychological concepts (i.e. treatment amenability & risk) insofar as the law is concerned. Naturally, this awareness is highlighted by the factors considered when assessing the treatment amenability of the juvenile presented in the vignette.

The top ten most important factors considered when judging the amenability of the juvenile described in the vignette included (1) No or Limited Contact with Legal System; (2) Not Rebellious Toward Authority; (3) Realistic Chance for Placement in Treatment Program; (4) Positive Involvement by Family; (5) Takes Responsibility for One’s Own Problems; (6) No School Misconduct; (7) Supportive and Accepting Family; (8) Generally Tells Truth (Not Chronic Liar); (9) Family Cooperation with Court; and (10) Receptive and Responds to Others Attempt to Help. Conversely, four factors – Psychologically Minded, Logical, Alcohol or Drug-Related Crime, and Plans to Change Criminal Lifestyle – were not judged to be important at all. The aforementioned findings are only partially consistent with previous literature pertaining to treatment amenability. Namely, characteristics of the juvenile’s family system and number of previous arrests have been considered to have important implications for a juvenile’s amenability to treatment (Keeney, 2000). Based on an analysis of the factors deemed important by child psychologists, Salekin and colleagues (2001) also found that the amenable juvenile is one who is interested in treatment, aware of his/her difficulties and wants to change, is considerate and tolerant of others, and has been successful in previous treatment settings.

Largely, these data indicates that, to some degree, clinicians assume juveniles would be challenging to treat in the absence of willingness to change, if criminality was overwhelmingly salient, and/or familial support was nonexistent. However, an interpretation of the Salekin et al. (2001) data most closely relates to two of the four – psychologically minded and plans to change criminal lifestyle – factors that were not considered at all in the present study. Although, one could argue that the identified factor “Receptive and Responds to Others Attempt to Help” parallels being motivated to engage in treatment, an amenability-related factor considered equally important by judges (Salekin et al., 2002). Nevertheless, the inconsistency of this study’s findings relative to previous research highlights the importance of expanding the empirical research related to treatment outcome when determining which factors are the most important to consider when making judgments about treatment amenability. Conducting more research in this area will afford clinicians ample opportunity to evaluate their own method of decision-making against the decision-making processes of their peers. Clinicians will be in a better position to scrutinize this process by determining whether similar factors are being considered during an evaluation of this type, and whether they are placing equal importance on the factors as compared with other clinicians. Ideally, a growth in the empirical literature would then lead to the development of additional assessment tools and decision-making backed by research rather than a heavy reliance on clinical intuition, which remains a concern in the area judging one’s amenability to treatment (Kenney, 2000).

Until the recent development of the Risk-Sophistication-Treatment Inventory (RSTI; Salekin et al., 2005), the scientific literature contained no specific measures intended to assess treatment amenability in the context of juvenile waiver to adult court. However, given the relative newness of the RSTI, it is unsurprising that few clinicians reported incorporating this measure into their assessment battery, a finding that supports the original hypothesis. Conversely, the top two most frequently reported assessment tools used by clinicians when evaluating treatment amenability are the Minnesota Multiphasic Personality Inventory- Adolescent (MMPI-A) and the Wechsler Intelligence Scale for Children (WISC). Other commonly utilized instruments included the Rorschach and the Wide Ranging Achievement Test – Fourth Edition (WRAT-4). These findings parallel previous research showing that any version of the MMPI is typically one of the most common assessment tools used during forensic evaluations, regardless of referral type (Neal & Grisso, 2002). This is unsurprising as the MMPI is among the most intensively researched assessment instruments available and has consistently been shown to have strong psychometric properties (Hunsley & Mash, 2007). Moreover, not only was the Structured Assessment of Violence Risk in Youth (SAVRY) the fifth most reported assessment tool used by clinicians when assessing treatment amenability, 93 percent of the sample reported assessing dangerousness. Frequent utilization of any structured risk assessment instrument echoes Salekin and colleague’s (2001, p. 402) claim that treatment amenability “extends beyond psychotherapeutic gains and applies more broadly to criminological lifestyles.” However, does assessing treatment amenability with traditional psychological measures address the issues pertinent to juvenile waiver?

