Treatment Plan? What’s a Treatment Plan?

So there is no inter-rater reliability or validity to child custody evaluations, there is no knowledge of attachment or family systems therapy or personalty pathology in the mental heath people treating your families, and there is no treatment plan guiding treatment.  As a clinical psychologist, my head is exploding.

The very first question a clinical psychologist asks about an assessment procedure is, “What’s the reliability?”  The next question is, “What’s the research on validity?”  Third question, “What are the possible cultural issues and limitations?” boom-boom-boom all clinical psychologists ask these same first three questions about an assessment procedure, and in that order – reliability, validity, culture.

The answers with child custody evaluations are, zero, there is none, and we don’t know.  Done.  There is not a clinical psychologist alive that accepts those three answers.  Done.

Basic to professional practice, and I mean obvious-fundamental duh-level basic to professional practice, is that you’re expected to know about the pathology you are treating (Standard 2.01a).  That is simply a no-brainer.  If you’re treating autism… you know about autism.  If you’re treating eating disorders… you know about eating disorders.  You know about that pathology you’re treating.  Obvious no-brainer, right?

So if you’re treating attachment pathology you know about the attachment system, right?  No.  Not in the alternate reality of forensic psychology.  You don’t need to know anything about the attachment system if you’re treating attachment pathology in forensic psychology.  Something about working for the court means you don’t need to know stuff anymore.  You’re exempt from knowing anything if it’s a court-involved family.

What about if you’re treating families, you would need to know about family therapy right?  You’d think so, but no.  Not in this alternate reality of forensic psychology.  You don’t even need to know about family systems therapy to treat families.  No knowledge necessary, just dive right in.

My head is exploding.

And in forensic psychology there’s no such thing as a treatment plan. A what?

I know.  That’s exactly what I’m saying.  What’s a treatment plan?  <sigh>

Look at a school IEP.  There it is.  That’s it.  That’s a treatment plan.

Do the same thing except for pathology problems rather than educational problems, and that’s a treatment plan in clinical psychology.

The public school system is slightly more formal in how they handle their treatment plans than is clinical psychology, but we in clinical psychology still have the full structure of the treatment plan in our intake assessment notes and our treatment progress notes.

So what do we notice right off the bat about a standard of practice routine school treatment plan for the child’s educational problems… it’s written.

You don’t even have to ask.  The IEP is written.  If you asked the school NOT to do a written treatment plan, they’d say no.  It’s a written treatment plan.

The educational treatment plan of an IEP is explained to parents fully, and parents have to agree to the proposed plan before the school has permission to enact the treatment plan described to the parent and documented in the written treatment plan.  In clinical psychology, this is called informed consent to treatment (Standard 10.01 of the APA ethics code).

A written treatment plan and full explanation and informed consent of the parent is standard-of-practice routine in the public schools.

As a parent in the public school system, you are provided with a written educational treatment plan for your child.  That plan comprehensively addresses each aspect of your child’s educational challenges, identifying goals, specific interventions, and ways that progress toward achieving those goals will be measured.

School system – routine standard of practice – written treatment plan.

And the professional standards of practice in forensic psychology require you to get a court order to learn what symptoms the child has.  I am writing letters for parents supporting their attorney’s efforts to get a court order to find out what the child’s symptoms are.  Far cry from an IEP standard of practice, wouldn’t you say?

Have you ever been given a written treatment plan for your therapy with your child?

What about for your child’s individual therapy, have you ever seen the therapy IEP for your child’s individual therapy?

My head is exploding.  We are going to ask… strongly suggest… expect… that all mental health professionals working with your children practice at least at the level of our public schools for when they develop educational assessments and interventions for your children’s educational problems.

Is that too much to ask forensic psychology?  That you practice at least at the level of the public school system when they assess and intervene with educational problems?

Because if that’s too much to handle forensic psychology, if you can’t make it up that hill to the standards that are routine for our public school system, then step aside please, because clinical psychology does treatment plans routinely, and we in clinical psychology can actually elevate the IEP plan process.  So we’re comfortable with written treatment plans ala IEP in clinical psychology.

AB-PA represents the return of clinical psychology to court-involved practice.

Parents, compare your treatment plans to the school IEP.  Oh my god, look how beneath professional standards of practice we are.  We should routinely be at school IEP documented treatment plan level… today…. right now…. yikes, yikes, yikes.  That’s seriously deficient where we’re at.

Forensic psychology, you’re going to need to up your game substantially and quickly.  IEP level written treatment plans.  Standards of practice at LEAST at the level provided by the public school system for the child’s educational needs.

No?  Well that’s a curious response, forensic psychology.  Because I suspect that may be a legal right of this parent.  At the level of the public school system.  You’re saying no to “at the level of the public schools”?  That may be actionable.  It’d be actionable in the public school system if the school didn’t do a written IEP level treatment plan for the child’s educational problems.

Oh, and if you’re saying no to practice at least at the level of our public school system… why?

Don’t these parents deserve the same respect and treatment that they receive from our schools?  Why don’t these parents deserve the same respect and treatment from professional psychology that the receive routinely as a standard of practice in the educational system.

Soooo, forensic psychology… you may have a problem saying that you are NOT going to provide standard of care in treatment planning that is at LEAST at the level mandated for treatment of educational problems in the public school system?

Treatment plans.  Expected standard of practice.

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

A Court Order? A Court Order? Contempt & Shame.

I want to note this day.  I want to note the contempt that forensic psychology has for these parents, and the shame this brings to all of professional psychology.

I just had to write a consultant letter of support for a parent seeking a court order to obtain information about their child’s symptoms…. not the child’s treatment, just the child’s symptoms.  Just to be told what the child’s symptoms are, requires that these parents obtain a court order.

Court Request for Symptom Information

Shame to professional psychology.  Shame to the APA.

Parents are being forced to obtain a court order just to be told their child’s symptoms.

Shame to the APA.  Shame to psychology.

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

A Dangerous Pathology

One of the things that is highlighted for me by my deidentified consultation report on data from the Parenting Practices Rating Scale and Diagnostic Checklist for Pathogenic Parenting is how exposed and vulnerable I am.  In every sentence I write, I’m being very precise in how I select my words and phrases now days.  Dangerous world.

I’m walking on the hair’s edge of professional destruction.  One wrong step, one wrong phrase, one wrong action, and I lose my license and livelihood.  Something to understand about working in court-involved psychology is that half of the legal profession wants to discredit and impeach you.  Nothing personal.  That’s their job representing their clients. 

So half of the legal profession at any one time wants to prove that I am awful and that the court shouldn’t listen to me because… reason, reason, reason.

Nothing personal in the reason, reason, reason.  Just doing their job.  Still, not pleasant for a clinical psychologist.  And they’re looking for reason, reason, reason.  I know that, one wrong sentence, one misstep…

We don’t have to deal with antagonistic attorneys when we’re treating ADHD and school behavior problems, or autism pathology.  Safe and comfortable.  Court-involved high-conflict divorce? Woowee, dangerous as all get out.

As a court-involved psychologist, it is my obligation to know the processes of the legal system; the scales of balance and fairness, and the blindfold of neutrality.  My role is neither to seek to evade nor impede the completely legitimate efforts of “opposing counsel”  to discredit and impeach me and my testimony.  Nothing personal, it’s their job. 

My role with court-involved psychology is to present my qualifications and my information openly and fully, and allow the court to make its decisions.  That’s why I have a Vitae Series on my YouTube channel.  I’m an open book, and this is the knowledge base I’m drawing on in my professional practice, including knowledge of community clinical psychology and organizational development, and knowledge of assessment protocol development for court-involved pathology.

