Standards of Practice: 2007 Documentation of Child Therapy Session

This is an actual therapy progress note from February of 2007.  It’s from the intern doing child therapy with a foster care child now adopted, probably about the 3 to 4 year-old age range judging by the treatment interventions being described.

These de-identified treatment notes I’m sharing come from a time before I was involved in the court-involved divorce-related conflict that I’m currently working with.

In those days I worked with kids in trauma and foster care.  We had a two-therapist treatment model, with one child therapist working directly in session with the child, and a second therapist meeting collaterally with the parent, or foster parent, or adoptive parent – whoever was the day-to-day adult caregiver for the child.

This treatment note indicates that I was serving as the collateral therapist for the adults while the intern worked directly with the child.  Our interns typically did the direct child therapy, while our licensed staff did the collateral caregiver therapy work.  Our post-docs straddled the two.  Post-docs are trainees who have earned a doctorate degree and they already have a full year of pre-doctoral supervised internship training, but now they need an additional year of post-doctoral supervised training before they can be licensed.

Licensing in psychology takes two full years of supervised clinical training, one year pre-doctoral and one year post-doctoral.  This note is likely from one of our post-docs, she’s reporting on some sensitive work with the child’s anger modulation system.

I used these de-identified notes in training interns and post-docs on features of treatment and treatment documentation.  For example, one of the things I might use this note for is to demonstrate expected specificity in treatment documentation.  It’s not a long note, but the therapist does a nice job of presenting what happened in terms of therapy. What were the therapy interventions, and what were the results. 

Not in blow-by-blow detail of “he did then I did”; but in an organized description using constructs that have meaning.  For example, the therapist notes that, “client began to demonstrate a turn-taking rhythm” – a turn-taking rhythm is an important feature of anger modulation therapy. 

Anger is explosive and draws the person into a self-engaged focus of venting.  In therapy for developing anger-modulation networks, we want to keep the child socially engaged with us, so that we can help in regulating the child’s anger and frustrations.  Once the child collapses out of the social field, anger is vented.  As long as we can keep the anger contained in the social field, we build the neural networks needed for anger modulation.

The basic rhythm of social engagement is the turn-taking rhythm of back-and-forth dialogue.  It starts with eye-gaze and smiling dialogues of infancy, pre-verbal dialogues of babbling, and into verbal dialogues of speech and the social rhythms of back-and-forth turn-taking conversation and dialogue.

All of this is captured by this intern in that one notation phrase.  Not only did the therapist and client make an important step forward in anger modulation for the child when mid-way through the session the child “began to demonstrate a turn-taking rhythm”  This documentation shows that the therapist knows what she’s doing.  If she’s noting an incident of establishing a turn-taking rhythm, she knows how to build the anger-modulation system of the brain’s emotional networks.

There are two levels of a chart note description.  The first is the reporting of pattern.  The documentation needs to describe the clinical psychology features of note; in this case the turn-taking rhythm.  The second level is documenting the evidence of the pattern, in this note it’s the specific notation of the child saying “Wait” to manage the back-and-forth rhythm.  Specifics do not exist of their own importance, only related to the pattern they reveal. It’s the pattern of interaction that’s important.  And when the therapist knows what they’re doing, they document the patterns and use details only to support descriptions of patterns.

Notice in the therapist’s description how chaotic the child’s activity is.  The child asks to leave the session to find the mother but when outside the session office the child didn’t seek mom’s therapy room, but instead began to play with other toys in other areas of the clinic.  The child didn’t want to find mom, the child just wanted – well, that’s not exactly clear – disorganized wants, no clear focus or purpose.

That’s such a classic symptom of trauma.  Disorganization; to behavior, to emotions, to thinking.  The impact of trauma is that we cannot organize our states, any state.  Our arousal level is too high, and in children it’s a “building the brain networks” thing for modulating arousal and anxiety, and anger, and sadness, and love… love is called attachment and empathy in the professional literature.

How does this exceptionally good child therapist respond to the child’s disorganization?  With gently applied containment.  Boundaries by which to establish self and other.  Poor kid.  Someone had so overwhelmed his boundaries that he had none left, he was flowing in a continual sea of chaos and fear management.  The therapist in this note was going into his world to find him, and recover him to us.

The headings for the note structure were mandated documentation format by the county Department of Behavioral Health.  Standard of ordinary practice in foster care world.


MHS: Individual Therapy

Client’s Role (Mental Status/Verbalizations)

Client was accompanied to the session by his adoptive parents.  He appeared clean, well groomed, and was dressed in age appropriate casual clothing.  Therapist was greeted with appropriate eye contact, but no smile. Client willingly accompanied therapist to play room.

Role of Significant Others (Verbalizations)

Client’s adoptive parents were in session with Dr. Childress, and were therefore not present during the session.

Therapist’s Role (Actions/Interventions)

Maintained focus on providing a supportive and responsive relationship with the child to foster his ability to cooperate.  This therapist provided client with craft activities and set limits on what toys client could access to help organize his play.  Actively established appropriate boundaries to help client understand that aggressive behavior is not acceptable.

Client’s Response to Above

Client presented as disinterested in craft activities provided by therapist as evidenced by stating he needed to see his mother.  Therapist followed client, who did not seek his mother, but attempted to retrieve toys from a different room.  When therapist re-directed client to return to the session room client complied.  Mid-way through session client began to demonstrate a turn-taking rhythm with therapist by stating “Wait” when he and therapist were cutting strips of paper.  During this activity the client began to “cut” the therapist’s hand with the child-safety scissors.  When therapist distanced herself and verbally stated that aggressiveness was not OK, client waited approx. 30 seconds while watching therapist and then asked for therapist to reengage stating “I’ll be nice”.  Client watchfulness may be indicative of his monitoring to see if therapist was angry and would abandon him.

Clinical Plan for Upcoming Session

Therapist will continue to introduce minor intrusions into client’s activities to strengthen client flexibility in organizing his behavior around adult directives without aggression and/or opposition.  Will actively maintain appropriate boundaries with client to provide modulated stress experiences that will help the child to reduce his aggressive behavior.



That’s the clinical chart note.  That was a case where the child had been abused, moved into the foster care system, and the abusive parent could not be recovered, parental rights were terminated and the child was adopted.  This was one of those cases.  The adoptive parent is sometimes the foster parent who has been with the child for awhile.

We were untangling all the impacts of childhood trauma.  The child therapist was skillfully working with the child to build social-related networks involved in emotional regulation flowing into behavioral regulation (containment of anxiety).  In a separate session the collateral therapist for the parents (adoptive parents in this case) would be teaching the parent about trauma-informed responding in ways that support the child’s recovery. 

Chart notes need to reflect the treatment plan.  What’s the problem, and how do we fix it.  This therapist clearly understands what she’s doing to fix things, and we can feel the treatment plan concepts that guide her work.  That’s what a chart note should do, document the application of a coherent treatment framework for child and family therapy.

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

Standard of Practice: 2007 Documentation of Court-Involved Case Management

I want to share something with you. Actual progress notes from therapy, not with this pathology of complex family conflict surrounding divorce, but from therapy with abused children in the foster care system. 

The physical and sexual abuse of these children was confirmed by the Department of Children’s Services, and they had placed these children in foster care.  For treatment, they were sent to my clinic.  I was the Clinical Director for a three-university collaboration treating the impact of childhood trauma within our foster care system.

In my role as the Clinical Director, I supervised interns and post-docs, which meant I signed off on their chart notes.  I also trained them in how to do trauma therapy with children, and how to document the therapy in their chart notes.  Over time in my training role as Clinical Director I de-identified some of the notes that came across my desk to use in the training of interns and post-docs regarding treatment, and treatment documentation.

When I left to enter private practice I apparently kept a file of these de-identified sample notes from actual cases tucked in a file cabinet in my garage.  I had forgotten I had them.  My goodness, they’re from 2007, tucked in a file folder in a file cabinet in my garage.  I now recollect thinking that these de-identified chart note samples might be useful if I ever entered another supervisory training role, as training examples of child trauma therapy and therapy documentation.

I’ve been going through and organizing the stuff in my garage.  My last round of doing this was with my books, this time is with my journal articles and folders.  I’m clearing my emotional-psychological decks for action; opening the gun ports in preparation for the upcoming ship-to-ship engagement, so to speak.  In going through stuff folder-by-folder I came across my folder of sample notes, and I started to read them.

Interesting stuff.  Not to me.  It’s just work stuff to me from 2007, long before I came to work with families of court-involved divorce.  But these notes reveal important stuff about professional standards of practice, because they are not created for this pathology of post-divorce family conflict, and they are not related to anything controversial.  They are just standard of ordinary practice from 2007.

At the time of these notes, and at the time they were archived away in my files, I had plans to die happily in complete obscurity, and having never even heard of anything called “parental alienation.”   In 2007, I had never heard the term, “parental alienation.”  This note is from trauma.  These are the actual notes for therapy with young kids in the foster care system. 

