Using Multiple Exemplar Training to Increase Fitness to Stand Trial

Abstract

Fitness to stand trial refers to an individual’s capacity to comprehend judicial proceedings related to a crime they have committed. There currently exists no legally codified or empirically validated procedures for training fitness in forensic inpatients with mental health diagnoses, developmental diagnoses, or dual diagnoses. The purpose of this study was to develop a teaching procedure based on multiple exemplar training (MET) that provides a procedural foundation for training fitness. Broadly, this study sought to yield the first objective teaching procedure and measurement system for improving fitness based on the principles of behaviour analysis. Specifically, MET was used to develop a variety of stimulus (questions) and response topographies, which were presented to participants and designed to increase acquisition of targets related to fitness. Results from one completed participant and three partial datasets provide preliminary to support MET as a procedure for increasing fitness, as indicated by an increase in correct responding across to all questions related to an individual’s fitness to stand trial. This study has implications for both judicial system and hospital settings, as the empirical validation of a standardized approach to training fitness could serve to streamline service delivery and mitigate the common barriers experienced by individual with dual diagnoses during legal proceedings.