Child Custody Evaluations

I am still reviewing the scientific literature on child custody evaluations. I’m at the third or fourth tier of research right now.  In my review of the literature to date, which is fairly extensive, I am deeply disturbed by what I’m finding, or actually NOT finding.

From what I see…

There is absolutely no scientifically based foundation to the practice of child custody evaluations. Zero. None.

Child custody evaluations are little more than exceedingly expensive guesses. As far as I can tell, the recommendations produced by child custody evaluations are no more valid that looking in a crystal ball or reading the entrails of a goat.

I have found no scientific research supporting the validity of the conclusions and recommendations produced by child custody evaluations. In fact, I’ve found no scientific research that has even TRIED to support the validity of the conclusions and recommendations of child custody evaluations.

And even the theoretical foundations from clinical and developmental psychology that might be relied on for making the guesses that occur in child custody evaluations appear to be absent or deeply flawed.

Let me be clear on this statement:

Based on my review of the research literature, there is no scientific research or scientifically derived data to support the validity of the conclusions and recommendations reached by child custody evaluations.

The Construct of Validity

The scientific construct of validity essentially means that the conclusions we reach as a result of our assessment or research are true… that they are valid.

According to a standard textbook on scientific methodology (Cozby, 2009):

“Validity refers to “truth” and the accurate representation of information” (p. 85).

The scientific construct of validity refers to the degree to which the findings of our assessment or research are true.

So, for example, the validity of an intelligence test means the degree to which the intelligence test actually measures the construct of “intelligence.”

A test of puzzle solving ability might represent a valid measure of intelligence, depending on how “intelligence” is defined, but a test of a person’s ability to count from 1 to 10 is not likely to be a valid test of intelligence (depending on how the construct of “intelligence” is operationally defined).

I don’t want to become too technical on this point, but I do want to establish that this isn’t me, this is standard scientific methodology, so again, turning to the textbook definition of validity:

“Construct validity refers to the adequacy of the operational definition of variables. To what extent does the operational definition of a variable actually reflect the true theoretical meaning of the variable?

“In terms of measurement, construct validity is a question of whether the measure that is employed actually measures the construct it is intended to measure.”

“Applicants for some jobs are required to take a Clerical Ability Test; this measure is supposed to predict an individual’s clerical ability. The validity of such a test is determined by whether it actually does measure this ability.” (Cozby, 2009, p. 96)

Validity is a central construct in scientific research and assessment.

The scientific method contains several defined approaches of establishing validity for an assessment instrument or procedure.  Again, according to Cozby (2009) these scientifically established methods for determining validity include:

Face Validity: The content of the measure appears to reflect the construct being measured.

 Content Validity: The content of the measure is linked to the universe of content that defines the construct.

 Predictive Validity: Scores on the measure predict behavior on a criterion measured at a time in the future.

Concurrent Validity: Scores on the measure are related to a criterion measured at the same time (concurrently).

Convergent Validity: Scores on the measure are related to other measures of the same construct.

Discriminant validity

Scores on the measure are not related to other measures that are theoretically different.

Cozby, 2009, p. 97

Again, I don’t want to get too technical in this blog post, I just want to highlight that this isn’t me.

The construct of validity is a standard scientifically defined construct regarding whether something we assert is true, and there are standard scientifically defined approaches to establishing an assessment procedure’s validity.

Regarding the validity of the conclusions and recommendations produced by child custody evaluations (i.e., are they true), no effort has even been made to establish the scientific validity of the conclusions and recommendations reached through the process of child custody evaluations. Much as I try (and I’m trying), I cannot find a single research study examining the scientific evidence for the validity of child custody evaluations.

I want to be clear on this, I’m not saying that the scientific data on the validity of child custody evaluations is weak… I’m saying it is NON-EXISTENT.

There is absolutely NO scientifically established foundation for the validity of the conclusions and recommendations produced by child custody evaluations. None. Zero. Not one study. Ever. Nothing.

There is no scientific support whatsoever for the validity of the conclusions and recommendations produced by child custody evaluations. Might as well cast tarot cards or have a monkey throw darts at a dartboard.

There is no scientifically based support for the validity of the conclusions and recommendations produced by child custody evaluations. None.

Child custody evaluations are essentially, “junk science” and “voodoo assessment.”

That’s a strong statement.

Yet I would challenge any proponent for the practice of child custody evaluations to cite for me one research study that even seeks to establish the scientific validity of the conclusions and recommendations produced by child custody evaluations. No one has even tried to establish the scientific foundation for the validity of child custody evaluations.

Even more to the point, however, I would challenge the proponents for the practice of child custody evaluations to cite me the research support demonstrating the validity for the conclusions and recommendations of child custody evaluations, the face validity, content validity, predictive validity, concurrent validity, convergent validity, and/or discriminant validity.

There is none. Zero. Nothing. There is NO scientifically established foundation for the conclusions and recommendations produced by the practice of child custody evaluations. None.

The systematic collection of data provides the APPEARANCE of scientific rigor, but the conclusions and recommendations are 100% guesswork. There is no scientific support for the validity of the conclusions and recommendations produced by child custody evaluations. None.

The conclusions and recommendations of child custody evaluations are essentially “junk science” – “voodoo assessment” – rattle some beads, perform some rituals of data collection, recite some incantations, and just make up some recommendations based on the whims and prejudices of the moment.

Despite the apparent rigor involved with the systematic collection of data, there are NO scientifically described or established criteria in any of the literature for linking the conclusions and recommendations made in child custody evaluations to the data collected. As far as I can tell, it is pure, unadulterated, guesswork that has no defined linkage to any theoretical or scientifically established foundation.

Might as well read the entrails of a goat.

Operational Definitions

As noted by Cozby, the key to establishing the scientific validity for any assessment procedure is to “operationally define” the construct being assessed.

If, for example, we are going to create an assessment for “intelligence,” we first need to “operationally define” what we mean by “intelligence.” Is it the amount of vocabulary the person knows? Is it some form of problem solving ability? Is it a combination of both? Are there different types of “intelligence?”

How do we define the construct of “intelligence” that we are going to be assessing?  The operational definition for the construct provides the foundation for the scientific validity studies that will follow.  If we don’t have an operational definition for the construct, then we cannot collect scientific data on the validity of the construct because we haven’t defined what the construct means.

Once we define what we mean by a given construct, such as “intelligence,” other people may then disagree with our definition, and a lively debate and dialogue ensues regarding the definition of the construct. And different approaches to assessment will emerge based on different approaches to defining the construct.

However, if we don’t ever define the constructs we’re assessing, then no debate or discussion ever occurs.  Everyone just makes up their own definitions based on whatever they need the construct to mean in order to justify what it is that they want to do.

In one case, the “best interests” of the child are factors xyz. In another case, they’re factors abc. In a third case, they’re factors qrs. There is no defined standard for determining what the “best interests” of the child are.

For evaluator A, the child’s “best interests” might be x.  For evaluator B, the child’s “best interests” might be y.  Without an operational definition for the construct, the “best interests” of the child become whatever I want them to be in order to justify my decision.

The “best interests” of the child becomes a fluid and malleable construct that I can define in any way I want based on whatever it is that I want to do.  If I want to recommend xyz, I simply emphasize xyz as being in the “best interests” of the child and I minimize the importance of qrs.  If, on the other hand, I want to do qrs, then I simply define qrs as being in the “best interests” of the child, and I minimize the importance of xyz.  The construct becomes a means to justify whatever decision I want to make.

My decisions aren’t based on the best interests of the child. In fact, it’s just the reverse, the “best interests” of the child are based on my decision. Whatever I decide, I then use the construct of the “best interests” of the child to justify this decision.

Q: But aren’t your conclusions and recommendations based on the data?

A: Naw, not really. I collect a lot of data, but then I can interpret and weight the data in any way I want. I can make this thing more important than that. Or I can ignore this data and highlight that data. I can do that in any way I want, because nothing is defined, there are no operational definitions for any of this. It’s all based on however I define the constructs based on my desires, whims, and prejudices. So I just decide what I want my conclusions and recommendations to be, and then I interpret the data accordingly, weighting this and discounting that.

Q: But what about all that data collection you do? Doesn’t that mean anything?

A: That’s just show. It’s a ritual we go through to give the appearance of scientific rigor.

By putting in so much effort and collecting so much information it looks like our conclusions and recommendations must be based on the application of “scientific principles” to the thorough collection of data. But that’s just a show for the audience. If we didn’t collect all that data, no one would give our conclusions any credibility. So we have to do it to establish our credibility.

But when it comes down to it, there’s no established principles or guidelines for how we INTERPRET that data, and it’s the interpretation of data that really matters. So we can pretty much do whatever we want in terms of coming up with our conclusions and recommendations, we can reach any conclusion we want or offer any recommendation, without any restriction or limitation imposed by whether our conclusions or recommendations are accurate or correct.

Generally it’s best to stay in the mid-range with recommendations.  If you don’t take a stand, you can’t really be attacked.  Just kind of go with the way things are, maybe a little nudge here and there.  And if there’s any unresolved issues, just recommend therapy.

Oh, and here’s the best part, because child custody evaluations are kept protected by the court, no other mental health professionals ever review our work for the accuracy of our interpretations, conclusions, and recommendations.  We can pretty much do whatever we want  And let me tell you, all that time spent collecting data, and then report writing, is pretty lucrative.

Providing operational definitions for a construct allows professional psychology to discuss and debate the accuracy of this definition. New ideas emerge and the understanding for the construct deepens and improves through professional dialogue and debate, which ultimately leads to better assessment procedures and improved methodologies. 

For example, in the field of intelligence assessment, developing an operational definition for the construct of intelligence has created tremendously robust professional dialogue and disagreement. There’s Spearman’s proposal for a general intelligence factor (“g”), there’s Thurstone’s set of primary mental abilities, there’s Cattell and Horn’s proposal for fluid and crystallized intelligence, there’s Howard Gardner’s (different Gardner) proposal for eight distinctly different types of intelligence.  With each proposal regarding an operational definition for “intelligence” our understanding for and assessment of the construct improves.

Absence of Professional Discussion

Where is the corresponding robust debate and dialogue regarding the constructs used and assessed by child custody evaluations?

What do we mean by the construct “best interests” of the child? How are we operationally defining this construct of “best interests?”

As important as our operational definition for this construct, what is the scientific evidence that supports our operational definition of the “best interests” of the child as being the factors we identify?  Where is the professional dialogue and debate?

What do we mean by the construct of “parental capacity?” How are we operationally defining the construct of “parental capacity?”

As important as our operational definition for this construct, what is the scientific evidence that supports the factors we’re using in our operational definition of  “parental capacity?” Where is the professional dialogue and debate surrounding the key factors in parenting?

Where is the robust debate and dialogue within professional psychology surrounding what factors define the “best interests” of the child, or what factors define “parental capacity?” There is none. It is totally absent. Doesn’t anyone else in mental health find that spookily disturbing? That we have NO professional dialogue or debate about such central tenets of child custody assessment?

Q:  How is it we have NO discussion or debate around defining these constructs?

A:  There’s no disagreement because we just let everyone make up whatever definition they want.  No definition.  No debate.

Try as I may, I cannot find a single operational definition for either of these key and central constructs for the assessment conducted in child custody evaluations. I find general guidelines, such as for the “best interests” of the child:

1.) the child’s wishes,
2.) any history of abuse,
3.) the parents’ wishes,
4.)
each parents’ ability to share the child with the other parent, and
5.) the environment that best promotes the development of physical, mental, and spiritual faculties.

Current statutes. (2003). In Handbook of forensic psychology: Resource for mental health and legal professionals. Oxford, United Kingdom: Elsevier Science & Technology.

But these general guidelines for domains of information to consider lack the specificity needed to be reliable operational definitions for the construct of “best interests” of the child.

How should we interpret the child’s expressed wishes? How much weight do we give them relative to other factors?

Debate: And if we consider the child’s expressed wishes, won’t we then be turning the child into a “prize to be won” by the parents, and won’t this lead to efforts by the parents to influence the child’s choice and preferences (“Choose me, Choose me. If you come live with me I won’t make you do homework. If you come live with me I’ll buy you a new gaming system.”). Won’t this turn the child into a battleground for the parents’ spousal dispute as a “prize to be won” by the “best parent” (by the parent who best appeases or most intimidates the child)?