Nevertheless, while making the legal world dangerous and highly uncomfortable for clinical psychologists, most attorneys are reasonable people doing their job.  Nothing personal.  However, court-involved practice becomes downright dangerous because of an aggressive group of legal professionals, the sharks.  An estimated six percent of the population has severe narcissistic personality pathology, and it doesn’t take many to become exceedingly dangerous.  That’s immensely stressful as a clinical psychologist.  I don’t have to deal with that when I’m treating ADHD or autism.  When I’m treating classroom behavior problems in a 10-year-old with ADHD, I don’t have to worry about an entire cadre of shark attorneys whose sole goal is to find ways to discredit, impeach, and destroy me.

Talk about pressure.  What rational clinical psychologist wants that kind of pressure?  When I was treating ADHD and school behavior problems my world was serene and peaceful, now there is a group of attorneys who are seeking to discredit, impeach and destroy me… and for some it’s personal.  Yikes.

That’s where we get forensic psychology.  The clinical psychologists don’t want to do it (too dangerous) so the forensic psychologists step in.  But the forensic psychologists practice in “safe-mode” – do nothing and solve nothing.  As long as the mental health person does nothing to disrupt the manifestation of the pathology, then the mental health person is safe.  It is only when the mental health professional tries to disrupt the pathology that their professional license is put at risk.

I notice the extent of my stress and pressure whenever I get a subpoena in the mail, my anxiety immediately shoots up the moment I see the envelope, and it remains elevated for a couple of hours as I process implications of the court documents, even minor stuff that doesn’t really involve me, may represent a threat to me, my stress and pressure goes up as I process the information from every conceivable angle.  Targeted parents know the feeling.  It’s the feeling when they receive an email from your ex-, “Ah jeez… what now…?” And the stress goes up for a couple of hours.  Even if it’s nothing… the stress is just there until I process all the various ramifications and make sure I’m safe and what my orientation should be.

High-conflict court-involved practice is incredibly dangerous for a clinical psychologist.  That’s why clinical psychologists don’t work court-involved high-conflict divorce.  Too dangerous.  And right now is the most dangerous time for me, Dr. Childress.  I’m exposed and I’m all alone. 

I’ve laid the groundwork carefully (Foundations), and I’ve been careful every step of the way.  And, right now, I’m standing all alone, waiting for voices from professional psychology to join me.  We need to protect these children, and this is the way to do it… a confirmed DSM-5 diagnosis of V995.51 Child Psychological Abuse – documented by the rating scales.

And actually, I’m not alone, because I’m reading reports written by mental health professionals citing AB-PA and Dr. Childress. 

We have an ally that I’ve known about all along… I’ve been sandbagging their existence.  It’s all the good and capable mental health professionals, the ones who want to do the right thing to protect the children but can’t figure out what that is, in the complexity of court-involved conflict.  They are joining with us in creating the solution, in protecting the children.  They “get it,” and they are standing up to protect the children from the psychologically abusive parenting of a narcissistic-borderline parent surrounding divorce.

All mental health professionals operate under two professional obligations, our duty of care and our duty to protect.  We have a professional obligation to stand up and protect the children.  I’ll stand here.  You can stand with me.  Here is supported by Bowlby, Minuchin, and Beck.  Here is supported by a structured assessment protocol and data documentation instruments.  We can be safe taking on the dangerousness of the pathogen as long as we stand here – Parenting Practices Rating Scale; Diagnostic Checklist for Pathogenic Parenting.

Everything is documented:  Assessment of Attachment-Related Pathology Surrounding Divorce, Diagnostic Checklist for Pathogenic Parenting, Parenting Practices Rating Scale, Parent-Child Relationship Rating Scale, Contingent Visitation Schedule, ABAB Single Case Design.

Everything is completely transparent.

We’re standing on solid ground.  Bowlby, Minuchin, Beck.

This is the most dangerous pathogen on the planet, and right now I am at my greatest risk.  I need to be exceedingly careful.

This is the most dangerous moment for me because it’s the time before the APA takes a position.  Once the APA takes a position, the orientation of professional psychology to AB-PA will be clear.  Until then, I’m on my own. 

The truth is the truth, and I also need to be exceedingly careful in everything I say and do.  There is a deeply malevolent force lurking that wants to destroy me, personally and professionally, in order to discredit and prevent the solution that is available from AB-PA.  Shark attorneys are most certainly swimming in the waters. 

Hey, APA.  I could use a little help here.  I’m out here exposed to narcissistic and borderline personality pathology in high-conflict court-involved divorce, with attorneys and family hostility and conflict and inflamed passions.  I could use a little help because it’s dangerous for a clinical psychologist to fulfill his or her duty of care and duty to protect obligations under such constant threat.

Yoo-hoo, Parental Alienation Study Group (PASG), are you going to leave me exposed and vulnerable?  Or will you come to support me?  You see what I’m doing.  These parents and I sure could use your help.  How about a statement from the PASG in support of the Petition to the APA?  Sure would be helpful in not leaving me out all alone with no support.  Oh, that’s right… you’re not actually an organization that does anything, just studies things.  Sure could use your help.

American Journal of Family Therapy editors… you’ve published a lot of articles on “parental alienation.”  I know you rejected my article submission in 2013 because the approach described did not pay sufficient homage to Gardner, but now five years later, perhaps you see more deeply into the solution being implemented through AB-PA, and perhaps you would like to support those changes?  You have my email address, invite an article from me.  Invite several, let’s publish an entire issue.  I can provide three articles (foundations and diagnosis; assessment and treatment; and solutions for the family court; and you can invite additional responding articles from whomever you want.  Sure could use your help.

I’m saddened that the International Conference on Shared Parenting in Strasbourg this coming November didn’t think that Dorcy and I had anything important to add to the conversation.  We submitted proposals, but they were rejected.  My proposal contained the additional note that I could present on whatever they wanted me to present on, and that this submission was just my proposal if you’re asking me.  But whatever they want, with possible suggestions listed.  I was rejected.  I have nothing relevant to add to the discussion.  It’s a reindeer game thing, I’m not allowed to play.

That’s a pity, because if our presentations had been accepted, Dorcy and I would be preparing to present in France in a couple of weeks, and we would have been able to provide additional presentation seminars for government officials, legal representatives, and mental health representatives in Europe.  Lost opportunity, I’d say.  Pity.  But hey, I suppose they know best, Dorcy and I have nothing of importance to contribute… or a lost opportunity.

Sure could use your support.  Or not.  I’ll do this alone if you make me.  I’d prefer you join me.  Either way, though… solution is coming.  We will not tolerate the continuation of this pathology and the family wreckage it creates.  We are going to bring this to an end, and we are going to do it by returning to the standard and established constructs and principles of professional psychology; the attachment system, personality disorder pathology, family systems therapy, and complex trauma.

I hope everyone can see that this is not about who the “expert” is.  I don’t want to be an expert.  I want to go away.  I want to go back to ADHD.  But this is important, we have to get this solved.  This pathology needs to end.  We need to provide these children and families with the professional knowledge and competence necessary from their mental health providers to solve the pathology.  Professional psychology needs to speak with clarity to the court, and the court needs to listen.

Add whatever pretty bells and dancing ponies you want to AB-PA, but let’s solve this, and we can solve this… using Bowlby, Minuchin, Beck.  So let’s do that.

Ultimately, we’re going to do away with “experts,” replaced with capable expertise across the profession, who possess specialized knowledge in attachment pathology, in family systems pathology, in personality disorder pathology, and in complex trauma pathology.  Let’s argue about dancing ponies later, add whatever ponies you want, but can we just solve this right here first, can we come together for this common purpose now.

