Forensic Psychiatry Residency Training Program

The Forensic Psychiatry Fellowship Program at the University of Virginia provides systematic training in the area of forensic psychiatry, the psychiatric subspecialty that focuses on interrelationships between psychiatry and the law.  The fellowship provides exposure to clinical cases, guided readings, interdisciplinary seminars, and research for all three major areas in which the law interfaces with psychiatry:  civil, criminal, and administrative.

• We offer one fellowship position per year
• The University of Virginia is a member of the Association of Directors of Forensic Psychiatry Fellowships. All fellowship programs use a common application form and adhere to a common timeframe for applications and interviews.  Information on how to apply is available here. 

Bruce J. Cohen, M.D.
Program Director, Forensic Psychiatry Training Program
Department of Psychiatry and Neurobehavioral Sciences
PO Box 800623, Charlottesville, Virginia 22908
Phone: (434) 924-5408
Fax: (434) 924-5149
psychresidency@virginia.edu

At the conclusion of this fellowship, the resident is expected to have received training in the following four areas:

1) Psychiatric forensic assessment of individuals involved with the legal system

The training program aims to provide exposure to a variety of evaluees of both genders, including adolescent, adult, and geriatric age groups, spanning a broad range of mental disorders and circumstances, in both the civil and criminal contexts.  These evaluations take place at the following training sites:

• The Institute of Law, Psychiatry, and Public Policy Outpatient Forensic Clinic
• Fluvanna Correctional Center for Women Psychiatry Service

2) The provision of specialized psychiatric treatment to individuals incarcerated in jails, prisons, or special forensic psychiatric hospitals.  This training takes place at the following training sites:

• Fluvanna Correctional Center for Women Psychiatry Service

3) Active involvement in the area of legal regulation of general psychiatric practice, with exposure to this area at the following site:

• The Institute of Law, Psychiatry and Public Policy, which provides specialized training programs and consultation to the state in the area of mental health law

4) Educational and research efforts.

Residents will gain proficiency at critically reading the forensic psychiatric and legal literature and acquire the ability to effectively communicate such findings to others.  This will be accomplished through a supervised, empirical research project in one of the above areas, through advanced forensic training programs that review the forensic research literature, through individually supervised readings of the research and legal literature, and through participation in the Institute of Law, Psychiatry and Public Policy’s research colloquium.

The Institute of Law, Psychiatry and Public Policy at the University of Virginia is an interdisciplinary program in mental health law, forensic psychiatry, and forensic psychology. Institute activities include academic programs, forensic clinical evaluations, professional training, empirical and theoretical research, and public policy consultation and review. The faculty includes attorneys, psychiatrists, psychologists, and social workers, and offers a variety of training programs pertinent to mental health practice, social policy, and the law.  The local residency program director for this site is Daniel Murrie, Ph.D.

The educational and training activities of the Institute include courses, seminars, workshops, symposia, and fellowships. These include a week-long course on how to perform basic criminal forensic assessments, a similar week-long course addressing forensic evaluations of juveniles, and more advanced one-to-three-day training programs on risk assessment for violence, capital sentencing evaluations, sexual offender evaluations, and other forensic assessment of juveniles. Some ongoing cases also are discussed at a weekly multidisciplinary teaching conference, attended by core clinic evaluators as well as by many of the Institute’s affiliate faculty.

Other courses and seminars constitute part of the curriculum of the School of Law and are taught each year by interdisciplinary teams. The resident audits at least one introductory law school course, such as Criminal Law. The resident can also attend a law school course addressing psychology/psychiatry issues in juvenile justice. The Institute is affiliated with the School of Law, the School of Medicine, the Curry School of Education Programs in Clinical and School Psychology, the Health Sciences Center at the University, and is supported in part by the Virginia Department of Behavioral Health and Development Services (DBHDS) and the Office of the Virginia Attorney General.