How will considering the child’s wishes affect, or be affected by, the parent’s ability to share the child with the other parent? Aren’t we making it harder for the parents to “share the child” by making them competitors for the child’s affection?

And how are we operationally defining the last construct of “the environment that best promotes the development of physical, mental, and spiritual faculties” of the child? What are the criteria by which we are making this determination?

In all of my efforts to date, and they have been considerable, I have yet to find an operational definition for either of the key and central constructs of child custody evaluations; the “best interests” of the child and the “parental capacity” of the parent. I see these terms used, I just haven’t located an operational definition for what these terms mean.

Without operational definitions for either of these key and central constructs of child custody assessments, then there can be no scientifically established basis for the assessment. The child custody evaluation becomes nothing more that “making it up as we go” by defining “best interests” or “parental capacity” in whatever way we want in order to justify whatever we decide to do.

I find a whole lot of guidelines for what data to collect, and for how the data should be collected. But that’s not the same thing as operational definitions for how to INTERPRET and use the collected data to reach a conclusion and recommendations. It’s this second part, regarding the criteria by which the clinical data obtained during the custody evaluation should be interpreted, in which the professional silence is deafening.

Not my Fault

The emperor has no clothes. Sorry.  He’s naked.  That’s not my fault.

To my professional colleagues… don’t get mad at me. Somebody needs to say it. Child custody evaluations have no operational definitions for the key and central constructs they use in their assessment, and they have no scientific support for the validity of the conclusions and recommendations they make.

Child custody evaluations are scientifically naked. The emperor has no clothes. Sorry. Not my fault. I’m not the tailor, I’m only the kid standing on the parade route, watching the (naked) emperor go by.

Child on the parade route: “Look mommy, that custody evaluation has no clothes on.”

Mommy: “Shhh, don’t say that, you’ll get in trouble.”

Don’t blame me, I’m not the tailor.  I’m just the kid watching the naked emperor go by.

There is no scientifically established basis for the conclusions and recommendations reached by child custody evaluations. They are “junk science” comprised of “voodoo assessment” – rattle some beads, perform some rituals, recite some incantations, and make up some pronouncement based on whatever whim, motive, or prejudice moves you.

Secrecy of the “Insiders”

Child custody evaluations are secret reports guarded and protected by the court. Since their release is restricted, they are not subject to critical professional review and scrutiny. They represent the judgement of one person, operating alone, without consultation or review. When they are subjected to review and scrutiny, it is typically by other forensic child custody evaluators to see if the “procedures” of the child custody evaluation process were followed, not regarding the accuracy of clinical data interpretation and the validity of the recommendations.

Any critical review of the child custody report is not about the clinical interpretation of the clinical data, or the validity of recommendations that were derived from the interpretation of the clinical data.  Instead the review is about the “procedures” employed in the custody evaluation; did the custody evaluator rattle the proper beads and perform the proper rituals to appease the tutelary spirits of child custody? Were collaterals interviewed?  Were home visits made?  Were the proper test instruments employed?

And the best way to stay out of trouble is to make middle-of-the-road recommendations.  And by all means, DON’T IDENTIFY PARENTAL PATHOLOGY (even if identifying the parental pathology is in the best interests of the child).

The rare professional reviews of child custody evaluations that do occur do not typically involve a critical analysis regarding the accuracy of the clinical psychology interpretations made regarding the clinical data collected, nor do they involve a critical analysis of the appropriateness from a clinical psychology framework regarding the recommendations made based on the interpretation of the clinical data.

In my role as an expert consultant in legal cases, on multiple occasions the court has made available for my review child custody evaluations. I have had the opportunity to review the clinical data reported in the custody evaluations, as well as the professional interpretation of this clinical data and the recommendations that were made based on this interpretation of the clinical data. As a clinical psychologist, I am deeply appalled by the extraordinarily poor interpretations of the clinical data that I have found in the child custody evaluations that I have professionally reviewed.

As a clinical psychologist, it is bad. VERY bad.

Statement to the Court

I have tremendous respect for the courts and our legal system.

My father, an attorney, worked for the federal court system for 30 years. He was with the State Bar of California and served as a magistrate within the court system. He was a man of great integrity. I have a deep respect for him, and for the court system in which he served.

Out of my deep respect for the justice system and for the Court, and from my professional integrity as a clinical psychologist serving children and families, and from my professional background in CLINICAL PSYCHOLOGY (not forensic psychology), my understanding of child and family psychotherapy, and my professional knowledge of child development, I wish to respectfully offer to the Court my extremely deep and troubling concern about the QUALITY of the clinical interpretations made in forensic child custody evaluations.

The secrecy in which these child custody evaluations are held prevents their professional review regarding the level of professional competency and therefore accuracy of the clinical interpretations of the clinical data collected in these forensic evaluations. These forensic evaluations do an exceptional job of collecting data, but the clinical interpretations of the clinical data is, in the cases I have reviewed, deeply flawed and deeply troubling.

I am concerned that an inherent conflict of interest exists within forensic psychology that prevents an adequate critical analysis within professional psychology regarding the practice of child custody evaluations, and that this inherent conflict of interest prevents relevant information from being made available for the Court’s consideration regarding the absence of scientifically established validity for the recommendations provided by child custody evaluations and the poor quality of clinical interpretations contained within these custody recommendations.

The field of child custody evaluations is currently within an echo chamber of like-minded forensic psychologists that prevents an appropriately critical professional oversight and review of the interpretations and recommendations made in child custody evaluations, and of the absence of scientifically established foundation for the interpretations and recommendations made by child custody evaluations.

Based on my review of the clinical interpretations made in the multiple child custody evaluations that the Court has allowed me to review as an expert consultant to my clients, I wish to respectfully offer to the Court my deep concern as a clinical psychologist regarding the level of professional accuracy contained in the CLINICAL interpretations of the clinically relevant data contained in child custody evaluations, which adversely affects the conclusions and recommendations reached in these child custody reports.

Recommendation to the Court

The recommendations I would respectfully offer to the Court are:

1.)  Consulting Psychologist:  I would recommend that the Court allow each parent (if they choose) to select a consulting psychologist in addition to the court-appointed forensic evaluator, thereby creating a panel of three psychologists surrounding the custody evaluation; one psychologist representing the court, and a psychologist representing each of the parents, much in the same way as each parent is represented by legal counsel in the courtroom.

2.)  Review and Consultation:  I would recommend that these consulting psychologists be empowered to review with the court-appointed psychologist the clinical data once it is collected by the court-appointed custody evaluator, and that they provide professional consultation to the court-appointed custody evaluator regarding the interpretation of the clinical data, and the potential conclusions and recommendations to be derived from the clinical data.

3.)  Dissenting Opinion:  I would also recommend that these consulting psychologists be allowed to write a “dissenting opinion” if they choose regarding the interpretation of the clinical data and the recommendations made by the court-appointed psychologist, which would be appended to the final report of the court-appointed custody evaluator.

This oversight and consultation by independent professionals is warranted by the tremendous importance of the decision and recommendations provided by the child custody evaluation and the complete absence of scientific foundation for the validity of the conclusions and recommendations reached by child custody assessments.

Professional Psychology

I would also call on professional psychology to critically examine and consider the theoretical and scientific foundations for the practice of child custody evaluations. My concerns are based on the following.

1.)  Absence of Scientific Foundation:  The complete absence of any research examining and supporting the scientifically established validity of the conclusions and recommendations reached by child custody assessments. There is no supporting scientific evidence for the face validity, content validity, predictive validity, concurrent validity, convergent validity, or discriminant validity of the conclusions and recommendations produced by child custody assessments. In the absence of such supportive scientific evidence, the recommendations offered by child custody assessments are little more than “junk science” and “voodoo assessment.”

2.)  Absence of Operational Definitions:  The complete absence of established operational definitions for the key and central constructs of the child’s “best interests” and the parent’s “parental capacity” that are central to the child custody assessment.  Given the incredible importance of the recommendations being rendered by child custody evaluations in influencing the Court regarding the lives of children and families, there needs to be a much more engaged and vigorous professional discussion regarding the specific factors defining the constructs of the child’s “best interests” and the parent’s “parental capacity” to meet those interests (similar to the robust discussions generated surrounding the construct of “intelligence”).

3.)  Cultural Considerations:  Any assessment of parenting and family processes is necessarily embedded in a cultural context. A robust and vigorous discussion needs to be engaged regarding the influence of culture on the process of child custody assessment and the formation of recommendations, particularly around the standard employed in assessing parenting practices and the establishment of family values.

4.)  Conflict of Interest:  The current practice of conducting child custody evaluations is financially lucrative. The ability of forensic psychology to critically evaluate itself is therefore compromised by an inherent conflict of interest. As a consequence of this inherent conflict of interest in meeting the needs of clients, it becomes even more essential to ensure that a deeply critical independent analysis be conducted regarding the scientific validity for the interpretations and recommendations reached by child custody evaluations.

5.)  Secrecy and Oversight:  Procedures need to be established to provide reasonable professional oversight regarding the validity of the clinical interpretations made by a child custody evaluator, especially given the complete absence of scientific support for the validity of child custody assessments and recommendations.

Conclusions

Based on my review of the scientific literature surrounding the conclusions and recommendations provided by child custody evaluations, I have reached the conclusion that the practice of child custody evaluations as currently structured represents little more than “junk science” and “voodoo assessment” which does not merit consideration in court proceedings.

I am certain that this conclusion will generate considerable disagreement.  My response is to request a citation to any scientific article that even assesses the face validity, content validity, predictive validity, concurrent validity, convergent validity, or discriminant validity of the conclusions and recommendations produced by child custody evaluations.

To take this incredibly low bar just a tad higher, I would request a citation to any research demonstrating the face validity, content validity, predictive validity, concurrent validity, convergent validity, or discriminant validity of the conclusions and recommendations produced by child custody evaluations.

Also, I would request a citation to any “operational definition” for the constructs of “best interests” of the child and “parental capacity” of the parent which are the central tenets of the assessment.

You don’t need to reference me to the general professional guidelines regarding what information to collect, or how to collect it.  I am asking for the reference to the actual operational definitions for what these constructs mean that can be applied to the collected data in interpreting and formulating the conclusions and recommendations of the assessment (i.e., an operational definition for what factors in the collected data indicate the “best interests” of the child or the “parental capacity” of the parent, and regarding an operational definition for what factors in the data indicate “non-best interests” and “non-parental capacity” of the parent.

Until the scientific foundation for the conclusions and recommendations of child custody evaluations is established, I must conclude that child custody evaluations are little more than “junk science” and “voodoo assessment” that do not merit court consideration. Rattle some beads and read the entrails of a goat.

Or offer me a citation for the scientifically established validity of the conclusions and recommendations derived from child custody evaluations.

Craig Childress, Psy.D
Clinical Psychologist, PSY 18857

References:

Cozby, P. C. (2009). Methods in Behavioral Research: Tenth Edition. New York, NY: McGraw-Hill.

Current statutes. (2003). In Handbook of forensic psychology: Resource for mental health and legal professionals. Oxford, United Kingdom: Elsevier Science & Technology.

Remedy: Single-Case ABA Design

“Remedy:  The manner in which a right is enforced or satisfied by a court when some harm or injury, recognized by society as a wrongful act, is inflicted upon an individual.”


I am a psychologist, not an attorney. For legal advice consult an attorney and follow the advice of your attorney.

When the three diagnostic indicators of attachment-based “parental alienation” are present, treatment requires the protective separation of the child from the pathogenic parenting of the narcissistic/(borderline) parent during the treatment and recovery stabilization period.

We cannot ask the child to expose his or her authenticity until we can first protect the child. 

“Parental alienation” is not a child custody issue, it is a child protection issue. The first and only consideration should be the child’s welfare. 

When the three diagnostic indicators of attachment-based “parental alienation” are present, the child’s welfare requires the protective separation of the child from the psychopathology and pathogenic parenting of the narcissistic/(borderline) parent during the active phase of the child’s treatment and recovery stabilization.

Achieving the required protective separation requires the cooperation of the Courts.

Courts, however, are not psychologists.  Superficially, the child appears bonded to the narcissistic/(borderline) parent.  The psychologically destructive impact of the role-reversal is not overly evident.  Courts may be reluctant to do what’s necessary, and may desire a more moderate response.

Until Courts recognize the severity of the pathology involved, we must work with the legal system as it is. Under the current conditions, providing judges with an alternative that is both balanced and temperate may help achieve a resolution. 

