ABSTRACT
This chapter explores the difficulties raised when a client’s behaviour and actions are inconsistent with the intentions and plans he discusses during an interview-based capacity assessment. It will consider how an “impairment of mind or brain” can affect a person’s ability to act upon her intentions in the moment and how behaviour may not always be guided by reasoning. Detailed case examples illustrates how it may be necessary to extend a capacity assessment beyond the interview format to incorporate behavioural observations and reports of everyday actions in order to fully understand decision-making capacity. As there are no gold standard psychometric tests for identifying the relevant neurobehavioural symptoms, their presence can only be inferred from clinical judgment based on careful observations of patterns of behaviour. The cases discussed in this chapter highlight the importance of understanding the influence that behavioural changes related to neurological, developmental or mental health conditions can have on capacity assessments.
