Dr. Sharp: [00:00:00] Hello, everyone. Welcome to The Testing Psychologist podcast, the podcast where we talk all about the business and practice of psychological and neuropsychological assessment. I’m your host, Dr. Jeremy Sharp, licensed psychologist, group practice owner, and private practice coach.
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Hey everyone. Welcome back to another episode. I am excited to bring you a fantastic guest today.
Dr. Nicole Vienna is a forensic psychologist and expert witness based in Los Angeles. She worked for ten years in correctional mental health within the Los Angeles county jails and juvenile halls before making the transition to private practice as an evaluator in 2015. Nicole is appointed to the Los Angeles County Adult Superior Court Panel of Psychologists and Juvenile De1linquency Panel of Experts. Her forensic areas of interest and expertise include malingering, trauma, neurodevelopmental disorders, and youthful offender evaluations in high stake cases. That last one is exactly what we’re talking about today.
We’re chatting all about youthful offender evaluations: what they are, what they entail, why they’re important, some history, context, and case law surrounding them. So we cover a lot of ground here. Nicole speaks in a nice succinct manner that is also quite warm and educational at the same time. So, a fantastic interview. I really enjoyed this one especially in an area that I don’t know much about. So, if you’re a forensic practitioner or just interested [00:02:00] in forensic evaluations of this type, stick around. I think you will learn quite a bit this time.
If you are headed into the summer and you have license renewal coming up, I just want to remind you that you can get CE credits for listening to The Testing Psychologist podcast. You can get those at athealth.com, search for The Testing Psychologist. And if you can use the code TTP10, you’ll get a discount on any CEs that you purchase, not just podcast episodes, so a pretty sweet deal.
All right, without further ado, let’s transition to my interview with Dr. Nicole Vienna.
Hey Nicole. Welcome to the podcast.
Dr. Vienna: Hey, Jeremy, thanks for having me.
Dr. Sharp: [00:03:00] Yes, of course. It’s good to see you.
Dr. Vienna: Good to see you as well.
Dr. Sharp: Thanks for coming on. We’ve known each other for a little while now, maybe a year. Time goes by fast.
Dr. Vienna: Yeah.
Dr. Sharp: Before we totally dive into the topic and content for today, I’ll give a little plug for your own podcast, which is specifically focused on the forensic world. I definitely recommend people check that out. I’ll put the link in the show notes and everything, but I’m going to pull just a little slice of your expertise today for our general testing podcast.
I always like to start with why this is important. So, out of everything you could do in psychology or in assessment or even in forensics, why this?
Dr. Vienna: This is important to me because I truly believe, and this is obviously backed in science, [00:04:00] that juveniles adolescents are fundamentally different from adults. So we can’t treat them the same as we do adults in the criminal justice system hence why they have their own system, the juvenile justice system.
And on a personal note, I have a sibling that went through the juvenile justice system, had some mental health issues and I really got to see from an insider perspective how the system treated minors at the time. And this was several years ago. This was in the 90s. And juvenile definitely shifts and changes every two years depending on laws and statutes and where you’re at in the country. Of course, they’re different, but I got to see what it was like for the family to go through that and my sibling himself and I thought, wow, there needs to be a lot of work done here and we really [00:05:00] need mental health experts to come in and help educate the trier of fact, help educate the attorneys, and really produce more research in the area of adolescent brain development. That’s so important in terms of sentencing for juveniles. So personal and professional interests.
Dr. Sharp: That’s usually what it is for a lot of us, right?
Dr. Vienna: Yeah. And it was interesting too growing up because I came from a law enforcement family. So it was very interesting. You got two sides of the coin both in the household and it’s like, “Whoa.” It was quite interesting.
Dr. Sharp: I bet. I cannot even imagine what those conversations might have looked like or sounded like.
Dr. Vienna: Lots of debate in the household. To take it another step further in my current adult life, I’m married to a police officer now. So much more interesting conversations now happen at the dinner table.
Dr. Sharp: Right. You’re living [00:06:00] it.
Dr. Vienna: Yes.
Dr. Sharp: This might be off script a little bit. Feel free not to answer if you don’t want to. That’s totally fine. What were some of the things that you noticed with your sibling going through this process? Can you remember anything that stuck with you right off the bat that you thought to yourself, this needs to be different or this isn’t fair or I don’t like this, anything like that?
Dr. Vienna: Yes, I want to say the time that stands out most to me is in sentencing juveniles. In my sibling’s case, there really wasn’t much consideration into some of the factors that we see that are really important to look at in youth like their immaturity and the family home environment. So, that was the biggest one. It just wasn’t talked about. It was just a lot of blame and there wasn’t much [00:07:00] consideration about why this behavior was happening. It was just, this happened now there’s a consequence. That’s it.
Dr. Sharp: So no consideration of circumstances or the factors?
Dr. Vienna: Exactly.
Dr. Sharp: Would you say, and I’m just going to give the caveat, as with any area that is outside my area of expertise and this certainly is, I will ask a lot of potentially dumb questions. So bear with me and the audience bear with me. But do you feel like there are differences there in terms of consideration of circumstances, environment, et cetera when you compare adolescents or juveniles to adults? I mean, do you think the standards should be different for adults compared to juveniles?
Dr. Vienna: Yes, because what we know from neuroscience is that the brain is different. We see in research that the brain [00:08:00] isn’t fully developed until age 25. In the past 10 years of research that I’ve reviewed, there is even more research now that points to the brain not being fully developed until closer to 30years, like the late 20s. So, kids are just fundamentally different from adults.
And that is exactly what the APA along with the American Psychiatric Association, and I believe it was the National Association of Social Workers that got together and did an Amicus Brief for the court in a significant case where they cited this exact language that the brain of a juvenile or an adolescent is fundamentally different from adults. And therefore you cannot hold juveniles or adolescents to the same standards. Adults have their brains fully developed and kids just aren’t because of many factors.
Dr. Sharp: Sure. Well, I know that we’re going to dig into lots of things here.
Dr. Vienna: Yeah, I don’t want to jump ahead, sorry.
Dr. Sharp: I know. [00:09:00] I’m getting ahead of myself too. I always do this. Let’s back way up. A lot of this will be for me but hopefully for the audience as well. Just setting some groundwork, when we say youthful offender evaluations, can you just define that? What exactly are we going to be talking about for the next hour or so?
