Bring Me a Goat

I love science.  My wife takes a bestseller novel to the beach to read, I take a book on quantum physics.  I love science.

And in my professional practice I’ve always been an old-school conservative psychologist.  Show me the data.  Scientifically grounded practice. 

And my background in early childhood mental health has grounded me in the neuro-development of the brain – Bowlby; Stern; Tronic; Shore; Fonagy (Fonagy’s work on parental “mentalizing” of the child’s psychological state is wonderful).

I love science, and I love scientifically grounded professional practice.  There is a beauty and elegance to scientifically grounded practice.

When I was supervising interns and post-doctoral fellows as a pediatric psychologist at Children’s Hospital of Orange County, and again when I was supervising interns and post-docs as the Clinical Director for an early childhood assessment and treatment center, I would always hold my trainee’s feet to the fire on diagnosis and treatment planning.  Justify your diagnosis.  Show me how this child meets the criteria for your diagnosis.   Tell me what your 3-month, 6-month, 9-month treatment plan is going to be for this child and family.  Justify how your treatment plan is going to solve your diagnosis.

I’m an old-school conservative clinical psychologist.

That’s one of the reasons I absolutely shudder at the Gardnerian model of PAS.  It’s bad.  Really, really bad.  If an intern had brought that “new syndrome” proposal to me, I’d have been pretty harsh. 

You can look through all of my writings about the pathology of “parental alienation” (and I’m certain the pathogen’s allies have already done that — which, as an aside, is actually kind of nice when you think about it; that they are so interested in my work – for odd reasons, but nevertheless…) and you will not find a single time when I ever advocated for adopting a Gardnerian PAS derivative model of the pathology.  From the very earliest days of my investigation into this attachment-related pathology, I have always grounded my approach in the established scientific literature (DSM-IV TR Diagnosis; Attachment Foundations: Regulatory Systems; The Regulatory Other).  Not once have I ever advocated for the adoption of a Gardnerian PAS derivative model for the pathology.

I am a conservative old-school psychologist who believes we should ground our professional practice in the latest scientific evidence.  If an intern or post-doc fellow had brought me a Gardnerian PAS proposal for a diagnosis, I would have provided a stern rebuke:

Dr. Childress:  Okay, see here where you say, “absence of ambivalence”?  That’s called “splitting” pathology.  Splitting suggests narcissistic and borderline personality traits.  So I want you to go back to this family and collect additional information about the potential presence of narcissistic and borderline personality features in a parent.  Look specifically for the allied and supposedly “favored” parent demonizing the targeted parent as all-bad.  If you find the splitting pathology, look for the surrounding personality traits of either a narcissistic personality organization or a borderline personality organization.  In particular, look for the parent using the child as a “regulatory object” for the parent’s emotional and psychological state. We can talk more about the child as a “regulatory object” for the parent next time if you identify personality pathology with the parent.

Dr. Childress:  And here, where you note the absence of guilt and remorse, that’s an absence of empathy, a primary feature of a narcissistic personality.  Go back and assess whether the allied parent – the supposedly “favored” parent – also evidences this same absence of empathy.  If the allied parent in this case happens to be a more borderline personality style mother (or father), assess for projective identification and the diffusion of psychological boundaries between the parent’s experience and the child’s.  If the allied parent in this case is a more narcissistic-style father (or mother), assess for a grandiose style haughty and arrogant judgement regarding the fundamental inadequacy of the other parent (the other spouse) – and probe for the diffusion of these inadequacy judgements regarding the other parent as actually having their origin in beliefs about the “spousal worth” of the targeted parent.