I’m taking the stand out here alone so that others can follow.  That’s part of my role in this.  I will support the mental health professional who follows standards of professional practice and applies the knowledge of professional psychology; the six-session treatment focused assessment protocol and AB-PA; Bowlby, Minuchin, Beck.  I will step up and propose the structure for the assessment protocol and for the interpretation of data, and I will steadfastly defend the structure of the assessment protocol and interpretation of the data for all mental health professionals who rely on it:

Parenting Practices Rating Scale
Diagnostic Checklist for Pathogenic Parenting

If other mental health professionals follow my suggestions for the clinical psychology assessment of attachment-related family pathology surrounding divorce, you will have my full voice of support and the support of Foundations.  Foundations is a diagnostic explanation of the pathology using four information sets from professional psychology; the attachment system, personality pathology, family systems therapy, and complex trauma.  Diagnosis is the application of standard and established constructs and principles to a set of symptoms.  Using multiple separate information sets from professional psychology to triangulate on the pathology provides a valid and reliable diagnosis.

I will become the target for the pathogen and its allies.  I’m okay with that.  Dangerous world, court-involved high-conflict divorce.  Knew that coming in.  That’s my role in this, to use my professional knowledge garnered over a career in clinical child and family therapy to help families and the court unravel attachment-related family pathology surrounding divorce. 

I am asking my professional colleagues who know the right thing, to do the right thing, make an accurate DSM-5 diagnosis, and shift the vulnerability and threat to me in whatever way you need to.  If that means that you do not overtly document the DSM-5 diagnosis of V995.51 Child Psychological Abuse, we can deal with that as long as you complete the symptom documentation instruments.  You do not even have to write a report or interpret their meaning, simply document whether the symptoms are present or absent.

It helps if you stand up, but I understand the danger.  It’s real.  Shift whatever threat you need to shift over to me.  Just document the presence or the absence of the family features and symptoms.  We need you to do that.  Say what you see, we can take it from there.  Or join us and tell what you see.

As a mental health professional, you do not need to complete a Parenting Practices Rating Scale on the allied narcissistic-borderline parent unless you have the information and professional courage to document this parent’s deficits in a statement to be used by the courts.  It takes a lot of professional courage to do that, and I understand if that’s beyond your comfort level for threat and danger surrounding your professional practice. 

We just need the Parenting Practices Rating Scale for the targeted parent and the Diagnostic Checklist for the child’s symptoms.  The Parenting Practices Rating Scale will document normal-range parenting for the targeted parent relative to diagnostic indicators 1 and 3 of the Diagnostic Checklist for Pathogenic Parenting.  It’s that set of information that we need documented.  What Level parenting is the targeted parent, and are these three child symptoms present, sub-threshold, or absent?

I know exactly how dangerous the pathogen is, and I am fully cognizant of my daily threat of misstep that could undermine my entire career.  If clinical psychology is going to reestablish its involvement with court-involved consultation, assessment of pathology, and treatment of pathology, we need to be able to provide protection to the mental health professionals who wonderfully select to work with this extremely difficult and extremely dangerous pathology.

Ultimately, we are going to be elevating these mental heath professionals to the highest caliber of professional respect, expertise, and knowledge in attachment pathology, personality disorder pathology, family systems therapy, and complex trauma.

As professional standards of practice form, protection is provided first by defined structure and clear documentation. 

I have a professional obligation to the child from my duty of care and my duty to protect as a clinical psychologist.  This obligation requires that I act to solve the high-conflict family pathology created by the parent’s narcissistic and borderline pathology that is leading to severe psychopathology in the child (diagnostic indicators 1, 2, and 3) and the loss of a loving parent-child bond from the child’s life.  My actions in developing the six-session limited scope treatment focused assessment protocol, the Strategic family systems intervention of the Contingent Visitation Schedule, and the ABAB single case design assessment and remedy protocol is toward fulfilling my obligations as a clinical psychologist in my duty of care and my duty to protect.

I also have a professional obligation through my decision to enter court-involved professional practice to be knowledgeable and always cognizant of my role and obligations within the legal system for fairness, balance, and neutrality, and to provide the court with the highest caliber of professional knowledge and standards of practice.

When in danger, vulnerability is not always a weakness, and truth is always a valuable ally.

If you think I’m defenseless standing out here all by myself… come give it a go and I’ll show you just how defenseless I am.  Oh, and I’m not quite alone.  There are 20,000 voices to the Petition to the APA who are standing right here beside me.  Heavens, I’m not alone.  Have you met Wendy Perry and Rod McCall, and all the parents they represent?  No, I’m not alone.  And hey, have you met Dorcy Pruter?  Oh my goodness gracious, you have to talk to Dorcy.  She’s standing right here next to me, here Dorcy, say something to the clever pathogen.  I’m not alone.

Everything I do is out in the open. I tell everyone ahead of time what it is I’m going to do and how I will interpret the data when it’s collected.  Nothing hidden.  The pathogen likes to hide.  We’re not going to let it hide.  Two data documentation instruments, that’s all we need.  Tell us what you see.

It’s time for all of us in clinical psychology who know the right thing to do the right thing.  I’ve staked out the ground so you can be safe identifying the presence of the pathology.  We need to protect these children.  Join me in protecting these children.

It’s the right thing to do.

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


Attachment Counter-Transference Scale

Social interactions have a feature of a call-and-response sequence.  Two of the most common call-and-response sequences are for social politeness, the “thank  you – you’re welcome”  gracious display and the “sorry – no problem” forgiveness call-and-response.

A call-and-response I recommend for targeted parents is the bonding call-and-response of “I love you – love you too.”  In the attachment pathology of AB-PA, the child will not provide the called for response.   However, that doesn’t matter.  For a fraction of a moment, that response was in the child’s brain, “love you too.”  The child then blusters and flusters to remove it… but it was there for a moment…

“Love you – love you too; uh, no I don’t, I hate you, I hate you so much you can’t even imagine how much I hate you.”

“I know.  Love you – love you too.  Stop it!  Don’t say that.  Stop telling me that.  You don’t love me, and I hate you.  So stop.”

“Okay.  Love you – love you… uggghhhhh, stop it.  I’m out of here, I hate you.  That’s all I have to say.  Hate, hate, hate.”

“Okay.  Bye.  Love you.”

The call-and-response puts the response in the other person’s brain whether they want it there or not. 


The first six questions of the Attachment Counter-Transference Scale use this quality of call-and-response.  They are simple and direct… calls.

“As a child, did you love your mother?”

Simple and direct.  It’s a call.  It will receive a response.  Pop, yes, no, kinda will enter the person’s brain.  The defenses may then kick in, but for a moment the authentic response is in this person’s brain. 

But no one is listening to their response but them.  They can use all sorts of defenses, but they know.  They know the truth.  They know what that first response is, they were there during their childhood, they know what the truth is.  And that truth is the first response, “did you love your mother?” – “did your mother love you” – now there is an interesting question.  Pop.  There it is, there’s the answer.

Does their answer matter?  No.  The question’s direct simplicity is triggering the authenticity of response  – and in the social isolation of the person’s own self-awareness, this is all within the person’s own head – between them and themselves.  They know the truth.  What they say and what they know to be the truth may be two different things, but we’ll deal with that shortly.  The question pops the answer, and they know the truth.

What the question does is prompt their self-realization of the truth to each of these questions, whether this truth quickly becomes layered with defenses is secondary.

“did you love your mother?”  “did your mother love you?”

“did you love your father?” – “ did your father love you?

There they are.  Those are the four counter-transference questions.  To a simple-direct question, each one is answered honestly for a moment in the mind of the respondent.  Defenses may come in reporting, in social exposure, but the person knows.

Then opens the second phase of the counter-transference assessment, does the person respond honestly or does the person lie?