Dr. Vienna: Youthful offender evaluations can mean a lot of different things across the country, especially in forensic work. We’re always giving that disclaimer that things can vary by state and even county or the jurisdiction you’re in because it’s guided by case law and constitutional law which we all know constitutional law is the same across the board, but statutes and case laws are not.
Youthful offender evaluations are pretty much those evaluations where an evaluator is doing a comprehensive mitigation type of [00:10:00] evaluation. We in California tend to refer to these as Franklin hearing evaluations because it falls into a significant court case, the Franklin court case, which piggybacks off the Miller Court case. Franklin’s court case was in California, the Miller case I believe happened in Alabama.
So, we are looking at youth who have committed a very serious crime. And again, different states have different laws and different ways of sentencing but I can speak for California. We’ve had so many changes even in Los Angeles county where this has been different, but basically, a Franklin hearing evaluation is where we are evaluating the youth and looking at the different, what we call the Miller factors at play that could potentially have a significant impact on their sentencing.
So it’s a youth that has committed a serious crime [00:11:00] such as murder that might be tried either in adult court. Austin, California, right now, specifically in Los Angeles, no juveniles are being tried in adult court for anything. And that was through one of our Prop 57 passages. And then specifically in LA County, our new district attorney has said, we won’t even have a consideration of them being tried in adult court. They are just going to be tried in juvenile court. And that is it.
So, we’re putting together this really mitigation packet for a future parole hearing. So this youth will eventually get a parole hearing. The parole board and some others involved with the state and some psychologists will eventually look at this packet and they’ll want to see the growth that has happened or the lack thereof, the maturity, those kinds of things, [00:12:00] rehabilitation potential so they can be considered for release from prison at some point.
Dr. Sharp: Got you. I have two questions to clarify. And again, if you don’t know, that’s totally fine, but how common is that across the country for there to be a blanket statement that juveniles are not tried in adult court?
Dr. Vienna: Are you asking, is it common across…?
Dr. Sharp: Is it common, yeah? Is that unique for LA county or California to not?
Dr. Vienna: No, there aren’t some states in some jurisdictions where juveniles are not tried as adults. In a lot of the States before our new da came in, they followed what we used to follow, which was that juveniles before they’re directly filed in adult court, district attorneys and the juvenile would have to have a hearing to be considered for the [00:13:00] players to decide in the courtroom whether or not that kid or juvenile should be tried in adult court if they’re fit to be tried. We call them Transfer hearings here in California or fitness hearings if the juvenile is fit to be tried in adult court or if they should be remanded to juvenile court for potential rehabilitation as a minor.
Some of the case laws like the cases I was talking about, like the Miller case and the Franklin case, especially the Miller case, the Supreme court held that it was the 8th amendment that prohibits juveniles to be sentenced to life without parole, we call it LWOP- life without parole or their functional equivalent. With that, some states redid their juvenile sentencing policies for those six significant crimes and other states didn’t. So it just depends on what state you’re in. I’m not familiar with all the states, but I know California we’re a [00:14:00] little bit more progressive and the juvenile system is really focusing on rehabilitation.
Dr. Sharp: Sure. It seems like it should, just to my untrained eye.
Dr. Vienna: You would think that, but in these cases, like in the Miller case, for example, this kid was, if I remember correctly, my gosh, he was 14 at the time and he had these circumstances, he came from a home where I think his mom was an alcoholic. I don’t know if dad was even in the picture. And he was basically in and out of the foster care system. I think it was Alabama. It could be Arkansas, but it might be Alabama. I think it’s Alabama. Yeah, Miller V. Alabama.
He was in and out of foster care. He was abused. There was significant child abuse cited in the court opinion. He was using drugs and [00:15:00] alcohol himself just as his mom was. We noted her to be an alcoholic. And I think there was a boy or some boys that were trying to sell drugs to his mom in their trailer or something. And so, he followed the guy home with a friend and eventually killed him, and then left the scene. And I think he returned to the scene to try to cover up the evidence. And through that, he lit a fire. So he was charged with murder, I think in the course of arson or something along those lines.
So he’s 14 though. And they tried him. I think the district attorney filed directly in adult courts. He was tried in adult court. Murder and in adult court holds significant ramifications, meaning you’re going to get a sentence equivalent to the crime that you committed. So for a 14-year-old to get life in prison without the [00:16:00] possibility of parole is pretty significant when the brain isn’t developed, right?
Dr. Sharp: Sure.
Dr. Vienna: But that’s what the court initially held until the appeals and so forth. So then, through appeals, that’s when they held that. The 8th amendment says that you cannot sentence a juvenile to life in prison without the possibility of parole because it violates the 8th amendment. So then we have some case law, right? Now it’s changing how states are seeing juvenile cases.
Dr. Sharp: Sure. Yeah, it’s interesting to look back with the benefit of hindsight to say, oh, well, thank goodness. Of course, that makes sense. A kid who’s 12, 14, 16, gosh, it’s just remarkable and sad that that has not always been the case, right?
Dr. Vienna: Right. And that’s why case law is so [00:17:00] important, especially in forensic work. To understand these cases, read the actual opinions so you’ll know how to start and formulate your evaluation for these mitigation cases.
Dr. Sharp: Yes. I want to bookmark that. I would love to hear more about how deeply you dive into case law and just legal opinion and things like that. I think that’ll come up during the course of our discussion. I hope it does.
In the meantime though, I did want to ask just to clarify, at what point in the process are you conducting these evaluations? Is this a post-sentencing or pre-sentencing or post-incarceration? I’m not sure what the right term is. Where exactly are you doing these?
Dr. Vienna: Post incarceration or are they on their way out? In California, some of them are youthful [00:18:00] offender evaluations, like I said, the Franklin hearing evaluations. So Franklin, let me just really quick the Franklin case. The Franklin case was a California case, and you can cut me off if the story’s too long. I think it’s just helpful to put it into context for people.
So, Franklin is similar to Miller but he was 16. He again had circumstances that were going on in his life. He lived in a really impoverished, violent community in the projects, I believe in Richmond, California. And he had some kids that were just targeting him and they were threatening his younger brother, I think. Somehow through all of that and some other factors, he ends up getting a gun from, I think his brother or his friend, and he wants to protect himself. And then he wants to make a showing, like don’t come mess with me or my family, et cetera.
And these were, [00:19:00] I think in the case they documented these kids that were targeting him as gang members. So he had gang members picking on him and his family and threatening them. Anyways, he ends up getting ahold of a gun and he goes with a friend to threaten these kids or do a show of don’t mess with me. And through the course of that, he got out of the car that he was in and he just shot at the person that was threatening his family and his younger siblings.