Toward that end, I have developed a possible remedy that may be acceptable to the Court.  It involves a scientifically grounded and evidenced-based approach to resolving “parental alienation.” This potential remedy employs a standard scientific research methodology called a single-case ABA design (actually a single-case ABAB reversal design). 

(In addition to teaching graduate-level courses in psychopathology, treatment planning, and child development, I also teach courses in research methodology.)

I have posted a description of this approach to my website, just below the Therapy article, and a direct link to the single-case ABA design article is at:

Single-Case ABA Design

If a Court wishes to employ this approach, I would be happy to consult with a psychologist in supervising the implementation of the single-case design.

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

SBS Intervention

“Remedy:  The manner in which a right is enforced or satisfied by a court when some harm or injury, recognized by society as a wrongful act, is inflicted upon an individual.”

http://legal-dictionary.thefreedictionary.com/remedy

Just a reminder, I am not an attorney.  I am a psychologist.  For legal advice consult an attorney and follow the advice of the attorney.  In this post I will be discussing a possible compromise intervention that may, in some cases, be presented to the Court as a proposed remedy based on the legal strategy of the attorney in a given situation.


I am increasingly being asked by attorneys to serve as an expert consultant or witness regarding cases of “parental alienation.”

Just for the record, I am not an expert in “parental alienation.”  From a clinical psychology perspective, the term “parental alienation” is not a defined clinical term. 

The proper clinical term for the interpersonal and family processes typically called “parental alienation” is “pathogenic parenting” (patho=pathology; genic=genesis, creation).  Pathogenic parenting is the creation of significant child pathology as a result of highly distorted parenting practices.

My professional expertise is in child and family therapy, diagnosis and psychopathology, parent-child conflict, and child development.

I recently met with a targeted parent and discussed her situation.  I then spoke with her attorney regarding the case.  The attorney believes the evidence of “parental alienation” is substantial.  There is a history of unsuccessful “reunification” therapy and a child custody evaluation is pending.

From a psychological perspective, I recommended that the approach remain focused on the child’s evident pathology (i.e., on pathogenic parenting) and the child’s treatment needs rather than on trying to prove that “parental alienation” has interfered in the relationship of the targeted parent and child.

Attachment-based “parental alienation” is not just a matter of disrupting the targeted parent’s relationship with the child, it is a matter of inducing serious and severe psychopathology in the child through the distorted pathogenic parenting practices of the allied and supposedly favored narcissistic/(borderline) parent.  I believe it is best to remain grounded in the child’s pathology and in the treatment needs of the child.

My concern is that if the focus shifts to proving “parental alienation,” then this invites an identification of harm or injury as being to the parental rights and parental relationship of the targeted parent, leading to a remedy directed toward satisfying the harm and injury done to the targeted parent

If, on the other hand, the focus remains on the extent and severity of the child’s pathology that is being created by the distorted pathogenic parenting of the allied and supposedly favored parent, then the remedy involves the treatment needs of the child that are necessary to restore the normal-range and healthy development of the child.

It’s not about injury to the parent, its about injury to the child.  The remedy isn’t focused toward the parent, the remedy is focused toward the child.

Attachment-based “parental alienation” isn’t a child custody issue, it’s a child protection issue.

Again, I am a psychologist not an attorney, but I would tend to recommend avoiding the construct of “parental alienation” as  I view this as chasing a rabbit down the rabbit hole.  The narcissistic/(borderline) parent responds, “prove it,” and then we’re into chasing a nearly impossible task of proving distorted parenting and we have lost the grounding afforded by a relentless focus on the nature and severity of the child’s pathology and treatment needs, and on what is necessary to restore the normal-range and healthy development of the child.

When we remain focused on the nature and severity of the child’s symptoms, we open the door to the treatment needs of the child.  The treatment needs of the child depend on the clinical diagnosis regarding the origin of the child’s pathology. I am a clinical psychologist.  That’s what I do.  I identify the origins of child pathology and I develop and implement treatment plans that will restore the child’s healthy development based on what the origins of the child’s pathology are.

Q:  Could the nature and extent of the child’s pathology be originating spontaneously from the child?  A: No.

Q:  Could the nature and extent of the child’s pathology be the product of the pathogenic parenting of the targeted-rejected parent?  A: No.

Q: If the child’s severe pathology is not originating spontaneously from the child, and is not a product of the pathogenic parenting of the targeted-rejected parent, then what could be the origins of the child’s pathology?

A:  The child’s pathology is being induced by the distorted pathogenic parenting practices of the allied and supposedly favored parent.

Remedy: What are the treatment needs of the child to restore normal-range and healthy development?

Again, this is not legal advice.  I am a psychologist.  This is just my opinion from my perspective as a clinical psychologist.  This is what I do for a living.  I first identify the nature and severity of the child’s pathology.  I then use features of the child’s pathology to identify the origins of the child’s pathology.  I then develop and implement a treatment plan to resolve the child’s pathology based on my assessment regarding the origins of the child’s pathology. 

I am a clinical child and family psychologist. That’s what I do.  I do this for autism-spectrum disorders, for ADHD-spectrum disorders, for child depressive and anxiety disorders, for oppositional and defiant child behavior, for school failure, for attachment disorders, for parent-child and family conflicts.

I do this across the developmental spectrum; for young children and their families, for school-age children and their families, for adolescents and their families.

1.)  Identify the nature and severity of the child’s pathology.

2.)  Use features of the child’s symptom display to identify the origins of the child’s pathology.

3.)  Develop and implement a treatment plan that will restore the child’s normal-range and healthy development based on the identified origin of the child’s pathology

Treatment Needs

The attorney and I then discussed what the treatment needs of the child are in this case based on the information I had from the targeted-rejected parent.

We discussed the child’s potential triangulation into the spousal conflict through the formation of a cross-generational coalition with the allied and supposedly favored parent against the other parent.

We discussed the child’s apparent narcissistic and borderline symptoms as described by the targeted parent, and the possible origin of these reported child symptoms in the pathogenic parenting practices of the allied and supposedly favored parent.

I described the hypothesis that the child was experiencing a misunderstood and misinterpreted grief response relative to the lost relationship with the beloved-but-now-rejected targeted parent, and we then discussed the treatment for that.

We discussed the means by which the child’s symptomatic rejection of a normal-range and affectionally available parent could be induced through a role-reversal relationship with a narcissistic-borderline parent who is using the child as a “regulatory object” to meet the emotional and psychological needs of the parent.

I discussed the importance relative to an attachment-based model of “parental alienation” of a protective separation of the child from the pathology of the allied and supposedly favored narcissistic/(borderline) parent during the active phase of the child’s treatment and recovery as representing a necessary condition for protecting the child if we are to ask the child to expose his or her authenticity.

Treatment Plan

As we discussed the remedy the attorney could seek from the Court for the severely pathogenic parenting associated with an attachment-based model of “parental alienation,” my  recommendation was Dorcy Pruter’s “High Road to Family Reunification” protocol. I have reviewed her protocol and I completely understand how she achieves the recovery of the children’s relationship with the targeted parent. The “High Road” protocol would be my first-line recommendation for restoring the parent-child relationship, over and above any other approach to family reunification.

Her protocol requires that the Court order a 9-month period of protective separation of the children from the pathology of the narcissistic/(borderline) parent.  I understand why this is necessary and I entirely agree with the requirement. 

With this protective separation in place, she asserts that her protocol is capable of restoring normal-range parent-child relationships in a matter of days, and based on my review of her protocol, I would agree with this assessment of the protocol’s effectiveness..

In my view, this is the best approach for restoring  children’s affectionally bonded relationship with the targeted parent because of its effectiveness, its intensity, and its speed.  The child’s initial recovery will be fragile at first, so a continued protective separation of the child from the pathogenic pathology of the narcissistic/(borderline) parent is needed to stabilize the child’s recovery.

The attorney and I then discussed the likelihood in this case that the Court would order a protective separation of the child from the allied and supposedly favored pathogenic parent.  This will likely be dependent on the strength of the evidence that can be presented to the Court regarding the severity of the pathogenic parenting as evidenced in the child’s symptoms, and the associated treatment needs of the child necessary to restore the child’s healthy and normal-range development.

The SBS Intervention

As we discussed remedies relative to the child’s pathology and treatment, and the possible reluctance of the Court to order the necessary protective separation of the child which would be required for the child’s treatment and recovery, I remembered an old “compromise solution” for the Court that I developed back in 2011, the Strategic-Behavioral-Systems Intervention (SBS Intervention). 

The SBS Intervention is a Strategic family systems intervention that targets the power dynamic in the family. 

Strategic Family Systems Therapy

From a Strategic family systems framework, the child’s symptom confers power.  Strategic family systems therapy analyzes the power dynamics within the family and develops a prescriptive intervention which, if followed, will alter the power dynamics so that the symptom just drops away because it no longer serves its function of conferring power within the family relationships.

Strategic family systems therapy is a less common form of family systems therapy because it requires a fair degree of sophisticated skill in family systems therapy to first analyze the power dynamics within the family and then to also develop a prescriptive solution which, when implemented, will automatically alter the power dynamics within the family in a way to release the symptom.

While difficult to develop, and as a consequence rare in clinical practice, a good Strategic family systems intervention, however, can be quite elegant and powerful in its operation. The major limitation to Strategic family systems therapy is the level of clinical skill required to develop a prescriptive intervention that alters the specific power dynamics within the family in a way that will release the symptom.

The SBS Intervention

The Strategic-Behavioral-Systems Intervention for attachment-based “parental alienation” represents my effort to develop a Strategic family systems intervention for attachment-based “parental alienation.”  My goal in this is to provide the Court with a possible compromise solution to removing the child entirely from the care of the allied narcissistic/(borderline) parent.

I sent the SBS Intervention protocol to the attorney with whom I was consulting for her consideration as a possible proposed remedy.

I have also posted the Strategic-Behavioral-Systems Intervention protocol to my website, and a direct link to it is at:

Strategic-Behavioral-Systems Intervention

Note:  My recommendation as a clinical psychologist would be for a period of protective separation of the child from the pathogenic pathology of the allied narcissistic/(borderline) parent during the active phase of the child’s treatment and recovery stabilization.

If the SBS Intervention is tried as a compromise solution to a complete protective separation, then I would recommend a six-month trial of the SBS Intervention.  If the SBS Intervention has not restored the child’s normal-range development after a six-month “Response-to-Intervention” trial, then I would recommend a complete protective separation of the child from the pathogenic parenting of the allied narcissistic/(borderline) parent and intervention with the High Road protocol.

If the High Road protocol of Pruter’s is not possible, then I would recommend a treatment model along the lines described in my essay on Reunification Therapy available on my website.

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

Generic Letter to Minor’s Counsel

For what its worth, I drafted a generic letter to minor’s counsel in an effort to explain the pathology of attachment-based “parental alienation.” This letter is up on my website, near the top, and a direct link to it is,

Letter to Minor’s Counsel

I am not optimistic that minor’s counsels (or therapists) will listen, people tend to do what they tend to do, and influencing them is hard.  But, I’m trying to provide you, the targeted parent, with the psychology words to understand and possibly explain what’s happening.
The appointment of minor’s counsel is essentially the appointment of legal counsel to represent the pathology in the family (see The Appointment of Minor’s Counsel Must Stop post). It’s a very bad thing that should stop immediately.
Craig Childress, Psy.D.
Clinical Psychologist, PSY 18857

Court Consideration of Adolescent Wishes

I was recently asked a question by a targeted parent about the practice in some Courts of considering the wishes of an adolescent in custody placement decisions, and I’d like to share my response.

While I will explain my response in a lengthy post, it’s actually quite simple: 

At no time should the Court ever consider the wishes expressed by the child whenever there is spousal-parental conflict.

Pretty simple.  Now let me explain why.  There are two primary reasons.

First, the authenticity of the child’s expressed wishes may likely have been compromised by a “role-reversal” relationship with the allied and supposedly favored parent (who is likely seeking the admission of the child’s wishes for Court consideration).

Second, whenever there is spousal conflict, seeking the child’s input essentially triangulates the child into the spousal-parental conflict.  This is EXACTLY the WRONG thing to do.  Bad.  Bad.  Bad.  Extremely destructive.  It not only supports the pathology in the family, it actually fosters and creates pathology in the family and it will have extremely harmful effects on the child’s underneath psychology.  We DO NOT ever want to triangulate the child into the spousal conflict.  No. No. No.  Never.  I don’t care what the age of the child is.  Never.  No.