People who authentically answer yes to all four questions are of minimal to no risk for negative counter-transference issues.  It’s the people who answer no or somewhat to one of those four questions who are of concern.  Still, we all have our various childhood traumas and we recover… we recover by acknowledging the truth of our trauma and dealing with it.  Hiding our trauma is a sign of our not having dealt with and processed the trauma experience – we’re still working it through.

So the actual answer to the first six questions isn’t about the actual answer, it’s about whether problems are concealed or admitted.  That is the counter-transference scale.

If the person tells the truth and acknowledges potential counter-transference issues, great.  Go speak with a professional colleague for a bit to make sure you understand the issues you may bring from your own childhood background.  That’s a good thing.  We’ve highlighted an important issue in the treatment of attachment-related family pathology, and we’ve got it taken care of in a simple and efficient manner.

But if the person lies, then we will never know.  They’ll say everything in their childhood was fine, when it wasn’t.

Yes, that is true.  And that’s okay too.  Because they will know.  If you lie on the Attachment Counter-Transference Scale, you 100% have counter-transference issues.  Ta-da.  Exposed.

Yes, granted, it’s only exposed to the mental health professional’s self-secrecy… but they know.  They know their first response to the questions.  They know they deceived, they hid their trauma.  They know.

And that’s the point of the Attachment Counter-Transference Scale.  People can deceive the scale by lying.  But then, they have their answer.  They know they have prominent counter-transference bias and unresolved childhood trauma, and they know that their work is fraudulent, that they are swindlers and charlatans, they have lied and they are not truthful.

We may not know… but they do. And that’s the point of the Attachment Counter-Transference Scale.  Asking six questions, simply and directly – call-and-response for the authentic response, and then… do you disclose or deceive?

Why hugs?  Why hugs for questions 5 and 6?

Affection.  Questions 5 and 6 trigger affection (call-and-response).

But lots of people may not be very huggy.  I know.  But it’s affection none the less.   I’m a clinical psychologist, things are never quite as they appear.  The question triggers affection.  Call and response.  I don’t care what the actual response is, I’m triggering affection and then looking how the person decides to disclose.  The person remembers their childhood hugs, or the absence of childhood affection, it’s a call and response.  And then, do they disclose or deceive?

Therapist:  “I never got hugs from my dad, he was never around.  But that’s okay.  I didn’t really need affection from my dad.  A dad’s love isn’t really important. I’m okay.”

Dr. C:  Of course you are.  and perhaps you may want to look at your relationship with your dad a little bit, perhaps there’s some sadness there that you haven’t noticed, perhaps wanting to bond more to him than maybe you did or could?  Maybe you’ll want to take a look at that a bit more, especially if you want to start working with children’s attachment pathology surrounding parents and divorce.  Wouldn’t want things with your own family of origin influencing how you see stuff with the current families you’re treating.

My goodness gracious, you’re a mental health professional, this isn’t a game.  This family needs your help, answer the questions honestly.  If you’ve got crazy-nutty in your childhood, no worries, trauma happens, we attend to it, we resolve it.  No worries.  Just acknowledge it so we know that you’ve dealt with it.

But if you’re hiding and not disclosing your childhood emotional traumas, then your childhood emotional traumas are going to come back through unconscious counter-transference issues when working with attachment pathology in families.  So this is a self-assessment for all mental health professionals… complete the Attachment Counter-Transference Scale.

First six questions, deceptively powerful. 

If you acknowledge issues in your childhood family of origin, go check in with a professional colleague for 4 to 6 sessions to clarify the issues and their possible influence on perceptions.  And then you’re good to go.

Don’t lie.  Tell the truth.  Deal with stuff if you’ve got stuff.

Simple as that.  Professional standards of practice for all mental health professionals working with attachment-related family pathology surrounding divorce.  Have you dealt with your stuff?  Show us.  Complete the Attachment Counter-Transference Scale.

Question 7

Question 7 of the Attachment Counter-Transference Scale is another deceptively revealing question.  Question 7 is qualitatively scored and interpreted.  The stem of the question rules out the three domains of child abuse, physical, sexual, and neglect.  The question then asks about rejection of a parent, are there justified reasons to reject a parent other than abuse?

There are a variety of answers that can be offered to this question.  It is a projective question designed to elicit counter-transference relevant schemas.  There are potential yes answers that can be supported, but what is the support offered?  That’s the schema.  This question will retrieve the schemas of the mental health professional surrounding parent-child relationships, and potentially discipline, loyalty, and affection issues.  This is a schema search question.

Importance of Relationship Questions

Next on the Attachment Counter-Transference Scale are four 0-100 rating scales for the importance of each of the four types of primary parent-child bond; mother-son, mother-daughter, father-son, father-daughter.  Scoring indicates that all four scales should be rated as 100, and that any lesser rating requires professional justification and research support.

And there may be times when one relationship might be given preferential treatment, such as the mother-child bond in the first 12 months of infancy.  Cite the research, make the case.  I’m good with that.  But default is 100 for all parent-child bonds; father-son, father-daughter, mother-son, mother-daughter.  Each of these relationships is unique, each type of bond is incredibly important to the child’s healthy development, and none of them are expendable – 100 for each relationship type, or make the case with research.

What these four questions do is get the mental health professional on record – documented.  All four are equal in importance.  Right?  Or no,… which then reveals the counter-transference, which relationship type is valued, which devalued – or make your case by the research.

Family of Origin

The structure of the family of origin is less important than the degree of conflict in the family of origin.  High conflict families of origin can undermine the person’s ability to recognize and use effective problem-solving skills for conflict resolution because this person never had these problem resolution skills modeled by parents during childhood development.

The person may have subsequently acquired knowledge of effective problem-solving and communication skills for conflict resolution, we simply want to be reassured of this, what skills have they learned, where and how, and what skills are they teaching families and applying in therapy?

The primary issue of concern is the ability to resolve conflict (the “repair” in the breach-and-repair sequence).  High conflict families are unable to resolve conflict. 

Moderate conflict families may or may not effectively resolve conflict, and resolution may be more intermittent.  Moderate conflict families of origin can go either way in terms of concern for counter-transference issues in the child who is now grown to adulthood and who is now occupying the role of therapist or evaluator for a client family.

The Curriculum Knowledge Scale

This is the curriculum for knowledge required to assess, diagnose, and treat attachment-related family pathology surrounding divorce.  This also exists as a stand alone scale:

Curriculum Knowledge Scale

There is no “acceptable” level of professional ignorance.  Attachment theory, personality disorder pathology, and family systems therapy are all established domains of knowledge and are all relevant to resolving attachment-related family pathology surrounding divorce.

An attachment-based model of “parental alienation” (AB-PA; Foundations) is a scaffolding support to knowledge, it is not the knowledge itself.  The Curriculum Knowledge Scale identifies the information from professional psychology required for professionally competent practice with attachment-related family pathology surrounding divorce.

Legal System

I think all family law attorneys should ask for a Curriculum Knowledge Scale from all child custody evaluators along with submission of their reports.  I think it’s kind of important to know what the mental health professional knows as a basis for their opinions.

I think all “reunification therapists” (there’s no such thing as “reunification therapy”; it doesn’t exist) should also be required to complete the Curriculum Knowledge Scale, providing a copy to parents as part of the informed consent process for each family they treat. 

I think family law attorneys working for their clients, should ask the court to formally request a copy of a Curriculum Knowledge Scale for each mental health professional working with the family, including the children’s individual therapists.  Might as well find out what they know… or don’t know.

Personally, I’d just ask for the more complete Attachment Counter-Transference Scale.  It contains the Curriculum Knowledge Scale as part of it, so it’s like a two-fer.