So he just shot at him several times and the kid died. I think he was a kid. The other kid died in the course of this action. So he was, the same thing, tried as an adult at 16, but what happened in his case is that they did uphold that in appeal. I think it’s in the appeals court that they upheld his 8th amendment rights were not violated because California, again, you have to pay attention to your State’s Penal Codes and case law and statutes.
So [00:20:00] in California, there’s another… this is why we dive deep into case law and stuff like that. In California, we have Penal Code sections 3051 I believe, I should have written that down 3051, that says our parole boards here in California have to consider psychological evaluations and risk assessments as part of like a… when they come up for release …potential release, that hearing that the board of California parole has for these youthful offenders, which I think comes around I want to say they’re age 25, somewhere around there. 23, 24, 25.
So they have to consider, the board of California, I’m sorry. I was going to say the Board of Psychology and California, the parole board has to consider psychological evaluations and risk assessments to see whether or not this youth, maybe now an adult has [00:21:00] gained some maturity, has rehabilitated in prison. They have to consider these things, right?
Therefore the Franklin case, the court said, no, it didn’t violate his 8th amendment rights because we have Penal Code 3051 that says he’s going to get a hearing when he’s like 25 to consider his release from prison. So there you go. And we just need to look at the psychological evaluations and the risk assessments, hence why attorneys, when they are going in for sentencing for these youth, so it’s at the sentencing phase, but I have attorneys that contact me from the beginning because these evaluations can take a long time, but they’re used at a specific hearing called the Franklin hearing and it’s really around the sentencing time.
And it’s really just so you can put, or so the attorney can put together a record of youth-related factors that [00:22:00] may have impacted this juvenile at the time of his offense. They want to put together this giant packet to be looked at in the future. So, it may not even be looked out for like 10 years.
Dr. Sharp: Until they come up for that parole.
Dr. Vienna: Exactly.
Dr. Sharp: Yeah, I got you. So just again, for some context, how much time, I know this probably varies, but what’s the range of time that may have elapsed between the offense and the evaluation/sentencing process?
Dr. Vienna: Well, it depends on how quick your courts get through things first of all. And with COVID right now, we’re a little behind on things, but generally, I would say I’m getting appointed to my Franklin cases about a year after the sentence, maybe 8 to 12 months. It just depends on how early the attorney wants it or how early they want to start it.[00:23:00] There are some retrospective Franklin hearings if you will. So because of our State bills and assembly bills that have passed, we’re looking at offenders who were sentenced years ago maybe violating the 8th amendment rights where they were sentenced to life without the possibility of parole before all these case laws came up and before new propositions came up. And so they are now being looked at retrospectively. So we may be evaluating someone that’s 40 to 50 years old, who was sentenced at 17 to life in prison. We’re looking way back so you could get it then, and they’re in prison. It’s pretty trippy. You’re looking way back.
Dr. Sharp: Yeah, that seems very challenging for a number of reasons
Dr. Vienna: It poses a lot of potential [00:24:00] challenges. Looking at records from back then, how reliable are they? How much weight you’re going to give to each source? Can you even get records?
Dr. Sharp: Oh, of course. Yeah.
Dr. Vienna: A lot of things.
Dr. Sharp: Right. It sounds like if I’m understanding right and you please tell me if this is off base, but it sounds like there are two uses for an evaluation like this. It’s coming into play there during the immediate more acute sentencing phase and it’s going to be held for down the road whenever they come up to possibly be released to serve as almost like a baseline. Is that a good conceptualization or would you change that?
Dr. Vienna: Yeah, it’ll serve as a snapshot in time when you’re doing your mental status exam, for sure. Which is really important. It is going [00:25:00] to serve as a record of mitigating factors specifically related to youth. So we’re doing this, look at what their brain looks like, where their brains at the time of the offense. So, you’re tying in a lot of neuroscience. You’re really commenting on what we call the 5 Miller factors, or I think there are 4 or 5 Miller factors that you can count on.
So things that are specific to youth at the time of their offense. These ones I did write down, so I didn’t miss any of them.
The first one, consideration of the juvenile’s chronological age. So how old they are and the relevant hallmark factors to that age, right? A 10-year-old is going to be different than a 14-year-old versus a 16-year-old versus a 25-year-old.
So we want to look at their chronological age and things like immaturity, failure to appreciate risk and consequences, family and home environment [00:26:00] like I mentioned earlier really important because the juvenile can’t get out of certain situations. They can’t live in a dysfunctional household, maybe if the court removes them but then they’re dealing with possible dysfunction in the foster care system or child abuse like the Miller kid.
So, we want to comment on all these different factors and also the kids’ role in the crime. Did they play an immediate role, a supporting role? Were they influenced by their peers? Were they under the influence of drugs or alcohol? Or even if they weren’t under the influence of drugs and alcohol, just by using drugs and alcohol at that time, we know that interrupts spring development in general. So even if they were sober at the time of their offense, it still plays a role. So we need a comment on that.
And then last, of course, their potential for rehabilitation. It goes in a nice little packet and goes off with them. It goes in their parole file and then it [00:27:00] gets reviewed years later. Now, sometimes attorneys will retain us not to do specifically a Franklin hearing evaluation, but nonetheless, a youthful offender mitigation evaluation where they will use it to try to mitigate the sentence.
So like a murder case, but another significant case, maybe it’s a carjacking case or an attempted murder case where they aren’t going to necessarily get sentenced to life in prison, but they’re looking at a significant time.
Dr. Sharp: Right. So, these evaluations may be used in the sentencing process, the results could be considered?
Dr. Vienna: Absolutely. And that’s why they’re so important. It has the potential to impact that juvenile’s life big time.
Dr. Sharp: Oh yes. That’s a very important role. Are these matter, of course? I mean, is this standard of care for any [00:28:00] case like this? Is every youth in this situation going to get an evaluation like this?
Dr. Vienna: In California, I know at least in LA county it’s pretty standard. If the attorneys aren’t doing it, then that could be a problem down the road of possibly getting ineffective counsel. It is pretty standard out here. Like I said though, in these cases where the inmates are 40, 50 years old, it didn’t happen because we didn’t have the case law at the time, or we didn’t have the statutes in place.
