Attachment #3.pdf
PDF 183 KB Posted
- Attached to
- PSYCHOLOGICAL EVALUATION SERVICES
- Solicitation number
- 5400024810
- Issued by
- South Carolina
About this file
This file is a psychosocial evaluation template form used by the South Carolina Department of Juvenile Justice (SCDJJ) for evaluating juveniles at the Coastal/Midlands/Upstate Evaluation Center. The form documents comprehensive psychological assessments for juvenile offenders, including information collection from interviews with juveniles and parents, contact with community specialists and Department of Social Services, DJJ file reviews, and psychological testing. The evaluation template captures information across multiple domains including family functioning, adolescent functioning, developmental and medical history, trauma history, school performance, peer relations, mental health symptomatology, cognitive and academic functioning, personality and emotional assessments, and psychosexual assessments when applicable to sexual offense cases. The form emphasizes that evaluations are conducted with informed consent from juveniles and parents, with explicit notification that results are not confidential and will be shared with attorneys, family court officials, and SCDJJ personnel, along with mandatory reporting requirements for suspected child abuse or neglect.
The document serves as a standardized framework for generating comprehensive psychological evaluation reports that inform disposition decisions within the juvenile justice system. Evaluators must document resiliency factors, diagnostic impressions, and recommendations based on psychological assessment findings and behavioral observations. The form restricts disclosure of evaluation information to qualified professionals and authorized personnel involved in legal proceedings, with guidance that release to parents or caregivers should be limited to pertinent information and preceded by explanation from a qualified professional to prevent misunderstanding or distortion of sensitive psychological findings.
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Other files
| File | Type | Posted |
|---|---|---|
| Attachment #5.pdf | ||
| Solicitation.pdf | ||
| Attachment #4.doc | DOC document | |
| Attachment #2.pdf | ||
| Attachment #1.pdf |
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Text version
CONFIDENTAL
SOUTH CAROLINA DEPARTMENT OF JUVENILE JUSTICE
COASTAL/MIDLANDS/UPSTATE EVALUATION CENTER PSYCHOSOCIAL EVALUATION
OR
COMMUNITY PSYCHOLOGY EVALUATION
904A 10-2019
Name: DOB:
JJMS #: Date(s) of Evaluation (Commitment):
Evaluator(s): Date of Report:
County: Community Specialist:
REFERRAL STATEMENT:
NOTICE:
This report is meant only for the use of qualified professionals and others involved from a legal perspective with this psychological evaluation for disposition. No unauthorized disclosure of this report or information contained in this report is allowed and any person who, without proper authorization, discloses information contained in this report assumes all liability associated therewith. Some individuals and family members may tend to misunderstand and/or distort the information presented herein, which could result in significant stress to the individual or may interfere with rehabilitative services. For individuals with certain mental health or behavioral issues, the consequences of disclosure may be serious. Release should be limited to only that information which is pertinent to the needs of the requesting party. Prior to release to parents/caregivers, the evaluation should first be explained thoroughly by a qualified professional.
Before beginning the evaluation, juvenile and parent(s), were informed of the purpose of the evaluation, what type of information would be requested, and how it would be used. They were also told that the results of the evaluation were not confidential and would be shared with the attorneys, family court officials, and South Carolina Department of Juvenile Justice (SCDJJ) personnel. They were informed that suspected child abuse or neglect must be reported to the proper authorities. Juvenile and parent(s) indicated that they understood the limits of confidentiality and expressed their willingness to cooperate with the evaluation.
SOURCES OF INFORMATION:
Interview with juvenile Interview with parent Contact with Community Specialist Contact with DSS Other Contacts DJJ file information (covers all collateral info documents, including mental health, school, etc) Psychological Testing (only those administered in this evaluation)
DJJ HISTORY AND SUMMARY OF CURRENT OFFENSE(S)
JUVENILE/PARENT ACCOUNT OF THE CURRENT OFFENSE(S)
(For sexual risk assessments, just state “See Psychosexual Assessment for this information”)
CONFIDENTAL
SOUTH CAROLINA DEPARTMENT OF JUVENILE JUSTICE
COASTAL/MIDLANDS/UPSTATE EVALUATION CENTER PSYCHOSOCIAL EVALUATION
OR
COMMUNITY PSYCHOLOGY EVALUATION (cont.)
904A 10-2019
FAMILY FUNCTIONING
• Parent/Guardian
• Siblings; Other relevant family members
• Who is living in the home
• Family dynamics
• Relevant community/environmental factors
ADOLESCENT FUNCTIONING
Relevant History
• Developmental History
• Medical History
• Trauma History
• Placement History
• School Functioning
• Peer Relations
• Community Functioning
• Adjustment to Evaluation Center (for secure evaluations)
• Mental Health Symptomatology
Psychological Assessment and Interpretation Behavioral Observations/Mental Status
Cognitive and Academic Functioning
Personality/ Emotional Testing
Psychosexual Assessment (Only for offenses that are sexual in nature)
RESILIENCY FACTORS
SUMMARY AND CONCLUSIONS
DIAGNOSTIC IMPRESSIONS
RECOMMENDATIONS
File details come from the government source that posted it. Updated .