Dr Childress Analysis – Notes 4: AFCC & NCJFCJ Joint Statement on Parent-Child Contact Problems

This is my fourth post of my line-by-line notes for the AFCC & NCJFCJ Joint Statement on Parent-Child Contact Problems.

Notes 4 is in response to the third sentence of the Problem Statement

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Line-by-Line Notes 4

From the AFCC & NCJFCJ:

“This problem may be exacerbated by (1) gendered and politicized assumptions that either parental alienation or intimate partner violence is the determinative issue; (2) contradictory rhetoric about the application of research findings and the efficacy of interventions; (3) indiscriminate use of services; and (4) a lack of understanding of different perspectives, education among family law practitioners, and resources.”

Dr Childress Notes 4:

From the AFCC & NCJFCJ: “(1) gendered and politicized assumptions that either parental alienation or intimate partner violence is the determinative issue.”

There is no such pathology as “parental alienation” and the use of that construct in a professional capacity is substantially beneath professional standards of practice in clinical psychology, and is in violation of Standard 2.04 Bases for Scientific and Professional Judgements of the APA ethics code.

2.04 Bases for Scientific and Professional Judgments
Psychologists’ work is based upon established scientific and professional knowledge of the discipline

Professional organizations should abide by ethical Standards of practice. The AFCC and NCJFCJ have failed in this obligation. There is no such pathology as “parental alienation.”

Note: the AFCC and NCJFCJ identify a non-existent pathology and IPV (intimate partner violence) but they fail to note possible child abuse, including possible psychological child abuse by a pathological narcissistic-borderline-dark personality parent, as a possible “determinative issue” of the pathology in the family courts. Why did they omit possible child abuse as a possible “determinative issue” (particularly possible Child Psychological Abuse – DSM-5 V995.51) for possible pathology concerns?

The family conflict in the courts potentially also represents a DSM-5 diagnosis of spousal emotional and psychological abuse of the targeted parent by the allied parent using the child as the weapon, a DSM-5 diagnosis of V995.82 Spouse or Partner Abuse Psychological – which would represent IPV of the targeted parent by the allied parent using the child as the weapon.

IPV is a possible “determinative issue” in creating the pathology. In fact, it may be a driving issue.

Attachment pathology is always caused by pathogenic parenting, the diagnostic question is which parent? When possible child abuse is a considered diagnosis, a proper risk assessment needs to be conducted.

In all cases of severe attachment  pathology displayed by a child, a proper risk assessment for possible child abuse needs to be conducted to the differential diagnosis of:

• • • Possible child abuse by the targeted parent creating the child’s attachment pathology toward that parent (identify it, treat it, resolve it and restore the child’s attachment bond to the parent),

• • • Possible Child Psychological Abuse (DSM-5 V995.51) by the allied narcissistic-borderline-dark personality parent who is creating a shared persecutory delusion in the child that then destroys the child’s attachment bond to the other parent for the secondary gain of manipulating the court’s decision surrounding child custody – a false attachment pathology imposed on the child – a Factitious Disorder Imposed on Another (DSM-5 300.19)

The Problem Statement of the AFCC and NCJFCJ has lost its focus on the issue of importance, i.e., is there child abuse by a parent? Is the child at risk? Is a child protection response needed?

From the AFCC & NCJFCJ: “(2) contradictory rhetoric about the application of research findings and the efficacy of interventions;”

All psychologists should be applying the same information, i.e.., the “established scientific and professional knowledge of the discipline,” as the bases for thiir professiona judgments.

2.04 Bases for Scientific and Professional Judgments
Psychologists’ work is based upon established scientific and professional knowledge of the discipline

Standard 2.04 Bases of Scientific and Professional Judgments requires – mandatory – that the “established scientific and professional knowledge of the discipline” be applied as the bases for professional judgements.

Google mandatory: required by law or rules; compulsory.

Google required: officially compulsory, or otherwise considered essential; indispensable.

Google indispensable: absolutely necessary.

All psychologists should be applying exactly the same information (the best), to reach exactly the same conclusions (accurate), and make exactly the same recommendations (effective) based on the application of the “established scientific and professional knowledge of the discipline.” If two doctors disagree on a diagnosis, that is a serious problem for one of the doctors because it means they are wrong. That’s called a misdiagnosis, and that’s bad for a doctor.