So, attorneys are coming on the cases now saying, okay, we need to get this established. We need to get a Franklin hearing done. And it happens. They retain an expert. We go in and we do the evaluation and they have it on record. And then they go back and I think it gets remanded to the sentencing court and the sentencing court hears it.
Dr. Sharp: Okay. Well, thank you for providing so much background. I think that is important just to [00:29:00] just understand exactly when this is happening, why it’s happening, where it comes from.
Dr. Vienna: Yeah, all I hear at least in California, it’s a new thing in the past two years. Like I said, the Miller case happened in 2012. The Franklin case happened in 2016. We people here in California, how we had Prop 57 passed two years ago which meant that DA’s were no longer allowed to directly file in juvenile court. So we had all these new laws and cases passed. So it is fairly new.
So when evaluators are being asked, even juvenile evaluators that work the juvenile court circuits, a lot of us, when we first started doing this were like, what is that? What do you want? What are you looking at? So we really had to dive into the cases and see what they upheld and what are factors that we should consider in the evaluation? What do we need to comment on? What are we looking for?
Dr. Sharp: Yes. I think that’s a nice segue [00:30:00] to the practice of these evaluations. What do these actually look like? I’d like to spend some time on the practice, of course, what this looks like clinically and how you conduct the evaluations and the report and everything. But I’d also like to spend some time before we wrap up, of course, on how to break into this area and how you might get referrals, just the business side of things.
Let’s start clinically though. Well, where do we start? Where do you start clinically with an evaluation like this?
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Dr. Vienna: Good question. Clinically, you are probably going to start collecting records. The attorney hopefully will get you what you need, but if not, it’s always helpful to talk to someone that has done these evaluations so we know what records to request. You’ll collect all of that stuff.
You’re going to want to interview the family, maybe treatment providers [00:32:00], and definitely the inmates or defendants or juveniles themselves depending on where are you getting retained in the case. If you’re getting retained on the juvenile side where the adolescents like 17, 16, or if we’re doing a retrospective one on someone that’s 40 or 50 years old, you’re you’ll interview them.
In the cases I’ve worked on, my attorneys have retained a forensic social worker or what they call an investigator, which is super helpful. So I actually tell the attorneys if they can get one of those on their cases because the forensic social worker will go out and interview the entire family. They’ll also review records and they’ll pull together and the defendant or the juvenile, they will put together this really nice steak, social summary for you, which is really important because we’re looking at that as one of the factors. So they’ll do [00:33:00] that and you can just review it. And then, of course, you should probably do your own clinical interview. It’s up to you.
Sometimes I know some evaluators will go back and re-interview family members and some won’t. I do it on a case-by-case basis. If I feel the psych socials enough from the social worker, I won’t. I may just consult with the social worker or if it’s an investigator, usually they’re retired police officers or detectives that are on some sort of panel and they do this investigation. It looks very similar to a social worker, a little less clinical, but it’s essentially the same thing. You’re getting information from all these sources. That’s what they’re doing.
So I just play, like I said, case by case basis. If it’s pretty thorough, I’ll just consult with them. If it’s not, and I have more questions as I’m reading through their Social psychology and there are gaps on pretty important things like trauma histories, mental health history, family dynamics, family, generational trauma, I’m going to go interview that person myself because I want that [00:34:00] information. It’s just another source. We look at multiple sources when we make an opinion, multiple sets of data. So, you’re going to spend a lot of time in that area.
Now, because of incomplete brain development with juveniles, some attorneys want a full neuropsych done. If you’re not a neuropsychologist, no problem. They’ll retain a separate neuropsychology expert. If you happen to be a neuropsychologist or someone with a good amount of training in neuropsychology, they’ll have you do it.
I have done full neuropsychs on my cases because I’ve had training in that. And it really speaks to where their brain is at in development in terms of executive functioning, the incentive processing system. And you can really show that in the data. So again, another source to support and a potential opinion.
Dr. Sharp: Yes.
Dr. Vienna: So that’s where you start. Testing really just [00:35:00] depends on what the attorney is asking for. If there are neurodevelopmental issues, of course, the attorneys are going to ask for it. If there’s someone that has an intellectual disability or special education in school, again, it’s another mitigating factor that we need to talk about.
Dr. Sharp: Of course. So let me go back and break down those components a little bit. I’ll go back to the beginning. You said if you’re going to request records, what records are you requesting? What’s important?
Dr. Vienna: I may be different from my colleagues on this, but I like to have a ton of records. It’s the way I approach the Triple P too. I couldn’t have enough information. I just wanted to have it all. So, I ask my attorneys to give me, for sure, I need school records. If they were involved out here, we call it the department of children and family services. So it’s the child welfare system. I’ll ask for those records unredacted because sometimes they’ll send it to you [00:36:00] with big black blocks because they block out all this info about child abuse. And I’m like, no, I need that stuff. So, unredacted DCFS records.
I ask for juvenile mental health records. If they’ve been an adult jail or prison, I asked for what we call their C file and their jail mental health records which is a really great source of information because you’re getting snapshots of their mental status through mental health records if they’ve been seen by a clinician. And that’s really helpful to see where they were at in terms of maturity and overall brain growth or incomplete brain development, where they are. The person looking at them down the road for the parole hearing is going to be able to see whether or not they have potentially rehabilitated, grown a little bit in terms of maturity. So it’s really important to get those records and document them.
Those are the big ones. I’ll also ask for [00:37:00] any, if it’s neuro-psych related, of course, I’m going to ask for all of those provider’s records like assessments. If it’s special Ed, I need the actual evaluations, not just the IEP notes. I want to look at what the psychologist said. And then any medical records that are relevant. Things that are irrelevant, I don’t need, but if it’s related to the neuropsychological diagnosis of neurodevelopmental disorder, I need it. I want to review it.
Dr. Sharp: Of course. I like records too. I agree with you. More information is better than less because I have so many questions when I’m doing evaluations and it’s helpful to at least have those sources of information, and then you can figure out if you need it or not.
Dr. Vienna: Yeah. And you’ll get the hours. If it’s important to the attorney to have you review it, they’ll give you the hours to review it, which is nice.
Dr. Sharp: Sure.
Dr. Vienna: Sometimes attorneys will. I have mixed feelings about attorneys. Sometimes they’ll say, [00:38:00] I don’t think you need to review all of it, just this page and this page. I’m just going to send you pages 5 and page 10 and they’re skimming through the records. Some of my colleagues, I hear they like it because it really cuts down on their time, but I’m still responsible for the opinions I make. And I don’t want an attorney to decide what’s important and what’s not in terms of psychological records or mental health records.