This one documenting court-involved case management is from a post-doc psychologist.  It’s a case-management note for billing her report for the guardian (probably grandparents) regarding treatment progress which will be submitted to the court.  I’ve been a court-involved clinical psychologist before, just not a divorce-involved one.  I’ve been trauma and child abuse court-involved clinical psychologist.

You know how the pathogenic parent is so concerned about the supposed “abuse” of their child?  I am exactly the psychologist that you want to send an abused child to.  I am that psychologist – except now I’m here with divorce-related pathology.  But I am an abuse and trauma clinical psychologist.  Foster care.  Early childhood, ages birth to five, up to eight…).

For all of these kids discussed in these actual chart notes, the pathology is confirmed physical or sexual child abuse, often including parental drug use, and possible prenatal exposure of the child to drugs and alcohol.  Anything that gets a child from birth to age 6 into the foster care system; that was our client population; the child and the siblings were our client, along with the (hopefully) recovering parents, the grandparent guardians providing kinship care, the foster parents with four to seven children in their care, adoptive parents adjusting to trauma in children, the social workers in child protective services, and the court.

Been there.  Here is a case management note.


Case Management with the Court

Purpose of Case Management

For the courts to make an educated decision regarding <child name>’s future , it is necessary for the court to consider the child’s mental health and functioning in her current placement.  Consultation and linkage with the client guardian’s legal counsel is meant to facilitate the continued stability and progress of the client.  The legal proceedings regarding guardianship will determine <child name>’s contact with her biological mother, which would have a direct impact on her behavioral and emotional functioning.

Summary of Case Management/Linkage Provided

In her placement with the current guardians, <child name> has made significant gains in the reduction of anxiety and aggression. This therapist wrote a progress letter at the request of the current guardians and their legal counsel to inform the guardianship proceedings.  Specifically legal counsel was interested in the progress that <child name> has made in therapy while in the care of her current guardians, dates of attendance, and wanted to know if her biological mother had participated in treatment.

Treatment Recommendations/Considerations

Recommended that if client mother resumes caregiving involvement she be required to participate in collateral therapy to prevent deterioration in reported gains.  Noted that <child name>’s progress can be attributed in large part to the current secure and stable caregiving environment.  For specific progress and treatment recommendations please refer to the document in client file.

Care Plan

Goal Objective

By 8/13/07, will reduce the severity of client’s anxious/distressed presentation upon separation from 7 times a week to four times a week as measured by parent report, will reduce client lying about significant events to 3 times per week as measured by parent report, will reduce non-compliant behavior in the home from 3 to less than 1 time per week based on parent report, client will follow caregiver direction with only two prompts 90% of the time based on parental report.

Intervention

Will provide linkage and consultation with the court through the legal counsel for client’s guardian in order to support placement decisions that provide the necessary stability and security needed for client’s continuing treatment progress.

Client Will Participate By

Clinical functioning and progress will be reported to the court through the legal counsel of the client’s guardian.



That’s the note example.

Documentation Standard of Practice

I would estimate that the child described in this note by Dr. Excellent has been physically abused, mother is probably meth-addicted, the child is probably in the 5 to 6 year old age-range.  I can tell all that based on how the post-doc worded things.  I know the post-doc who wrote this, and if it was sexual abuse there would be different sentences.  The treatment goals she describes are consistent with physical abuse, and the lying is probably neglect from a meth-addicted mother (neglect leaves an imprint where the child takes whatever they want on impulse and then lies without remorse; it’s a survival symptom of neglect, particularly characteristic of meth-addicted mothers).

Notice the category headings for the note, these are standard mandated headings for a case management note for county-funded work.  We were county funded, foster-care work.  We had county mandated documentation requirements.  All of these note examples are county-level standard of practice for documentation.

This note is for billing purposes.  The post-doc is doing non-treatment activity and is billing the county under a billing code for case management.  This is her billing documentation note.  She has to justify the time spent.  This starts by identifying the child’s needs that are being addressed by the case management.

Note that she is working with the guardian’s attorney to provide information about treatment recovery to the court.  The guardian is likely the grandparent, and they are probably worried about the potential return of the child to an actively meth-addicted and physically abusive mother (the grandparent’s daughter).  The post-doc therapist is working with the grandparent to help stabilize the child’s recovery.

Childhood Trauma and Abuse

This note is from 2007.  This is the world I come from; the treatment of childhood trauma.

Forensic psychology uses the words trauma and abuse a lot, but they don’t actually ever work with trauma and abuse, just this court-involved divorce related family conflict. 

They don’t actually treat children in the foster care system who have been physically and sexually abused by parents.  I do.  Those are my clients.  I’m that guy,  that clinical psychologist, my clinic, that’s where they sent the abused kids for treatment.  To me.

I’ve worked with the courts before this current family-divorce pathology.  Only back then, I was on the foster care child abuse consultation side.  But I’m completely familiar with court-involved consultation surrounding child abuse, and in my world – this is what a case management note looks like.

Notice the treatment plan documentation.  Standard of practice on every progress note…. progress note.  That’s just on the note, there’s a whole four to six page treatment plan in another section of the chart. 

We do in-house QA on our charts every six months – no fun, Saturdays with pizza, and our charts are audited by the county – at random intervals.  Standard of practice, at CHLA, at Choc, at my clinic in 2007.

This is what I would consider a standard of practice note for case management in my world as a clinical psychologist.

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

Director of Psychological Services,
CCPI; Custody Resolution Method

 

 

The Legal Argument Package: Forensic or Clinical Psychology

Things are changing. 

We are shifting from a forensic psychology non-solution to a clinical psychology solution for complex family conflict surrounding divorce.

This is not a child custody issue.  The conflict surrounding child custody is a symptom. The issue is family pathology that is creating complex attachment-related  pathology in the family; complex family conflict surrounding divorce.

This is a family pathology and treatment issue.  Conducting family therapy is the domain of clinical psychology, treating attachment pathology in the family is the domain of clinical psychology (a child rejecting a parent is an attachment-related pathology), treating the expression of parental personality disorder pathology in parenting and the family is the domain of clinical psychology, and treating the trans-generational transmission of complex trauma is the domain of clinical psychology.

This is a clinical psychology issue, diagnosing and treating family pathology; the attachment system, family systems therapy, personality disorder pathology, complex trauma.  Clinical psychology.

The DSM-5 diagnosis for pathogenic parenting that is creating significant psychopathology in the child is V995.51 Child Psychological Abuse.  Diagnosing and treating child abuse is the domain of clinical psychology.  This is not a child custody issue; it’s a child protection issue. 

The clinical psychology concern is the significant degree of psychopathology being created in the child by the pathogenic parenting of the allied narcissistic-borderline personality parent… assessing, identifying (diagnosing), and treating psychopathology is the domain of clinical psychology.

Following divorce, a spouse is using the child as a weapon of revenge and retaliation against the other spouse-and-parent in the divorce, in order to inflict severe emotional abuse on the other spouse-and-parent through the psychological trauma of losing their child (traumatic grief).  This pathology is a form of domestic violence (Intimate Partner Violence; IPV), the emotional abuse of the ex-spouse using the child as a weapon of spousal revenge and retaliation for the divorce, and in the process psychologically abusing the child by creating severe pathology in the child.

The assessment, diagnosis, and treatment of Intimate Partner Violence (IPV; domestic violence) and child abuse is the domain of clinical psychology.

This is not a child custody issue.  The child custody conflict is a superficial symptom of much deeper clinical pathology in the family.  The issue is one of psychopathology, that’s the domain of clinical psychology.  The clinical psychology argument package represents the return of clinical psychology to court-involved consultation, court-involved assessment of pathology, and court-involved treatment of pathology.

Identification of pathology is called diagnosis.  Assessment leads to diagnosis, and diagnosis guides treatment.  Treatment solves conflict and restores the child’s healthy family context and healthy development.

We are shifting the legal argument package that is being presented to the court.   Parents and their attorneys will be asking the court for a clinical psychology assessment of family pathology, not a forensic psychology assessment for child custody.

The Forensic Package

Up until now there has been only a single option for parents and their attorneys, the forensic psychology legal argument package that frames the issue as one of custody and visitation.  That has changed.  There is now an alternative approach; a treatment focused approach from clinical psychology.

The clinical psychology legal argument package is grounded on a different set of constructs in professional psychology (Bowlby; Minuchin; Beck) than is the forensic psychology argument package (arbitrary and unknown foundations), and the clinical psychology option seeks a different remedy from the court than the forensic psychology argument package. 

Since the focus of the forensic psychology legal argument is on child custody, the initial forensic psychology remedy moves inexorably into a “child custody evaluation” as the only means to obtain the input of professional psychology into the question of the child’s non-compliance, and potentially influenced child behavior regarding compliance, with the custody visitation orders of the court.

The task of each parent then becomes proving their position regarding the child’s rejection of a parent to the child custody evaluator, who will decide on the “evidence” presented to the custody evaluator regarding the relative merits of each party’s position, and will decide on the custody and visitation schedule for the family – thereby ABROGATING the duties of the judge… to hear argument and evidence, to make a determination of fact, and to render a decision regarding the custody visitation schedule.

