What Jessica’s Law demands

As a California psychologist in private practice, I have concerns about The Times’ depiction of billing by evaluators of sex offenders in the article, “Jessica’s Law pays dividend for some.” I do not do these specific evaluations, but I feel the need to correct misapprehensions the public may have after reading the article. I do not wish to defend what may be predatory billing in some cases, but I do wish to clarify the several factors not mentioned in the article that may cause high billing amounts.

First, work may have been done in a time period not reflected by the date of the bill. A single bill may include many evaluations conducted over months or even years.

Second, the hours spent on an evaluation depend on the complexity of the case and the number of medical and legal records to be reviewed. Sometimes these number in the hundreds, running to many inches and even feet of stacked paper. Reading -- and not merely scanning -- such documents can take hours.

Third, any psychological evaluation of an offender is complex and requires skill. The purpose is to predict what a felon will do in the future and how serious any future offenses may be. For example, will the offender download pictures of young girls onto his computer, or will he kidnap and rape? The psychologist or psychiatrist has a serious job that combines science, art and intuition.

What the article does not present is an objective perspective of the “typical” evaluation. How long does a typical sex offender evaluation session last? (A statistical average would be helpful indicator.) How long does an evaluator take to review records? (Again, a statistical average is the best indicator.) How long does a typical evaluator take to write a report? Such a task involves the selection and exposition of the salient facts of a case; it involves ruminating about a sex offender’s “state of mind” (going by the known facts and professional expertise); it also involves making a cogent argument for a “thumbs-up or thumbs-down” decision often required by law. All opinions and judgments need to be well-argued and supported by facts because the evaluator may be called into court to defend his or her report. This effort is not reflected simply in the number of pages of a report but in the quality of the content -- and the hours spent doing an evaluation.

If the public has required the government to protect us from violent sexual predators by some form of incarceration beyond the sentences served, due process demands careful assessment of future risk. The behavioral science behind such prediction does not allow the precision that is accepted in medical science. The spectacular advances in neuroscience have not produced simple markers in brain scans to identify potential sex offenders -- or any other kind of offenders. Psychological testing is much slower than brain scanning -- and more uncertain. The greater the consequences of a false prediction of a sex offender’s likelihood to re-offend and the greater the intuitive uncertainty (especially in borderline cases), the more thorough and longer an evaluation should be.

The Times presents cases of seemingly excessive billing by some evaluating psychologists and psychiatrists, but the reader is left in the dark regarding the circumstances. There is no attempt to inform the reader as to the procedures for billing and payment, the specialized expertise of evaluators involved and the nature of managerial scrutiny and approval. I hope The Times will continue its investigations of Jessica’s Law in a more balanced and enlightening fashion. Otherwise, this article can be read as a shotgun smearing of my profession.

Philip Kaushall is a clinical and forensic psychologist who lives in San Diego.