So I err on the side of caution, I just say, send them all to me. Can you get me the hours? And we go from there. Now, if we don’t get the hours, then I’m going to make a note of that in my report that the court did not approve the hours. Here’s what I got. Here’s a summary of what I could do in those hours.
Dr. Sharp: That’s good to know. I’ll definitely want to circle back to the hours and how you budget time for something like this. We’ll pin that.
As far as the interview, you mentioned this a little bit, but sometimes that might [00:39:00] be farmed out it sounds like to one of these forensic social workers, which sounds like a cool service, but what are you looking for in the interview? You mentioned trauma history. Like what is crucial to obtain during this interview?
Dr. Vienna: We’re looking at not just the mental status of how they are in front of you at the time, but we really want to look at those factors relevant to youth. So we want to look at brain development. So that’s where the neuropsychological testing is. Some attorneys want full batteries. Sometimes maybe you’ll just do some executive functioning stuff, but you’re looking at brain development, okay?
We’re also looking at the big one family and home environment. What is it like where they’re growing up at? Who were their adult influences, their caregivers? [00:40:00] Is there any child abuse? Are they exposed to violence in their community? What peers are they hanging out with? We know adolescents are susceptible to peer influences. We want to know what’s going on in their social lives.
Trauma is really important. We know from research again in neuroscience that child abuse, physical abuse, especially sexual abuse, significant repeated acts of these can cause changes in the structure and functioning of the brain. So we want to assess for that. We want to assess for generational trauma. Maybe it’s happening because this is what’s happened in the family for years on end. Again, the youth cannot really get themselves out of that situation. So, how are we supposed to hold them at the same level of accountability as an adult that has the choice to leave? So we’re looking at those kinds of [00:41:00] factors.
Dr. Sharp: Can I ask you a question real quick, Nicole?
Dr. Vienna: Yeah.
Dr. Sharp: I’m generalizing here. Tell me if this is totally off base, but I could see with kids who are in these situations that it might be hard to get a hold of caregivers or parents or folks who can speak to some of these factors. Do you find that’s true or are you able to get access to a lot of these individuals?
Dr. Vienna: It can be difficult sometimes because parents might be… And in some cases, it’s really rare. I haven’t had any contact with the parents because you don’t know where they’re at. The kid might’ve been left or abandoned early on in their life and they’ve grown up in the foster care system. So we try, maybe the clinicians that have been working with them or if they have foster parents. Even if you can get ahold of them, something we have to consider is the reliability and the weight that we give to their report. [00:42:00] So that’s why we want to look at multiple sources, not just maybe one parent, but two parents if we can, caregivers, grandparents, therapists’ reports, we want to look at it all. So, it can be difficult.
Dr. Sharp: Right. Another random question. I think when I talked with Chris Mulchay about Custody Evaluations, he mentioned, I think it was him who mentioned social media records. Do you ever consider social media records in some of these cases?
Dr. Vienna: I haven’t asked for them on my list. One of the next training I plan to go to is social media, I forgot what it’s called, but it’s through the American Academy of Forensic Psychology. I think they have a workshop coming up on how to use social media in forensic evaluations because that’s just not something I’ve done.
Now, I have had to review records that [00:43:00] included social media accounts of juveniles in some of their cases because I have to look at discovery. It’s in there. I haven’t specifically asked for it but I have seen some. And I think would be important too. Again, it gives you some insight depending on what the messages are, what’s posted, I guess. It can give you some insight into what they’re thinking, what’s going on in their brain, how they’re making decisions or lack thereof.
Dr. Sharp: Of course. And then as far as the testing, I don’t know if there’s a whole lot else to say about testing. It sounds like you’re just trying to get a good sense of what their brains are up to. Is there anything specific or any special considerations with these forensic evals from the neuroscience side?
Dr. Vienna: I think the attorneys that I’ve worked with if they’re asking for neuropsychs, it’s usually because the kid has had a history of being diagnosed with some sort of neurodevelopmental [00:44:00] disorder. Like, they had a prior history of regional center or the intellectual disability diagnosis or they’ve had something in that area.
So again, we’re just coming in as the neutral third parties to confirm those results and see where they’re at now compared to where they were before. So as a neuropsychologist, you’re looking at the pattern of brain dysfunction or deficits and seeing if that correlates with some behaviors, maybe specifically in our cases, how it is related to the crime-related factors that are going on.
And for youth specifically, we’re looking at the frontal lobe. That’s really important because it’s the last to come online and develop and more connections happen as we get older. And so, we’re looking at how they’re making decisions, reasoning and judgment, their inability to look to the future and process long-term consequences or consider long-term consequences, [00:45:00] all the things that your frontal lobe does not quite online yet with adolescents. So, we’re looking at all that kind of stuff.
Dr. Sharp: That seems super important.
Dr. Vienna: And the ability to modulate emotions. We can’t forget that. Even on adults, I’m looking at that, but we’re looking at, can they regulate, can they modulate, what kind of coping skills do they have or lack thereof?
Dr. Sharp: Right. Now, I don’t necessarily know that we need to dive deep into battery selection. That feels like a big can of worms to open, but anything to stay away from, or are you using standard Wechsler instruments, personality, MMPI, MCM, MACI, that sort of stuff?
Dr. Vienna: Yeah, in short, it definitely is a can of worms. I have talked to some of the child custody evaluators. It’s like the same thing with them, but definitely, in forensics, we’re using [00:46:00] measures and instruments that meet the standard, meaning that they’re used by people in our field and they have hopefully they have good inter-rater reliability. So you want to stick with those.
I am using standard Wexler measures in mine. So, I’m using the WAIS often the WISC, and the WRAT. And in my neuropsychological batteries, I tend to do full, comprehensive neuropsychological batteries. That’s a long list of tests, but again, they’ve all passed and are considered scientifically sound by our community. So, no problem there.
Personality measures is a very big can of worms, especially with juveniles. The attorneys, at least in my experience, do not like them because if a juvenile hits, even an adult, you give an MMPI to an adult and they hit on the anti-social scale based on their [00:47:00] behaviors. Any district attorney that sees that is like, oh no, go, they’re “bad.” They’re not capable of rehabilitation because you can pull up research, personality disorders are the hardest to treat, so they don’t want you to give personality measures.