All done by the custody evaluator – not the judge.  The judge may either then accept or reject and alter the ruling of the custody evaluator – typically without benefit from a second opinion from professional psychology regarding the family symptoms and family pathology.

Custody and visitation decision-making has essentially been assigned out of the courts to forensic psychology, and the only approach available from forensic psychology is an invalid (no inter-rater reliability) six- to nine-month forensic child custody evaluation costing between $20,000 to $40,000. 

Each parent tries to influence the custody evaluator to their position.  The position of the allied parent (supported by the child) is that the targeted parent is “abusive” and “deserves to be rejected” by the child.  The position of the targeted parent is that the child’s attitudes and behavior is being influenced and controlled by the allied parent as a means to inflict emotional suffering on the targeted parent for the divorce (that the child is being used as a weapon of spousal revenge and retaliation for the divorce).

The custody evaluator meets with everyone to hear their “arguments” – exposing the evaluator to their influence and efforts at manipulation of the evaluator’s opinion.  This is a deeply concerning assessment process because of its vulnerability to the unconscious biases of the evaluator (called counter-transference in clinical psychology). 

Counter-transference (unconscious bias) from the psychologist ALWAYS exists, in all cases, in all contexts.  The introduction of the psychologist’s own unconscious biases are identified as “schemas” in professional psychology.  Personal biases in the assessment of information is always present, and is entirely unconscious to the person.  This is a fact of psychology, and of all assessment processes.

In the forensic psychology process, the custody evaluator acts as the “judge” regarding the relative arguments offered by each parent, and the custody evaluator makes a determination of fact – typically whether a poorly defined construct called “parental alienation” is present and to what degree – and decides on the remedy based in the child’s custody visitation schedule with each parent.

Note: There is no pathology known as “parental alienation” in clinical psychology.  That is a new form of pathology that is entirely the construction of forensic psychology.  It does not exist.  In clinical psychology, defined knowledge exists, and the identification of pathology (called diagnosis) is based solely on the established constructs and principles of professional psychology (attachment; family systems therapy; personality disorder pathology; complex trauma).

The alternative focus on the treatment of family pathology will move this into clinical psychology and a clinical psychology assessment of pathology. 

Which legal argument and remedy package to present to the court is a decision for parents and their attorneys.

The Challenge of the Forensic Psychology Argument

The focus of the forensic psychology argument for the targeted parent is to prove a pathology (“parental alienation”) to a judge in order to obtain the remedy, typically a reversal of custody from the supposedly “favored” parent to the currently rejected targeted parent. 

That is the burden, proving the family pathology of “parental alienation” to a judge at trial.  The sole means to prove “parental alienation” to a judge at trial is through a forensic psychology child custody evaluation.  A child custody evaluation costs between $20,000 to $40,000 and takes between six- to nine-months to complete.

There is no other option from the forensic psychology legal argument package.  No second opinion is available because of the expense ($20,000 to $40,000) and length of time required (six to nine-months) for a child custody evaluation.

This approach is hardly ever successful for the targeted parent.  This approach typically takes years of litigation and potentially hundreds of thousands of dollars in legal costs, with substantial damage to both the parent-child relationship and the family’s financial foundations during and throughout the years of litigation required by the forensic psychology approach.

Successful resolution of the family conflict is exceedingly rare using the forensic psychology legal argument package, because it’s not a treatment focused approach.  Treatment is clinical psychology, and a clinical psychology assessment of pathology has not been conducted.

The forensic psychology approach typically only achieves success in the most severe cases of “parental alienation” in which the pathology of parental influence on the child is clearly evident, and then only after years of conflict and litigation have already robbed the child of a normal-range and healthy parent-child relationship with a loving and beloved parent (their mom or their dad; the targeted parent), and the loss of a normal-range childhood of healthy emotional and psychological development (bonded in loving relationships with both parents).

The forensic psychology approach offers no solution, it is destructive of families and children’s healthy emotional and psychological development, and this approach needs to change – because it offers no solution.  It is not treatment focused.  Treatment of child and family pathology is the domain of clinical psychology.

Clinical Psychology Argument

Clinical psychologists create change.  We create change in individuals (individual therapy) and we create change in families (family therapy).  Clinical child and family psychologists solve complex family conflict.  That’s what we do.   We solve complex family conflict.  It’s called family systems therapy.  Solving complex attachment-related family pathology surrounding divorce requires a solution from clinical psychology.

Clinical psychology can absolutely – 100% – solve this family pathology (cross-Slide52generational coalition; emotional cutoff; narcissistic-borderline parent (“splitting”); multigenerational transmission of complex trauma). 

The solution requires the application of professional knowledge from four domains of professional psychology: the attachment system, family systems therapy, personality disorder pathology, and complex trauma.  So it is not easy to solve. But it is entirely solvable with the application of the established knowledge of professional psychology.

Attachment – family systems therapy – personality disorder pathology – complex trauma.  Established knowledge in professional psychology.  Bowlby – Minuchin – Beck – van der Kolk.

I have posted a Curriculum Knowledge Checklist to my website that identifies the books from professional psychology that contain the professional knowledge needed to solve complex family conflict surrounding divorce.

It is a complex and difficult pathology.  But it is both understandable and solvable.

Court Involvement

Solving this pathology will require a cooperative relationship between clinical psychology and the Court.  The narcissistic-borderline parent will lead this family conflict into the court system by manipulatively creating and then exploiting the child’s refusal to comply with court orders for custody and visitation.  Once the child begins refusing visitation contact with the targeted parent (with the tacit support of the allied narcissistic-borderline parent), the targeted-rejected parent must then return to court seeking enforcement of the existing court orders for custody and visitation.

That’s how the pathology of one spouse-and-parent (the allied parent who forms a cross-generational coalition with the child) drives the post-divorce family into the family court system.  The family pathology will enter the legal system because the targeted parent needs to seek enforcement of the existing court orders for custody and visitation as a consequence of the child’s (manipulated and psychologically coerced) refusal to cooperate with the court orders for custody and visitation.

Since the issue is superficially the enforcement of orders for child custody and visitation, the issue will present to the court as one of “child custody” – but it’s not about custody and visitation.  Court orders already exist.  It’s about parental pathology in the family creating attachment-related pathology in the child in order to exploit the child’s symptoms to manipulate the court’s orders for custody and visitation (using the pathology – the rejection of a parent – created in the child).

This is a family pathology issue.  That’s the domain of clinical psychology.

Victimized Child – Influenced Child

Upon entry into the legal system, the narcissistic-borderline parent will present the “victimized child” argument to the court; that the child is supposedly being “victimized” by the allegedly “abusive” parenting of the targeted parent, and the remedy sought by the allied narcissistic-borderline personality parent will be to severely limit the other parent’s time with the child ostensibly to limit the child’s contact with the supposedly “abusive parent.”

The targeted parent, on the other hand, will present the court with the “influenced child” argument surrounding the child’s refusal of contact, and the targeted parent will seek the remedy of limiting and restricting the child’s time with the allied and “favored” parent in order to resolve the “influenced child” refusal of the court-ordered custody and visitation.

The judge will need to resolve between these two argument packages; “victimized child” offered by the allied and supposedly “protective” parent, and the “influenced child” argument offered by the targeted and rejected parent.  Once the judicial decision is made regarding the arguments, an appropriate remedy will then need to decided upon by the Court.

Adjusting the Argument Package

The clinical psychology argument package adjusts both the focus (treatment of family pathology rather than child custody schedules) and the framing for how the “influenced child” argument is presented to the court.

The clinical psychology argument will NOT use the construct of “parental alienation” – and indeed, the use of the construct of “parental alienation” would be considered beneath professional standards of practice in clinical psychology.  In clinical psychology, if a psychologist wants to apply a “new form of pathology” (such as “parental alienation”) to the interpretation of symptoms, this is done only AFTER having applied the standard and established knowledge of professional psychology; the attachment system literature, constructs from family systems therapy, personality disorder pathology, complex trauma, and the DSM diagnostic system.  After.

The clinical psychology argument does NOT use the construct of “parental alienation” (because this construct is non-supported in the scientific literature of professional psychology), and is instead based entirely and solely on the solidly established constructs and principles of professional psychology (the attachment system, family systems therapy, personality disorders, complex trauma) – (Bowlby, Minuchin, Beck, van der Kolk, Millon, Kernberg, Perry, Haley, Bowen, Madanes, Linehan, Ainsworth…) – the standard and established knowledge of professional psychology applied to the symptom features of the pathology.

Up until now, the only option available to targeted parents and the court for obtaining input from professional psychology surrounding complex family conflict has been through forensic psychology and a child custody evaluation regarding the structure of the child custody schedule – and NOT the resolution of the family pathology issue.

The legal argument presented to the court is changing – from a forensic psychology package to a clinical psychology legal argument package.  Parents and their attorneys are now beginning to ask for a clinical psychology assessment of family pathology; the pathology that is creating the complex family conflict that has entered the legal system.