Dr. Childress:  And see this, where you’re proposing that the primary symptom of this supposedly “new syndrome” is an unwarranted child rejection of a parent?  Well, a child’s rejection of a parent involves the child’s attachment system – the neurological brain system that governs all aspects of love and bonding throughout the lifespan, including grief and loss.  The loss of an attachment bond will always – 100% of the time – produce a grief response.  So go back and do an analysis of this family from an attachment perspective.  For one thing, identify where the child’s grief response is at the loss of the attachment bond to targeted-rejected parent.  How is the child manifesting this grief response?  Work that out, and then we’ll talk some more.  Also, assess whether the allied parent is expressing unwarranted and excessive anxiety about the parenting ability of the other parent; is the allied parent obsessively fixated on “protecting” the child when there is actually no risk to the child?  Parental signals of anxiety surrounding the parenting practices of the other parent will act to define the other parent as representing the “predator threat” relative to the child’s attachment system.  So excessive signals of parental anxiety and “protection” could account for the termination of the child’s attachment bonding motivations toward the targeted parent, who is being defined to the child’s attachment networks by the anxiety of the allied parent as representing the “predator threat.”  Parental signals of anxiety will also motivate the child through the attachment networks to remain in continual close “protective proximity” to the supposedly “protective parent,” and not to separate from this “protective parent” who is giving off anxiety signals.

Dr. Childress:  And what’s this crazy “independent thinker” symptom.  Everyone always believes that their feelings are authentic to them.  That’s true 100% of the time in every diagnosis; depression, oppositional defiant disorder, child abuse trauma.  You can’t just go around discounting and invalidating people’s opinions and experiences.  What I think you’re trying to get at is that the child may be misattributing the cause of the child’s authentic self-experience to an incorrect causal source.  The child may authentically feel sad and hurt surrounding the targeted parent, but under the distorting influence of the allied parent the child is misattributing this experience of sadness to something bad that the targeted parent is “doing” – after all, when people do bad things to us, it hurts.  Whereas in actual truth, the origins of the child’s sadness may be a misunderstood and misinterpreted authentic grief response that the child is having to loss – first to the loss of the intact family that occurred with the divorce, and then amplified exponentially when the child began rejecting  a relationship with the beloved-but-now-rejected targeted parent; the child’s authentic sadness and hurt triggered by the presence of the targeted parent is actually grief surrounding the loss of the beloved-but-now-rejected targeted parent.  But this “independent thinker” symptom, that’s just not allowed.  You cannot simply invalidate the authenticity of someone’s self-experience like that.

Dr. Childress: So don’t bring me a “new syndrome” diagnosis.  Go back and do the work.

Child Custody Time-Share

I am an old-school conservative psychologist.  I love science.  I love scientifically based decision-making.  Professional practice needs to be based in science, not strange constructs that are simply made up out of thin air.  When psychologists start to move away from the solid bedrock of science and the surrounding theoretical literature, we open the door for introducing our own personal biases and our own personal histories into our decision-making. 

We may have had a bad relationship with our own mother growing up, so we unconsciously side with the father and child against the mother in our assessment and interpretation of the data.  Or maybe we had a childhood history of our father being cruel to and mistreating our mother, so we feel a natural affinity to protect the mother and child when we are presented with this narrative in the assessment.  In professional psychology, introducing our unconscious bias from our own history into our work is called “counter-transference” – and recognizing the potential for our own counter-transference in psychological work is as old as Sigmund Freud.

Since we are all formed in the context of families, the dangers of professional bias due to counter-transference is so intensely present in psychological work with families that we need to remain scrupulously grounded in the scientifically established literature for our assessment and interpretation of data.  The more subjective we become in our interpretations of family-related data, the more the danger increases that our own counter-transference issues will unconsciously creep into our work – and we will not realize it – because our own counter-transference issues are always unconscious to us in their hidden influence on our perceptions and interpretations.

As professional psychologists, we need to remain entirely grounded in the scientific research and surrounding theoretical literature.