All mental health professionals working with attachment-related family pathology surrounding divorce should complete the Attachment Counter-Transference Scale as a standard of practice.  Document family of origin concerns, address family of origin concerns… or lie… and become a charlatan and fraud. 

We know the counter-transference bias is out there.  We want to put the pressure of exposure on it.  We want to identify it – to itself, so the person has the opportunity to do the right thing and deal with their childhood trauma issues, so that their own childhood stuff won’t affect their work with current families.  That’s the right thing to do. 

The Attachment Counter-Transference Scale puts pressure on them to do the right thing, we know you, even if you hide… and we know that you know you.  Tell the truth.  Do the right thing, be authentic, acknowledge childhood trauma, deal with whatever needs to be dealt with.


From Aaron Beck on schemas:

“Evaluation of the particular demands of a situation precedes and triggers an adaptive (or maladaptive) strategy.  How a situation is evaluated depends in part, at least, on the relevant underlying beliefs.  These beliefs are embedded in more or less stable structures, labeled “schemas,” that select and synthesize incoming data.” (Beck et al., 2004, p. 17)

“The content of the schemas may deal with personal relationships, such as attitudes toward the self or others, or impersonal categories.” (Beck et al., 2004, p. 27)

“When schemas are latent, there are not participating in information processing; when activated they channel cognitive processing from the earliest to the final stages” (Beck et al., 2004, p. 27)

“When hypervalent, these idiosyncratic schemas displace and probably inhibit other schemas that may be more adaptive or more appropriate for a given situation.  They consequently introduce a systematic bias into information processing.” (Beck et al., 2004, p. 27)

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

Beck, A.T., Freeman, A., Davis, D.D., & Associates (2004). Cognitive therapy of personality disorders. (2nd edition). New York: Guilford.



The Shame of the APA: Cruelty and Contempt Shown to Grieving Parents

Over 20,000 parents are asking the American Psychological Association to affirm its support for Standard 2.01a of its ethics code requiring professional competence… and they are met with silence… nothing… no dignity, no respect for their suffering… just silence, contempt, and disrespect.

You don’t matter.  You don’t even merit a response.  Cruelty, contempt, and disrespect.

No answer.  Just silence.

Petition to the APA – 2018 (online)

Petition to the APA – 2018 (booklet)

The ethics code of the American Psychological Association is hollow and without meaning.  It means nothing if the APA does not support it… and the APA will not support it’s own ethics code.  The APA cares that it looks good with it’s nice words, but will not back those hollow words when needed.  The APA ethics code is vacuous, empty words without meaning.

Over 20,000 parents reaching out to the American Psychological Association, asking the APA for a simple press release affirming the APA’s support for Standard 2.01a of the APA ethics code requiring professional knowledge and competence…

Silence.  Nothing.  The APA does not even show these 20,000 parents the dignity and respect of a reply.  Just contempt.  Contempt and disrespect for 20,000 parents seeking professional knowledge and competence with their children and families.  Shame to the APA for its contempt and cruelty.  Shame to the APA for its complicity in tolerating ignorance and professional incompetence.  Silence.  Nothing.

APA: Complicity with Child Abuse

If a psychologist is treating families, that psychologist should know how family systems function – Minuchin, Bowen, Haley. 

Question to the APA: Is it reasonable for parents to expect that the psychologists who are working with their families know about family systems constructs; triangles, cross-generational coalitions, and emotional cutoffs – Salvador Minuchin, Jay Haley, Murray Bowen?

Silence.  No response from the APA.  Contempt and disrespect.  These parents don’t even merit a response; “You don’t matter.  Your pain and suffering doesn’t even merit a response.”

So apparently psychologists working with your families don’t need to know anything about families.  The APA is silent.  The APA ethics code is hollow.  Empty words without meaning.  You are alone, the APA has abandoned you and your children.  The APA will not support you in your efforts to acquire professional knowledge and competence in the psychologists treating your families.

If a psychologist is treating attachment-related pathology, that psychologist should know about the attachment system; Bowlby, Ainsworth, Mains and the research literature. 

Question to the APA: Is it reasonable for parents to expect that psychologists who are working with their children and families to resolve parent-child attachment pathology know about the attachment system, how the attachment system functions and how it dysfunctions?

Apparently that is not necessary.  The APA is silent.  So apparently it is not necessary for psychologists to know about the attachment system when assessing, diagnosing, and treating attachment-related pathology in the family; Bowlby, Ainsworth, the attachment research literature… not necessary to know when treating attachment-related pathology.

The APA ethics code is hollow and without meaning, Standard 2.01a is hollow and without meaning, because the American Psychological Association is silent when 20,000 parents ask for support from the APA for Standard 2.01a. 

Silence is complicity, and in this case silence is also cruelty.  Twenty thousand parents deserve a response.  Say something.  They deserve a response.  They are people who are suffering, they are parents who are suffering the loss of their children.  They are not invisible.  See them.  At least acknowledge them.  Respond to their Petition.  But silence is cruelty.  Silence is contempt.

Wendy Perry: is your contact.  Not me.  Talk to Wendy.  She speaks for these parents.  She is your contact.

Silence from the APA is abandoning these parents to their emotional and psychological abuse.  Abuse from the sadistic cruelty of their narcissistic-borderline ex-spouse, corrupting and taking the children away from the beloved and loving parent in revenge and retaliation for the divorce, and from a failed family court system that does not diagnose pathology.  Family courts are matters of law, not of diagnosing pathology.

To the APA:  Your silence communicates your contempt and disrespect for the suffering of these parents, that these people do not even merit a response from you.  That they are of no value.  That they don’t matter.  Their immense suffering from the loss of their children means nothing to you, – silence, not even a response.  Nothing. 

That is cruel.  Contempt and cruelty.

Twenty thousand parents come to you in their pain, and you treat them with contempt and disrespect – with cruelty for their suffering.  They have lost their children.  At least say something. 

Nothing.  Silence.  Contempt, cruelty, and disrespect.

Shame is on the APA.  This is to your shame.

The ethics code of the APA is hollow and without meaning when it is not supported by the APA.  These parents are simply asking that the APA release a statement of support for Standard 2.01a of their ethics code requiring professional knowledge and competence, these parents can take it from there.  That is all they are asking… for the APA to simply voice its support for Standard 2.01a of its own ethics code.

Silence.  Nothing.  Not even a reply to say why they won’t issue a statement supporting Standard 2.01a.

To the APA:  Your silence to these parents tells them, “You are of no value.  Your suffering and the loss of your children means nothing.  You are not even worth a reply.  You are invisible.  You don’t exist.  Your suffering doesn’t matter, your suffering doesn’t exist.”

Shame to the APA.  Cruelty to trauma.  Contempt.  Disrespect to suffering.  You mean nothing, not even a response.

Complicity in the cruelty, trauma, and abuse.  Shame to the APA.

Complicity with Abuse

Silence is complicity.  The APA knows that personality disorder pathology exists.  the APA knows that the narcissistic-borderline personality will collapse in response to the rejection and perceived abandonment surrounding divorce.  The APA knows that the narcissistic-borderline pathology is high-conflict, manipulative, and exploits others.  The APA knows all of this.

And yet, when the parent-spouses of these collapsing, high-conflict, psychologically abusive narcissistic-borderline parents come to the APA for support of professional knowledge and competence… silence… nothing.  You don’t matter enough to even give a reply.  You mean nothing to us.

The APA is complicit in the psychological abuse of children by the pathology of a narcissistic-borderline parent surrounding divorce.  They know.  And their silence is complicity.

