Neurorehabilitation at Psicon (NAP)

News and Views

Assessing Capacity. Recommendations from Professor Graham Powell.

Professor Graham Powell gave a lecture at an event on Mental Capacity for the British Psychological Societies Division of Neuropsychology on 28th April 2015 in London. The event focus was on practical aspects of assessing capacity in clinical and Medico-Legal contexts for those individuals with acquired brain injury.


Prof. Graham Powell’s lecture titled ‘The Cognitive Psychology of Decision Making with Respect to Assessing Mental Capacity’ gave an excellent review of necessary considerations in relation to capacity assessment.


Prof. Graham Powell draws attention to common weaknesses and tendencies in capacity assessments. He empahasises that there is a tendency to overvalue the usefulness or relevance of standard tests. Test results are only one of the cues in determining capacity and there are other ecologically valid cues that should be utilised. Standardised tests are an entirely different scenario to the task demands of decision making in real life.


He also stresses that the capacity assessment needs to illustrate the impact of the individuals lack of understanding and not just state the face of the lack of understanding (and the same applies here in relation to lack of IQ, lack of memory, lack of insight etc)


Prof. Powell also points out that there can be a reluctance in capacity assessments to appreciate that an unwise decision can still be a reasoned decision and can validly reflect an individual’s ‘beliefs’ or ‘values.’


Professor Powell emphaises the ethos of the Mental Capacity Act where the focus is ‘all practical steps’ have been taken to ‘help him’ make a decision, and this should be done by using ‘simple explanations’ and ‘visual aids’.


You can view Professor Graham Powell’s presentation in full here.