1. The Role-Reversal Relationship

One of the central concepts in understanding “parental alienation” is the role-reversal relationship.

In healthy child development, the child uses the parent as a “regulatory other” for the child’s emotional and psychological state.  When the child faces a developmental challenge that the child cannot independently master, the child emits “protest behaviors” that elicit the involvement of the parent who helps the child regain an emotionally and psychologically organized and regulated state.

The parent acts as an external “regulatory other” (also called a “regulatory object”) for the child.  In doing so, the parent “scaffolds” the building of the child’s own internal networks for self-regulation.  With the brain, we build what we use.  Every time we use a brain system it gets a little stronger, more sensitive, and more efficient through use-dependent changes.

In healthy child development, every time the parent acts as a “regulatory other” for the child by scaffolding the child’s state transition from a disorganized and dysregulated brain state (as manifested in disorganized and dysregulated behavior) back into an organized and well-regulated brain state (as manifested by calm and cooperative behavior) all of the brain networks and brain systems that were used in this transition process become stronger, more sensitive, and more efficient.  We build what we use.

Over multiple repetitions of these state transitions, the child’s own brain networks for making these transitions become stronger, more sensitive, and more efficient so that the child develops the internalized capacity for “self-regulation” without the need for the scaffolding support of the “regulatory other” of the parent.  Overall, this development of internalized self-regulatory capacity is called the child’s development of “self-structure.”

This is a very important construct… the development of the child’s own self-structure through the repeated scaffolding support provided to the child by the “regulatory other” role of the parent.

The parent’s role as a “regulatory other” for the child is extremely important for the healthy development of the child.  In fact, it is THE central role of parenting beyond providing basic food and safety.  By acting as a “regulatory other” for the child, the parent “scaffolds” the child’s internal development of healthy “self-structures” for the child’s independent self-organization and self-regulation.

One of the leading figures in attachment research, Alan Sroufe, describes this process.

“At first, they [caregivers] are almost solely responsible for maintaining smooth regulation.  They attend to the infant’s changes in alertness or discomfort and signs of need, imbuing primitive infant behaviors with meaning  In the typical course of events, caregivers quickly learn to “read” the infant and to provide care that keeps distress and arousal within reasonable limits.  And they do more.  By effectively engaging the infant and leading him or her to ever longer bouts of emotionally charged, but organized behavior, they provide the infant with critical training in regulation.”

“The movement toward self-regulation continues throughout the childhood years, as does a vital, though changing, role for caregivers.  During the toddler period, the child acquires beginning capacities for self-control, tolerance of moderate frustration, and a widening range of emotional reactions, including shame and, ultimately, pride and guilt.  Practicing self-regulation in a supportive context is crucial.  Emerging capacities are easily overwhelmed.  The caregiver must both allow the child to master those circumstances within their capacity and yet anticipate circumstances beyond the child’s ability, and help to restore equilibrium when the child is over-taxed.  Such “guided self-regulation” is the foundation for the genuine regulation that will follow.” (Sroufe, 2000, p. 71)

However, in a role-reversal relationship the normal roles for the parent and child are reversed, so that it is the parent who uses the child as a “regulatory object” for the parent’s emotional and psychological state.  This is extremely destructive to the child’s emotional and psychological development.  The parent is essentially robbing the child’s self-structure development to support the parent’s own inadequate self-structure.

In healthy child development, the parent empathizes with the child and responds in ways that keep the child in a regulated state, i.e., acts as a “regulatory other” for the child.  This scaffolds the healthy development of the underlying neurological networks in the child’s brain that are central to healthy self-structure development.

In a role-reversal relationship, this is reversed so that it is the child who empathizes with the parent and responds in ways that keep the parent in a regulated state.  The roles are reversed.  The parent becomes the child and the child fulfills the psychological parent-role for the psychologically infantile parent.  This is extremely destructive to the child’s healthy development of self-structure.

And this unhealthy role-reversal relationship will be passed on to future generations.  The child in a role-reversal relationship will have his or her self-structure development robbed by the parent to feed the parent’s own inadequate self-structure.  When this child grow up, this child-now-adult will have inadequate self-structure organization because it was robbed in it’s healthy development in order to feed the parent’s inadequate self-structure. 

So this child, now an adult, will repeat the role-reversal use of the child with his or her own children.  The child-now-adult will use his or her own children in a role-reversal relationship to feed the inadequate self-structure of the parent which had been robbed from the parent’s development during the parent’s childhood. 

The role-reversal relationship is a pathology that is passed on trans-generationally from one generation to the next.

And so it goes, from generation to generation.  Parents using their children to meet the emotional and psychological needs of the parent, rather than healthy child development in which the parent meets the emotional and psychological needs of the child.  Instead, in the pathology of the role-reversal relationship each generation of parents rob their children of their healthy childhood development to meet the inadequate childhood development of the parent who had been robbed of self-structure development in his or her own childhood with his or her own parent.

Key Construct:

In a healthy parent-child relationship, the child uses the parent as a “regulatory other” for the child’s emotional and psychological state. 

In a pathological role-reversal relationship, the parent uses the child as a “regulatory other” for the parent’s emotional and psychological state.

So, to turn now to the question of adolescents’ “independent” judgment;

For any child no matter the age who is engaged in a role-reversal relationship with a parent, the child’s capacity for “independent” judgment has been significantly compromised by both the severity and the specific nature of the pathology of the role-reversal relationship. 

Instead of a normal and healthy childhood development that would result in normal-range and healthy self-structure, the child’s psychological development has been severely compromised by the use of the child in the parent’s psychopathology to serve as a “regulatory object” for the parent’s own emotional and psychological needs.

If a child has experienced normal-range development then we may be willing to provide some consideration to the expressed wishes of an adolescent.  However, the development of a child in a role-reversal relationship with a parent has been severely distorted by the role-reversal relationship so that their judgment is significantly compromised.  The child’s expressed wishes no longer reflect the authenticity of the child, but are instead being used in the service of meeting the needs of the pathological parent. 

When the child is in a role-reversal relationship with the pathology of the parent in which the child is meeting the needs of the psychologically infantile parent, the child’s expressed wishes are no longer authentic to the child.

The analogy would be to a hostage situation.  In the case of a role-reversal relationship the child is a “psychological hostage” as a “regulatory object” to the needs of the pathological, inadequate, and psychologically infantile parent.

Would we consider the statements made by a hostage as being authentic while the hostage is still in the custody of the hostage taker?  Absolutely not.

The child is acting under psychological duress (whether the child realizes it or not). 

Would it be sufficient to ask the hostage, “Are you being influenced by anyone in making these statements?” while the hostage was still in the custody of the hostage taker?  Absolutely not.  Of course the hostage will say, “No, I’m not being influenced” to our question.

Imagine an American hostage held by Islamic terrorists.  The American makes a televised statement critical of American policies.  Would we believe that these statements made by the hostage while the hostage was still being held by the terrorists represented the authentic beliefs of the hostage, and weren’t being coerced and influenced by his captors?  Of course not. 

What if the Islamic terrorists allowed a newspaper reporter to ask the hostage, “Are you making these statements of your own free will, or are you being told what to say by your captors?”  and the hostage said, “I am making these statements of my own free will.  No one is telling me what to say.”  Would we then say, “Well, I guess that settles it, these are the hostage’s authentic beliefs.”  That would be just plain stupid beyond imagination.

The statements made by the hostage are under duress as long as the hostage is in the custody of the captors, even if it is under psychological duress.

In a role-reversal relationship, the child is a “psychological hostage” to the pathology of the parent.  The child is being “psychologically held” in a role-reversal relationship by the pathology of the parent to act as a “regulatory object” for the parent so that the pathology of the parent can feed off of the child’s self-structure development, robbing the child of self-structure to support the inadequate self-structure formation of the parent.

But to all external appearances, the child will appear to be in a hyper-bonded relationship with the allied and supposedly favored – but actually severely pathological – parent. 

Role-reversal relationships are extremely pathological. The inadequate self-structure of the parent is feeding off of the healthy self-structure of the child to the extreme detriment of the child’s healthy development. 

The child is being robbed of a normal and healthy childhood in the service of meeting the emotional and psychological needs of a pathological parent, who was robbed in his or her own childhood of healthy development. 

Parents feeding off of their children’s self-structure to support the parent’s own inadequate self-structure development is extremely pathological.

So when evaluating the statements made by a child of any age, a prominent “moderator variable” in our consideration needs to be the possible presence of a role-reversal relationship in which the child is being used by a pathological parent as a “regulatory other” to meet the emotional and psychological needs of the parent. 

Before considering the statements of any child, the question is whether the child is being held as a psychological hostage through the child’s use as a “regulatory other” to the pathology of the parent.

To all external appearances, the child will look like he or she is in a bonded relationship with the pathological parent.  But to a trained and expert eye, the role-reversal relationship is clearly evident in a variety of features.  Only an incompetent and ignorant psychologist will miss a role-reversal relationship and believe the superficial presentation of a bonded relationship. 

Unfortunately, many mental health professionals who work with children are incompetent and ignorant.

If a role-reversal relationship exists, this is extremely destructive to the child’s healthy emotional and psychological development, and if left untreated and unresolved the role-reversal relationship represents a continuing risk not only to the current child but to the development of future generations of his or her children as well, so that treatment and resolution of the pathology becomes imperative and child protection considerations become prominent concerns.

2. Triangulation of the Child

Whenever there is spousal conflict there arises a significant risk that the child will be “triangulated” into the spousal conflict.

Triangulating the child into the spousal conflict is extremely destructive for the child’s healthy emotional and psychological development.  We NEVER want to triangulate the child into the spousal conflict.  Never, never, never.  Under any circumstances.  Never.

The spousal conflict is a two-person event.  When the child is brought into the middle of it, either the child will be torn apart by allegiances to both parents, or the child will need to take sides in the spousal conflict.  Either way, it is extremely destructive to the child to be triangulated into the spousal conflict.  We want to keep children out of the middle of their parents’ conflict.

When the child does become triangulated into the spousal conflict, the direct goal of therapy is to untriangulate the child from the spousal conflict.

Whenever there is spousal conflict, the risk of pathologically triangulating the child into the spousal conflict is extreme.

If we ask the child or adolescent what they want, WE ARE TRIANGULATING THE CHILD INTO THE SPOUSAL CONFLICT!!!!!!

No. No. No. This is exactly what we DON’T want to do.

Furthermore, any hopes for therapy will be smashed.  Abandon all hope of successful therapy for the child’s well-being.  The Court has essentially inflicted the pathology onto the child. 

Under NO circumstances do we ever want to ask the child what the child wants when there is spousal conflict.  We are essentially asking the child to choose sides in the spousal conflict, and we are opening the door directly to the role-reversal use of the child by the parent to meet the parent’s emotional and psychological needs. Pathology, pathology, pathology.

If the Court is concerned about the child’s well-being, then the Court should appoint a psychologist to serve as the voice of the child’s healthy development.  But under no circumstances should we ask the child to choose sides in the spousal conflict.

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

References:

Sroufe, L.A. (2000). Early relationships and the development of children. Infant Mental Health Journal, 21(1-2), 67-74.

Testimony by a Treating Therapist

I am sometimes asked by a treating therapist for a consultation regarding attachment-based “parental alienation.”  I have just added a handout to my website, near the top, regarding my thoughts on how a treating therapist might describe in Court testimony the issues surrounding attachment-based “parental alienation.”

A direct link to this handout is:

Testimony by a Treating Therapist

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

Online Seminar: The Diagnosis & Treatment of Attachment-Based Parental Alienation

My 11/21/14 online seminar regarding the Diagnosis and Treatment of Attachment-Based “Parental Alienation” through the Master Lecture Series of California Southern University is now available online for the general public at:

https://vimeo.com/calsouthern/review/113572265/8d0b48de77

A handout of the Powerpoint slides for this seminar is available on my website: www.drcachildress.org

I believe this seminar is significant in several primary areas:

Standards of Practice: This seminar describes clearly defined standards for professional competence in the diagnosis and treatment of this “special population” of children and families experiencing attachment-based “parental alienation.”