The established scientific and professional knowledge of the discipline that is required to be applied as the bases for professional judgmens is:

• • • Attachment – Bowlby and others
    • Family systems therapy – Minuchin and others
    • Personality disorders – Linehan and others
    • Complex trauma – van der Kolk and others
    • Child development – Tronick and others
    • Self psychology – Kohut and others
    • DSM-5 diagnostic system & delusional thought disorders

If there is concern about the research or professional constructs being used in any of the above domains of knowledge, then specify what concerns exist in the attachment research, in the family systems principles and constructs used, in the personality disorder research applied, in the research on child abuse and complex trauma, in the child development research, in Kohut’s psychoanalytic model of child psychological development, or in the diagnostic criteria surrounding delusional thought disorders and Factitious Disorder Imposed on Another.

Be specific. What professional knowledge is not being applied appropriately, or being misapplied, from the “established scientific and professional knowledge of the discipline.”

This is the professional action required:

1, Document the child’s symptoms and surrounding family context.

2. Apply the diagnostic criteria for possible child abuse by the targeted parent – i.e., for Child Physical Abuse (V995.54), Child Sexual Abuse (V995.53), Child Neglect (V995.52), Child Psychological Abuse (V995.51).

3. Apply the diagnostic criteria for possible Child Psychological Abuse by the allied parent, i.e., creating a false attachment pathology and shared persecutory delusion in the child.

From the APA: “Persecutory Type: delusions that the person (or someone to whom the person is close) is being malevolently treated in some way.”

If the child is not being “malevolently treated in some way” by the normal-range parenting of the targeted parent, then rate the child’s false belief using the Brief Psychiatric Rating Scale (BPRS), “one of the oldest, most widely used scales to measure psychotic symptoms” (Wikipedia: BPRS: https://en.wikipedia.org); Item 11 Unusual Thought Content.

BPRS (Ventura, Lukoff, Nuechterlein, Liberman) https://www.researchgate.net/publication/284654397_Brief_Psychiatric_Rating_Scale_Expanded_version_40_Scales_anchor_points_and_administration_manual

In my clinical opinion, a BPRS rating should be obtained for child symptom severity for ALL court-involved evaluations of parent-child relationship conflict on the following items: Item 2 Anxiety, Item 3 Depression, Item 4 Suicidality (if warranted), Item 5 Guilt, Item 6 Hostility, Item 9 Susiciousness, Item 11 Unusual Thought Content.

If there is concern about the information being relied upon, then rely upon the “established scientific and professional knowledge of the discipline.” Document the child’s symptoms. Apply the diagnostic criteria for the respective differential diagnoses under consideration that could be causing the child’s symptoms. Diagnose the pathology in the family – identify the problem in the family – and place the problem (pathology) on a written treatment plan to fix it.

Google WikiHow Mental Health Treatment Plans

For personality disorder pathology, I recommend Dialectic Behavior Therapy (DBT; Linehan) as the organizing treatment structure for the family therapy, informed by attachment-related principles and treatment approaches (e.g., Tronick breach-and-repair sequence, Emotionally Focused Therapy; Johnson).

Treatment is based on diagnosis. The treatment for cancer is different than the treatment for diabetes. What diagnosis is being treated in the family courts? Is it an accurate diagnosis or a misdiagnosis? If we treat cancer with insulin then the patient dies from the misdiagnosed cancer. The appellate system for a disputed diagnosis is second opinion.

From Improving Diagnosis: “Clinicians may refer to or consult with other clinicians (formally or informally) to seek additional expertise about a patient’s health problem. The consult may help to confirm or reject the working diagnosis or may provide information on potential treatment options. If a patient’s health problem is outside a clinician’s area of expertise, he or she can refer the patient to a clinician who holds more suitable expertise. Clinicians can also recommend that the patient seek a second opinion from another clinician to verify their impressions of an uncertain diagnosis or if they believe that this would be helpful to the patient.”

Improving Diagnosis in Healthcare, a report from the National Academies of Science, Engineering, and Medicine: https://pubmed.ncbi.nlm.nih.gov/26803862/

There is substantial research and professional knowledge that can be universally agreed on and applied to understanding and treating the attachment pathology in the family courts. This represents the “established scientific and professional knowledge of the discipline.”

If it is not known or is not being applied by the forensic psychologists in court-involved practice, then that speaks to the deficient standards of practice in forensic psychology and raises prominent concerns for compliance with Standard 2.01 Boundaries of Competence related to the following domains:

• • • Attachment pathology
      • When assessing, diagnosing (identifying), and treating (fixing) severe attachment pathology displayed by the child.

• • • Delusional thought disorders
      • When assessing, diagnosing (identifying), and treating (fixing) possible delusional thought disorder pathology in the parent being imposed on the child.

• • • Narcissistic, borderline, and dark personalities
      • When assessing, diagnosing (identifying), and treating (fixing) the potential impact on family relationships of parental personality pathology.

• • • Family systems therapy and constructs
      • When assessing, diagnosing (Identifying), and treating (fixing) family conflict.