The narcissistic-borderline parent has forced the targeted parent to return to court to seek enforcement of the existing child custody orders because the child has become severely symptomatic and non-cooperative with the established custody visitation schedule.  This is the manipulative set-up by the narcissistic-borderline spouse-and-parent to make this about custody and visitation, driving the conflict into a forensic psychology approach focused on child custody (possession of the child) rather than a clinical psychology approach of diagnosis and treatment of pathology.

That is changing.  An alternative legal argument package is available from clinical psychology for a treatment-focused assessment of the family.  The referral question for the clinical psychology assessment is:

Referral Question: Which parent is the source of pathogenic parenting creating the child’s attachment-related pathology, and what are the treatment implications?

This clinical psychology referral question can be answered by a limited-scope clinical psychology assessment, typically requiring about six sessions and costing approximately $2,500 to complete.  It is structured around two symptom documentation instruments, the Diagnostic Checklist for Pathogenic Parenting and the Parenting Practices Rating Scale.

The relatively low cost (~ $2,500) and short time frame (six to eight weeks) for the clinical psychology assessment allows for a second opinion assessment if desired, and the use of structured symptom documentation instruments (the Diagnostic Checklist and Parenting Practices Scale) allows for easy and clear comparison of findings from a first and second opinion report from clinical psychology.

The targeted parent is still offering the “influenced child” argument to the court, but is changing how that argument is structured and presented for the court’s consideration. Instead of using the incredibly weak construct of “parental alienation” that will drive the assessment into forensic psychology, the clinical psychology argument is solidly grounded in the established knowledge of professional psychology: the attachment system, complex trauma, and family systems therapy.

Of note is that the clinical psychology argument package presented to the court will not be using the personality disorder information sets from professional psychology in the argument presented to the court.  The personality pathology information from professional psychology will emerge over time within the broader background understanding within the legal and mental health systems that develops from increasing familiarity with the pathology.

From the perspective of a clinical psychology family therapy solution, we do not want to emphasize the other parent’s pathology.  There are other ways.  Identifying pathology is important, because diagnosis guides treatment – but diagnosis is only important because it guides treatment.  We do not want our focus to be on diagnosis, but on treatment.  We want to pivot as quickly as we can away from identifying pathology (the diagnosis) and over to treatment.

The clinical psychology approach is solution focused; not problem driven.  How do we fix things, how do we restore healthy parent-child bonds of affection, how do we restore the child’s normal-range and healthy childhood development?  Solution focused.

What’s the pathology?  A cross-generational coalition and emotional cutoff (attachment pathology).  Minuchin’s diagram provides strong support for this argument.  It displays exactly the pathology of concern.

Slide52The Family Pathology: The child’s “triangulation” into the spousal conflict through the formation of a “cross-generational coalition” with the allied parent against the targeted parent, resulting in an “emotional cutoff” of the child’s relationship to the targeted parent (Minuchin; Haley; Bowen; Madanes; family systems therapy).

This type of family pathology is caused by “multigenerational trauma” (Bowen), also referred to as the trans-generational transmission of trauma in the attachment and complex trauma literature (Bowlby; van der Kolk).

The clinical psychology argument package presented to the court is that significant family pathology is resulting in the obstruction of court orders for custody and visitation.  The remedy sought by the targeted parent is a treatment focused, trauma-informed, clinical psychology assessment of the family pathology.

That’s quite the mouthful for the assessment description. 

Treatment Focused:  The “treatment focused” indicator shifts the focus of the assessment off of the false child custody issue over to identifying a treatment oriented solution for the complex family conflict (through a written treatment plan for the resolution of child and family pathology; identified by the assessment). 

Trauma Informed:  The indicator of “trauma-informed” ensures that proper information sets from professional psychology are applied by the assessment. 

Clinical Psychology:  The clinical psychology orientation is to move the family conflict out of forensic psychology that offers no solution and over to clinical psychology for the identification (diagnosis) and treatment of the (“high-conflict”) pathology in the family.

The initial remedy sought is:

Initial Remedy:  A treatment-focused, trauma-informed, clinical psychology assessment of complex family conflict surrounding divorce.

The clinical psychology referral question is:

Referral Question:  Which parent is the source of pathogenic parenting creating the child’s attachment-related pathology, and what are the treatment implications?

The focus is NOT child custody (which parent should “possess” the child following the divorce), it’s treatment.  How do we restore normal-range and healthy child development?  The targeted parent is making a treatment-focused argument to the court; that the custody violations to the court orders are a symptom of family pathology, and the targeted parent is seeking a clinical psychology assessment of the family pathology (along with the enforcement of existing court orders for custody and visitation) as the remedy.

This clinical psychology argument package effectively nullifies the “victimized child” argument offered by the narcissistic-borderline parent, since the treatment-focused, trauma-informed, clinical psychology assessment addresses the arguments from each parent and provides remedy for both.

If the child is indeed being victimized by an abusive parent (thereby justifying the child’s reluctance to be with the rejected parent) as is alleged by the allied parent and child, then a trauma-informed, treatment focused assessment from clinical psychology is just the assessment to identify this child abuse and victimization of the child by the targeted parent.

The narcissistic-borderline parent is using (exploiting) the child’s induced pathology (the child’s rejection of a mother or father) to make the issue about child custody (“possession” of the child following divorce; who’s the “better parent” – who “deserves” possession of the child).  The targeted parent is altering this, and is instead using the induced child pathology created by the other parent to make the issue about the diagnosis and treatment of pathology. 

Since both agree on the existence of pathology, just not its causal source, a clinical psychology assessment and diagnosis, that identifies the treatment implications, is entirely warranted as the initial remedy for both arguments.  Let’s find out what’s causing the child’s attachment-related pathology following the divorce – that’s a clinical psychology issue – identifying pathology is called diagnosis.

A clinical psychology argument package will extract targeted parents from the court system and return the assessment, diagnosis, and treatment of complex family conflict to clinical psychology, and it will prevent families with newly emerging divorce-related conflict from entering years of litigation in the family courts surrounding child custody, by making identification of the pathology in the family the first order from the court.  Identify (diagnose) what is causing the child’s attachment-related pathology surrounding the divorce.

Initial Orders Sought for Remedy

Custody and visitation are not the focal point, they are symptom features of the complex family conflict.  We need a treatment focused assessment from clinical psychology to determine what is going on, what the source for the complex family conflict is – using the standard and established knowledge of professional psychology (a trauma-informed assessment of complex family conflict).

A secondary remedy sought by the targeted parent is the enforcement of existing court orders for custody and visitation (and possibly sanctions on the allied parent for their responsibility in creating the breaches to the court orders).

In response to the clinical psychology argument package from the targeted parent, that carries a secondary remedy of enforcement and possible sanctions surrounding existing court orders for custody and visitation, the judge may decide to wait until the results of the clinical psychology assessment of family pathology before making a ruling on the custody orders from the court, and the judge will likely rule in favor of the targeted parent’s request for a “trauma informed, treatment focused, clinical psychology assessment of the complex family conflict.”

Second Opinion

The other party will possibly argue against this clinical psychology assessment.  The rebuttal to this argument that can be offered by the attorney for the targeted parent is “second opinion”; that the opposing party is free to obtain a second opinion, a second trauma-informed clinical psychology assessment of the complex family conflict.

If someone is concerned about a diagnosis in clinical psychology, get a second opinion.  That’s how it’s done in clinical psychology (and health care generally). Get a second opinion if you’re concerned about the accuracy of diagnosis.

Child Protection Issue

Child pathology and child protection is the framing for the clinical psychology legal argument package.

The “custody” symptom (the child refusing court orders for custody and visitation) is a symptom of the family pathology.  This is not a child custody issue, this is a child pathology issue.  Is the targeted parent an “abusive” parent creating the child’s rejection, or is it the allied parent who is creating the child’s pathology through pathogenic parenting of psychological control and manipulation?

The referral question for the (“trauma-informed”) clinical psychology assessment is:

Referral Question: Which parent is the source of pathogenic parenting creating the child’s attachment-related pathology, and what are the treatment implications?

If the pathogenic parenting of the allied parent is creating significant developmental pathology in the child (attachment system suppression; diagnostic indicator 1), personality disorder pathology in the child (narcissistic personality traits; diagnostic indicator 2), and delusional-psychiatric pathology (encapsulated persecutory delusion; diagnostic indicator 3), the DSM-5 diagnosis is V995.51 Child Psychological Abuse, Confirmed, and the considerations shift to child protection.

In all cases of child abuse, physical child abuse, sexual child abuse, and psychological child abuse, the professional standard of practice and duty to protect requires the child’s protective separation from the abusive parent.  The child’s healthy development is then recovered and restored, and once the child’s healthy development is stabilized, contact with the formerly abusive parent is reestablished with sufficient safeguards to ensure that the child abuse does not resume once contact is restored.

This is true for physical child abuse, this is true for sexual child abuse, this is true for psychological child abuse.