Psychological Child Abuse: It establishes the theoretical foundations and support for identifying attachment-based “parental alienation” as psychological child abuse that warrants the DSM-5 diagnosis of V995.51 Child Psychological Abuse, Confirmed.

Diagnostic Criteria: It defines a set of clear diagnostic criteria based in established and accepted psychological principles and constructs that can reliably identify attachment-based “parental alienation” in every case, and that can reliably differentiate attachment-based “parental alienation” from other forms of parent-child conflict, including false allegations of “parental alienation.”

Protective Separation: It defines the structure necessary for treatment that begins with a protective separation of the child from the pathogenic parenting practices of the narcissistic/(borderline) parent during the active phase of the child’s treatment and recovery.

This online seminar is now available for review by therapists, child custody evaluators, attorneys, judges, and the general media, and so can serve as a referral resource for targeted parents trying to increase general public awareness and the understanding of legal and mental health professionals regarding the issues surrounding an attachment-based model of “parental alienation” and the mental health needs of children and families experiencing this type of tragic family process.

With the proper professional understanding that leads to an appropriate legal and mental health response, the solution to attachment-based “parental alienation” in any individual family circumstance is likely to be achievable within a relatively short period of active treatment intervention.

The family tragedy of “parental alienation” needs to end.  Today.

Every day that passes that we do not enact the required solution is another day that we tolerate the profoundly destructive psychological abuse of the child.

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

The Solution

Any solution to “parental alienation” that requires that we prove “parental alienation” in Court is a failure.

1.  Financially Prohibitive: Proving “parental alienation” in Court is simply too expensive for the vast majority of targeted-rejected parents. The financial costs associated with proving “parental alienation” in Court places it beyond the means of 95% of targeted-rejected parents.

 Any solution that requires proving “parental alienation” in Court is only a solution for 5% of targeted-rejected parents. This is no solution.

2.  Requires Egregious Displays of Alienation: Proving “parental alienation” in Court is only possible in the most egregious cases of alienation. The more subtle cases of insidious alienation are nearly impossible to prove in Court.

Any solution that requires proving “parental alienation” in Court is only a solution for the limited number of targeted-parents who have sufficient financial resources and only in the most egregious cases. So now we’re down to 1-2% of the cases of “parental alienation.”

While proving “parental alienation” in Court may seem like a solution to professionals who work within the Court system. For those of us who work in the daily lives of people who cannot financially afford attorneys and child custody evaluations, it is no solution at all.

3.  Robbing the Child: The high financial costs of fighting “parental alienation” in Court robs the child of what should be his or her college education fund. Every dollar paid to an attorney or child custody evaluator harms the child by taking money from the child that should be going to his or her college education.

Any solution that requires proving “parental alienation” in Court harms the child by draining financial resources from the family that should be going toward the child.

4.  Too Slow: Proving “parental alienation” in Court can often take years of protracted legal battles.  During this time, important child developmental phases come and go, and are lost forever.  Lost childhood can never be reclaimed.  A mother only has 365 days of her child being 8 years old, that’s it.  And not a single lost day can ever be reclaimed.  A father only has a brief time with daddy’s little girl, with his princess. Once lost, this time never returns.

Years to enact a solution is simply too long.  Months are too long a timeframe.  Any solution to “parental alienation” should be able to be enacted within weeks in the life of the child. If we require months, so be it, but definitely not years.

Any solution that requires proving “parental alienation” in Court irrevocably harms the child by robbing the child of important and irretrievable developmental phases and experiences with a loving and affectionally available parent. It simply takes too long.

Of note is that I recently had the opportunity for a conversation with Ms. Dorcy Pruter (http://www.consciouscoparentinginstitute.com).  During our conversation she said she can enact the child’s restoration with the targeted-rejected parent in a matter of days, once the Court orders a protective separation of the child from the alienating parent, and based on my initial review of her approach during our conversation I suspect her treatment model can accomplish what she claims for it.  Just to be generous, I’ll give her some leeway and say weeks rather than days (yet days makes sense to me based on her description of the model), but the point is, in a very short time frame. Her approach seemingly has the proper components to accomplish what she claims for it.

Once we achieve a protective separation of the child from the ongoing pathogenic parenting of the narcissistic/(borderline) parent, restoration of a normal-range and affectionally bonded relationship with the targeted-rejected parent is relatively straightforward because we are working WITH the normal-range functioning of the child’s own attachment system.  The child’s authentic brain WANTS to bond to the targeted-rejected parent.  We just need to provide the setting, structure, and guidance to allow the child’s natural attachment bonding motivations to achieve completion. 

Once the child’s attachment bonding motivations are able to achieve completion, the child’s (misinterpreted) grief response resolves, and the impact on the child of the narcissistic/(borderline) parent’s distorted and pathogenic parenting practices is eliminated.  We have recovered the authentic child.  We then take steps to build the child’s “psychological immune system” relative to the pathogenic parenting of the narcissistic/(borderline) parent and then we can begin to restore the child’s relationship with the narcissistic/(borderline) parent.

If the narcissistic/(borderline) parent cooperates with the treatment process, that would be wonderful.  If not, then we need to take steps to ensure the child’s ongoing stability and balance in response to the narcissistic/(borderline) parent’s continuing pathogenic parenting.

The Solution

Any solution to “parental alienation” that requires that we prove “parental alienation” in Court is no solution at all because of the immense financial barriers, legal hurdles, and inherent harm to the child’s normal-range developmental trajectory associated with the long and arduous task of trying to prove “parental alienation” in Court.

An attachment-based model of “parental alienation” provides a solution. Once the paradigm shifts away from a Gardnerian PAS model to an attachment-based model, the solution becomes available immediately.

Phase 1

An attachment-based model of “parental alienation” immediately identifies a set of standards of practice for professional competence involving an advanced level of professional understanding for the attachment system (and intersubjective system), and a professionally advanced level of understanding for narcissistic/borderline personality dynamics, their characteristic displays, their underlying dynamics, and processes of their manifestation in family relationships.

Once the paradigm shifts to an attachment-based model of “parental alienation” these children and families become immediately identified as a “special population” requiring specialized professional knowledge, training, and expertise to diagnose and treat.

Phase 2

Once professional practice in this specialty field is limited to a qualified set of highly trained and knowledgeable experts, the diagnosis of pathogenic parenting associated with an attachment-based model of “parental alienation” is established in a clearly defined set of three Diagnostic Indicators (see Diagnostic Indicators and Associated Clinical Signs post), supported by an additional set of confirming clinical signs.

This set of three clearly defined and dichotomous (i.e., present or absent) Diagnostic Indicators has a corresponding DSM-5 diagnosis of:

309.4  Adjustment Disorder with mixed disturbance of emotions and conduct

V61.20 Parent-Child Relational Problem

V61.29 Child Affected by Parental Relationship Distress

V995.51 Child Psychological Abuse, Confirmed

(for an analysis of the DSM-5 diagnosis of an attachment-based model of “parental alienation” see “Childress, 2013: DSM-5 Diagnosis of ‘Parental Alienation’ Processes” on my website)

Phase 3

All specialized experts in High-Conflict Family Divorce (HCFD specialty practice) will make the same DSM-5 diagnosis in response to the identifiable set of three clearly defined and dichotomous (present-absent) Diagnostic Indicators of attachment-based “parental alienation” (i.e., pathogenic parenting). 

This means that all HCFD specialty psychologists will make a DSM-5 diagnosis of V995.51 Child Psychological Abuse, Confirmed.

Phase 4

In making the DSM-5 diagnosis of V995.51 Child Psychological Abuse, Confirmed, these HCFD specialty psychologists then engage a professional responsibility to take protective action for the child.  Chief among these protective steps, and an option that I strongly urge them to enact, is to make a child abuse report to Child Protective Services (CPS) regarding their diagnosis of Child Psychological Abuse, Confirmed.

Phase 5

CPS workers will initially not know how to deal with the influx of child abuse reports by this group of specialist psychologists who are providing a DSM-5 diagnosis of v995.51 Child Psychological Abuse, Confirmed along with their report.  CPS agencies will have one of three possible options,

1.  Ignore the reports (which is an unlikely response, especially as these reports continue to come in)

2.  Accept the DSM-5 diagnosis of the HCFD specialist and remove the child from the custody of the alienating (pathogenic) parent and place the child in the custody of the targeted, normal range and healthy parent (i;e;, engage a protective separation of the child from the psychopathology and pathogenic parenting practices of the narcissistic/(borderline) parent).

3.  Conduct their own investigation of possible child psychological abuse.

I suspect that CPS agencies will choose option 3. 

In the context of having a clinical psychologist who is expert in High-Conflict Family Divorce provide a confirmed DSM-5 diagnosis of Child Psychological Abuse, if the CPS system wants to conduct their own investigation then they will need to obtain similar training in the assessment of an attachment-based model of “parental alienation” upon which the psychologist’s diagnosis is based (i.e., CPS case workers will need to develop professional competence in the specialty practice area of identifying child psychological abuse that occurs within high-conflict family divorce settings) since this knowledge base serves as the foundation for the diagnosis of V995.51 Child Psychological Abuse, Confirmed made by the HCFD specialist psychologist.

So ALL CPS workers everywhere will receive training in an attachment-based model of “parental alienation” and the three definitive diagnostic indicators of pathogenic parenting associated with the child’s cross-generational coalition with a narcissistic/(borderline) parent against the other parent that is inducing significant developmental (Diagnostic Indicator 1), personality (Diagnostic Indicator 2), and psychiatric (Diagnostic Indicator 3) pathology in the child.

Phase 6

The Diagnostic Indicators for attachment-based “parental alienation” are clearly defined and dichotomous, either attachment-based “parental alienation” is present or absent.  Once CPS has a set of clearly defined dichotomous criteria by which to identify pathogenic parenting associated with an attachment-based model of “parental alienation,” they will become empowered and confident in removing the child from the care of pathogenic narcissistic/(borderline) parent in every case where the three Diagnostic Indicators are present.

The Solution

Once a case of pathogenic parenting associated with an attachment-based model of “parental alienation” enters the specialty practice of an HCFD specialist psychologist, a child abuse report will be filed with CPS that includes the psychologist’s diagnosis of V995.51 Child Psychological Abuse, Confirmed.  Once the report enters the CPS system, the CPS case worker will confirm the presence of the three Diagnostic Indicators of pathogenic parenting and will confirm the DSM-5 diagnosis of V995.51 Child Psychological Abuse, Confirmed, so that the diagnosis has now been confirmed by two independent assessments of mental health professionals expert in the family processes associated with high-conflict divorce.

CPS will then immediately remove the child from the custody of the alienating narcissistic/(borderline) parent (i.e., a protective separation of the child from the psychopathology of the pathogenic parent) and place the child with the normal-range and healthy targeted parent to allow for the treatment and resolution of the child’s symptoms.

This establishes the necessary protective separation conditions for a Pruter-style model of treatment that resolves the child’s symptoms within days or weeks.  Once the child’s symptoms have been resolved under the treatment guidance of an HCFD specialist psychologist, the child’s own “psychological immune system” can be strengthened to resist “reinfection” by the distorting pathology of the narcissistic/(borderline) parent, and the child’s relationship with the narcissistic/(borderline) parent can be reestablished.

Of note is that Ms. Pruter also indicated that she has a treatment protocol component for the alienating parent to complete as a requirement for their “reunification therapy” with the child.

This solution never enters the Court system.

It provides an immediate protective separation of the child from the psychopathology of the narcissistic/(borderline) parent.

It solves the family conflict in a matter of weeks and so restores the child to a normal-range developmental trajectory quickly.

It is relatively cost free to the parent so that it does not require an extensive parental financial investment of funds that should be allocated to the child’s future college education.

This is the solution.

If the case does enter the Court system, the judge can order a Treatment Needs Assessment report, which would be a targeted assessment by an HCFD specialist for the presence or absence of the three Diagnostic Indicators of pathogenic parenting associated with an attachment-based model of “parental alienation.”  The targeted Treatment Needs Assessment would be focused and so less extensive than a full child custody evaluation.  Since all child custody evaluators would have become HCFD specialists, this could be a secondary professional service available from them.

My estimate of a Treatment Needs Assessment is that it could be completed in four to six weeks and could provide a clear directive to the Court regarding the treatment needs of the child. If the three Diagnostic Indicators of pathogenic parenting associated with an attachment-based model of “parental alienation” are present, then the HCFD specialist psychologist conducting the assessment would make the appropriate DSM-5 diagnosis of the child (relative to the issue of pathogenic parenting) which would include the DSM-5 diagnosis of V995.51 Child Psychological Abuse, Confirmed.