Does the Joint Statement by the AFCC & NCJFCJ meet professional Standards for Competence in the relevant domains of pathology, i.e., Standards 2.01 Boundaries of Competence, for the involved psychologists, and with regard to Standard 2.04 Bases for Scientific and Professional Judgments regareding the established scientific and professional knowledge they applied or failed to apply as the bases for their professional judgments?

From the AFCC & NCJFCJ: “(3) indiscriminate use of services;”

Mental health services should accurately diagnose the pathology and effectively treat it and resolve it. Over-use of mental health services should not be an issue because the pathology should be accurately diagnosed, treated, and resolved when it encounters the mental health system.

If pathology is not being effectively resolved when it enters the mental health system, that’s a problem in the mental health system not in the use of services by the clients.

“Indiscriminate use” is not the client’s concern, the existence of this feature suggests a breakdown in the ability of the “services” to effectively resolve the pathology (problem) on the initial encounter.

Diagnosis guides treatment. The treatment for cancer is different than the treatment for diabetes. What diagnosis for the family conflict pathology is guiding the “use of services” in the family courts?

From the AFCC & NCJFCJ: “(4) a lack of understanding of different perspectives, education among family law practitioners, and resources.”

These sound like personal opinions. Citations please to the research support for all four assertions:

• • That the problem in the family courts is being exacerbated by assumptions that either parental alienation [note there is no such diagnostic entity] or Intimate Partner Violence is the determinative issue;

• • • Why was possible child abuse omitted from consideration as a “determinative issue”?

• • • Where is the research support for this statement?

• That the problem in the family courts is exacerbated by rhetoric about the application of research findings and the efficacy of interventions;

• • • Where is the research support for this statement?

• That the problem in the family courts is exacerbated by indiscriminate use of services;

• • • Where is the research support for this statement?

• That the problem in the famiy courts is exacerbated by a lack of understanding of different perspectives, education among family law practitioners, and resources.

• • • Where is the research support for this statement?

This Problem Statement appears to be unsupported personal opinions of whoever is on the committee drafting the Joint Statement from the AFCC and NCJFCJ.

In professional psychology, a “lack of understanding…” is called incompetence. In professional psychology, a “lack of understanding” represents deficient professional practice. In professional psychology, a “lack of understanding” is called misdiagnosis.

All psychologists are expected to understand the pathology they work with (Standard 2.01 Boundaries of Competence) or else they shouldn’t be working with it.

All doctors should be applying exactly the same knowledge (the best) to reach exactly the same conclusions (accurate), and apply exactly the same treatments (effective). Psychologists are required to be competent by their education, training, and experience in the pathology they are working with (Standard 2.01 Boundaries of Competence) and to undertake ongoing efforts to maintain their competence, Standard 2.03 Maintaining Competence.

2.01 Boundaries of Competence
(a) Psychologists provide services, teach, and conduct research with populations and in areas only within the boundaries of their competence, based on their education, training, supervised experience, consultation, study, or professional experience.

2.03 Maintaining Competence
Psychologists undertake ongoing efforts to develop and maintain their competence.

The professional standard for competence with a pathology in clinical psychology is to know everything there is to know about the pathology, and then read journals to remain current.

It sounds like the AFCC & NCJFCJ are identifying professional incompetence, i.e., a “lack of understanding” due to inadequate “education” among the various professionals. Psychological pathology is the domain of psychologists. The psychologists should know what they are doing. There should be no “lack of understanding” displayed by the psychologists, and their education and training level should be appropriate to the pathology they are working with.

It sounds like the AFCC & NCJFCJ are offering the unsupported personal opinions of the committee members. A review of the psychologists’ vitaes on the committee is warranted to examine for their competence relative to Standard 2.01 in the following domains:

• • • Attachment pathology
      • When assessing, diagnosing (identifying), and treating (fixing) severe attachment pathology displayed by the child.

• • • Delusional thought disorders
      • When assessing, diagnosing (identifying), and treating (fixing) possible delusional thought disorder pathology in the parent being imposed on the child.

• • • Narcissistic, borderline, and dark personalities
      • When assessing, diagnosing (identifying), and treating (fixing) the potential impact on family relationships of parental personality pathology.

• • Family systems therapy and constructs
    • • When assessing, diagnosing (Identifying), and treating (fixing) family conflict.

Does the AFCC & NCJFCJ Joint Statement meet Standards for professional practice, or does it instead represent personal opinions offering “contradictory rhetoric about the application of research findings and the efficacy of interventions”?

Dr. Childress Notes 4.

Craig Childress, Psy.D.
Clinical Psychologist, CA PSY 18856