As noted above, the most common form of forensic psychiatry in this country is what might be styled private forensic practice. In this model, the forensic psychiatrist is retained or hired by one of the attorneys in a case or, at times, directly by the judge in a court-appointed role.
Clinical psychiatry involves diagnosis and treatment. In contrast, as the definition of forensic psychiatry above would suggest, much of forensic work involves applying certain clinical conditions to legal criteria, the latter defined by statutes, case law or regulations. Such work, though based on a clinical foundation, requires the translation between psychiatry and law, two strikingly different paradigms of human behavior and interaction driven by markedly differing assumptions. I have compared forensic work to an operational Rosetta stone, wherein differing languages might be translated back and forth. Such translation requires an understanding of the law and legal criteria, as well as their practical application.
A second specialty element of forensic psychiatry is the knowledge of courtroom activity. This awareness requires familiarity with the serial challenges of that arena: presentation of one's opinion on direct examination in clear, jargon-free language that is accessible to the lay jury, withstanding of often forceful cross-examination and avoidance of the many pitfalls in presenting testimony that derive from peculiarities of the Socratic dialogues required. As one senior expert noted to me in a personal communication, "Testifying is lecturing under combat conditions."
Finally, a case might be made that forensic psychiatrists must attain the ability to manage the wide range of possible biasing factors that can enter into and distort objective testimony.
As a subspecialty of psychiatry, forensic psychiatry offers the opportunity to contribute to the legal system in a number of ways. Stressful, controversial, but probably indispensable, forensic work offers unique opportunities for the practitioner willing to enter into legalized combat in the courtroom.