Upon receiving the report from the HCFD psychologist that contains the DSM-5 diagnosis of V995.51 Child Psychological Abuse, Confirmed, the judge could order removal of the child from the custody of the narcissistic/(borderline) parent and placement of the child with the targeted, normal-range and healthy parent during the active phase of the child’s treatment and recovery.  Under the guidance of an HCFD specialty psychologist, the child and targeted parent could receive a Pruter-style treatment protocol that would restore their relationship within weeks, followed by building the child’s “psychological immune system” response to the distorted pathogenic parenting practices of the narcissistic/(borderline) parenting, culminating in “reunification therapy” between the child and the narcissistic/(borderline) parent.

This is the solution.

Enacting the Solution

I have created the solution.  All the dominoes are in line, and through my writings on my website and blog I have tipped the first domino.  In my view, it is just a matter of time now.

My estimate is the change in paradigm will take about 10 years.  The solution I have enacted has no natural allies.  Establishment mental health has little to no interest in “parental alienation.”  Their interest tends toward Attention Deficit Hyperactivity Disorder and the typical types of parent-child conflict.  “Parental alienation” isn’t really on their radar.  They are likely to simply equate an attachment-based model of “parental alienation” with the Gardnerian PAS model as being “controversial” (when actually an attachment-based model is not at all controversial – all of the constructs are standard and accepted psychological principles and constructs).

The Gardnerian PAS experts are likely to be reluctant to see the end of their favored paradigm for conceptualizing “parental alienation” because they have fought for it for so long and hard.  To see it simply disappear and be replaced by a new paradigm about which they are entirely unfamiliar will likely be hard for them. The Gardnerian PAS experts are likely to simply ignore an attachment-based model and to continue their efforts to seek Court-based solutions for the PAS model.

So an attachment-based paradigm for “parental alienation” will probably languish in obscurity for a while.  Eventually it will get picked up (for a variety of reasons, one of the primary reasons will be its promise for guiding future research efforts).  It will likely become established through the efforts of a new generation of psychologists and mental health professionals who will see the value in a paradigm shift because they have no prior attachment to the PAS model.  They will have an easier time letting go of the PAS model and adopting a new paradigm for describing and understanding “parental alienation” processes.

Eventually the paradigm will shift.  The moment it does the other dominoes will begin to fall.  There is actually a line of dominoes that will also begin to fall that will solve the issue of false allegations of child abuse that are such a troubling part of “parental alienation,” but I’ll leave a description of that line of dominoes for another post.

It’s just a matter of time.

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

False Allegations of Abuse: Technical Issues

False Allegations of Incest

Let me approach this discussion with the basic premise that all mental health professionals have the child’s best interests as their primary consideration. All mental health professionals wish to protect children from sexual abuse. No mental health professional seeks to expose a child to sexual abuse victimization.

If there are differing viewpoints on how to accomplish this goal, they are good-faith expressions of “equally valid poles of a dialectic” (Linehan, 1993), and the goal should be to move toward synthesis of differing perspectives rather than adopting adversarial positions.

Authentic sexual abuse occurs far too frequently. We must act to protect children from sexual abuse victimization.

And… on occasion,

A narcissistic/(borderline) parent will induce or elicit false allegations from the child of sexual abuse victimization by the other parent as a means to exploit these child allegations to achieve power over the situation and the other parent. When this occurs, not only does the child lose a loving and affectionally bonded relationship with a normal-range targeted parent, the child also loses the potential protective influence that the normal-range psychological organization of the targeted-rejected parent can have in lessening the distorting pathogenic influence of the narcissistic/(borderline) parent on the child’s development.

Furthermore, for a narcissistic/(borderline) parent to induce or elicit from a child false allegations of sexual abuse against the other parent represents extremely distorted parenting that rises to the level of severe psychological abuse of the child. Failure to respond to this type of psychological child abuse when it is present is to abandon the child to the severely distorting effects of the psychological child abuse of the narcissistic/(borderline) parent that will have a long-term destructive impact on the child’s psychological development, likely influencing future generations of the family as well through the transmission of the effects of the child abuse to the next generation through the future pathogenic parenting of the current child with his or her own children.

Our goal should be to protect the child from ALL forms of child abuse, particularly the severe forms being considered in this discussion. It is NEVER acceptable to abandon a child to any form of child abuse.

Assertion 1: Child Sexual Abuse Allegations are Not Developmentally Normal

Under no circumstances does a child ever spontaneously develop a false belief that a parent sexually abused the child. It doesn’t happen. Ever.

Children may develop on their own symptoms of hyperactivity or inattention, or anger control problems, or cognitive delays, or social problems, or phobic anxieties. All of these types of symptoms can sometimes arise endogenously to the child’s own developmental course.

Children NEVER spontaneously develop, on their own, a false belief that a parent sexually abused the child.

When a child asserts that a parent sexually abused the child, there are only three differential diagnostic possibilities:

1)   Authentic child abuse incest by the parent

2)   Extremely distorted pathogenic parenting by a narcissistic/borderline parent in which this parent induces or elicits the child’s false belief of sexual abuse,

A)  In order to exploit the child’s symptoms to achieve power over the situation or other parent, or

B)  As a result of semi-psychotic decompensation of the narcissistic/borderline parent into a delusional belief in the (false) threat represented by the other parent, with the parental delusional belief then being transferred to the child through severely distorted parenting practices of the narcissistic/borderline parent.

“When particular schemas are hypervalent, the threshold for activation of the constituent schemas is low: they are readily triggered by a remote or trivial stimulus. They are also “prepotent”; that is, they readily supersede more appropriate schemas or configurations in processing information. (Beck et al., 2004, p. 28)

“The conceptualization of the core pathology of BPD as stemming from a highly frightened, abused child who is left alone in a malevolent world, longing for safety and help but distrustful because of fear of further abuse and abandonment, is highly related to the model developed by Young… that some pathological states of patients with BPD are a sort of regression into intense emotional states experienced as a child. Young conceptualized such states as schema modes…” (Beck et al., 2004, p. 199)

3)    The child, typically an adolescent, lacks a moral conscience, typically as a result of extraordinarily poor parenting, and is consciously, intentionally, and independently using a false allegation of sexual abuse against a parent as an intentional manipulation to achieve a desired goal or outcome.

This is not a spontaneous development of a false belief, this is simply a conscious lie perpetrated by the adolescent for manipulative gain.

Exclusionary caveat: The adolescent’s actions are not the product of influence from an allied and supposedly “favored” parent to allow the parent (or parent-child alliance) to then exploit the child’s allegations for manipulative gain (i.e., Causal Origin 2).

In my clinical practice I have known adolescents who admitted to me that they colluded with peers on how to create marks on their body to substantiate false allegations they made about physical abuse from a parent. In one of these cases the motivation of the adolescent was to obtain a custody change from the current parent to the desired parent. However, it wasn’t so much that the desired parent was in a cross-generational coalition with the child as much as the desired parent was exceedingly lax and permissive as a parent, which was a parenting style preferred by this adolescent over the current parent’s more structured expectations.  Other adolescents in my clinical practice have threatened their parents with filing false child abuse allegations against the parent if the parent did not capitulate to the child’s demands in some area. These families had a history of highly dysfunctional relationships.

In all three causal origins for sexual abuse allegations made by a child against a parent, there is extremely bad parenting somewhere within the family. Sexual abuse allegations made by a child against a parent are ALWAYS evidence of extremely bad parenting occurring somewhere within the family. The only question is where.

Personal Estimates of Prevalence

Note: There is no existing reliable data to support these estimates. These are personal estimates based solely on my clinical judgment.

From the domain consisting of all sexual abuse allegations made by a child of incest by a parent, my estimates of the prevalence for the three different origins for the child’s sexual abuse allegations against a parent are:

1. Authentic child abuse

Estimate of the likely prevalence of this causal origin for the child’s allegations: I would estimate that authentic sexual abuse of the child is the causal origin of the child’s allegations in approximately 95% of the cases of children’s alleged sexual abuse by a parent.

2.  Extremely distorted pathogenic parenting by a narcissistic/borderline parent that induces or elicits from the child a false allegation of sexual abuse against the other parent

Estimate of the likely prevalence of this causal origin for the child’s allegations:  I would estimate that pathogenic parenting by a narcissistic/borderline parent that induces or elicits from the child a false allegation of sexual abuse against the other parent is the causal origin of the child’s allegations in approximately 1% – 2% of the cases of children’s alleged sexual abuse by a parent.

3. An intentional adolescent lie as a manipulative or retaliatory action against the parent

Estimate of the likely prevalence of this causal origin for the child’s allegations:  I would estimate that an independent intentional lie created by an adolescent as a manipulative or retaliatory action against the parent is the causal origin of the child’s allegations in approximately 3% to 5% of the cases of children’s alleged sexual abuse by a parent

Individual Assessments

In any individual case, the estimated population prevalence is not a relevant consideration.

For example, in the 1% or 2% of the cases in which the child’s allegation of sexual abuse incest against a parent is induced and elicited by the pathogenic parenting practices of a narcissistic/borderline parent, in those 1% – 2% of cases the likelihood that the child’s symptoms were induced or elicited by the pathogenic parenting practices of a narcissistic/borderline parent is 100% – in those cases.

Is the specific case under consideration one of these rare cases? Perhaps. And if this specific individual case is one of those rare cases, then the probability that the child’s allegations are the induced or elicited product of pathogenic parenting practices by a narcissistic/borderline parent is 100% (i.e., if this specific case is one of those 1% – 2% of cases).

So population prevalence is not a consideration in evaluating any specific case. Each case is individual.

This is a foundational construct in psychological testing.  Just because the population prevalence of any specific issue, such as learning disabilities, ADHD, or mental retardation, is an infrequent occurrence in the general population doesn’t mean that this specific child doesn’t have the issue in question.

General population prevalence is not relevant to the assessment of any individual case. The assessment of each specific case is individualized to the specific data of that individual case.

Decisional Errors

There are technical considerations in establishing the criteria by which we make decisions.  In some cases the data allows us to make decisions based on 100% certainty, but this is extremely rare in decisions about psychological issues. When 100% certainty is not available, there are two possible types of errors we can make in our decisions based on the data

When a child makes sexual abuse allegations against a parent, there are two possible hypotheses that can be supported or disconfirmed by the data,

“Null Hypothesis” – no sexual abuse occurred

“Clinical Hypothesis” – sexual abuse did occur

Type I Error: A Type I error is when we erroneously accept the Clinical Hypothesis that sexual abuse occurred when, in truth, there was NO sexual abuse of the child. This is called a “false positive” decisional error, when we erroneously say something took place when it actually didn’t occur.

Type II Error: A Type II error is when we erroneously accept the Null Hypothesis that NO sexual abuse occurred, when in actuality the child was sexually abused by the parent. This is called a “false negative” decisional error, when we say nothing took place when it actually did occur.

These two types of decisional errors are interrelated. The lower the probability of making one type of decisional error, the higher the probability of making the other type of decisional error.

In establishing the criteria for making a decision from data that does not allow 100% certainty, the question is which type of error is worse in the context of the issue under consideration. So if we are making a decision about whether a child has been sexually abused by a parent, is it worse to,

A)  Erroneously conclude that the child was sexually abused when in actuality no sexual abuse took place (a Type 1 Error).

The consequences of this decisional error would be that we would needlessly and erroneously terminate the child’s relationship with a normal-range and affectionally available parent, and we would abandon the child to the custody of a narcissistic/borderline parent who is engaging in extremely distorted parenting practices that will severely distort the child’s emotional and psychological development (Causal Origin 2), or

We will terminate the child’s relationship with a parent in collusion with the child’s manipulative intent of attaining a desired goal or outcome (Causal Origin 3)

B) Erroneously conclude that the child was NOT sexually abused when in actuality the child was sexually abused by the parent (a Type II Error)

The consequence of this decisional error would be that we DO NOT terminate the child’s relationship with a sexually abusive incestuous parent, thereby abandoning the child to continued sexual abuse victimization.