An estimated 6% of the population is diagnosable with narcissistic personality pathology; an estimated 6% of the population is diagnosable with borderline personality pathology:

  • “Prevalence of lifetime NPD was 6.2%”

Stinson, et al., (2008). Prevalence, correlates, disability, and comorbidity of DSM-IV narcissistic personality disorder. Journal of Clinical Psychiatry. 1033-1045.

  • “Prevalence of lifetime BPD was 5.9%”

Grant, et al., (2008). Prevalence, correlates, disability and comorbidity of DSM-IV borderline personality disorder. Journal of Clinical Psychiatry. 533—545

Narcissistic and borderline personality pathology exists.  We know this. 

The narcissistic personality is vulnerable to collapse in response to rejection, the borderline personality is vulnerable to collapse in response to abandonment.  We know this. 

Divorce represents both rejection and abandonment by the spousal attachment figure.  We know this. 

We should therefore anticipate that approximately 10-15% of all divorces should evidence collapsing parental/(spousal) narcissistic-borderline pathology.  We know this.

The narcissistic-borderline personality is high-conflict.  We know this.

The 10-15% of all divorces that contain a narcissistic-borderline parent will comprise 80-100% of the high-conflict divorces, because the narcissistic-borderline personality will definitely collapse in response to divorce and the narcissistic-borderline personality is high-conflict.  We know this.

Now… the spouses divorcing the high-conflict pathology of a narcissistic-borderline spouse are seeking professional competence in personality disorder pathology from the psychologists who are assessing, diagnosing, and treating their families and the children’s attachment pathology surrounding the divorce.  They are asking that the psychologists working with their families know about personality disorder pathology: Beck, Kernberg, Millon, and Linehan.

Question to the APA: Is it reasonable for these parents who are exposed to the narcissistic and borderline personality pathology of their ex-spouse surrounding the divorce to expect that the psychologists working with their families know about personality disorder pathology; Beck, Kernberg, Millon, and Linehan?

Apparently not.   The APA is silent.  It is not necessary for psychologists working with personality disorder pathology to know about personality disorder pathology. 

Twenty thousand parents asked the APA to affirm its support for Standard 2.01a that would require professional knowledge and competence.  Silence.

APA: Complicity with Child Abuse

Nothing.  No response.  Contempt and cruelty.

Shame to the APA.

Two full years before the current Petition to the APA, in February of 2016, these parents came to you with their first petition. 

Parent’s First Petition to the APA – 2016

Do you remember what you told them?  I do.  I was watching as these parents organized their petition seeking  your help in solving the suffering in their families.  I was listening when you answered them.  You told them that you would form a committee to “look at the research.”  Do you remember that?  I do.  I can get the emails from these parents if you’d like. 

You told them that you’d form a committee to look at the research.  They waited.  They aren’t seeing their children the entire time they’re waiting for you to form your committee.  All of 2017 they waited for you.

Nothing.  In 2018, I wrote the second Petition to the APA using my knowledge of professional psychology, and my understanding of the rampant and unchecked professional ignorance and incompetence these families are facing from professional psychology.  It’s now nearly three years later, it’s approaching three years since these parents first approached you… where is this committee you promised them in 2017?  Nothing.  Disrespect.  Contempt.

Empty words. 

Cruelty.  Contempt.  Disrespect.

In 2016 these parents came to you with their first petition seeking your help.  All they want is professional knowledge and competence from the psychologists treating their families – basic knowledge; Bowlby, Minuchin, Beck, Linehan, Bowen.  That’s all they want, just basic knowledge and competence from the psychologists treating their families.

These parents are suffering the loss of their children.  Some haven’t seen their children in years… two years, five years, ten years, they haven’t even seen their own beloved children.  They are normal people, loving parents, they did nothing – their only crime was marrying a narcissistic-borderline personality spouse who used the child viciously and cruelly as a weapon of revenge in the divorce.  No one’s protecting their beloved child from the psychological cruelty of the narcissistic-borderline personality parent.

These parents are grieving the loss of their children.  They are traumatized.   They have lost their beloved children.  Their grief is immeasurable.

The response of the APA to their suffering? 


Contempt.  Cruelty. 

APA: “Your suffering is not our concern.  We abandon you.  You are invisible.  You don’t matter.”

Shame to the APA.  Parents seeking knowledge and competence from their treatment providers.  Just asking for a statement from the APA supporting Standard 2.01a of the APA ethics code… and getting no response.  Silence.  Contempt.  Cruelty.

No reply.  These parents do not even deserve a reply.  Nothing.  They don’t matter. Their suffering doesn’t matter. 

Shame to the APA.  Cruelty.  Disrespect.  Contempt shown to suffering and grief.

Hollow Ethics

The APA ethics code is hollow.  Why should any psychologist affirm the APA’s ethics code when the APA won’t even affirm the APA’s ethics code?

Parents are left with no choice.  They have been abandoned by professional psychology and by the APA.  Their only choice for acquiring professional knowledge and competence is to file individual licensing board complaints on a case-by-case basis against violating psychologists who do not possess the required knowledge and competence, thereby compelling the acquisition of knowledge and competence: Bowlby, Minuchin, Beck, Millon, Kernberg, Bowen, Ainsworth, Haley…

Will licensing boards enforce Standard 2.01a requiring professional knowledge and competence?  No.  Why should they?  The APA doesn’t even affirm its support for Standard 2.01a requiring professional competence.  The APA ethics code is hollow and without meaning.  So, no, the licensing boards are not likely to enforce standards for professional competence without the APA indicating its support for Standard 2.01a.  As long as the APA does not support Standard 2.01a, the licensing boards will not support enforcement of Standard 2.01a.

To Psychologists: The APA ethics code is hollow and without meaning.  No need to abide by it.  A few select features are relevant, no sex with clients, maintain confidentiality, no dual relationships.  But the rest of it is pretty much empty words and without real meaning, especially that part about knowing what your doing, Standard 2.01a, no need to abide by that.

Principle E: Respect and Dignity

APA Ethics Code: “Principle E: Respect for People’s Rights and Dignity: Psychologists respect the dignity and worth of all people.”

To the APA:

Twenty thousand parents come to you seeking help in acquiring professional knowledge and professional competence in the treatment of their families, and your response?   Silence.  Nothing.  Their suffering doesn’t even merit a response. 

Is that treating these parents with respect, dignity, and worth?  No, it’s not.  These parents at least deserve a response from the APA, and they deserve the support of the APA in seeking professional knowledge and competence.

Are you honestly going to take the position that psychologists working with families don’t need to know Minuchin, Bowen, and Haley (family systems)? 

Are you honestly going to take the position that psychologists working with attachment pathology don’t need to know Bowlby, Ainsworth, and the research literature on attachment (attachment theory)? 

Are you honestly going to take the position that psychologists working with personality disorder pathology in the family don’t need to know Beck, Millon, Kernberg, and Linehan?

If so, then Standard 2.01a is hollow and without meaning.

You will eventually issue a statement in support of your own ethics code Standard 2.01a, because these parents are asking you to do so.  It will help them attain professional knowledge and competence with their children and families.

Or you can abandon these parents and children.  Silence.  Complicity in their suffering and abuse.

These parents are suffering daily.  They need the knowledge of professional competence in family systems, personality disorder pathology, and the attachment system, now… today.  Each day is one more lost day without their child, and a child deprived of a mother or father by the cruelty of a narcissistic-borderline parent.

They came to you in 2016.  Nothing.  Two years later, they came to you again in 2018.  Nothing.  Cruelty, contempt, and disrespect for their suffering.  The APA knows the truth of their suffering, and the APA is silent.  Not even showing these parents the dignity of a response.

I am not your contact.  Don’t speak to me.  Speak to the parents who are suffering.  Speak to the parents that need your help.