As a clinical child and family psychologist who’s worked with oppositional defiant disorder across the various developmental periods of childhood – from infancy to teenagers – and with ADHD and other regulatory disorders, with autism-spectrum disorders, and with abuse and attachment-trauma disorders in childhood, of all types; sexual abuse trauma, physical abuse trauma, neglect trauma, including foster care placement and issues surrounding prenatal exposure to drugs and alcohol, I am exceedingly familiar with the research and theoretical literature surrounding parenting; normal-range and healthy parenting, parenting and the development of child pathology, and parenting’s involvement in the neuro-development of the child’s various brain systems, including self-structure systems and emotional-behavioral regulatory systems.  I know the scientific research and surrounding theoretical literature on parenting.

So let me be entirely clear on this:

With the exception of child abuse…

There is nothing – absolutely nothing – zero – in the scientific research and the surrounding theoretical literature that would allow us to determine the relative outcomes of various parenting time-share schedules following divorce.

In the absence of child abuse, there is absolutely nothing – nothing – in the scientific research and surrounding theoretical literature that would allow us to determine the relative benefits in any given situation regarding the future benefits to the child from a 60-40% custody time-share, or a 70-30% custody time-share, or an 80-20% custody time-share, or a 90-10% custody time, or a 50-50% custody time-share following divorce.

In the absence of child abuse, whenever professional psychology is asked to render an opinion regarding the relative benefits of various custody time-share schedules in any particular family following divorce, there is nothing – absolutely nothing – in the scientific research and surrounding theoretical literature that would allow us to render an opinion on this question.  Nothing.

Am I clear enough.

So any opinion rendered by any mental health professional regarding the relative benefits of differing custody time-share schedules in any specific circumstance is EXTREMELY vulnerable to the personal biases of this specific mental health professional – because there is NOTHING in the scientific research or surrounding theoretical literature that would justify a professional opinion.

Child Custody Evaluations

In my consultation on legal cases I have read countless child custody evaluations. I love science.  I love scientifically based decision-making.  So let me be equally clear on this point…

The practice of child custody evaluations is essentially voodoo assessment.  There is no – absolutely no – scientifically established foundation for the conclusions and recommendations offered by child custody evaluations.  They are little more than performing “magical” rituals under the cover of “professional procedures” (the data collection procedures), the recitation of “magical incantations” of professional-sounding words in writing a report, and “reading the entrails of a goat” in prognosticating the supposed future “best interests” of the child based on completely arbitrary criteria with no foundation in the scientific research or surrounding theoretical literature..

Furthermore,…

There is absolutely zero established reliability (inter-rater reliability) or scientifically established validity to the conclusions and recommendations offered by child custody evaluations.  Zero.   Each child custody evaluator makes up their own interpretations and conclusions – and two different custody evaluators can reach two entirely different interpretations and two entirely different sets of conclusions and recommendations from exactly the same data (a professional construct of assessment called “inter-rater reliability”).

The conclusions of child custody evaluations simply represent the personal bias of a single evaluator, who is simply a person with a full bevy of personal counter-transference biases, who happens to also have a degree in psychology that allows him or her to perform the “magical ritual” of a child custody evaluation – reciting the incantations – and reading the entrails of a goat.

Given the complete absence of scientifically established validity for the practice of child custody evaluations, I am astonished that they are allowed as evidence in court.  Okay… that’s one person’s opinion.  What’s Joe the barber’s opinion.  Since there is no scientific research or surrounding professional theoretical literature on which the custody evaluator is basing his or her opinion, Joe the barber’s opinion is just as valid.

Since the custody evaluator’s opinion is just this one person’s opinion – shouldn’t we get a second opinion?  Not on whether the “proper procedures” were followed (did the custody evaluator “rattle the proper beads” and “recite the proper incantations”), but on the evaluator’s INTERPRETATION of the data, which is where the inherent unconscious bias of counter-transference enters.  Shouldn’t we have a second, balancing opinion on the INTERPRETATION of the data?

The first evaluator has mommy-issues from his or her past that unconsiously bias this evalutor’s interpretation of the data, the second opinion might have daddy-issues that unconsciously bias this intepretation.  But at least we get both perspectives before the court. Otherwise, the court only gets one, biased interpretation that is simply the luck-of-the-draw regarding the initial assignment of the custody evaluator.