According to Heilbrun, Rogers, and Otto (2020) the instruments commonly used during forensic evaluations can be sorted into one of three classes. The first class, referred to as Forensic Assessment Instruments (FAI), represents instruments specifically designed to more or less directly assess the capacities associated with the legal question, such as instruments designed to measure abilities associated with competence to stand trial. The RSTI would belong to this class as it is specifically intended to assess treatment amenability, which the measure broadly conceptualizes as referring to the likelihood of being responsive to treatment (Salekin, Salekin, Clements, & Leistico (2005). The second class, referred to as Forensically Relevant Instruments (FRI), denote instruments that measure clinical constructs that are sometimes pertinent to psycho-legal concepts. For example, measures of psychopathy, such as the Psychopathy Checklist-Youth Version (PCL-YV), often map onto questions of direct relevance to the court. The third class, referred to as Clinical Assessment Instruments (CAI), describes standard psychological tests developed for use with clinical populations. The MMPI-A and WISC belong to this class of assessment instruments.

Clinical Assessment Instruments indeed provide valuable information regarding underlying forensic issues. Consider treatment amenability and the RSTI, a forensic assessment instrument. The treatment amenability scale on the RSTI is comprised of three sub-scales or “clusters” – Psychopathology, Responsibility and Motivation to Change, and Consideration and Tolerance of Others (Salekin, Salekin, Clements, & Leistico, 2005). The Psychopathology cluster addresses type, degree, chronicity, and treatability of psychopathology, areas that likely are more aptly addressed by a CAI. In their survey of structured assessment tools used to aid expert judgment in forensic contexts, Neal and Grisso (2014) found that half of the overall (i.e. not specific to referral question) top ten frequently used assessment instruments were CAIs. However, despite their value, CAIs represent a class of instruments that is furthest away from forensic issues. Thus, the limitations with traditional assessment measures arguably diminish their importance in juvenile waiver evaluations. For this reason, diversity in test selection, insofar as it relates to the aforementioned three-class typology of assessment instruments, is essential to yielding a truly meaningful forensic evaluation. Furthermore, research suggests that relying on approximately four to six variables essential to the pertinent issue is the optimal approach to valid and reliable decision-making (Kahneman, 2011). Accordingly, various pieces of information are integrated to form one overarching variable. For example, the MMPI-A, Rorschach Inkblot Test, and MACI – each of which are CAIs – might be combined to represent “Psychopathology,” one of the three clusters specific to the treatment amenability scale on the RSTI. Conversely, the cluster “Consideration and Tolerance of Others” might be assessed by integrating information from the PCL-YV, a forensic assessment instrument that assesses a variety of areas including lack of remorse and unstable interpersonal relationships (Vincent, Odgers, McCormick & Corrado, 2008), with information gathered from collateral sources.

In addition to the PCL-YV being the second most frequently utilized risk assessment measure reported in this study, every participant included in the sample reported obtaining information from collateral sources when assessing treatment amenability. Perhaps what is most surprising about the latter finding concerns the focus of the collateral information. Excluding information acquired from neighbors and friends of the juvenile defendant, criminal and legal sources (e.g. police reports, juvenile records, etc.) were the least frequently utilized sources of information. The most frequently used collateral source, teachers and academic records. Moreover, the Student-Teacher Relationship Scale (STRS; Pianta, 2001), a 28-item instrument assessing conflict, closeness, and dependency, was the most frequently utilized measure to evaluate treatment readiness. Naturally, an assessment of the juvenile’s academic proficiency will likely provide an indication regarding his or her ability to learn new information, including new methods of coping. Relatedly, research in the area of child custody evaluations suggests that details about how a child behaves and achieves in school may assist in an analysis of family dynamics. For most children, the classroom is their primary environment and their fundamental task is to succeed as a student academically and socially (Newton, 2011). Thus, teachers are deemed valuable collateral sources as they have substantial exposure to a child over an extended period of time and in a variety of situations. For example, the information gathered by the teacher not only includes observations about the social interaction and classroom behavior of the student, but may also contain information about parent involvement (Newton, 2011). From this perspective, it is unsurprising that academic sources are the most frequently utilized collateral source considering at least four – not rebellious toward authority, positive involvement by family, no school misconduct, and supportive and accepting family – of the ten most important factors considered when judging amenability can be assessed via this source.