That’s the shift that is occurring.  The legal argument package being presented to the court, both in its foundations (Bowlby, Minuchin, Beck) and in the remedy sought (a clinical psychology assessment; psychological child abuse diagnosis; protective separation period and treatment recovery) is shifting to a clinical psychology legal argument package of solution

The world is changing.  An attachment-based and trauma-informed model of complex family conflict surrounding divorce represents the return of clinical psychology to court-involved practice.

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

 

The door of empathy…

I’m going to share something very important from clinical psychology for all the targeted parents, but I’m going to do it off the record.

The reason I want this off the record is because I do NOT want to imply in any way, shape, manner, or form that the targeted parent is doing anything to create the child’s attachment pathology.  Nope, nope, nope.

Nor do I want to give targeted parents advice on how to get the child to love them, which would only expose the child more fully to their psychological brutalization from their narcissistic/(borderline) parent – we must first protect the child before we can ask the child to reveal authenticity.  The child is doing what the child must do to survive.

There is a reason for psychological defenses. We do not take away a defense until there is no need for the defense.  Right now, coping with the pathology of a narcissistic/(borderline) parent requires the child to say and do things.  This is a deeply disturbing aspect of the pathology.  Deeply disturbing, and it rises to the level of a confirmed DSM-5 diagnosis of Child Psychological Abuse

This is a trauma pathogen.  Complex trauma is born in an absence of parental empathy, and it is solved through it’s antidote, the opposite, the application of abundant empathy for the child.

When we ask others to understand our pain… that’s not empathy.  When we put our pain aside and seek to understand the child’s world… that’s empathy.

But we’re afraid.

Trauma pathology is also a world of fear.  Anxiety rules in trauma, and anxiety pulls us into our self-absorption of our own experience.  Anxiety captivates us and constricts our ability to flow outward into others, into empathy.  Anxiety motivates a self-focus, how do I keep myself safe?  Anxiety stops empathy.

Empathy is available when we are in a relaxed and calm state.  For a trauma mental health team that goes in after a major mass shooting or bombing, the trauma therapists have to be calm and composed.  We’re the ones bringing the empathy to the psychological treatment of trauma.  We need to be relaxed and composed, otherwise we lose the capacity for the very empathy that heals.

It doesn’t help any of the victims of trauma if the mental health trauma team is running around flustered and overwhelmed.  In trauma, someone needs to remain grounded.

In complex family conflict surrounding divorce (“parental alienation”; AB-PA), we’re dealing with a trauma pathogen, the ripple of trauma through the generations.  Complex trauma (relationship-based trauma) is born in the absence of parental empathy for the child.

The treatment of complex trauma is abundant authentic empathy for the child.

Not empathy for the pathology.  The pathology is a delusion; a false trauma reenactment narrative being imposed on the child by the unresolved childhood attachment trauma of the narcissistic/(borderline) parent.  A false reality.

Instead, treatment is a resonant empathy for the authentic child alive beneath the pathology.  An empathy that draws forth this authentic child, because we, through our empathy, we see the authentic child – and the child sees their own self-authenticity reflected in our empathy.

What I want to share with targeted parents is an important – extremely valuable – communication skill.  It’s the empathy skill.  It’s simple, oh so simple.  And it will be one of the hardest things you will ever do.

Because you have buttons that can be pushed that will trigger your anxieties, and you will act from your (unconscious) anxieties and fears, and our anxieties and fears stops our empathy.

“But, but, but…”  Wait, these are your anxieties.  See how early they come.  The mere mention of your buttons and anxieties and up they pop, “but, but, but…”  Wait, calm… listen.

If you develop this empathy communication, magic opens up. I’m a clinical psychologist, it’s a healing magic.  It is one of the most magnificent communication skills you can possibly use.  I use it whenever I have the opportunity as a clinical psychologist, always with wonderful results.

Are you ready? Okay, here it is.

Don’t become defensive.

Simple. Isn’t that simple? When something is said, don’t defend.

“Well, what if…”

I know.  I told you it would be one of the hardest things you will ever do.  Didn’t I tell you that?  And right out of the gate you start hitting me with “what if… and what if… and am I just supposed to accept it?…” anxiety.

So I’ll wait.  When your anxiety is exhausted, we’ll move on.  No worries.  Anxiety starts us spinning, we don’t push past it, that just creates more anxiety and spinning.

The antidote is the opposite. Anxiety is up-arousal, the opposite is down arousal.  Relax.  Allow.  Notice the anxiety, and just let it float on by.

Ready?

Why don’t we defend?  It’s important for you to understand the why.  That’s really important, because it will help you.  Knowing why, you’ll catch yourself defending and go, “dang,” and then you’ll relax and self-correct (that’s a Dorcy term; my psychology term is “self-regulate” – I like hers better; no worries, just self-correct and move on).

When we defend we make the child absorb us, the child must understand us.  The empathy is flowing the wrong direction.  I don’t care what the content is, I’m talking the flow of empathy; which direction?  In severe family pathology like this, we shouldn’t put the burden of solution on the child.  That’s not what the child needs. The child needs empathy FROM us.  The child needs us to understand them.  But when we defend, we’re asking them to understand US.

See?   Does that make sense about the direction for the flow of empathy, from the parent to the child?

So to help the child, to rescue the child from the quicksand, we stand on the bank and we extend a branch of understanding – of our empathy – and say, “Here, take this empathy and hold on, I’ll pull you out.”

We don’t need the parent jumping into the quicksand with the lost and confused child, that’s not going to help.  Nor do we need the parent asking the child to understand the parent’s world, that’s like throwing the child a boulder and saying, “Here, grab hold of this rock” as they sink under its weight.

Yeah, okay, you threw them something, but not something they can use to get out of the quicksand that they’re stuck in.

We need a parent.  That other parent isn’t such a good parent.  With that parent, the child gets all twisted up and confused.  The child needs a parent to help the child get un-twisted and un-confused.  That’s you.

How do you do that?  Off the record… Don’t respond defensively.

The child says, “You’re a bad parent” and you say, “No I’m not” – ahhhh, see.  You’re defensive.  You just got defensive.

“But what am I’m supposed to do? Am I supposed to agree with the child?”

I know. That’s your anxiety again.  I told you, it’s really simple… and oh so hard.  We’ll wait while your anxiety clears.  It’ll spin you for a while, just relax, don’t fight against anxiety – that’s just adding more tense.  Anxiety goes away when we relax and accept, notice the experience, and let it go by.

Dorcy calls it spinning.  I like that term.  In my psychology-speak I’d call it anxiety or self-regulation.  I think she has better terms for this stuff; self-correct, spinning. They’re good ways of describing the process.

So, have you calmed down from your anxiety and regained self-regulation?  Yuch, ugly word… Has the spinning stopped?  Okay.

So you don’t want to defend.  The child is full of the other parent’s nonsense (Dorcy calls it garbage; again, a better term).  The child does NOT need you adding your stuff by asking the child to understand you and your world.  So do we have that clearly understood?  No defending.

Anxiety all gone, ready to listen?

So then how do we respond with empathy and without defending?

Yay!  Woo hoo.  You’ve done it.  You’ve broken through to an amazing opportunity for solution… simply by asking the right question.

There’s probably half a dozen ways to respond with empathy and without defending, but you will NEVER find them or use them unless you first ask the question… unless you want to know.

Whew.  So we’re through the first important step – don’t defend, and have made it through your first round of anxiety (“but, but, but…”).  So if there’s six to eight things we can do, let me share a couple…

First, the one I use most often is, “Tell me more about that.”

Did I agree with what the child said?  No.  Did I defend?  No.  What did I do?  I cared about the child’s experience. I asked to learn more about the child.

As I learn about the child, I am bringing something valuable to the child… it’s called the “eyes-of-the-other” – the eyes-of-the-other is like the lantern that old man in the tarot cards holds, or on that Led Zeppelin album, you know that guy?  The eyes-of-the-other is like bringing that lantern into the darkness of the child’s self-experience.

Hmmm, I wonder what’s over here?  What’s this?  I’m learning about the child, and so is the child.  I’m not pushing, or going, or teaching, or doing anything at all.  I’m just following, curious.  I wonder, because I care.  What’s it like to be you?  I want to understand.

That’s empathy.

The child’s experience is all twisted up in some way.  What’s up with that?  I want to find out more.  That’s called caring and empathy for the child’s world.

From the degree of the child’s emotionality, that must be a very painful place to live in, the child.  What is the pain, and what can we do about it?  Let’s find out.

Oh, but then you know what’s going to happen if I ask the child to tell me more?  The child is going to say all this untrue and foul stuff.  I know.  That’s all the garbage from the other parent, isn’t it.  Boy oh boy, that must feel awful in the child to be holding onto all that garbage.

I bet the child needs to get that garbage out of them.  But where can it go?… to you.

Yep.  We need a parent.  The child is all full of this emotional garbage, and is all hurt and confused.  Yep, the child needs a parent to help sort this out.  And it’s not going to be the other parent, they’re the one that’s twisting up the child in the first place. It’s going to have to be you.

So then, how do we respond to this next round of assault from the child, all that garbage that’s being spewed at you and into your home?  Well, we know one thing… non-defensive.  So how do we respond non-defensively and empathically to nonsense garbage?