Does any mental health professional disagree?  There is a Comment section to this post.  Cite for me a single research study that demonstrates the inter-rater reliability for the conclusions and recommendations offered by child custody evaluations… a single study… I’m waiting…  <crickets>

Not one.  Nothing.  Nada.  Zero.  There is no scientifically established inter-rater reliability to the conclusions and recommendations offered by child custody evaluations.  Might as well have a monkey throwing darts at a dartboard.  Luck of the draw regarding the personal biases of the custody evaluator.

Standardization of data collection is NOT the issue.  The inherent counter-transference bias enters in the INTERPRETATION of the data – not in the collection of the data.  Standardizing the collection of the data does NOT affect the bias in the INTERPRETATION of the data.

A foundational principle of assessment – absolutely foundational – is that an assessment procedure CANNOT be valid (provide true and accurate information) if it is NOT reliable.

This is an absolutely bedrock foundational principle of professional assessment.

Again, I challenge any mental health professional to cite for me a single research study demonstrating the inter-rater reliability of the conclusions and recommendations of child custody evaluations.

This doesn’t mean that custody evaluators are bad people.  They’re good people who authentically want to be helpful.  It just means that they are inherently biased by their own family of origin histories.  And their inherent bias is entirely unconscious.  They can’t help themselves.  None of us can.  That’s why basing our professional practices in scientifically established research and the surrounding theoretical literature is so crucially important.

And there is nothing – absolutely nothing – zero – nothing – in the scientific research and the surrounding theoretical literature that would allow us to determine the relative outcomes of various parenting time-share schedules following divorce.

Scientifically Based Practice

Honestly, I feel like I’m living in the middle ages regarding our approach to child custody decisions.  When it comes to child custody, it’s like professional psychology is putting on bizarre bird-like masks and calling for the leeches, “Bring me the leeches, we need to bleed the child to balance the child’s humours.”

Please, if there is any psychologist who disagrees, please… there is a Comment section to this blog post.  Provide a single citation to research that demonstrates the inter-rater reliability of the conclusions and recommendations offered by child custody evaluations.  <crickets>  Nothing.

Or if you disagree, provide me with a single citation – just one – to the scientific research or surrounding theoretical literature that would allow us to make a determination regarding the relevant future benefits for the child from differing custody time-share schedules in any given situation – by what scientifically established criteria would a 70-30% custody time-share be better for the child than a 60-40% custody time-share in any specific situation.  <crickets>

Or bring me a goat.

50-50 Custody Timeshare

I love science.  I’m a scientifically grounded guy.  I believe we should make scientifically supported and scientifically grounded decisions.

So, once again, let me be abundantly clear regarding the scientific foundation for custody-related decisions…

In the absence of a scientifically supported justification (provide the citation) for a professional opinion regarding the relative benefits of a 60-40% custody time-share, or a 70-30% custody time-share, or an 80-20% custody time-share, or a 90-10% custody time, or a 50-50% custody time-share following divorce. …

The ONLY professionally responsible opinion is that children benefit from a complex relationship with both parents…

And – with the exception of child abuse – the ONLY scientifically and theoretically supported professionally responsible opinion regarding custody time-share following divorce should be for a 50-50% custody time-share schedule.

That is the ONLY opinion supported by the scientific evidence and surrounding theoretical literature.

The child’s parents can agree to a different time-share arrangement. That’s fine.  That is within their parental rights and prerogatives.  If the parents agree to a different schedule, fine by me.  But the only professionally responsible opinion would be based on the foundational premise that children benefit from a complex relationship with both parents – leading to a professional recommendation of a 50-50% custody time-share in all cases except child abuse.

“But Dr. Childress, sometimes it is clearly obvious that one parent is a better parent.”

Fine.  Cite for me the scientific research and theoretical literature that serves as your foundational criteria for “better parent” – develop your assessment protocol for this criteria – conduct the psychometric research to establish inter-rater reliability and validity for your assessment procedure – and we’ll be good to go.  Scientific foundation.