Now, I tell my attorneys that sometimes it can be very helpful. It could be very helpful in terms of diagnostic clarification. It could be very helpful, especially if we’re doing a risk assessment. If you want me to consider whether or not this person can be a danger to society if released, we need some of these clarifications. So, sometimes we will even give a PCL-R. I mean, we have to have a good amount of sound data here.
I talk to the attorneys and they’re usually pretty open to it. Most of them are going to know where their clients are going to hit at anyways. So they kind of already know [00:48:00] and better to have a good evaluation than just one that’s going to make them feel better because that’s not going to help them in court.
They make us look bad. And they know that. I’ve worked with some really good attorneys. They’re pretty open to what I suggest. They trust my expertise if you will.
Dr. Sharp: Good. They should. So tell me about the report. What does your report look like? Is this lengthy, is it brief? What are the important components? And I think most importantly for me, what kind of recommendations or opinions are you offering at the end?
Dr. Vienna: My youthful offender evaluations, whether it is specifically for the Franklin hearing or it’s just purely for sentence mitigation on maybe a less serious offense than murder [00:49:00] like we talked about earlier, mine are pretty comprehensive because these are so important in juvenile court. And I do comprehensive evaluations because I explained the importance of them to the attorneys and the attorneys pretty much know.
I make sure that I get the hours needed to be able to do a comprehensive evaluation so I don’t have any factors barring me from wanting to include everything that needs to be included and give myself enough time. So, they are pretty lengthy reports. They’re some of my longest reports as compared to maybe a competency evaluation. Those evaluations for me are like maybe 3 pages, maybe 4.
A youthful offender mitigation type of evaluation, my minimal running time 15 pages. I don’t think I’ve done one more than 15 pages. And when I say 15 that’s because we’re doing a full neuropsychological, so I’m integrating my results. I’m not doing it like a standard clinical eval where I’m like, here’s what test I used. Here’s what the test [00:50:00] data says. And then down here, I’m going to repeat that, summarize it, and write the opinions. I’m just integrating that into my opinion. So 15 pages, I can get you out at neuropsychological evaluation.
Now, it could even be longer if you’re attaching a full risk assessment to if they want. Can this person be safely released into the community? What’s their risk of re-offending? You’re attaching a risk assessment that may make it longer too, but mine typically are about 10 to 15 pages.
Dr. Sharp: And what are the primary components in the report?
Dr. Vienna: Primary components, of course in mine, you’re listing your relevant sources of information- where you pull data from, listing the records that you reviewed. I include in mine, I’ve given the defendant or the juvenile informed consent or they did an informed consent. Most of the time I get court orders, so they’re court-ordered to participate. They [00:51:00] have the right not to, and we go over all that and the limits of confidentiality. So, I have a little blurb that explains that.
And then I also include somewhere just at the outset of my report the referral question, I guess in clinical practice, you call it a referral question. So it’s similar in forensic reports. And I cite why we’re doing a Franklin hearing evaluation or a youthful offender evaluation and relevant case law statutes, just to explain what I’m doing. It also helps keep me within the referral question, right? I’m not trying to go outside of the referral question. I’m staying within the scope. So that’s important. You should have something in your report that covers that.
And then after the sources are listed, I’m going into… I have to be honest. I’ve changed my reports l in the past two months. I used [00:52:00] to do a whole background information section like you would do in clinical practice. So we’ve got birth history, developmental milestones, mental health scores, or whatever, et cetera.
Now, I’ve almost changed that and I followed practice by another colleague of mine who told me all about this findings-based report, which has now been, I guess, it’s a workshop by some folks in the American Academy of Forensic Psychology who are moving towards these different approaches to reports to streamline them and make them very concise to the point where we’re not repeating information.
So, I’ve incorporated it. It was really hard because I’m like, “No, I want to include everything. I’m very detail-oriented. I don’t want to miss anything.” But changing to that made me realize I’m not missing anything. I’m just not including things that aren’t relevant to the factors I’m [00:53:00] looking at like the Miller factors, the family background, their home environment, and their brain development. I’m not missing anything because I’m addressing that in finding number one.
So, I’m looking at all these factors that we mentioned, the Miller factors, and I address each one of them in a bullet point. So if the kid came from like impoverished, violence-ridden community, I’m going to write that. And this is not in any particular order. I’ll write that finding one, so-and-so grew up in an impoverished neighborhood exposed to community violence. Then I’ll list out what I normally would have put in maybe the Psychological Social sector of the report. I’ll list it all right there. And that’s it.
I’m not doing any opinion in that first section. I’m just listing my findings. So same thing, if we’re including a risk assessment or the neuropsychological testing, I’m going to list my findings here. Boom, boom, boom. [00:54:00] In the next section, I’m going into my opinion section. And then I comment on each one of those findings. So if I had five findings based on the Miller factors, I’m going to have five different opinions. I mean, it’s all going into one grand opinion because at the end I’m doing a 1 to 2 paragraphs summary, then it’s the grading it and tying it into neuroscience research, everything should be based on that.
There are some really great sources I think you’ll list in show notes of people to read their research on adolescents and juvenile brain development. So I’m listing my findings, then I’m going into a different section about opinions, and then I have a summary section that kind of ties it all together. Those are the important parts. And it’s really a streamlined approach. Before I would list out a whole background section and now it’s like, okay, we’re going to round this up.
Dr. Sharp: I like that. If someone wanted to learn more about this findings-based [00:55:00] approach, could you just Google findings-based report writing or where is that?
Dr. Vienna: Not to my knowledge. I don’t think so. I heard about it from a colleague that does forensic work as well. I signed up for the class through the American Academy of Forensic Psychology. They do a report writing class quite often. And I think I did two of them from two different experts and they provided us samples of what that looked like for them.
And then I, of course, tailored it to my state and county because of course, I had different case laws and statutes that we abide by than they do because they’re in different states. And then I incorporated my informed consent blurb and stuff. So I made it my own, but I took the skeleton from doing a finding-based section and then do an opinion section and then do a summary. Take the class. [00:56:00]Some are 4 hours and some are 8 hours. Great information and sample work.
Dr. Sharp: I’m very intrigued. Yeah, I’ll put that in the show notes. We’ll dig around and try to find one of these classes or a link to the AFP and see if we can help people find that. That sounds very intriguing.
So it sounds like a lot of the report is driven by these Miller factors. You’re sort of in investigating or looking at those in the background and the history or the findings. Are you writing an opinion for each of them even if they’re not relevant? I don’t know if that’s the right word to use. I mean, are you addressing all 4 or 5 in every one of these evaluations that you do?