Well, sometimes no response is needed (another Dorcy construct that is wonderful; to disengage), and we allow the child to recognize the nonsense and self-correct.  No need to escalate the nonsense by us getting all wrapped up in it.

Sometimes, allowing the self-correct is all that’s needed.  The garbage is out, you allow the child to self-correct, “You done?” “Yeah.”  Then you move on – you take the garbage out of the kid and you dispose of it.  Don’t you hold on to it too.  No, no, no.  That’s garbage from the other parent, take it outside and get rid of it.

It was in the child.  The child gives it to you.  You take it from the child (through your empathy and caring) and now it’s out of the child.  Don’t escalate, don’t hold onto it yourself.  Allow the child to self-correct and then return to normal.

But there’s more you can do than just no-response-necessary.  But the good stuff is changing your buttons.  Once we change your buttons, well… good stuff starts to happen.  Dorcy refers to this is as changing how you show up.  Nice words for the constructs… changing how you show up, you show up differently.  Interesting.

But this is where it’s going to get hard.  It’s not really, but it’s going to seem that way until you stop making it hard.  You thought non-defensive was hard… this buttons place is where all the trauma anxiety marbles are.

So here it is… You need to not spin (not become dysregulated) in response to the trauma-triggers that the child is going to throw at you.  You’ve got buttons.  They’re not bad.  In any other situation, no worries whatsoever.  We all have our buttons.

They come from our childhood experiences.  I call them micro-traumas; totally normal.  They form us psychologically.  They form our unconscious beliefs and expectations about ourselves and others.  They’re unconscious, so we don’t know about them.  But other people can see them.  And we project them all the time.  No worries, totally normal.  The problem is…

Your ex- knows your buttons.bruce lee quote

The narcissistic and borderline personality seeks vulnerability.  Your buttons make you vulnerable. See what Bruce Lee says.  He’s right.  You know he’s right.  He’s talking about your buttons.

The other parent is implanting button-pushing pathology into your child, and sure enough, guess what happens – the child pushes your buttons and off you go, responding defensively instead of empathically.  Whenever you’re asking the child to understand you, you’re responding from the trauma-triggers, which keeps the garbage in the child.

If you’re a clinical psychologist following along, notice the structure of the pathogen in the role-reversal relationship; a child being used to meet the needs of a parent.  On the one side is the child being used by the narcissistic/(borderline) parent (the pathogen), and this then sets up the other parent to SEEK the child’s nurture (the child’s love and affection); the child meeting the parent’s needs.  On both sides, the child is being asked to meet the emotional needs of the parent.  That’s the pathogen.

Once you see that this is a trauma pathogen and its structure, every detail becomes crystal clear and the pathology is clearly evident.

The solution is empathy for the child.

We have to get the garbage out of the child and straighten out the twisty.  We need a parent to respond non-defensively and guide the child in the child’s self-awareness back into the child’s self-authenticity – NOT into understanding what the pathology is (the child already knows that), that just puts the child smack dab in the middle of the loyalty conflict and the child’s emotional suffering.  Don’t make the child “understand.”

Help the child find self-awareness, and through self-awareness to find self-authenticity.  We need a parent.  We need a guide.  A calm and confident guide for the child’s emotional twisty.

The other parent is not a good parent.  We need you to be a parent to the child.  I know the child is mean to you, and says untrue and hurtful things.  That’s all the garbage from the other parent, trapped in the child.

In my therapy with normal everyday sorts of family conflicts, the child will sometimes tell the parent, “You’re not listening to me” and the parent says, “Yes I am.”

I stop it right there and say, “No you’re not.”  If you had said, “Tell me more about that” you would be listening to the child and what the child just said would then actually be wrong.  You do listen to the child because you just demonstrated it.  Instead, what you said discounted what the child said as being untrue.

This is important… we dispute the child NOT with our words, but through our actions, through what we do.  The child is wrong not because of what we say, but because of what we do.

“I do, I do, I do, I say this, I tell the child that…”  The anxiety again.  That’s the only thing that makes it difficult.  But it does and there’s no way around that.  Trauma solutions are always going to bring anxiety.  That’s just the way of it.  Once you learn anxiety release skills though, it becomes a whole lot easier to just allow and relax and stop spinning.

Better?

See, communication is not the words we say.  In the series: You don’t listen – Yes I do – that’s not listening… that’s disagreeing.  Listening is, “Tell me more about that.”  That’s listening.

You’re a bad parent — No I’m not — Yes you are, you do x and y and z that’s bad — I don’t do those things, you’re exaggerating and making things up. — No, that’s what happened, and you’re a bad parent. — That’s not what happened, I’m not a bad parent, I love you. — You’re a liar, that’s so fake. — That’s not fake, I do love you…

Do you hear any listening?  I don’t.

So, for communication, we need someone listening.  Who shall we ask to do that first? Somebody is going to have to start listening, who’s it going to be?  Shall we ask the child to listen to the parent, or the parent to listen to the child?

Shall we ask that the child listen to the parent?  Is that the directional flow of empathy we want, from the child to the parent?  The child taking care of the parent?  Is that where we should start?

No.  We never start with the child.  Parents are bigger, stronger, and more mature, we need an adult, we need a parent, we start with having the parent understand the child.  I don’t care what the content is, we start with the parent giving empathy to the child.

Is the child’s reality true?  No.  Do we agree with a false reality?  No.  So how do we disagree without becoming defensive?  Yay, wonderful question.  See how, as you relax your anxieties, you find really productive questions.

We solve this with empathy.  What appears to be locked by the trauma pathology, is unlocked by empathy.  We don’t have to convince the child of anything.  We lead with a lamp into their own authenticity.  Awareness brought from our honest and sincere desire to understand the child’s world from the child’s experience.

Do we agree with delusions?  No.  Do we know where they come from?  Yes.  Does the child need to know?  No.  The child simply needs to become re-anchored in reality.  So we need you in reality, not spinning in the trauma pathology of your ex- like the child is.  Your ex- is trapped, the child is trapped.  Don’t you be trapped too.  We need someone who is grounded.

First though, we have to ask the right questions that will lead us through the right door; the door of empathy for the child.  Then we have to get over the anxiety of our own stuff.  Anxiety is the remnant stuff of trauma world, the ripple of trauma.

Next… and here’s where we arrive, we have to identify our own buttons so we can remove them, move them to a different location, disconnect their wires, whatever we have to do so that your ex- can’t find and push your buttons anymore (through the child; your ex is pushing your buttons by manipulating the child to do it).

Yes, I entirely agree, your ex- is manipulating the child in awful ways.  Bad parent.  Stop it.  And… you’re the one with the buttons.  It’d be helpful if you hid those or got rid of them somehow so your ex- can’t find them all the time using the kid.  That we have buttons is normal, that your ex- is manipulating the child to push those buttons… it would be helpful if we altered those buttons so your ex- can’t do that anymore.  That will free you from the trauma pathogen, and then you can free the child.

It doesn’t help the child in quicksand if you jump in too.  Then we just have two people in the quicksand.  Stand on solid ground and hold out your empathy for the child to grab on to.  Use the light from your empathy (your “eyes-of-the-other”) to help bring self-awareness into the discovery of self-authenticity.

Remember, the child is doing what the child must do to survive with the narcissistic/(borderline) parent.  The child didn’t choose this parent.  You chose this parent for the child.  It’s not the child’s fault the child has to cope with this parent.  The child is in a difficult position having to cope with the pathology of their parent surrounding divorce.  Empathy for the child.  We must be able to protect the child before we can ask the child to reveal their self-authenticity.

The kid’s not the kid, you know that.  That’s your ex- pushing your buttons.  Bad ex-, bad parent.  Stop it.  And… they’re your buttons.  If you can remove them, move them, or disconnect them then you can short-circuit the pathology.  Once you’re out of the loop of crazy; Yay, one’s free.  And you can then guide the child out of crazy.

Let me be clear, none of this attachment pathology surrounding divorce is being caused by the targeted parent.  The targeted parent is a target of domestic violence – emotional spousal abuse using the child as a weapon.

Furthermore, in weaponizing the child the allied parent is creating such severe psychopathology in the child that it rises to the level of a confirmed DSM-5 diagnosis of child psychological abuse (V995.51; p. 719).

The family pathology in complex family conflict surrounding divorce is a cross-generational coalition of the child with a narcissistic-borderline parent who is using the child as a weapon against the other spouse-and-parent.  It is the responsibility of professional psychology to fully assess, accurately diagnose, and effectively treat this pathology

It is a trauma pathology.  The trans-generational transmission of trauma.  The ripple of trauma across the generations.

Complex trauma is created by the absence of parental empathy for the child.  It is solved by parental empathy for the child – not for the delusion – empathy for the child.

For therapists, start with some basic human empathy for the targeted parent, the victim of the intimate partner violence.

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

 

AB-PA: The Scientific Method

AB-PA is the scientific method.   Did you know that?  It is.  AB-PA is science.