Yay.

Otherwise, you’re simply reading the entrails of a goat.

In the absence of this scientifically or theoretically grounded decision-making – the ONLY professionally responsible opinion regarding custody time-share following divorce should be for a 50-50% custody time-share schedule (with the exception of child abuse).

“What about when there is a history of domestic violence?”

Now we’re talking about the issue of child abuse (hostile-aggressive dangerous parenting).

“What about the manipulative pathology of a narcissistic or borderline personality parent following divorce.”

Now we’re talking about the issue of child abuse (psychological abuse).

“What about chronic parental alcoholism or substance abuse?”

Now we’re talking about the issue of child abuse (neglect).

If you document for me the current risk of child abuse, I’m with you 100%.

But in the absence of child abuse, there is no scientifically or theoretically supported criteria by which we can render a professionally responsible opinion regarding the relative future benefits to the child afforded by a 60-40% custody time-share schedule as compared to a 70-30% custody time-share schedule, as compared to an 80-20% custody time-share schedule, as compared to a 90-10% custody time-share schedule, as compared to a 50-50% time-share schedule.

Or bring me a goat.

Craig Childress, Psy.D.
Clinical Psychologist, PSY 18857

5 thoughts on “Bring Me a Goat”

  1. Here’s a tough question, how do we demonstrate to a court ” There is no – absolutely no – scientifically established foundation for the conclusions and recommendations offered by child custody evaluations. “?
    How do we show the absence of a scientifically established foundation?

    1. I don’t know. I am not an attorney.

      My suggestion as a psychologist is to ask the child custody evaluator in direct or cross examination to explain what “reliability” is (the stability of the assessment’s findings across situations or raters). Then ask what “validity” is (the truth or accuracy of the assessment’s findings). Then ask if the results produced by an assessment procedure can be valid (true and accurate) if they are not reliable (stable and consistent)? The answer is no; the findings of any assessment cannot, by definition, be valid if the findings are not reliable. If I use a test to measure your IQ this week and it is 130 (superior), and when I measure it next week it is 60 (mentally deficient), then my test of your intelligence is not reliable (stable; in this case test-retest reliablity), and so my findings that you are either brilliant or mentally deficient are not true and accurate – because my test results are not stable. Because my assessment procedure is not reliable (does not produce stable results), it is not a valid test of your intelligence.

      Once I have the custody evaluator acknowledge that an assessment procedure cannot, by definition, be valid if it is not reliable, then…

      Ask the custody evaluator to explain what inter-rater reliability is (the consistency of findings across two different raters). Then ask the custody evaluator to cite a single research study that demonstrates the inter-rater reliability of the conclusions and recommendations (an important phrase – the conclusions and recommendations) reached by child custody evaluations (there is none). So then, can two different evaluators reach two entirely different sets of conclusions and recommendations based on differing interpretations of the exactly the same data? The answer is yes. If the evaluator tries to hedge this answer – ask again for a single citation to research demonstrating the inter-rater reliability of the conclusions and recommendations of child custody evaluations.

      To wrap it up, I might finish with the question, “So if the conclusions and recommendations reached by child custody evaluators are not reliable, and two different evaluators can reach two entirely different conclusions and recommendations based on differing interpretations of exactly the same family-related data, how can the conclusions and recommendations be valid if they are not reliable?”

      Just for the hell of it, you might also ask what an “operational definition” is (the definition of a construct used in measuring it; such as “depression” might be operationally defined in an assessment as the person’s score on the Beck Depression Inventory). Then ask the evaluator what operational definition he or she used for the determining the construct of the child’s “best interests.” That should be an interesting answer. I have yet to run across an operational definition for the “best interests of the child,” so I have no idea what the evaluator’s answer to that question will be – because as far as I know, custody evaluators do not operationally define the construct of “best interests of the child.” They just decide what they want to decide and then label whatever that decision is to be the “best interests of the child.” Kinda backwards from what it should be. We should first decide on the definition of what the “best interests of the child” means, and then collect data related to this definition. Custody evaluations seem to do the exact opposite with regard to the “best interests” construct. They collect data first and then decide what the term means later – which just happens to coincidentally coincide with whatever decision the custody evaluator reaches. Stroke of luck there, eh? That whatever decision the custody evaluator makes ALWAYS just happens to coincide with the “best interests of the child” even though we are never provided with a definition of what constitutes the “best interests of the child” prior to the evaluation.

