Therapeutic issues associated with confidentiality and informed consent in forensic evaluations.

Any particular rule, procedure, or role may be therapeutic, antitherapeutic, both, or neither. This forms the basic tenet of David Wexler and Bruce Winick's construct, "Therapeutic Jurisprudence."' Therapeutic jurisprudence is concerned with the extent to which the law itself causes or contributes to psychological dysfunction or "juridical psychopathology," a concept similar to that of iatrogenic illness in medicine. The law may contribute to psychological dysfunction through substantive rules, legal procedures, or the behavior of legal and judicial professionals. This paper will focus on contributions of the legal system and mental health professionals pertinent to a therapeutic or antitherapeutic outcome for the mentally disabled defendant which occur as a result of the relationship between forensic evaluation, confidentiality, and informed consent. Although special attention will be directed at competency evaluations, many of the issues are relevant for any type of assessment. Forensic mental health professionals perform a variety of services within the judicial system from administrator and consultant, to examiner and therapist. The responsibilities of these roles are different and the focus of allegiance for the professional varies according to