The pathogen thinks AB-PA (an attachment-based model of “parental alienation”) is a new theory.  That’s because the pathogen is stupid.  It’s a trauma pathogen and trauma is simply pattern, it can’t reason.

The pattern the pathogen is familiar with is Gardner’s PAS, that’s the model that shaped the defensive structures of the pathogen.  Gardner proposed a “new theory” of pathology, Parental Alienation Syndrome.  The pathogen attacked the “new theory” of Gardner’s proposal and the eight unique new symptoms he created for a supposedly unique new form of pathology he called “parental alienation.”  Gardner’s PAS is a new theory; AB-PA is not… AB-PA is diagnosis.

I knew the pathogen would attack any “new theory” proposal, so I simply didn’t propose a new theory.  Instead, I used the standard and established constructs of professional psychology – attachment, personality disorder pathology, family systems therapy, and complex trauma, to work out the explanatory pathway (the diagnosis) for the child’s pathology (a child rejecting a parent following divorce).

It wasn’t all that hard.  It’s just that no one ever seems to have done that before, apply the standard and established constructs and principles of professional psychology to the child’s symptoms of rejecting a parent surrounding divorce.  I have no idea why they haven’t.  Diagnosis is standard of practice, yet no one is diagnosing – everybody is running with this “new theory” proposal of Gardner.

AB-PA is not a “new theory” – it’s diagnosis.  Diagnosis is the application of standard and established constructs and principles to a set of symptoms.  Diagnosis.

Gardner didn’t do that.  He skipped the step of diagnosis – he skipped applying standard and established constructs and principles to a set of symptoms – and instead he took a lazy approach of proposing a “new theory” for a new form of pathology, a pathology that is supposedly unique in all of mental health.  In doing that, Gardner led everyone away from the path of established professional standards of practice for assessment, diagnosis, and treatment, and he led the entire field into the wilderness of “new theory” forms of pathology.

He shouldn’t have done that.  It’s great that he identified the pathology, but he shouldn’t have broken professional standards of practice by proposing a “new theory” – first he should have diagnosed the pathology by applying the standard and established constructs and principles of professional psychology to the set of symptoms.

Establishment psychology tried to tell him, but he wouldn’t listen.  Nor would his followers, the Gardnerian PAS “experts.”  They just don’t listen.  They’re very locked up into being “experts” about something, and apparently it’s too hard to be an expert in something real, like attachment or trauma, because there’s already established experts in those fields.  But if there is a “new pathology” then these Gardnerians have something to be “expert” in – the pathology the think they’re “discovering.”

I didn’t do that.  I listened to the constructive feedback of establishment psychology – which, by the way, I agree with.  Gardner’s 8-symptom PAS model is a horrific model for a pathology.  If a student had submitted Gardner’s PAS to me as a professor, I’d have given it a D-. The only reason it’s not an F is because the student turned in something.  He tried.  So I’d give it only a D-.

If you’re curious as to HOW bad Gardner’s 8-symptom model for a “new theory” of pathology is, I did a video series discussing each of the eight symptoms:

Gardner’s PAS Series

Gardner’s 8-symptom “new theory” of pathology model is simply awful.  That’s why it is “controversial” even after 40 years of using it, and that’s why it doesn’t work to solve the pathology, even after 40 years of using it.  It is NOT a good descriptive or explanatory model for a pathology.

Gardner proposed a “new theory” – I’m not.  AB-PA remains entirely within established constructs and principles that are fully supported by mountains and mountains of scientific evidence – attachment, personality pathology, family systems therapy, complex trauma.

AB-PA is not “new theory” – it’s diagnosis.  But the pathogen doesn’t recognize that, because it’s stupid as sin.  That’s because the trauma pathogen neurologically inhibits frontal lobe executive function systems – the logic and reasoning systems of the brain… trauma doesn’t think, it repeats patterns.

AB-PA is also science.  In science, an explanatory model (like AB-PA) makes a prediction which is testable – provable or disprovable – by the evidence.  Then the evidence is collected.  If the prediction is confirmed by the evidence, then the explanatory model that made the prediction is confirmed.  That’s called the scientific method for proving something:

Make a prediction – collect the evidence – and see if the prediction is confirmed.

AB-PA is grounded in the scientific method.  It’s science.  AB-PA makes a prediction – three impossible symptoms will be present in the child’s symptom display.  Now we simply need to collect the evidence and see if the evidence supports the prediction.

Did you know that all three diagnostic indicator symptoms of AB-PA are impossible?  They are.  All three symptoms of AB-PA are impossible.  They never show up anywhere – ever.  They are all impossible symptoms.

The expected prevalence for Diagnostic Indicator 1 (attachment system suppression toward a normal-range parent) is zero.  We never see this.  Maybe sometimes we see attachment suppression toward a severely abusive parent – but a severely abusive parent is NOT normal-range.  We never see a child’s attachment bonding suppression toward a normal-range parent.  There is no pathway by which that could occur.  Bad parenting creates an insecure attachment, never a suppression of the attachment system.

There is no explanatory path for Diagnostic Indicator 1… it is an impossible symptom… it never happens… and yet the AB-PA explanatory diagnostic model predicts that this – impossible symptom – will be present in the child’s symptom display.  So… is it?

Let’s play scientists and test the prediction… is Diagnostic Indicator 1, a suppression of the child’s attachment system toward a normal-range parent, is that predicted symptom present, absent, or somewhat present in the child’s symptom display?

Scientific method.  AB-PA makes prediction.  Test it.  Is the predicted symptom present, absent, or somewhat present?

Prevalence rates for Diagnostic Indicator 1 in the general population are zero.  It is an impossible symptom.  And yet, it is the symptom predicted by an AB-PA explanatory model for the pathology.

Diagnostic Indicator 2 – the five narcissistic personality traits – is also a provable or disprovable prediction from AB-PA, and a narcissistic personality disorder is also impossible in a child.  We would never expect to see five narcissistic personality traits in a child’s symptom display because a narcissistic personality disorder in a child is not possible.

In the general population, the prevalence of children with five narcissistic personality disorder traits is zero.  We will never find that.

Yet… AB-PA predicts this impossible symptom.  This prediction of the AB-PA explanatory model is ALSO testable by the evidence.  Are these five narcissistic symptoms present, absent, or somewhat present in the child’s symptom display?  Simple.  We would expect the answer to be no in 100% of cases, because five narcissistic personality disorder symptoms in a child’s symptom display is impossible.  It never happens.

So then, let’s look.  Are they present?  Because if they are, that is proof – empirical evidence – for the explanatory model that predicted exactly this set of impossible symptoms.

And then, there’s Diagnostic Indicator 3; the trauma reenactment symptom of the child’s persecutory delusion toward a normal-range parent.  There is absolutely no pathway to a normal-range parent creating a persecutory delusion in the child.  Can’t happen.  It is an impossible symptom, we never-ever see it, it never happens.

In the general population, the prevalence of child persecutory delusions toward a normal-range parent is zero.  It never happens because it is an impossibility.

And yet… AB-PA is predicting exactly this impossible symptom. And not just one impossible symptom… AB-PA is predicting THREE impossible symptoms – that never occur – they are impossible.  The expected prevalence in the general population for any of these predicted child symptoms is zero.

So, let’s test the predictions of AB-PA with the evidence.  Are these three symptoms present, absent, or somewhat present in the child’s symptom display.

Aren’t you curious what we’ll find?  I know, I am too.  It’s called scientific curiosity.  Isn’t it wonderfully exciting, science.  We make a prediction, then we test it with empirical evidence… empirical means we look to see if something’s there, and document it if it is.  I love science.

If AB-PA is wrong – then none of these symptoms will be present because no other pathology in all of mental health produces these predicted symptoms – they are impossible symptoms.  So… let’s put AB-PA to the test – the scientific method.

Are the predicted symptoms of AB-PA present?  That is so simple to test. If people say they want proof of AB-PA, okay… let’s put AB-PA to scientific proof… are these three impossible symptoms that are predicted by AB-PA present or absent in the child’s symptom display?

If AB-PA is not true as an explanatory model, then the three predicted impossible symptoms won’t be present, and since each of the three symptoms is actually impossible, that’s what we would expect… that none of the three symptoms will be present in the child’s symptom display.

It’s called the scientific method.  An explanatory model (AB-PA) makes a testable prediction that is provable or disprovable by the evidence.  Then the evidence is collected, and the explanatory model is proved or disproved.

So.  Collect the evidence:

Diagnostic Checklist for Pathogenic Parenting
http://www.drcachildress.org/asp/admin/getFile.asp…

It’s called science.  If someone doesn’t think AB-PA is true as an explanatory model of the pathology – conduct the experiment for yourself.  Are the three impossible symptoms of AB-PA present or not?  Simple proof or disproof.  Check, check, check – yes, no, somewhat.

If the predicted symptoms aren’t there – which they shouldn’t be – we would expect them to not be there in 100% of cases because they are all impossible symptoms – then AB-PA is wrong.