Dr. Vienna: Yes.
Dr. Sharp: Okay.
Dr. Vienna: And usually in my experience, the kids or the juveniles that I get and even the adults, most of them that I’ve evaluated have [00:57:00] all of the factors. Now, if they don’t, then I won’t comment on it. If it’s not relevant then you won’t comment on it. In my experience, I haven’t had one person yet that has not had anything in one of those areas.
Somebody said, a forensic psychologist, and I can’t remember his name right now, it just stuck with me, but he said, every person that is in the criminal justice system has experienced trauma, but not every person that has experienced trauma is in the criminal justice system. I found that to be largely true.
Dr. Sharp: Just anecdotally, it seems like it would hold true. I’m sure you know the research better but it seems.
Dr. Vienna: Right, which is why it’s important to really read the research by Steinberg and some of these others, like Elizabeth Kaufman, who does a lot of work in incomplete brain development with [00:58:00] youth, and then what the trends are with the crime committed earlier than later. All those factors are important.
Dr. Sharp: Of course.
Dr. Vienna: They’re going to seek your opinions in the opinion section. So when we’re writing about Johnny was abused by his father and then sexually abused by a cousin and an uncle, we want to look at the research that is behind child abuse, sexual abuse, and what the correlations are to different kinds of crimes and offending. And you can make a really good sound opinion if you know the science behind that or the research behind that.
Dr. Sharp: Sure. So speaking to the opinion just to sort of close the loop with the report, can you give a ballpark of sorts or an approximation of what this summary opinion might sound like? What are you putting in those final two paragraphs generally speaking? [00:59:00] What’s the tone or content of that?
Dr. Vienna: The tone is neutral. I would say…
Dr. Sharp: Sorry, maybe tone isn’t the right word. It’s aggressive. It’s very provocative. No. Sorry, tone is not the right word. What’s the general content? We’ll just stick with that. What are you communicating in those last two paragraphs?
Dr. Vienna: We’re basically summarizing the youth history and we’re summarizing the relevant factors if not all five that are present, but you’re summarizing the relevant factors and they’re tied to brain development, their potential for rehabilitation. It’s just a giant summary and you really want to base it, like I said, in the research. And so, what I use is, I actually, [01:00:00] parallel and quote some of the Amicus Briefs that the APA wrote. They made some pretty strong statements and of course, they put together this nice packet for the courts of adolescent brain development. So, I am citing these things in my summary. I’m tying what I found in that youth and the relevant factors to what we know in the research about bringing them relevant.
Dr. Sharp: Got you.
Dr. Vienna: Yeah. And then maybe you might be speaking to their risk of re-offending if that’s a secondary question asked by the attorney.
Dr. Sharp: Okay. I was curious how firm you might be with these opinions.
Dr. Vienna: If you’re citing them, you better be confident. When we’re making a comment on risk, you’re using structured professional judgment tools like the HCR-20 [01:01:00] or the SAVRY if you’re evaluating a kid under 18, but basically, you’re looking at historical factors that aren’t going to change. They’re just present in history. You’re looking at clinical factors that might be a little bit more dynamic and you’re looking at risk management factors. So, you’re using structured professional judgment tools to support your opinion. It’s not just saying like, Hmm, I think that Johnny will have a medium risk. No, it’s going to be tied in the data and in the research.
Dr. Sharp: Right. Well, let’s talk a little bit about the business side of things. Let’s assume someone has the training to do these evaluations. We’ll just let that be a given. How does one launch a practice around this? Who are you connecting with? Where do you get the referrals? [01:02:00] What does that look like?
Dr. Vienna: I started my practice. It was a clinical practice and I was seeing clients for therapy. I was forensically trained. I was just doing forensic evaluations on the side building that kind of practice. I think I started out by making connections through my practicums and my internships. Because I went for a forensic program, I really geared all my training towards obtaining forensic sites.
So I did practicums at the jail, an internship, a post-doc in the juvenile justice system. And through that, I met other clinicians that had gone into private practice that had previously worked at the jail. I met and worked with different judges because we had certain programs in the jails.
I worked in where we had to evaluate…We did some evaluations with folks that were incompetent to stand trial. We did more of the restoration side of it. [01:03:00] So you have to write reports to the core, interact with an attorney. So you make the connections there. And then from there, I waited my time. In our county, you have to have five years. I think you have to be licensed for five years or postdoc for five years to be able to apply to be on the court panel.
And when you’re on what we call the court panel, you’re on this list where attorneys, public defenders, district attorneys, because you can get retained on both sides and I do, and you can be listed on here. And then that’s when the attorneys often look at the pool of their experts to come in and do these evaluations.
From there, then I also have met some private defense attorneys because they maybe used to work at the county public defender’s office, or they were former district attorneys and they saw my report. So when they have their own firm, now they’re like, “Hey, can you come take a case from us?” So it just building slowly.
That’s pretty much how I built my practice. [01:04:00] I think in about… I opened my practice in 2015. I got on the panels in 2017 and then it just took off from there. And now I’m turning the corner now and doing a little bit more private defense work, but still a lot with the district attorney and the county public defender’s office.
And I’m largely based in LA. I’ll do evaluations in the surrounding counties because I’m very close to Riverside, San Bernardino, and Orange County, everyone in an LA knows these counties. So I’ll go that way and do my evaluations for who calls first. And I put them in order on my calendar. That’s pretty much how I do things.
Dr. Sharp: That sounds good. Well, it reminds me, it just keeps coming back. It’s like build relationships and do good work. And that helps.
Dr. Vienna: Absolutely. I probably worked harder than I ever had at any agency job when I first started my practice, even now, but now you have [01:05:00] a little bit more help if you hire staff and you get a team put together, it makes things run smoothly.
Dr. Sharp: Right. Well, this has been super helpful. It’s just personally interesting to me to be able to talk about an area that I don’t know much about, and I’m hoping that other forensic folks out there are taking away a lot of information from our discussion.
Dr. Vienna: Well, if I could add just one more thing. So not just applying to be on your court panels and starting there working private defense firm cases, but you also want to get the appropriate training. Especially for these evaluations, if you’re working with juveniles, a lot of times we’ll see reports by psychologists that work solely with adults and they really miss the big points about incomplete brain development.
