Forensic child and adolescent psychiatry: A review of the past 10 years

Objective: To review important developments in child and adolescent forensic psychiatry from 1987 through 1996. Method: Major changes in the law and developments in research and practice were surveyed in the areas of the legal regulation of psychiatry, family law (divorce and child abuse), consultation to juvenile and criminal courts, civil litigation, and the development of the subspecialty. Results: There has been a large increase in research based on quantifiable descriptive data of forensic populations, although studies using comparison or control groups remain relatively rare. While managed care has heavily influenced treatment practice, legal liability remains largely with the clinician. Issues regarding techniques of evaluation for sexual abuse have been scrutinized by the courts and by researchers. Legislative responses to rising rates of juvenile violence have been in the direction of treating violent adolescent offenders as criminally responsible adults. There has been a major move toward setting standards for forensic evaluations, training, and credentials. Conclusions: Child and adolescent forensic psychiatry remains an area encompassing diverse clinical issues. It remains unclear the extent to which it will develop into a formal subspecialty.