Wendy Perry:
parent-child advocate

Silence is cruelty.  Speak.  Say something.  These parents deserve a response.

Silence is shame.  Silence cruelty and contempt for suffering.  Silence is complicity with abuse.

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

The Parenting Practices Rating Scale

The Parenting Practices Rating Scale is designed to document the clinical assessment of parenting by the targeted parent.  The scale contains four primary items:

1.)  Category Level of Parenting:

Item 1, the Category Level of Parenting, identifies deviant-abusive parenting relative to broadly normal-range parenting. 

The Level of parenting is rated on a 4-point Likert scale (abusive, severely problematic, normal-range problematic, normal-range healthy), anchored by descriptive categories of parenting.  Identifying the category of parenting locates the parenting in the corresponding Level of the rating scale. 

The 4-point Likert scale is then brought together into two broad categories of parenting; deviant-abusive (Levels 1 and 2) and normal-range (Levels 3 and 4).  It is this dichotomous classification that is used for diagnostic indicator 1 by the Diagnostic Checklist for Pathogenic Parenting to define a “normal-range parent” (Levels 3 and 4)

Ratings on Item 1: Category Levels should offer parenting examples to support the category rating.

2.)  Permissive-Authoritarian Rating

Item 2, the Permissive-Authoritarian Rating, is a 0-100 dimensional rating along the continuum of lax and permissive parenting to over-controlling and authoritarian parenting, with normal-range parenting represented by the mid-range scores.  This clinical rating represents the clinical judgement of the assessing mental health professional based on identified features of parental attitude and approach.  Ratings on Item 2: Permissive-Authoritarian Rating should be supported with examples.

A heuristic for clinical rating is that scores in the upper and lower 20% (0-20 and 80-100) should be considered sufficiently extreme to raise child protection considerations (for neglect at the lower extremes and for hostile-aggressive parenting at the upper extremes).

Normal-range parenting should be considered ratings between 25-75, with allowances provided for the cultural values, religious values, and personal values of the parent.  Clinical psychology typically recommends a mid-range balance along this dimension that incorporates flexible dialogue and negotiation with clearly defined rules, structure, and expectations (preferred rage of 40-60). 

However, some parents tend to be more lax, negotiable, and permissive (building relationship at the expense of child maturity; 30s), while other parents tend to be more rule-oriented, authoritarian, and structured (building child maturity at the expense of relationship; 60s).  These are value laden decisions for each parent, and as long as the parenting is broadly normal-range (25-75), parents should be allowed the right and discretion to form their families consistent with their cultural, religious, and personal value systems.

3.)  Empathy

The nature of parental empathy is not a decisional factor, but is an important descriptive feature for treatment-related considerations.  Throughout the professional literature, authentic parental empathy for the child is identified as the most important factor in parenting.  Highly lax and permissive parenting (30s) can be entirely healthy for the child with the addition of authentic parental empathy for the child’s autonomous experience, and can be damaging for the child’s development in the absence of authentic parental empathy.  Similarly, highly structured and authoritarian parenting (60s) can be entirely healthy for the child with the addition of authentic parental empathy, and can be damaging to the child’s development in the absence of authentic parental empathy.

The Empathy item is rated along a 5-point Likert scale, extending from narcissistic-style parenting evidencing an absence of authentic empathy for the child (emotional indifference or psychologically dominating projective identification), to borderline-style parenting of intrusive psychological over-involvement (psychologically anxious-intrusive parenting and projective identification).

Normal-range parental empathy is rated as a 3.  Narcissistic absence of empathy is rated as 1.  Borderline over-intrusive projective identification is rated a 5.  The mid-range scores of 2 (absent of parental psychological involvement) and 4 (anxious over-intrusive parenting) are indicators of normal-range parenting of concern, while the more extreme scores of 1 or 5 would represent prominent clinical concerns for the child’s development. 

Children flourish emotionally and psychologically from authentic parental empathy that is not projective of the parent’s own emotional and psychological needs and history (a normal-range rating of 3).

4.)  Issues of Clinical Concern

Item 4 identifies parenting behaviors of potential clinical concern, such as psychiatric issues, substance use issues, and trauma history issues.  These clinical concerns are modified by treatment.  If the parent’s psychiatric issues are being stabilized by treatment, if the parent’s substance use issues are in substantial remission (1 year), and if the parent’s own trauma history has received treatment, then these issues are all of lesser and limited clinical concern.  On the other hand, untreated major psychiatric pathology in a parent, active parental substance abuse, or unresolved parental trauma are all domains of prominent professional concern regarding the emotional and psychological well-being of the child.

Item 4, Issues of Clinical Concern, is a nominal rating scale of six categories of parental factors that would trigger treatment-related considerations.

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


Two Diagnostic Models: Your Choice

You need to be an informed consumer of mental health services. These are your children and it is your family.  Which diagnostic model is used with your children and with your family is your choice.

So let’s compare.

There are currently two diagnostic models for determining the cause of a child’s rejection toward a parent surrounding divorce, the 8-symptom Gardnerian PAS diagnostic model, and the three-symptom AB-PA diagnostic model. They are assessed in different ways, and they lead to different outcomes.

The 8-symptom Gardnerian PAS diagnostic model has been applied for the past 35 years. It is the current diagnostic model being used. It is responsible for the current situation. If you want to see what the Gardnerian 8-symptom diagnostic model leads to, just look around… we’ve been using the 8-symptom Gardnerian PAS diagnostic model for 35 years, and it is currently the most prevalent diagnostic model being used to assess the pathology of “parental alienation” (attachment-related family pathology surrounding divorce).

AB-PA: The AB-PA diagnostic model was first described by Childress in Foundations (2015). It is mostly unknown in professional psychology, but it is rapidly gaining awareness in professional psychology.

As evidence of this increasing awareness, Dr. Childress has already conducted a six-session treatment focused assessment by court order (conducted across three consecutive days of clinical assessment sessions with the family; and a turn-around time for the treatment focused assessment report to the court in less than two weeks). An AB-PA pilot program for the family courts is also currently available in Houston, Texas; with 15 AB-PA knowledgeable mental health professionals trained to administer the six-session treatment focused assessment protocol, trained to manage the Strategic family systems intervention of a Contingent Visitation Schedule, and knowledgeable in solution-focused family therapy (Minuchin, Bowen, Berg) for stabilizing the post-divorce separated-family structure, along with 10 AB-PA knowledgeable amicus attorneys to coordinate family treatment with court orders and court support.

The three-symptom AB-PA diagnostic model represents change.

The AB-PA diagnostic model represents the application of the highest caliber of professional knowledge (Bowlby, Minuchin, Beck) and standards of practice to the assessment, diagnosis, and treatment of attachment-related family pathology surrounding divorce.

The 8-symptom Gardnerian PAS diagnostic model is based on the proposals of one man, a psychiatrist in the 1980s, that there exists a “new form of pathology” unique in all of metal health, so unique that this “new form of pathology” needs its own unique new set of symptoms unlike any other symptoms for any other pathology in all of mental health, eight symptoms made up 35 years ago, in the 1980s, by this one psychiatrist .

The three diagnostic indicators of AB-PA are based in the standard and established constructs and principles of professional psychology; Bowlby, Minuchin, Beck; the attachment system, personality disorder pathology, family systems therapy.

The 8-symptom Gardnerian diagnostic model is assessed using a six to nine month child custody evaluation costing $20,000 to $40,000.

The three diagnostic indicators of AB-PA (an attachment-based model for the pathology) are assessed in six sessions for around $2,500.  All three symptoms of AB-PA are standard symptoms fully within the existing scope of practice for all mental health professionals to identify.

