A recently published book (Oxford University Press) in the National Academy of Neuropsychology Series on Evidence-Based Practices provides a great resource for scholars, researchers, and practitioners involved in the study of or the evaluation of civil capacities. This article provides a summary of the contents of the book and some brief comments about the book.

Civil Capacities in Clinical Neuropsychology: Research Findings and Practical Applications

Clinical neuropsychologists are increasingly involved in the evaluation of civil capacities and are in demand by other professionals, particularly attorneys and judges, to assist their decision-making about these sometimes-complex issues. While there has been some neuropsychological research in this area, this has not been assembled into a single volume nor have practice recommendations been provided. This volume fills these gaps. The first part of this volume reviews and synthesizes the research literature on neuropsychological aspects of civil capacities. The specific capacities addressed include driving, financial and healthcare decision-making, testamentary (i.e., will-making) capacity, and personal care and independence. Each chapter addresses relevant background issues, conceptual/theoretical advances, and empirical findings. The chapters also include an illustrative case study that demonstrates how the authors (each expert in the various areas) evaluated and conceptualized the case. Each chapter is written from an evidence-based perspective and, where appropriate, uses research to inform practice recommendations.

The second part of this volume provides recommendations to practitioners on how to conduct civil capacity evaluations that utilize neuropsychological assessment. There are chapters on an evaluative framework for the assessment, capacity test selection and psychometric issues, working with other data sources besides testing (e.g., collateral interviews), best practices in report-writing and testifying, as well as common ethical issues in such cases. Throughout, these chapters provide practical “how to” advice to improve neuropsychological practice and consulting in civil capacity cases. In addition to these chapters, there is a chapter written by legal consumers of psychological reports. This chapter offers a wealth of useful information and recommendations that, if followed, will further serve to advance psychological report writing and consultation in civil capacity evaluations.

Chapter Outline

Part I: Background Issues

1. Introduction to Basic Issues in Civil Capacities by George J. Demakis

2. Legal perspectives on civil capacity by Elissa Kolva and Barry Rosenfeld

Part II: Civil Competencies and Guardianship

3. Assessment of financial capacity: A neuropsychological perspective by Dan Marson, Amy Knight, Kristen Triebel

4. Healthcare Descision-Making Capacity by Barton Palmer, Gauri N. Savla, and Alexandrea L. Harmell

5. Testamentary capacity by Carmelle Peisah and Kenneth Shulman

6. Driving capacity by Penny Wolfe and Jessica Clark

7. Personal care and independence by Erik Everhart, Katie A. Lehockey, Alicia M. Moran, and Jonathan M. Highsmith

8. Adult guardianship by George J. Demakis

Part III: Applications

9. Assessment of civil capacities: An evaluative framework and practical recommendations by Stacey Wood and Meryl O’Bryan

10. Civil capacity instruments: Research trends and recommendations for future research by Karen Sullivan

11. Other aspects of data collection in the capacity evaluation by Robert Ruchinskas

12. Forensic report-writing and testimony in capacity evaluations by Patricia A. Zapf and Gianni Pirelli

13. Ethical issues in capacity and competency evaluations by Paul J. Moberg and Sanjay Shah

Part IV: Conclusions

14. A legal consumer’s perspective on competency by Fredrick Benson and M. Joanne Romano

15. Conclusions and future directions by George J. Demakis

Author Information

George J. Demakis, PhD, is Professor of Psychology and Health Psychology and Director of Clinical Training in the Health Psychology program at the University of North Carolina at Charlotte. As a licensed psychologist in NC, he has considerable clinical experience conducing a variety of civil capacity evaluations. He has worked closely with attorneys, legal guardians, and legal decision makers (clerks of court and judges) in a wide variety of capacity evaluations. He has also consulted with the North Carolina Guardianship Association. He has published on a variety of topics including financial decision-making capacity, malingering, Alzheimer’s and Parkinson diseases, and meta-analytic approaches to outcome after mild traumatic brain injury and executive functioning.