One of the particularly devastating consequences of this decisional error with regard to child sexual abuse allegations against a parent is that we communicate to the child that we do not believe the child’s report is accurate when the child is, in actuality, telling us the truth. This is psychologically devastating to the sexually abused child. For the child to overcome the personal shame and family secrecy surrounding sexual abuse victimization and to come forward in disclosing the abuse, and then not to be believed and to be abandoned to their continued victimization, is psychologically devastating to the child, compounding the severity of the trauma for the child.

The decision as to which is worse, the impact of Type I errors or the impact of Type II errors, with regard to any particular issue is a value judgment regarding the comparative impacts. Based on this value judgment we then set decisional criteria that minimize either the likelihood of making a Type I decisional error (thereby increasing the likelihood of making a Type II decisional error), or we establish decisional criteria that minimize the likelihood of making a Type II error (thereby increasing the likelihood of making a Type I decisional error), or we seek decisional criteria that provide some sort of balance between the risks of making Type I and Type II errors in our decision making about the data.

But the criteria we establish for making our decisions is based on value judgements regarding the relative dangers of making a Type I decisional error (called a “false positive”) compared to the dangers associated with making a Type II decisional error (called a “false negative”).

Prosecution and Child Protection

The legal system in the United States has traditionally made a value judgment to minimize the potential for Type I errors (“false positive” decisions of convicting an innocent person). The decisional criteria in the legal system would prefer to set free numerous criminals (i.e., Type II errors of “false negatives”; saying the person is innocent when the person is actually guilty) in order to avoid (to the extent possible) convicting an innocent person (i.e., to minimize the risk of making a Type I error of a “false positive”).

This approach to establishing decisional criteria is based on our value judgments concerning our desired system of justice.

The impact of this approach within mental health and social service systems dealing with child allegations of parental sexual abuse, however, is troubling to many. The value judgment of the legal system to minimize Type I errors (“false positives” of saying there was child abuse when in actuality there was no child abuse) will correspondingly increase the probability of making Type II decisional errors (“false negatives” of saying there was no child sexual abuse when in truth there actually was child sexual abuse), meaning that many instances of actual child sexual abuse by a parent will not result in a proper child protection response as a result of our Type II decisional error.

Advocates for child protection rightly become extremely concerned about the rate and frequency of Type II decisional errors that leave children unprotected, even when, and especially when, the child discloses the sexual abuse. Parental sexual abuse of the child is surrounded by tremendous personal shame for the child, and is masked beneath the cover of family secrecy. For the child to break free from this family secrecy and personal shame associated with parental incest is a significant achievement for the child. But then for the child not to be believed and to be cast back into the abusive relationship with an incestuous parent compounds trauma upon trauma.

The psychological injury caused to the child by a Type II decisional error of saying there was no sexual abuse of the child when in truth there was, and when the child actually takes the momentous step of disclosing the sexual abuse to others, is extremely severe and devastating to the child. That child advocates within the mental health and family service fields are highly concerned about the frequency of Type II decisional errors is understandable and justified.

And…

There are a certain percentage of cases of false child allegations of parental sexual abuse (i.e., Causal Origins 2 and 3).

Within the legal system, the wrongful conviction of a parent as a pedophile (i.e., a Type I decisional error of a “false positive” attribution), so that this parent is wrongly identified with the lifelong stigma as being a “sex offender” can have an extremely devastating impact on this parent. Given the heavy consequences for an innocent person of a wrongful conviction as being an incestous sexual pedophile, the legal system is justifiably reluctant to make Type I errors, and would prefer to allow some guilty people to go free rather than convict an innocent person. So the decisional criteria within the legal system are adjusted toward limiting the probability of making Type I decisional errors (i.e., a “false positive” attribution that convicts an innocent person).

Most people support this general legal philosophy of limiting to the extent feasible the probability of convicting innocent people for crimes they did not commit (i.e., of making Type I decisional errors of saying something happened when in truth it didn’t), and we are willing to adjust to the negative consequences associated with sometimes allowing the guilty to go free in order to minimize to the extent feasible the risk of convicting an innocent person.

Despite our best efforts, we nevertheless sometimes convict innocent people (i.e., make a Type I decisional error), and this is extremely distressing for both the legal system and the general public, and yet it is also unavoidable. The only way we can ensure with 100% certainty that we will NOT make a Type I decisional error of convicting an innocent person is to set our decisional criteria so far in favor of not making a Type I error that we make far too many Type II errors of allowing all, or nearly all, criminals go free rather than run even the barest of infinitesimal risks of possibly convicting an innocent person.

In our decisions we must balance the risks of making a Type I error (a “false positive”) against the risks of making a Type II error (a “false negative”). As we lessen the risk of one type of decisional error we increase the risk of making the other type of decisional error. That’s just the way it works.

While in general, we can appreciate the reluctance of the legal system to convict an innocent person, so that we accept and tolerate the release of burglars and thieves, and even murderers, when it comes to the sexual abuse of children we become disturbed by the possibility of exposing children to continued sexual abuse victimization in order to limit the risk of making a Type I decisional error of a “false positive” attribution that the parent is an incestuous pedophile when in truth no sexual abuse of the child occurred, especially when the likely population prevalence of “false positives” is so incredibly low (for example, my estimate of between 4% to 7% of all sexual abuse allegations made by children against a parent; Causal Origins 2 and 3).

While we are willing to tolerate the consequences of a “false negative” decision that results in the release of a thief or even a murderer, we are much more reluctant to tolerate the consequences of a “false negative” decision that results in the release of a parental pedophile, in which we will be re-exposing the child to continued sexual abuse predation by the parent.

Given the very low estimated population prevalence of “false positives” (i.e., parents who are accused of sexual child abuse when NO abuse occurred), if we wanted to eliminate the risks of making a Type II error (a “false negative” of saying there was no sexual abuse of the child when in fact the child had been sexually abused by the parent) because of the devastating effect of a Type II decisional error on the emotional and psychological well-being of the child, we could simply accept all child allegations of sexual abuse as valid. This would mean that we would likely make between 4% and 7% Type I errors of making a “false positive” attribution (i.e., saying there was sexual abuse of the child by the parent when, in truth, the parent did not actually sexually abuse the child). In accepting the consequences of making an estimated 5% to 10% (rounding off) wrongful convictions of innocent parents as being incestuous sexual predators when they are not, we can ensure that we do not re-expose ANY child to authentic sexual abuse victimization.

This would represent a value decision regarding the comparative negative consequences associated with making a Type I decisional error as compared to making a Type II decisional error.  The decisional criteria we decide on regarding the acceptable probability of making Type I versus Type II decisional errors is based on our value judgments regarding the comparative damage of making each type of decisional error. The more we reduce the chances of making one type of decisional error, the more we increase the chances of making the other type of decisional error.  

Since the estimated population prevalence of “”false positives” (i.e., false child allegations of parental sexual abuse) is so small relative to all child allegations of parental sexual abuse, it is conceivable that a reasonable discussion would consider the relative benefit of accepting all child allegations of parental sexual abuse as valid in order to eliminate the possibility of making Type II decisional errors of “false negative” decisions that continue a child’s exposure to an incestuous pedophiliac parent even after the child has disclosed the predatory sexual abuse victimization.

However, if this decision is made we should also recognize that we are accepting that there will be a certain, not insubstantial number of “false positive” Type I decisional errors in which we wrongly say that an actually innocent parent sexually abused his or her own child. Recognizing that we will be making such errors in a relatively substantial number of cases (my personal estimates are between 5% to 10% of all cases of child sexual abuse allegations), we would likely want to limit the damage to these wrongly convicted parents.

One approach to limiting the damage to innocent parents who are wrongly accused of sexual abuse that they did not actually commit is to separate the legal from the social service responses, so that the social service response to child allegations of parental sexual abuse would be to accept ALL child allegations of parental sexual abuse as valid, recognizing that approximately 5% to 10% of these allegations are not true, in order to eliminate the damage to children re-exposed to authentic sexual abuse incest because of an erroneous Type II “false negative” decision and response from us. Whereas the legal response of convicting the parent as a “sex offender” would be disconnected from the social service response, so that the legal criteria for conviction would maintain higher standards against making a Type I “false positive” decisional error of convicting an innocent person.

This approach would result in ALL child accusations of parental sexual abuse being accepted as valid by social service agencies, so that ALL child accusations of parental sexual abuse result in termination of parental contact with the child, but only a limited number of these cases would actually result in a legal conviction of the parent as a “sexual offender.”

While separating our social service response to child allegations of parental sexual abuse (limiting our risk of making Type II decisional errors) from our legal response to child allegations of parental sexual abuse (limiting our risk of making Type I decisional errors) would provide for interesting and lively discussion, such an approach to separating decisional criteria would be unlikely to withstand legal challenge in the Courts. But I believe this possibility at least merits considered discussion as we strive for synthesis of equally valid poles of the dialectic.

Low Base-Rate Phenomenon

When a condition is rare in the general population this can substantially affect the rate of “false positive” decisions (Type I errors) we make from our assessments. For example,

Say we are assessing for TRAIT X in the population.

The population prevalence of TRAIT X is 5% (i.e., a “low base-rate”) and our instrument for identifying TRAIT X is 95% accurate. No approach to identifying a psychological trait in a population will be 100% accurate and in most cases a sensitivity of 80% is generally considered excellent. But for the purposes of our example, let’s say we have an amazingly good assessment instrument that can accurately identify 95% of the cases of TRAIT X.

So out of 1000 people assessed for TRAIT X, the prevalence of TRAIT X will be 50 people (i.e., 5%). Our 95% accurate instrument will then correctly identify roughly 48 people with TRAIT X, and will miss only 2 people who actually have TRAIT X but who we said didn’t have the trait (i.e., “false negatives,” a Type II error). Correctly identifying 48 of the 50 people with TRAIT X (i.e., “true positives”) while only missing 2 people with TRAIT X (i.e., “false negatives”) is pretty good.

Great. So far, so good.

However, there are 950 people in our population of 1000 without TRAIT X, and our instrument has a 5% error rate, so our 95% accurate instrument will identify 5% of the 950 people without TRAIT X as incorrectly having the trait (i.e. “false positives”), so that our instrument will incorrectly say that 48 people have TRAIT X when they don’t (5% of 950).

This means that out of 1000 people, our 95% accurate instrument will correctly identify 48 people as having the trait (“true positives”) and will miss only 2 who have the trait (“false negatives”), and will also incorrectly identify 48 people as having the trait when they don’t (“false positives”). So essentially, our identification of TRAIT X is only 50% accurate, we correctly identify as many people as having the trait (“true positives”) as we incorrectly identify people as having the trait when in actuality they don’t (“false positives”).

This is the result of what’s called “the low base-rate phenomenon” – no matter how accurate our assessment instrument (even an insanely accurate 95%) we will nevertheless produce and inordinately high number of “false positives” because of the low-base rate of the characteristic in the population.

Out of all the cases of child allegations of parental sexual abuse, the base rate of false child allegations is going to be low (my estimate is around 1% to 2%, others may assert other prevalence estimates).

If our value system says that we should avoid “false positive” identifications (i.e., avoid Type I decisional errors), then any approach that identifies as many “false positives” as “true positives” is going to present a problem. If we are trying to identify cases of “false child allegations of sexual abuse” and out of 1000 cases of alleged sexual abuse we identify 50 cases of false allegations, but in order to do this we also incorrectly identify 50 children who were ACTUALLY sexually abused by the parent as NOT being sexually abused by the parent, that’s a lot of kids who were authentically abused who we are not protecting simply because of the low base-rate phenomenon.  We protect as many children from child abuse as we expose to child abuse.

AND… if our assessment method is less that 95% accurate, then the number of decisional errors increases substantially. So in actual practice, in order to identify the 50 cases of false allegations of sexual abuse we may wind up erroneously identifying 200 or 300 children who were actually sexual abused as NOT being sexually abused by the parent.  This may mean that for every one parent-and-child we protect from the pathology of a false allegation of sexual abuse, we expose as many as four or five other, authentically abused children to continued sexual abuse victimization.

At what point does the damage caused to the 200 or 300 children who were authentically abused outweigh the damage to the 50 children who were not abused and whose false allegations were the product of severely distorted parenting by a narcissistic/borderline parent?

And yet do we simply abandon these “false allegation” children to the severe psychological abuse inflicted on them by the psychopathology of the narcissistic/borderline parent in order for us to reduce the harm to other children who were authentically sexually abused?  Is it moral to knowingly sacrifice one to save many?

