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The Maccat-ca and the Ecst-r: A Critical Evaluation and Comparison of Second Generation Competency to Stand Trial Instruments
Among all the standardized tests available to assess competency to stand trial, the MacArthur Competence Assessment Tool-Criminal Adjudication (MacCAT-CA) and the Evaluation of Competence to Stand Trial-Revised (ECST-R) are unique in that they are among the most extensively developed tools. While developed for the same purposes, they differ in both the theoretical foundation and the approach to assess competence. These differences have fostered questions regarding whether outcomes on each test could potentially vary when used with the same defendant. the purpose of this review was to provide an in-depth understanding of each test by exploring what is known about the psychometric properties of each test; as well as what is known about the way each instrument works across various populations. the research available offers some basis to make tentative recommendations for the clinical utility of these tests that are offered herein. Below follows a discussion of the limitations and recommendations for use of each in clinical practice. While recommendations for clinical use of the tests are provided, any suggestions offered should be considered tentative, as there is a lack of consensus in the field regarding how the instruments should be used.
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