      Returning to the direct line of questioning, I might ask the evaluator to define the construct of “counter-transference” (the unconscious influence of the mental health professional’s own family of origin experiences on the mental health professional’s perceptions and interpretation of client-related material). Ask if counter-transference processes can lead to unrecognized and unconscious biases in the interpretation of data. The answer is yes. Since counter-transference is an unconscious bias – one we are not aware of, ask how counter-transference is reduced or eliminated in assessment procedures? The answer is by following standardized procedures in the collection – and INTERPRETATION – of the data. It’s in the interpretation of data that counter-transference creeps in. If we establish criteria for interpretation of data and decision making BEFORE we conduct the assessment, then we can reduce the influence of our biases in the subsequent interpretation and decision-making surrounding the data. If there is ABC, then that means XYZ. If there is not ABC, then that means QRS. Then, once we operationally define the construct, we assess for ABC.

      The mental health professional may try to slip the counter-transference issue by citing that it’s a psychoanalytic term that the evaluator doesn’t believe in. If the mental health professional tries this dodge, just switch the term to “schema” rather than counter-transference. Schema is the cognitive-behavioral term for the same construct.

      But again, I’m a psychologist, not an attorney. My role in legal proceedings is not to convince judges of anything. All I can do is present the facts of psychology-related information to the Court. The judge can then weigh this evidence in the context of other evidence before the Court and reach a decision. As a party to the proceedings, you may want to convince the judge of something, but as a psychologist I just offer the Court information that can assist the Court in decision making.

      Ultimately, from my point of view, it’s to professional psychology to clean up it’s professional practices to bring them into line with scientifically established standards of practice.

      I’m trying to move in that direction by standardizing the documentation of features – child symptom features through the Diagnostic Checklist for Pathogenic Parenting and parenting features through the Parenting Practices Rating Scale. We simply want the data documented. This will allow for a much clearer understanding of the issues. Just document the child’s symptoms. Just document the professional assessment of the targeted parent’s parenting.

      Once we get documentation, we can then get a second opinion on the same features, which will allow greater insight into inter-professional agreement (inter-rater reliability issues) and areas of discrepancy in differing professional opinions on the features evident in the family.

      But again, it is fundamentally up to professional psychology to enter the world of scientifically grounded practice. The ONLY professionally responsible opinion (in the absence of child abuse) regarding custody time-share schedules that would be supported by the scientific research and surrounding theoretical literature is for a 50-50% custody time-share based on the foundational principle that children benefit from a complex relationship with both parents. No other professional opinion is warranted by the scientific research support or surrounding theoretical literature.

      However, as long as reading the entrails of a goat is so financially lucrative, there appears to be little motivation within professional psychology for a more rational and scientifically grounded approach to custody-related decision making.

      Craig Childress, Psy.D.
      Clinical Psychologist, PSY 18857

      1. Excellent question and response!
        The “data” in the original article, the comment/question voiced and the Doctors response suggests that the doctor has Lean Six Sigma training and/or knowledge!

        Example:
        -“operational definition”
        -“show me the data”
        -“accuracy and repeatability”
        -drive towards “standard work”
        -hints at collection of factual data for the “who’s, what’s, where’s, why’s, how long’s”

        Being personally involved in a “high-conflict” divorce situation and all of the “standard process” steps of the family court system, I totally agree with the direction the Doctor is headed in educating the public on the factual constructs of this ugly family situation and the reality of true “abuse” and who’s the true “abuser”.

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