Whereas Grisso (1998) contends that a definition of successful treatment also considers a juvenile’s ability to adjust to the typical demands of school, Salekin and colleagues (2001) acknowledge that police reports, arrest affidavits, juvenile court records, etc. are equally essential to juvenile waiver evaluations. Notably, Grisso’s (1998) statement appears to be related to the concept of treatment amenability, one of several components inherent to an evaluation of juvenile waiver. However, Salekin et al. (2001) seem to be referring to juvenile waiver evaluations more broadly. An analysis of these ideas leads one to question whether, in practice, clinicians carefully differentiate between the totality of circumstances involved in the waiver process before combining this information to yield an opinion. Put another way, do clinicians recognize “treatment amenability” as being a separate component of juvenile waiver that must be assessed accordingly or is the tree lost in the forest?

When tasked with assessing a juvenile defendant facing waiver to adult court, the RSTI was among the least frequently mentioned instruments employed. Instead, clinicians once again tended to report a heavy reliance on objective personality measures, with the MMPI-A being the most frequently reported objective measure used. Similarly, the WISC was the second most utilized measure employed, suggesting that evaluations of cognitive capacity are central to juvenile waiver evaluations. Moreover, a similar percentage of clinicians reported assessing the dangerousness of the juvenile when asked about juvenile waiver more broadly. However, with regard to specific measures used, both the SAVRY and PCL-YV were applied more often when the focus was on juvenile waiver as opposed to treatment amenability. Clinicians also tended to rely more on collateral information obtained from legal sources as well as the parent or guardian of the juvenile when conducting an evaluation for the purposes of juvenile waiver. In addition to evaluating personality structure, which can inform about the behavioral controls of the defendant, these findings suggest that when conceptualizing juvenile waiver from a broad perspective clinicians are primarily concerned with assessing the risk of future harm to others and the likelihood that a delinquent act will be repeated. Thus, unless treatment amenability is emphasized, it appears that clinicians are mostly attuned to the dangerousness branch of the Kent criteria when faced with a juvenile waiver evaluation.

When asked to identify which of the three Kent factors they judged to be most important when deciding whether to recommend waiver, a majority of clinicians rated treatment amenability as being more important than dangerousness and sophistication/maturity. Not only do these results support the original hypothesis, they also mirror what has been found in the literature pertaining to clinician’s view of treatment amenability.

For example, in his examination of the impact of risk and treatment amenability on judges’ decisions regarding juvenile transfer, Lyons (2011) found a significant interaction between the two variables. When juvenile defendants had both a high level of risk for reoffending and high treatment amenability, judges were still likely to transfer the juvenile to adult court, albeit at a lower rate relative to low amenability and high risk.

There appears to be no significant association between statute language and waiver preference. Further examination of the data finds that almost all clinicians (XX%) made the judgement to not waive the hypothetical defendant to adult court.

Psychologists disagree among themselves as to whether they should be allowed to testify concerning the ultimate question or issue before the presiding judge (e.g., Who should have custody of the child? Was the defendant insane at the time of the murder?). Again, whether a psychologist is allowed to testify on that issue depends on the presiding judge

Judges reported being more likely to transfer juveniles to criminal court when they are at high risk for offending, but there was a significant interaction between risk and treatment amenability. Amenability made a substantial difference in the decision when the juvenile’s risk was high, but had little influence on the decisions regarding low-risk juveniles.

