I am a clinical psychologist. Diagnosis and treatment are what I do. I specialize in child and family therapy, parent-child conflict, parenting, and child development. I also teach graduate level courses in models of psychotherapy, clinical assessment, diagnosis and treatment planning, and child development. This is what I do. And you know what? I’m pretty good at what I do.
I was recently consulting on a court-involved case in which I was reviewing the clinical data, conclusions, and recommendations of a child custody evaluation. Like far too many child custody evaluations I’m asked to review, the collection of clinically relevant data was excellent, but the interpretation of the data was abysmal, and the recommendations were 100% wrong. Harmful in fact.
As part of my analysis of this custody evaluation for my client and his attorney, I wrote up a more accurate case conceptualization based on the clinical data reported in the child custody evaluation, along with a possible treatment plan based on this case conceptualization. I did what I do as a clinical psychologist. I collect relevant clinical data (in this case the custody evaluator collected the data for me), I formulate a case conceptualization based on the clinical data (which is called diagnosis), and I develop a treatment plan based on the case conceptualization. I’m a clinical psychologist; that’s what I do.
After completing my brief report for the attorney, my brain was still swirling with all the information and I thought to myself: this information may be more broadly useful to other parents in similar situations. While my case conceptualization and treatment plan was individual to the family situation I was reviewing, the pathology of “parental alienation” (as described and defined in Foundations), is pretty similar across families. It’s a cross-generational coalition of the child with one parent (a narcissistic/(borderline) parent) against the other parent. This is standard family systems pathology (with the addition of parental personality disorder pathology that transforms the cross-generational coalition into a particularly malignant and virulent form).
The treatment plan recommendations are two variants of a prescriptive Strategic family systems intervention. Strategic family therapy is one of the major schools of family therapy, but it requires a fairly sophisticated and knowledgeable family therapist to formulate and enact a Strategic family systems intervention. It is unlikely that most targeted parents will find a general family systems therapist, and it’s extremely unlikely that they will find one capable of developing a prescriptive Strategic family systems intervention. But here I had just done it for this case. For the possible benefit of other targeted parents, I decided to take out the individualized material and construct a generic mini-report on case conceptualization and treatment plan recommendations for the family systems pathology of a cross-generational coalition of the child with one parent against the other parent.
The Strategic family systems intervention requires the cooperation of Court-order to enact. The case I’m consulting on is Court-involved, so that’s what the attorney for my client is seeking. My case conceptualization and treatment plan provides my client’s attorney with an alternative proposal – based in clinical psychology and family therapy – to the extremely flawed recommendations of the child custody evaluation – which are based in forensic psychology of collect the data and then make things up… basically punt because the evaluator has no idea what to do (because they are forensic psychologists who collect data and makes things up, not clinical psychologists who actually do family therapy and solve family pathology).
I have posted my generic case conceptualization and treatment plan to my website, way down at the bottom. A direct link to it is:
I’m not sure if this will be helpful to other targeted parents or not. If it is, I’m happy. If not, oh well, I tried.
Craig Childress, Psy.D.
Clinical Psychologist, PSY 18857