So it’s really important that you not only have [01:06:00] forensic training, like knowing how to administer certain forensic measures or assessments, and then just our general clinical measures and assessments, but you also have enough training in adolescent brain development and adolescence in general. Knowing about the maturity issues and the things that happen during development.
So having that plus your clinical expertise really allows you to make opinions that are, like I said, based on science and ethically sound. So get the training from sources like Concept and the American Academy of Forensic Psychology, the APLs. You want to get adequate training and of course, consultation or supervision from people that are already doing these evaluations. That piece is really about.
Dr. Sharp: Thank you so much for highlighting that. I think a lot of us hear about different areas of practice and it’s easy to get excited and want to leap into things, and it’s so important [01:07:00] just to make sure that you’re doing so ethically and with solid training.
Well, let’s see. I think we’d be remiss if we didn’t mention two more things. I mentioned your podcast at the beginning, but can you just tell people exactly what the name of it is and what kind of stuff you talk about on your podcast?
Dr. Vienna: Sure. I have a podcast that I started two months ago. It might’ve been even last year. It’s called The Forensic Psychologist podcast. It is a podcast that I started really to help educate and support students and early career psychologists going into the field of forensic psychology.
I started it because I was getting a lot of emails from students across the country that found my website or I hire interns and psychologist assistants throughout the years. So, of course, my ads, whether it’s on [01:08:00] LinkedIn or Indeed, they’re finding and they’re like, oh, I’d love to do this, but I don’t know what I need to have education-wise to be able to apply for this.
Clearly, in my job description, I’m like, you need to be this, this, and this.
So I’m like, “There are so many questions.” I’m like, “Wow, how come we’re not talking about this? And how come even students in grad programs know very little about the field of forensic psychology?” So I thought, hey, let’s put out some information and really give people what they’re looking for in one place.
So, I have two episodes out. I think we’re on like episode 10. I really do it about once a month because forensic practice we’re so busy, but I try to get out one at least once a month, sometimes two if we’re lucky. And we talk about, I say we, sometimes I’ll have guests, sometimes I do it myself. So we just talk about different kinds of forensic evaluations and go over the basics. [01:09:00] We do broad overviews.
I plan in maybe season two to go a little bit more in-depth, but I just wanted to introduce the kind of forensic evaluations that we do. So I’ve done some interviews on these Franklin hearing evaluations, competency evaluations, child custody evaluations we have in the works, and immigration evaluation. So all different kinds of forensic evaluations, kind of like how you interviewed me, broad overviews, what kind of training do you need? What kind of ethical considerations are there, et cetera. We talk about that stuff.
A little bit about the business side. We’ll get into that more maybe season two. Everyone I’ve interviewed has graciously agreed to come back. So I’m like, I will call you. I’m going to call you.
Dr. Sharp: Right. When you get a good guest, you want to lock them in.
Dr. Vienna: I’m going to do a round table, hopefully, and we’re going to discuss the business because it’s a little different than clinical practice. [01:10:00] My systems changed completely when I did my forensic practice full-time and dropped my clinical caseload. So, it’s a little different.
Dr. Sharp: Yeah. Well, I’m going to totally leverage this to ask you to come back and talk about the business side of forensic practices.
Dr. Vienna: Yeah, I’d love to. That’ll be awesome.
Dr. Sharp: Awesome. The second thing that we got to mention is that you are a Master Scuba diver, so not related to forensic practice at all, but pretty cool. I just wanted to acknowledge that. And I’m curious how you chose to do that and how much time you’re putting into that these days.
Dr. Vienna: I am an avid scuba diver. I got certified when I was 18years old on a study abroad trip in Australia. I got certified out at the Great Barrier Reef before it got destroyed. It’s growing back now but it took a pretty big hit over the past two years.
I got into it just [01:11:00] because I grew up by the beach. I love the water and there’s a whole world underneath the ocean. And since then, I’ve achieved different certifications. And now I’m at the top. I’m maxed out, I guess, at the RESCUE dive level. So I’m a master scuba diver. I have completed a rescue diver course specialties, et cetera.
I’m actually doing photography now underwater. So if anyone finds me on Instagram, it is a nice blend of forensic-related topics plus my scuba diving photos. And people are like, “How do these two go together?” Here’s how. Just as clinicians, that work with people that have trauma or just people in general, in forensic work, we do a lot of evaluations and a lot of work if you’re on the treatment side with people that have experienced so much in their life. We see human suffering and you [01:12:00] have to have a way to process that.
And for me, having scuba diving vacations or I live locally to the beaches so I’m able just to jot down there, which is nice. It helps provide some balance and some lightheartedness to the work I do, right? It’s a break from carrying all the trauma. You’re going out in the water and seeing all the beautiful things underneath. It actually helps with anxiety, too, learning how to scuba dive. There’s all kinds of research on that and the breathwork that goes into it.
So the two are connected. That’s how I break away. And I actually talk about it a lot with my attorneys. I noticed the young ones that come in, they’re so inundated with the kids’ trauma and I’m like, “You need to take some breaks sometimes.” I take a vacation every three months. I may not go on a big vacation, [01:13:00] but I definitely take 1 to 2 weeks off every three months and I just disconnect.
Dr. Sharp: I love that. That’s a nice note to end on. Take vacations, people.
Dr. Vienna: Yes. My attorneys, they’re like, Nicole, you were just on vacation three months. I’m like I know, but do you know what we’ve been working on? Do you know how many murder cases we’ve had? I need the break. You should take one too.
Dr. Sharp: Absolutely.
Dr. Vienna: Yeah, it’s good self-care.
Dr. Sharp: Well, I so appreciate your time and expertise, and willingness to chat with me for a little bit. This is great.
Dr. Vienna: Of course, anything.
Dr. Sharp: And your contact information. We’ll put that in the show notes, of course. So if anybody wants to reach out, they can do that. Hopefully, this is just round one and maybe we’ll talk again in the future.
Dr. Vienna: Absolutely. Thanks for having me.
Dr. Sharp: All right, everyone. Thank you so much for listening as always. If you have not subscribed or followed the podcast, [01:14:00] now is a great time to do so. Always grateful for those subscriptions and follows so that you don’t miss any episodes that come out.
We are headed into the summer, got plenty more clinical episodes and business episodes coming up.
So stay tuned and don’t miss any of those.
Like I mentioned at the beginning, if you need CE credits here as your license renews, ours renews every two years in August. So we are scrambling to get those CE credits. You can get those at athealth.com and just search for The Testing Psychologists.
All right. Until next time. Y’all take care.
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