Introduction
When a court finds a defendant incompetent to stand trial, the case doesn’t end — it pauses. Proceedings stop until the person can be restored to the point where they understand the proceedings and can assist in their own defense. For decades, the field has had a quiet problem with that task: there has been no standard, validated way to do it — and for juveniles, often no accepted curriculum at all. Restoration too often becomes, in the program manual’s own words, “a box-checking exercise,” producing “a cycle of repeated incompetency findings, wasted system resources, and… compromised justice.”
The Mental Competency Assessment & Training (MCAT) Program was built to close that gap. Developed in 2007 by Dr. Craig West, Psy.D., President and CEO of Psychwest, Clinical & Forensic Psychology, Inc., MCAT is a standardized, remote-capable competency-restoration program for both adults and juveniles. This is the in-depth overview: what makes it different, how the curricula and tools actually work, and how an agency can stand up and run its own MCAT program.
What competency restoration actually requires
Competency to stand trial is a legal threshold, not a diagnosis. Under Dusky v. United States (1960), a defendant must have a rational and factual understanding of the proceedings and the present ability to consult with counsel. Restoration is the targeted work of getting a person to that threshold — not general mental-health treatment, but structured education and skill-building aimed at specific, court-relevant capacities.
That distinction is the whole design philosophy of MCAT. Every lesson, activity, and assessment maps back to one of four court-defined capacities, so progress can be taught deliberately and measured honestly — rather than assumed because a defendant “seems better.”
Two curricula, not one program stretched across ages
One of MCAT’s defining choices is that juveniles are not treated as small adults. The program ships two complete, separately licensed curricula, each with its own workbook:
- The Adult Curriculum (58 lessons in the traditional track, 35 in fast track) — for adults, and for juveniles transferred, waived, or certified to adult court. It references crimes, trials, and the criminal justice system, and is paired with the MCES evaluation scale.
- The Juvenile Curriculum (57 / 35 lessons) — for minors in the juvenile system. It carries the same structure but reframes everything into juvenile-court terms (delinquent acts, jurisdictional and adjudication hearings) and is paired with the J-MCES.
This matters because juvenile incompetence is frequently driven by developmental immaturity rather than mental illness — a different cause that demands different content. It’s a gap the field has largely left unfilled; the J-MCES is, per its technical manual, built where “no other validated psychometric assessments currently exist for evaluating juvenile competency.” Agencies can subscribe to the adult curriculum, the juvenile curriculum, or both.
The four phases of restoration
MCAT organizes restoration into four sequential phases. A defendant advances as they demonstrate readiness — not on a fixed clock — and each phase has a defined set of lessons.
- Phase 1 — General Legal Knowledge. Courtroom personnel, terminology, charges, pleas and penalties, and how a case proceeds. The factual-understanding bedrock courts ask about (~20 lessons).
- Phase 2 — Tolerating Stress and Behavior/Conduct. Courtroom etiquette, behavioral control, and stress and anger management — so a defendant can “prepare for testimony without becoming overwhelmed” (~21 lessons).
- Phase 3 — Working with an Attorney. The attorney–client relationship, confidentiality, disclosure, and the give-and-take of building a defense.
- Phase 4 — Ability to Consult with Counsel / Case-Specific. Applying it all to this defendant’s actual charges, evidence, and options — the capstone that makes the ability to assist real rather than abstract.
Three delivery tracks sit across the phases: Traditional (the full curriculum), Fast Track (condensed), and a Modified Fast Track (tailored to a client’s needs) — so the same evidence-based content can flex to the defendant in front of you.
How clients actually learn: a multimodal toolset
Restoration fails when it’s a worksheet and a lecture. MCAT is deliberately multimodal and experiential, so clients gain both receptive knowledge (recognition) and expressive knowledge (the ability to explain in their own words). Through the online portal and Resource Library, the program delivers:
- Slide-deck lesson plans — interactive, animated presentations — plus teacher’s-edition curriculum with answer keys and client-facing workbooks;
- Flashcards and legal-photo sets — 82 text flashcards and 96 “legal photos” depicting real courtroom roles and situations, organized by content area;
- Puzzles and games — 77 crossword activities, 72 word searches, and roughly 91 fill-in-the-blank exercises, all produced in paired adult and juvenile versions;
- Game-based practice like the MCAT Ladder quiz game, the Witness Box activity, and the Case Closed interactive digital board game;
- Guided audio relaxation activities supporting the Phase 2 stress and anger work;
- A Client Progress & Attendance Log with a goal-attainment tracker to document every session.
Because the materials are organized by phase and tagged adult or juvenile, a trainer always has the right tool, at the right level, for the capacity they’re building.
Run it remotely, in a clinic, or in custody
MCAT supports three delivery settings — community-based, jail/hospital-based, and fully remote — because the people who need restoration are scattered across all three. The remote model is core to the design: staff log into the portal, share the program materials with the client in real time over a secure tele-platform of the agency’s choosing, and guide the session live. The manual’s standard is explicit — remote delivery “ensures the same level of training as traditional in-person services while expanding accessibility.”
For the all-too-common situation where a defendant is waiting in jail for a restoration bed that may be months away, that reach is the point: structured restoration can begin where the person already is, instead of after a transfer that hasn’t happened yet.
Built for your agency to run — and to prove it works
MCAT is designed to be operated by the agencies that already handle these cases — county behavioral-health and hospital systems, regional centers and developmental-disability service providers, probation departments, and forensic psychology practices. It defines a clear three-role team so responsibilities don’t blur:
- Trainers deliver the curriculum and document sessions (they do not opine on competency). The recommended minimum is a bachelor’s degree in a related field or equivalent experience.
- Supervisors review logs and notes.
- Evaluators — typically licensed psychologists or psychiatrists — administer the MCES/J-MCES at intake, after each phase, and at exit, and render the formal competency determinations.
The workflow is a closed loop: referral → intake evaluation and baseline → placement into a level and track → phase-by-phase training → re-evaluation against the intake baseline → exit and certificate. As the program puts it, “assessment and training are two halves of a single process” — the very name says so. Agencies also get psychometric data storage and analytics to monitor outcomes, and can be listed publicly as a Subscribing Training Agency. (Running the program requires a licensing agreement with the author.)
Does it move the needle? In the program’s pre/post outcome data, participants’ Overall Mental Competency scores improved with statistical significance across all 13 competency measures — adults rising on average from roughly the mid-30s at intake to the mid-60s at exit (a gain of more than 30 T-score points), and juveniles by a similar margin. The MCES/J-MCES instruments behind those numbers have been used in thousands of adult and juvenile court proceedings since 2007. We dig into that measurement story in Measuring Progress, Not Just Status.
Bring standardized restoration to your caseload. The MCAT Training Subscription gives your team the full four-phase program — adult, juvenile, or both — with every tool above. Subscribers also purchase APA-approved continuing-education courses at a discount.
Related Posts
- Competence in the Community: Rethinking Restoration Beyond the State Hospital
- Measuring Progress, Not Just Status: Tracking a Defendant Across the Four Phases of Restoration
- The Competency Restoration Crisis: Why Defendants Wait Months in Jail
- The MCES & J-MCES: A Psychometric Approach to Competency Evaluation