Designed as a structured clinical judgment instrument
that guides evaluators through an assessment of the
specific psycholegal abilities required of a defendant
to stand trial, the FIT–R demonstrates reliability and
predictive validity and is useful for screening out indi-
viduals who are clearly competent to stand trial.
Competence (or fitness) to stand trial is a well-
established legal principle designed to ensure that crim-
inal defendants have the ability to participate in legal
proceedings. Defendants must be able to understand the
charges against them, understand the possible conse-
quences of legal proceedings, and communicate with
their attorney. Defendants whose ability to participate
competently in their trial is in question are typically
referred for a forensic assessment, since mental health
issues are central to the evaluation. If the court later
determines that a defendant is competent, legal pro-
ceedings are resumed; if the defendant if found incom-
petent, the legal proceedings are suspended until
competence is restored.
There are a number of forensic assessment instru-
ments designed to assist in this process, and the
FIT–R, a semistructured interview and rating scale, is
one of them. While initially designed for use with
adult defendants, research has also shown that it can
be used to evaluate competence in juvenile popula-
tions. The current version is a revised and updated
version of an earlier edition. A thorough review of
pertinent U.S. and Canadian legislation is included in
the introductory section of the FIT–R manual, and a
brief review of research on fitness to stand trial is
provided. However, the authors have noted that the
FIT–R can be used in most common-law jurisdictions
due to the similarity in legal criteria for competence
to stand trial.
Administration of the FIT–R takes approximately
30 to 45 minutes. The instrument is intended to serve
as a tool for assessing legal issues in concert with
other methods of assessing additional clinical issues,
including mental status and diagnostic considerations.
The format follows a semistructured interview, ensur-
ing that all legally relevant aspects of fitness criteria
are addressed while allowing clinicians the flexibility
to probe and further question the specific knowledge
and abilities of the accused. Following the interview,
the evaluator completes a rating scale in which the rel-
ative degree of incapacity for each of the items is eval-
uated. This semistructured format allows evaluators to
conduct more uniform competence evaluations while
still providing for flexible assessments.The FIT–R comprises 16 items divided into three
sections that parallel the Canadian and U.S. legal crite-
ria for competence to stand trial. The first section,
Understanding the Nature or Object of the Proceedings:
Factual Knowledge of Criminal Procedure, examines
a defendant’s understanding of the arrest process, cur-
rent charges, role of key participants, legal process,
pleas, and court procedures. The second section,
Understanding the Possible Consequences of the
Proceedings: Appreciation of Personal Involvement in
and Importance of the Proceedings, examines a defen-
dant’s appreciation of the range and nature of possible
penalties, available legal defenses, and likely outcomes.
The third section, Communication With Counsel:
Ability to Participate in Defense, examines a defen-
dant’s ability to communicate facts to a lawyer; inter-
personal capacity to relate to lawyers; and ability to
plan legal strategy, engage in the defense, challenge
prosecution witnesses, testify relevantly, and manage
courtroom behavior. Each section comprises a number
of items reflecting the requisite psycholegal abilities
required for competence in each area. An individual’s
degree of impairment on each item is rated using a
three-point scale (no impairment, possible/mild impair-
ment, and definite/serious impairment), which is
clearly explained and defined for evaluators. The eval-
uator then rates the accused’s degree of impairment in
each of the sections. These ratings as well as an assess-
ment of the defendant’s mental status are used by the
evaluator to make an overall determination of the indi-
vidual’s competence to stand trial. In scoring the
FIT–R, the instrument does not rely on “cutoff” or
“total” scores for making decisions about an individ-
ual’s competence, largely because the weight assigned
to any one item will likely vary across individuals.
It is important to recognize that the FIT–R was
designed to reflect the relative competence status of
an accused individual at the time of examination, and
it can serve neither a predictive nor a retrospective
assessment function. Research has shown that few of
the accused individuals ordered to undergo fitness
assessments are found incompetent to stand trial. The
FIT–R can be used as a brief screening instrument for
assessing fitness, where individuals who score at an
“unfit” or “questionably unfit” level will be referred
for a more thorough evaluation. Research has demon-
strated that it yields good sensitivity (the probability
that the predictor variable is positive given a recom-
mendation of unfit) and negative predictive power (the
probability of a recommendation of fit given that theFitness Interview Test–Revised (FIT–R)——— 323F-Cutler (Encyc)-45463.qxd 11/18/2007 12:42 PM Page 323