Services


Medical-Legal Assessments and Independent Medical Examinations (IME)

These assessments provide an independent psychological opinion regarding psychological injuries and disability following motor vehicle accidents, other transportation incidents, industrial accidents, work-related incidents, sexual or physical assault, stalking and interpersonal harassment. The assessments provide opinions as to any psychological conditions and functional disability from which a person may suffer, the relationship of such conditions to the subject event (e.g., causal analysis), the prognoses for the conditions and treatment recommendations. It is my practice to ensure that I do assessments for both plaintiff and defense as a way of maintaining a truely "independent" and objective assessment practice.

In order to provide the highest quality in forensic and personal-injury assessment, the assessment process is much more than a one-time clinical interview. The assessments are a multi-step process that results in a report and conclusions that answer specific questions with supporting data. By understanding the assessment process, you can have confidence that the assessment will be evidence-based and provide you with the information you need. The steps in the assessment process are the following:

Initial Contact - Referrals can be made either by telephone or email. Upon referral, I will schedule an appointment date and time for the client to come in for the assessment. Additionally, I am happy to speak with you about the case and any specific issues you would like me to address in the assessment.

Instruction Letter - After the assessment has been scheduled, I request that you either mail, email or fax an instruction letter specifying the questions you would like me to address in the assessment. The standard assessment usually answers the following questions:
a) Any psychological injuries or emotional difficulites the client is having and the course and nature of those difficulties.
b) The causal relationship, if any, between the subject event (e.g., motor vehicle accident, assault, workplace incident) and the client's emotional problems or mental health diagnoses. Did the event make a pre-existing problem worse? Did the event cause the psychological injuries? Is the event unrelated to the person's psychological difficulties?
c) What are the functional difficulties the client is having as a result of their psychological injuries? How do the injuries impact the person's ability to work, carry out household or recreational activities, or to have a personal or family life?
d) What is the prognosis, both short and long-term, for the identified psychological difficulties?
e) What are appropriate treatments for the identified psychological problems and what are their success rates?

Background Records Review - Prior to the assessment date, I review and summarize any relevant background medical information. Ideally, I can recieve this information at least a week prior to the scheduled assessment date and this information usually comes with the instruction letter.

Assessment Interview - Assessments generally start at 9:00AM on the scheduled date and I recommend that the client be told to expect to be there for most of the day. The assessment consists of reviewing informed consent, taking a detailed history of the subject event, completing a semi-structured clinical interview and having the client complete a variety of written questionnaires. Sometimes the assessments are completed in as little as three hours, but they generally last in the four to five hour range. Clients are given a break to get lunch as well as breaks throughout the assessment as needed.

Written Report - Upon completion of the assessment interview, I usually complete a written report within two to three weeks. The written report follows the format required by the BC Supreme Court Civil Rules. The report summarizes the facts and assumptions based on a review of relevant psychological research, the clinical interview, results of psychological testing and review of medical records. The conclusions and answers to specific referral questions follow from the facts and assumptions, making it clear for the reader or trier of fact to understand the basis for the opinions.


Consultation to Lawyers Regarding Other Reports 

There is considerable variability in the quality of psychological and psychiatric expert evidence. I can assist lawyers in understanding issues with and vulnerabilities in the conclusions of psychological and psychiatric expert reports. The consultation can either take the form of verbal report, or more formal written critiques of an expert report


Assisting Lawyers in Developing a Cross-Examination Strategy 

Consultation regarding cross examination strategies based on written reports submitted by psychologists or psychiatrists. This includes assisting the lawyer in understanding the nature of the report conclusions, how they appear to have been reached and reliability and validity issues that could limit the basis of the expert opinion. This is generally done when there are specific concerns about the validity of conclusions in an expert report.


Psychological Treatment 

Providing evidence-based cognitive-behavioral therapy for a number of psychological conditions and difficulties including: posttraumatic stress disorder (PTSD), depression, generalized anxiety disorder (GAD), panic disorder with and without agoraphobia, obsessive-compulsive disorder (OCD), specific phobias and stress management. I was one of the first psychologists in Canda to be certified in cognitive-behavioral therapy by the Canadian Association of Cognitive and Behavioral Therapies (CACBT). For more information about psychological treatment services, please visit www.raminader.com.


Therapy recommendations

Providing standalone treatment recommendations for individuals experiencing psychological or emotional difficulties. This can either be requested from the client directly, or from a lawyer on behalf of a client. The treatment recommendations provide a detailed, evidence-based plan, outlining the nature of the recommended treatment, skills that the treatment should address and an estimated timeline or number of sessions.