Outcomes from a University-Based Outpatient Competency Restoration Program

Date of Award


Document Type

Doctoral Research Paper

Degree Name



Graduate School of Professional Psychology

First Advisor

Neil Gowensmith, Ph.D.

Second Advisor

Debbie Gowensmith, M.S.

Third Advisor

Michael Karson, Ph.D., J.D.


Outpatient competency restoration program, Incompetent to stand trial, Competency restoration, Competency to stand trial, Outcome evaluation

Publication Statement

Copyright held by the author. Permanently suppressed.


Amidst the national competency crisis in the United States, outpatient competency restoration programs (OCRPs) have gained popularity in the past decade as an alternative to inpatient restoration services for individuals adjudicated as incompetent to stand trial (IST). OCRPs provide restoration services for individuals who do not need the highest level of care or security of inpatient settings, subsequently helping to reduce lengthy waitlists for beds at such sites. Despite their increasing popularity, there is a lack of research regarding OCRP outcomes and operations. The University of Denver’s Forensic Institute for Research, Service, and Training (Denver FIRST) created an OCRP in 2015. This study describes the demographic information, treatment adherence, restoration rate, and predictors of success for 120 individuals who participated in the Denver FIRST OCRP between April 2015 and June 2019. Most participants were male with a mean age of 30 and had been charged with a violent misdemeanor offense. The most prevalent diagnoses included substance use, psychotic, and developmental disorders. The median number of days spent in restoration services was 164, the average participant attended 62.0% of their scheduled sessions, and the program produced a restoration rate of 13.3%. Although this restoration rate is lower than other published OCRP restoration rates, overall the program produced a “successful outcome” rate of 74.2% when considering all program outcomes. Suggestions for program improvements and recommendations for OCRPs in general are provided.


29 pgs

Paper Method

Program Evaluation/Development

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