The Institute’s research activities include multidisciplinary studies in clinical criminology, empirical studies of psychiatric and legal decision-making, and the analysis of mental health law and policy. Institute research projects have been sponsored by the National Institute of Mental Health, the National Institute of Justice, the MacArthur Foundation Research Network on Mental Health and the Law, the National Science Foundation, and private foundations. Some past funded projects have involved empirical study of how best to approach the assessment of competence to consent to clinical treatment, competence to stand trial, risk assessment for violence, the use of coercion in the inpatient psychiatric admissions process, the characteristics of sexually sadistic criminals, personality pathology among female prison inmates, bias in forensic evaluations, bias in forensic science procedures, and the factors associated with psychiatric civil commitment and how they might be amenable to legal reform.

Institute faculty members are involved in professional and public service activities on the international, national, state, and community levels. In addition to membership in major organizations in law, psychiatry, psychology, and social work, Institute personnel hold elected offices, serve on editorial advisory boards, chair and serve on commissions, committees, and task forces, at the state, national, and international level.

The Forensic Psychiatry Clinic is directed by Daniel Murrie, Ph.D. Clinical supervision is provided by forensic psychologists Daniel Murrie, PhD, Sharon Kelley, JD, PhD, Elisha Agee, PsyD and by several board-certified forensic psychiatrists including Bruce Cohen, M.D.

The Clinic has provided evaluation services for over thirty years. Criminal defendants referred to the clinic typically have committed more serious offenses such as homicide or sexual assault. They typically are referred for assessment of competence to stand trial or related competence issues, criminal responsibility, or for assessment related to sentencing issues (including capital sentencing evaluations). About 20% of the clinic’s cases are adolescents referred by juvenile court. The Clinic also sees quasi-forensic evaluations such as pre-employment evaluations, fitness for duty evaluations, and private risk/threat consultations for businesses or universities.

The Clinic’s cases are often selected for their pedagogical value, and add a clinical dimension to the Institute’s educational endeavors. For example, an actual case might be observed via a closed-circuit monitor by psychology interns, general psychiatry residents, and law students, and might be discussed during a break in the evaluation. Questions raised by the class can then be integrated into the clinical evaluation when it resumes. Most cases are videotaped to help fellows develop better interview skills and to provide material for forensic teaching exercises. The Clinic performs about 50-100 evaluations per year, and the resident has the opportunity to participate in all of these, with the workload and case mix being adjusted over the year to allow for an optimal educational experience.

The Institute also provides fellows with opportunities to learn research skills through seminars and through supervision in designing and conducting their own research project during the course of the residency training program.

The resident provides psychiatric care in the prison correctional setting at Fluvanna Correctional Center for Women. FCCW houses about 1200 offenders, about 700 of whom are prescribed psychotropic medication and are followed by the psychiatry service. The site supervisor is Meredith Cary, M.D., who is board certified in both general psychiatry and forensic psychiatry and is the Chief Psychiatrist for the Virginia Department of Corrections. The forensic resident treats patients at FCCW one day per week, typically seeing 14 patients in a given day (2 new patient visits and 12 follow-up visits). The typical total case load is about 80 patients. Unlike most other correctional centers in Virginia, FCCW includes a licensed hospital psychiatric unit and a sheltered psychiatric residential unit. The resident receives additional supervision on-site by Bruce Cohen, M.D. and Alisa Williams, M.D., both of whom also are board-certified in both general and forensic psychiatry and who also have long experience in providing psychiatric care in both the jail and prison settings. The site also provides the opportunity to work with a team of master’s-level qualified mental health professionals (QMHPs) who provide psychotherapy and therapeutic modalities such as DBT and trauma recovery. A wide range of Axis I and Axis II psychopathology is encountered among this correctional population, particularly Mood Disorders, Psychotic Disorders, Alcohol and Substance Use Disorders, PTSD, and severe Personality Disorders. Treatment modalities include medication management and brief individual supportive and educational psychotherapy.