Or do we still try to identify these “false allegation” children anyway, even though we know that this will lead to more Type II errors in identifying children who were authentically abused, so that we will be abandoning some authentically abused children to the psychopathology of their pedophile parent?

It would be wonderful if we could achieve 100% accuracy in our diagnosis of both “true positives” (children we identify as being sexually abused who were actually sexually abused by the parent) and “true negatives” (children who make false allegations of sexual abuse and who we identify as false allegations), but be we can’t. There will always be some error in our decisional criteria. Do we wish to limit Type I errors and increase Type II errors, or do we wish to limit Type II errors and increase Type I errors. This is a value judgment based on the relative damage we judge to result from each type of decisional error.

Another consideration in this discussion is that the legal system itself will bias decisional criteria to limit Type I errors (i.e., to limit the probability of incorrectly identifying children as being sexually abused by a parent when there was no sexual abuse), so that the rates of not identifying authentic sexual abuse will already be inordinately high.  Since this is already the case, should we then try to identify actual cases of false allegations of child sexual abuse in order to rescue and protect as many of these children as we can, since trying to identify actual cases of false allegations of child abuse is not likely to affect rates of identifying authentic child sexual abuse cases since the Court is already not identifying these cases anyway by its decisional criteria to limit Type I errors.

Conclusion to Part I

The issues are complex. My assumption is that ALL mental health professionals want what is best for children, and that ALL mental health professionals want to protect all children from all forms of child abuse.

Differing views on how to achieve this represent “equally valid poles of a dialectic” (Linehan, 1993). We should work for synthesis of these poles in which we achieve consensus on a reasonable approach to very difficult and challenging issues, rather than engaging in continual unproductive adversarial conflict in which each side falsely “demonizes” the other as being callously unconcerned about protecting children from child abuse.

We all want to protect children from child abuse. The issues are difficult and challenging.

Moving forward, I hope to engage in productive dialogue regarding these complex and challenging issues in which reasonable people can disagree about approaches while still maintaining a fundamental agreement about the underlying desire to protect ALL children from ALL forms of child abuse.

In a future blog post (Part II) I will discuss my personal views regarding potential resolutions of the complex and difficult issues surrounding child allegations of parental sexual abuse. In this next blog post on the subject of false child allegations of parental sexual abuse, I will offer my thoughts on whether there are specific distinctive identifying features in the 1% to 2% of cases reflecting false child allegations of sexual abuse as a result of the pathogenic influence on the child of a cross-generational coalition with a narcissistic/(borderline) parent (Causal Origin 2).   If there are distinctive and reliable identifying features for false child allegations of parental sexual abuse originating from the pathogenic influence on the child of a narcissistic/(borderline) parent, then we may be able to protect some of these children without inordinately affecting our ability to ALSO protect children whose allegations of parental sexual abuse are true.

I recognize ahead of time that no matter what position I take in this second blog post there will be those who disagree, and that the views of these people are reasonable and well founded. Down the road, they may convince me of the greater correctness of their views, or I may convince them of my views. At this point I believe the primary issue is engaging in reasoned and productive dialogue that recognizes that both poles in the dialectic represent reasonable and understandable positions that merit careful consideration and dialogue.

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

 References

Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York, NY: Guilford

“Staff splitting,” as mentioned earlier, is a much-discussed phenomenon in which professionals treating borderline patients begin arguing and fighting about a patient, the treatment plan, or the behavior of the other professionals with the patient… arguments among staff members and differences in points of view, traditionally associated with staff splitting, are seen as failures in synthesis and interpersonal process among the staff rather than as a patient’s problem… Therapist disagreements over a patient are treated as potentially equally valid poles of a dialectic. Thus, the starting point for dialogue is the recognition that a polarity has arisen, together with an implicit (if not explicit) assumption that resolution will require working toward synthesis.” (p. 432)

What Can I Tell the Court?

I received the following question from a targeted parent:

“I am in a custody/divorce battle that has gone on for over two years. I have spent every penny that I could raise on this, over $150k and I am now little more than a broken parent living on very little. I can no longer afford anything for my case so I am now representing myself in Court. I would love to get some ideas on how to present PA in Court.  Thanks much.”

I receive variations of this request a lot. I wish there was some positive answer I could offer.

This is exactly why the Gardnerian model of PAS is a failed paradigm. The Gardnerian PAS paradigm requires that the targeted parent prove “parental alienation” in Court, and this becomes a long and expensive process. Too expensive for all but a few parents, and it takes years of legal struggles.  And all the while, through the years of protracted legal battles trying to prove “parental alienation” in Court, the child’s symptoms become ever more severely entrenched, so that recovering the authentic child becomes increasingly difficult even if there is a positive outcome in Court.

But, except in the most severe cases of “parental alienation,” there is seldom a positive outcome in Court.

The Court will issues orders for custody and visitation that the narcissistic/(borderline) parent will ignore. The targeted parent will return to Court seeking contempt charges, and the Court will not levy sanctions but will instead modify its orders and stress to the narcissistic/(borderline) parent the importance of following Court orders, and these new orders will simply be ignored by the narcissistic/(borderline) parent. The targeted parent will AGAIN need to return to Court to obtain the compliance of the narcissistic/(borderline) parent with the PREVIOUS Court orders and the judge will reprimand BOTH parents for not adequately co-parenting.

Meanwhile, time passes and the child’s symptoms become ever more severely entrenched, the child grows farther away from the love of the targeted parent, and the child increasingly surrenders with each passing day to the distorted influence of the narcissistic/(borderline) parent.

The Court will order “reunification therapy,” even though no such thing as “reunification therapy” exists in any established models of psychotherapy (see On Unicorns, the Tooth Fairy, and Reunification Therapy post). The construct of “reunification therapy” is a fraud perpetrated by mental health professionals on the Court and public. No such thing exists.

I’m aware that “fraud” is a strong accusation, but this blog has a Comments section and I challenge any mental health professional to provide me with a professional reference for what “reunification therapy” entails.  None exists.   No model of “reunification therapy” has ever been proposed or defined within the professional literature. There is no such thing as “reunification therapy” and professional psychology should be ashamed of itself for fostering this “junk therapy” upon the Court and public.

Since “reunification therapy” has no established model, it is essentially whatever the “reunification” therapist makes it up to be. The construct of “reunification therapy” is a made up and fraudulent therapy construct. If any therapist disagrees, there is a Comment section available to you on this post…

There are psychoanalytic models of therapy, humanistic-existential models of therapy, cognitive-behavioral models of therapy, family systems models of therapy, and post-modern models of therapy, but there are no models that define what “reunification therapy” entails.

Nevertheless, the Court will order “reunification therapy” as if it exists, and even this therapy will be delayed by the non-cooperation of the narcissistic/(borderline) parent. When it does eventually take place, the reunification therapist is revealed to be clueless regarding how to treat and resolve “parental alienation” and the ineffective and pointless “reunification therapy” will continue for months, or even years, without producing any change whatsoever.

And all the while, the child’s symptoms become ever more established and entrenched, the loving relationship with the targeted parent becomes ever more hostile and rejecting, and the child falls ever more fully under the distorting pathogenic influence of the narcissistic/(borderline) parent. No one apparently sees or recognizes the degree of the pathology.

This is the only “solution” offered by Gardner’s model of PAS, and it is no solution at all. Gardner’s model requires the litigation and proof of “parental alienation” in Court. As long as the construct of “parental alienation” is defined through Gardner’s model of PAS then there will be no solution available to the nightmare of “parental alienation.”

An attachment-based model for the construct of “parental alienation” redefines the construct of “parental alienation” entirely from within standard and established psychological constructs and principles, and seeks the solution FIRST in the mental health system, which can then be leveraged to achieve an efficient and effective solution in the legal system.

When mental health speaks with a single voice, then the legal system will be able to act with the decisive clarity necessary to solve “parental alienation.” The solution to “parental alienation” is in the mental health system, not the legal system. Mental health remains divided by the Gardnerian model of PAS (i.e., it is not accepted by establishment mental health as represented by the DSM diagnostic system), so it requires that targeted parents prove “parental alienation” in Court.

An attachment-based model for the construct of “parental alienation” is based entirely in established psychological constructs and principles that are accepted by establishment mental health (i.e., the attachment system, personality disorder dynamics, delusional processes), which can then be used to establish professional standards of practice, and the single voice from mental health can then be used to efficiently and effectively guide decisions before the Court.

Until a paradigm shift occurs, no solution is available.

I fully understand the desperate struggle of targeted parents seeking a solution, as you feel your relationship with your child slipping away into a nightmare of distortions, hostility, and rejection. I understand that you’re hoping that because I understand what “parental alienation” is that I will have some magic words to give you that will help the Court and therapists understand. Unfortunately, I don’t have magic words to enlightened the unenlightened.

The solution is to be found in a paradigm shift to an attachment-based model of parental alienation (see Finding Empowerment post), and until this paradigm shift occurs within establishment mental health, no solution will be available.  I’m sorry.  I wish it were different. But its not.

If you’re struggling with the Court, your attorney may find my expert testimony helpful (my professional expertise is in child and family therapy, child development, and parent-child conflict; not in “parental alienation”). I can review reports by other mental health professionals and provide a second opinion on the clinical data contained in these reports, and I can provide testimony in response to hypothetical questions that are posed to me by your attorney that mirror the features of your case. This may or may not be helpful to your case.  I am not an attorney.  For legal advice consult an attorney and follow the advice of your attorney.

In general, my opinion as a psychologist is that reframing the issue away from “parental alienation” and over to “pathogenic parenting” that focuses on the child’s symptoms may possibly be helpful, but that is a decision for you to make in consultation with your attorney.

For parents who lack the financial resources to hire an attorney… I fully understand, and I am sorry, because it is unlikely that you will be able to have my testimony or materials admitted into your case because you probably don’t know how to navigate the requirements of the legal system. That’s the expertise that attorneys provide. But legal representation is expensive. I understand that, which is why I am convinced that any solution to “parental alienation” that requires extensive litigation will be unproductive. We need a solution that is practical, that can be accomplished within 6 months, and that does not require excessive financial expenditures. In my view, an attachment-based model of “parental alienation” provides this solution once it is accepted into establishment mental health.

However, I am not an attorney. For legal advice, consult an attorney.

To achieve any hope of a solution, the Gardnerian paradigm of PAS requires that you have a good attorney who can effectively navigate the legal system. Trying to be successful in the legal system on your own will very likely prove unproductive with regard to “parental alienation.” To make use of my testimony or my materials in Court will likely require the expertise of an attorney to actualize. I’m sorry. I wish it was different. I’m working to make it different. But that is seemingly the current state of affairs.

The current Gardnerian model of PAS is a failed paradigm. There is no pragmatic and practical solution available under the current paradigm. Under the Gardnerian paradigm you must prove “parental alienation” in Court.  In the vast majority of cases, this is not a practical solution that can be actualized.

However, the moment an attachment-based model of “parental alienation” is accepted by establishment mental health (and there are no barriers to this acceptance, see Nothing New – No Excuses post) then the solution becomes available immediately.

The solution to parental alienation” is to be found in the mental health system, not the legal system. Any effort at a solution that requires the litigation of “parental alienation” in the legal system will be unsuccessful. Litigation in the legal system is far too expensive, takes far too long, and almost invariably produces inadequate results.

I wish I had a different answer. I don’t know what you can provide to the Court to persuade them. If you have an attorney and your attorney thinks my expert testimony may be helpful, then I am available to provide my insight to the Court .

Note: Not every post-divorce parent-child conflict is the result of “parental alienation.” In any analysis of clinical data, I will follow wherever the clinical data leads.  If other potential factors besides “parental alienation” are evident in the clinical data, I will say so.  I have no personal investment in finding “parental alienation,” and I am clear in my writings that I define what has traditionally been called “parental alienation” as “pathogenic parenting” evident in a specific set of child symptoms.  I am a clinical psychologist, and my expertise is in child and family therapy, child development, and parent-child conflict, not in “parental alienation.”

The ultimate solution to parental alienation, however, is to be found in the mental health system, not the legal system, and the solution is not to be found on a case-by-case basis.  The fate of targeted parents will rise or fall together.  It will be solved for everyone, or will be solved for no one.

Once mental health speaks with a single voice, then the legal system will be able to act with the decisive clarity necessary to solve the family tragedy of “parental alienation.”

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