A federal judge's declaration Wednesday that Jared Loughner is unfit for trial will likely send the accused Arizona shooter into a treatment program aimed at rehabilitating him so he can be tried.

The 1960 Supreme Court decision Dusky v. United States laid the legal framework for determining psychological capacity to be tried in court, establishing that an individual must be able to communicate with his lawyer and understand the charges against him. Doctors who examined Loughner said he could do neither, citing his paranoid distrust of lawyers.

Declaring someone criminally insane carries much more weight and often involves years in a psychiatric hospital. But those labelled unfit for trial generally go through a temporary period of treatment aimed at restoring their ability to stand trial. This consists of both medication and education on what a trial would entail, from the fundamental workings of the justice system to basic rules of behavior.

People can be restored to competency with treatment most of the time, said Dr. Pogos Voskanian, a clinical and forensic pychiatrist who has provided expert testimony in trials. They don't have to be perfect as long as they can reasonably well cooperate with their lawyer and they have reasonable comprehension of the charges against them.

While it is possible that further adjutication will find Loughner insane, Voskanian said that such cases are extremely rare.