Future research might be asked to answer an open-ended question regarding what specific abilities/characteristics/personality variables are generally regarded as central to their assessment of treatment amenability as it relates to juvenile transfer to adult court.

Brannen et al. 2006 transfer to adult court a national study

Although the juvenile court judges rated information on the three main transfer constructs as “very useful,” they noted that of the psychological reports they typically receive only 77% contained information on dangerousness, 84% included information on sophistication-maturity, and 86% contained information on amenability to treatment. Do not provide rehabilitation and treatment options and these should be comprehensive and extensive A lot have little information regarding prior involvement with [treatment] services.

These findings indicate that dangerousness may be one of the most important factors in the decision making of judges regarding whether or not to transfer a youth to adult court

When juvenile court judges were asked to make bright line decisions to transfer or retain the particular case they had received on their docket, both dangerousness and sophistication-maturity emerged as significant predictors of their decisions, whereas amenability to treatment did not

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The juvenile justice system was established at the turn of the 20th century on the premise that young offenders have greater rehabilitative potential than adults, and therefore, their dispositions should emphasize treatment and intervention rather than punishment (Melton et al., 2007).

We have seen that man incessantly presents individual differences in all parts of his body and in his mental faculties. These differences or variations seem to be induced by the same general causes, and to obey the same laws as with the lower animals. In both cases similar laws of inheritance prevail. Man tends to increase at a greater rate than his means of subsistence; consequently he is occasionally subjected to a severe struggle for existence, and natural selection will have effected whatever lies within its scope. A succession of strongly-marked variations of a similar nature is by no means requisite; slight fluctuating differences in the individual suffice for the work of natural selection; not that we have any reason to


Pianta, R. C. (2001). STRS Student-Teacher Relationship Scale. Professional manual. Odessa, FL: Psychological Assessment Resources

Newton, S. (2011). Obtaining and analyzing school-related data in a child custody evaluation. Journal of Child Custody, 8, 189-211. doi: 10.1080/15379418.2010.512232

Grisso, T. (1998). Forensic evaluations of juveniles: A manual for practice. Sarasota, FL: Professional Resource Press.

Vincent, G., Odgers, C., McCormick, A., & Corrado, R. (2008). The PCL:YV and recidivism in male and female juveniles: A follow-up into young adulthood. International Journal of Law and Psychiatry, 31, 287-296. doi: 10.1016/j.ijlp.2008.04.012

Heilbrun, K., Rogers, R., & Otto, R. K. (2002). Forensic assessment. In J. R. P. Ogloff (Ed.), Taking psychology and law into the twenty-first century (pp. 119-146). New York, NY: Springer.

Neal, T. & Grisso, T. (2014). Assessment practices and expert judgment methods in forensic psychology and psychiatry. Criminal Justice and Behavior, 41, 1406-1421. doi: 10.1177/0093854814548449

Salekin, R., Salekin, K., Clements, C., & Leistico, A. (2005). Risk-sophistication-treatment- inventory. In T. Grisso, G. Vincent, & D. Seagrave (Eds.), Mental health screening and assessment in juvenile justice, (pp. 341-356). New York, NY: Guilford.

Ryan, C., Nielssen, O., Paton, M., & Large, M. (2010). Clinical decisions in psychiatry should not be based on risk assessment. Australasian Psychiatry, 18, 398-403. doi: 10.3109/10398562.2010.507816

Brown, J. & Singh, J. (2014). Forensic risk assessment: A beginner’s guide. Archives of Forensic Psychology, 1, 49-59.

Keeney, M. (2000). Underlying predictors of clinicians’ judgements of juveniles’

Amenability to treatment (Doctoral dissertation). Hanneman University, Philadelphia


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