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The Competency Restoration Handbook: A Guide and Resources for Clinicians

By Laura M. Grossi
Oxford University Press October 2025

Specifications

ISBN-13
9780197768044
Publisher
Oxford University Press
Publication
October 2025
Format
Hardback
Jurisdiction
U.S. ? Countri(es) for reference only

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Details

In order for defendants facing legal charges in the United States to be able to move forward with the legal process, they must be competent to proceed with their cases. Defendants are presumed to be competent to make legal decisions, until someone calls their competency into question. Once the presumption of competency is questioned, their legal case is paused and the defendant is evaluated, so that the court can determine whether they are competent to proceed. If a person is not adequately knowledgeable about how the court system works, or too psychiatrically unstable to proceed with their case, their case gets put on pause and the defendant is ordered for "competency restoration."

The Competency Restoration Handbook is a collection of foundational materials for competency restoration providers who work with adult pretrial defendants in the United States. The book begins with a description of the legal context related to adjudicative competence and an overview of foundational competency restoration practices. Following these foundational resources are chapters explaining how various clinical interventions can be adapted to help restore individuals to competency, and an assortment of practical tools (study guides, vocabulary-based games, and other hands-on activities) for use with defendants undergoing competency restoration.

Covering empirically informed, theoretical, and creative approaches that can be individualized for each specific defendant, the book encourages and facilitates best practices in competency restoration. Readers are encouraged to adopt these interventions to address defendant-specific barriers to competency. The authors also encourage competency restoration providers to consider adapting other treatment modalities (i.e., particularly those which are empirically supported or newly developed) to facilitate competency restoration.

Table of Contents

Foreword
About the Authors
Acknowledgements & Disclaimers

Section 1: The Psycholegal Context
Chapter 1: Introduction to Adjudicative Competence
Elizabeth Hunt and Laura M. Grossi

Section 2: Competency Restoration Treatment as Usual (TAU)
Chapter 2: Fundamentals of Competency Restoration in Practice
Laura M. Grossi, Alexandra Brereton, Mollimichelle McClendon, and Melanie Schneider
Chapter 3: Psychotropic Medications and Competency Restoration
Sidra Qadir and Shree Sarathy

Section 3: Cognitive Abilities as a Barrier to Competency
Chapter 4: Competency Restoration for Defendants With Intellectual and Developmental Disabilities (the Slater Method)
Maddison Schiafo and Kevin Waymire
Chapter 5: Cognitive Remediation (CogRem) and Competency Restoration
Alexandra Brereton and Laura M. Grossi

Section 4: Situational Distress as a Barrier to Competency
Chapter 6: Cognitive Behavior Therapy (CBT) and Acceptance and Commitment Therapy (ACT) and Competency Restoration
Kevin Waymire and Maddison Schiafo
Chapter 7: Religion and Spirituality (RS) and Competency Restoration
Meredith Cain Munson

Section 5: Severe Mental Illness (SMI) as a Barrier to Competency
Chapter 8: Music Therapy (MT) and Competency Restoration
Kendall Joplin and Kate Stanley
Chapter 9: Cognitive Behavior Therapy for Psychosis (CBTp) and Competency Restoration
Laura M. Grossi and Alexandra Brereton

Section 6: Personality Disorders as a Barrier to Competency
Chapter 10: Dialectical Behavior Therapy (DBT) and Competency Restoration
Lyndsay Brooks and Mollimichelle McClendon

Section 7: Appendices
A: General Competency Restoration Games and Activities
B: Clinically Focused Competency Restoration Materials
C: Independent Study Materials
D: Materials for Restoration Providers
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