When the three diagnostic indicators of AB-PA are present in the child’ symptom display, the DSM-5 diagnosis is V995.51 Child PsychologicaL Abuse, Confirmed.

When the 8-symptom Gardnerian PAS diagnostic model is used, this does NOT lead to a DSM-5 diagnosis of Child Psychological Abuse. The 8-symptom Gardnerian PAS diagnostic model does NOT result in a DSM-5 diagnosis of Child Psychological Abuse.

The 8-symptom Gardnerian PAS diagnostic model requires that targeted parents prove “parental alienation” through a court trial. It is in the two year run-up period to the trial that the child custody evaluation is typically ordered.

Since child custody evaluations take six to nine months to complete, this typically extends the time needed to obtain the court trial that’s needed to prove “parental alienation” using the 8-symptom Gardnerian PAS diagnostic model to about two years, or longer, from the start of the pathology (six months to get the court order for the custody evaluation, nine months for the custody evaluation to be completed, and three to six months to schedule the trial).  Assuming there aren’t court scheduling delays or delay tactics used by the allied narcissistic-borderline parent, the minimum anticipated time before trial is two years, and it often takes closer to three to five years before trial due when court delays and delay tactics by the allied narcissistic-borderline parent are factored in.

With the three diagnostic indicators of AB-PA, the pathology can be assessed by a mental health professional in six sessions.  This means that the time frame for an assessment and report to the court can be as short as two weeks, and typically not longer than 8 weeks.  Because the AB-PA diagnostic model returns a confirmed DSM-5 diagnosis of V995.51 Child Psychological Abuse, the start of treatment, including a possible protective separation of the child from the pathogenic parenting of the allied narcissistic-borderline parent, can begin within months of the start of the pathology.

With the 8-symptom Gardnerian PAS model (the one currently being used throughout psychology), it typically takes at least two years and over $100,000 in legal costs before even reaching the point where a decision is made by the court… and who knows what the custody evaluator will decide and then what the court will decide.

Typically the initial custody report returns a vague “both parents are contributing” analysis and conclusion (it’s a safe middle-of-the road position), with a recommendation for no change in the current de facto sole custody to the allied parent that is created by the child’s rejection of the targeted parent, and a recommendation for “reunification therapy” between the child and targeted parent to rehabilitate their relationship (that’s being damaged by the allied parent).

After a year of utterly failed “reunification therapy” in which the severity of the child’s rejection of the targeted parent has become more severe and more fully entrenched, a second “follow-up” custody report is usually ordered, typically with the same evaluator because it’s assumed the prior knowledge of the evaluator with this family will be useful. However, this assumption is usually not warranted. If the mental health professional doesn’t have the knowledge needed to correctly identify the pathology the first time, then the second time is probably not going to be all that different.

The time frame using the 8-symptom Gardnerian PAS diagnostic model becomes:

  • Initial order for a custody evaluation: six months to a year from the start of the pathology (cost: $20,000 to $40,000 per evaluation).
  • Completed custody evaluation: Six to nine months to complete the custody evaluation, typically recommending no-change in the de facto sole custody to the allied parent, and usually recommending “reunification therapy.”
  • “Reunification Therapy”: One year of failed “reunification therapy.”
  • Update custody evaluation: Six months to complete the follow-up custody evaluation, and three months to schedule the court date.

So by the time the trial arrives, it has typically been at least three years since the start of the pathology.

No matter what the outcome at trial, three entire years of the parent-child relationship is lost with the targeted parent. That time can never be recovered no matter what decision is ultimately reached at trial.

In addition, if an ultimate decision is made at trial of “parental alienation,” this means that the child has been abandoned to the pathological parenting of a narcissistic-borderline parent for three entire years of development without the compensating healthy influence of the normal-range targeted parent.  Using the 8-symptom diagnostic model of Gardnerian PAS, the damage and pathology is allowed to continue for three to five years before it is addressed.  The damage is done, and three years of parent-child time with the normal-range, loving and beloved parent, is lost, and can never be recovered.

Because the 8-symptom Gardnerian PAS diagnostic model is assessed using a child custody evaluation and proving “parental alienation” in a court trial, legal costs can often run in excess of $100,000, and often closer to $150,000 through three years of litigation and trial before action is taken to solve the pathology (typically three to five years of litigation is needed before reaching trial).

Dr. Childress: In my view as a clinical psychologist, every cent of this money should go to the child’s college education fund, not to attorneys and child custody evaluators.  In my view as a clinical psychologist, it is both unethical and immoral practice for any psychologist to actively collude with and participate in a process that is known to abandon a child for up to three years with a pathological parent, and that will knowingly drain the family’s money needed for the college education of the child, to pay for the legal and therapy costs imposed by the diagnostic model of the pathology.  When there is a more efficient, successful, and better way, it is the ethical obligation of all psychologists to take this route.

The three diagnostic indicators of AB-PA are made by a mental health professional within six to eight weeks of the initial identification of the pathology, and it is the DSM-5 diagnosis of V995.51 Child Psychological Abuse from this assessment by a mental health professional that is provided to the court to support the targeted parent’s requests for orders from the court.

With the AB-PA diagnostic model, a confirmed DSM-5 diagnosis for the pathology can be made in six-sessions ($2,500) and the targeted parent, whether represented by an attorney or self-representing pro se, begins the litigation process with a confirmed DSM-5 diagnosis of Child Psychological Abuse for the parenting practices of the allied narcissistic-borderline parent.

Dr. Childress: In my professional view as a clinical psychologist, this is a lock-down reason for selecting the AB-PA diagnostic model. The AB-PA diagnostic model provides (in six assessment sessions) a confirmed DSM-5 diagnosis of Child Psychological Abuse for the pathology.

The 8-symptom Gardnerian PAS diagnostic model does not result in a DSM-5 diagnosis of Child Psychological Abuse (in six to nine months of assessment; $20,000 to $40,000 for just the assessment).

If you use the 8-symptom Gardnerian PAS diagnostic model, the differential diagnosis in the assessment process is a pathology that’s been made up in forensic psychology to coincide with their construct of “parental alienation,” called “justified estrangement.” If targeted use the 8-symptom Gardnerian PAS diagnostic model, they will need to defend themselves against the allegation that the pathology is “justified estrangement,” meaning that the targeted parent “deserves” to be rejected for past parental failures.  When the 8-symptom Gardnerian PAS diagnostic model is used, targeted parents must defend their prior parenting, that they do not “deserve” to be rejected because of their prior problematic parenting (“justified estrangement”)

Since there are no criteria for “justified estrangement,” the mental health professionals assessing for the 8-symptom Gardnerian PAS diagnostic model can find a blend (a “hybrid”) of both “parental alienation” and “justified estrangement” – typically leading to no treatment for the “parental alienation” because the targeted parent is deemed to be partially contributing to their “justified estrangement.”

In the AB-PA diagnostic model, the presence of the three diagnostic indicators of AB-PA is a confirmed DSM-5 diagnosis of V995.51 Child Psychological Abuse. Period, end of story.  In AB-PA, there is no such thing as “justified estrangement.”

In AB-PA, the construct of “justified estrangement” is called physical and sexual abuse of the child by the targeted parent, and the rule-out diagnosis for the targeted parent is that there is no physical or sexual abuse of the child by the targeted parent, that the parenting practices of the targeted parent are broadly normal-range.

These are not differences of opinion regarding the two diagnostic models, these are the facts surrounding the use of each diagnostic model. You are the parent.  These are your children, and this is your family.  You should be an informed consumer of mental health services.

You are the parent.  The choice as to which diagnostic model you want to ask be applied with your children and with your family is up to you.

Craig Childress, Psy.D.
Clinical Psychologist, PSY 8857