If… on the other hand… the three symptoms predicted by AB-PA are present… then this proves the explanatory model that predicted them.

It is called the scientific method.  Make a prediction.  Collect the data to prove or disprove the prediction.

If these three symptoms ARE present in the child’s symptom display… then they have to be explained.  How did the child develop these three specific symptoms, each of which is impossible? 

There is no other explanatory path to these three symptoms other than AB-PA – which PREDICTS exactly these three – impossible – symptoms.  Try it.  Try to explain the presence of all three of these diagnostic indicator symptoms; how did the child acquire all three of these symptoms?  See.  There is only one explanation, AB-PA, which not only explains the presence of all three impossible symptoms, AB-PA predicts them.

So for anyone who doubts that AB-PA is true… try it.  Do the experiment for yourself.  Collect the data to prove or disprove AB-PA.  If AB-PA is not true, that’s easy enough to prove… none of the three impossible symptoms will be present; and since they are all three impossible, that’s what we would expect.  The prevalence rate for impossible is zero, so none of these three symptoms should be present in the evidence – in the child’s symptoms.

If… on the other hand… these symptoms ARE present… then they require an explanation for how these impossible symptoms… are possible… because you have confirmed the evidence for their existence – the child has exactly the three symptoms predicted by AB-PA.

There is only one explanation.  It’s proven by the scientific method.  The explanatory model makes a prediction that can be proven or disproven based on the evidence.  So… collect the evidence for yourself.  Do the experiment.  Are these three predicted symptoms present or not?

Isn’t it fun being a scientist, it’s so exciting.

For the critics of AB-PA who don’t think it’s true… my goodness, it’s easy-peasy to disprove AB-PA as an explanatory model for the child’s pathology, the three predicted and impossible symptoms WON’T be present.  Easy as pie to disprove AB-PA.  Let’s give it a try, let’s do the experiment.  Are these three symptoms present – yes or no.

It’s called the scientific method.  Science is a good thing.

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

Director of Psychological Services,
Conscious Co-Parenting Institute;
Custody Resolution Method

The Legal Argument Package

Forensic psychology gives parents and the courts only one legal argument option, and it seeks its particular goal by marshaling a particular set of evidence to present to the court in favor of that goal.

The goal of the legal argument package from forensic psychology is to obtain a court order for a reversal of custody away from the allied and “favored” parent, over to the targeted and rejected parent, and the evidence to support this desired reversal-of-custody court order is through proving, at trial, to a judge, that “parental alienation” is the cause of the child’s rejection of the targeted parent.

Up until recently, this forensic psychology legal argument approach has been the ONLY option available for parents and for the court.

Things have changed.

Parents and the court now have two separate legal argument packages, seeking different orders from the court, and there are now three separate approaches for marshaling evidence in support of the sought-for court orders.

The Forensic Psychology Legal Argument

This is the standard legal argument approach used for the past 40 years.  It seeks to prove “parental alienation” at trial and it asks for the remedy of a change in custody.  Since it seeks a change in custody, this legal argument package leads directly to a child custody evaluation.

The parents and children then present their “evidence” to the child custody evaluator who makes an arbitrary decision as to whether “parental alienation” is present based on vague criteria arbitrarily applied.  Typically, the evaluator reports a mix of “parental alienation” and “estrangement” (both made up constructs without clear definition).  Rarely (almost never) will the evaluator recommend a reversal of custody based on an opinion of “parental alienation.”

Occasionally, after years of fighting in court, a second or even third custody evaluation may find that the “alienation” is so severe that the evaluator is compelled to recommend a reversal of custody – but this is rare, and this point is typically reached only in the most severe cases.

The forensic psychology legal argument is built around proving “parental alienation” in court through an extended court trial.  This is an exceedingly expensive and long process, usually requiring years of “high-conflict” litigation, with each parent trying to prove the other parent is unfit, creating even more spousal hostility and further entrenching “sides” in the family conflict.  This process is NOT supportive of a successful family transition to a healthy post-divorce separated family of collaborative co-parenting. 

This forensic psychology legal argument package is seeking to identify and prove complex family pathology to a legal professional, the judge, by rules of evidence in a court trial.  The forensic psychology approach is seeking a court-solution to family pathology.  This is the wrong system for solution.  The diagnosis of pathology is not through trial in the legal system, the diagnosis of pathology is through the principles and practices of clinical psychology.

In the forensic option, the entire time the legal conflict drags on the child is either actively caught in the middle of the spousal conflict, or the child is in the sole custody and entirely under the influence of the pathogenic allied parent who is creating the severe psychopathology in the child, who is creating severe suffering and grief for the targeted parent (which is the purpose of weaponizing the child into the divorce), and who is irrevocably damaging the child’s emotional and psychological development – the lost years of childhood cannot be recovered.  Childhood once gone is lost.  Years of severe family conflict and lost parent-child love are extremely damaging to the child, yet that is the requirement imposed by the forensic psychology solution.

The goal of the forensic psychology legal argument package is a reversal of custody because of “parental alienation.”  

Gardnerian Caused Confusion:  The Gardnerian “experts” are seeking to sow confusion by co-opting the term “protective separation” from the AB-PA legal argument package and applying it to the “parental alienation” legal argument package as the supposed remedy – but it doesn’t apply when transferred across diagnostic models, they know it, and they are deceiving parents by using the term “protective separation” for the Gardnerian “parental alienation” legal argument package.  They are doing this intentionally to sow confusion among parents and attorneys between the two legal argument approaches.

Explanation:  The three diagnostic indicators of AB-PA, an attachment-based model for the family pathology, results in a confirmed DSM-5 diagnosis of V995.51 Child Psychological Abuse.  It is this confirmed DSM-5 diagnosis of Child Psychological Abuse that represents the legal and mental health argument justification for a protective separation period (a protective separation from the abusive parent is the standard of practice response to a DSM-5 diagnosis of child abuse – to protect the child from child abuse – a protective separation).

The Gardnerian Lie:  The identification of Gardnerian “parental alienation” does NOT lead to a DSM-5 diagnosis of V995.51 Child Psychological Abuse.  The Gardnerian PAS “experts” wish it would, but diagnostically, it doesn’t.  They know this.

However, the Gardnerian “experts” are feeding on the vulnerability and lack of knowledge of targeted parents to sow confusion and prevent solution, because the moment parents start using a non “parental alienation” legal argument (an apporach other than proving “parental alienation” in court trial), then these “parental alienation” “experts” cease to be “experts” – because they are not actually real experts in any real forms of pathology, like attachment, or personality disorders, or complex trauma.  So they make up a “new form of pathology” so they can pretend to be “experts” in something.

The protective separation construct does NOT apply to the construct of “parental alienation” – the “parental alienation” legal argument package seeks a reversal of custody; not a protective separation. 

The Gardnerian “experts” know this, they are simply being obstructionists by sowing confusion – intentionally – to delay parents from recovering their children so that these “experts” can remain “experts” in their supposedly new form of pathology.

Thousands of children and families will be hurt, families will be destroyed, and parent-child bonds will be lost because of the confusion that is intentionally being sown by the Gardnerian “experts” regarding the protective separation construct – it doesn’t apply to the Gardnerian 8-symptom “parental alienation” diagnostic model – before we will be able to clarify for parents their multiple options. 

But the Gardnerian “experts” (led by Bill Bernet, Karen Woodall, and several others) will continue to sow confusion and seek to obstruct any solution that does not make them an “expert.”  So the confusion they are generating is simply a fact that we must overcome.  That’s up to parents and attorneys.  It’s your choice which legal argument package you pursue.

Forensic Package:  Proving “parental alienation”

Since the forensic legal argument package of proving “parental alienation” is a court-driven solution, it requires targeted parents to collect and present the proof of “parental alienation” to the court (step one) to then ask for the remedy of a court-ordered reversal of custody (step 2).

The forensic psychology approach (the one used for the past 40 years without success and which continues to be the approach advocated by the Gardnerian PAS “experts”) requires convincing the court of three things (all three):

1) That “parental alienation” exists as a pathology;

2)  That “parental alienation” is occurring in this family and is responsible for the child’s rejection of the targeted parent (as opposed to the bad parenting of the targeted parent);

3)  Then – after proving the first two – the next level of proof required of the targeted parent will be to convince the judge that the remedy for the parent-child conflict is a reversal of custody in which the targeted parent is given sole custody while contact with the currently “favored” parent is blocked.

So there are multiple significant barriers of legal proof required – all for a normal parent simply to love the child.

So far, in the 40 years this legal argument package has been used, it is rarely successful.  And it is the only option offered through the “parental alienation” forensic legal argument package. 

Since the “parental alienation” legal argument package seeks a reversal of custody, it will lead directly to a child custody evaluation since ONLY a child custody evaluator is permitted to talk about child custody and visitation schedules (clinical psychologists will lose our license if we discuss custody and visitation; that’s a bad thing that needs to stop because it is silencing your advocates and it isolates you from clinical psychology and professional knowledge.  Clinical psychology refuses to work with your children and families because our license is threatened by forensic psychology if we do; “I don’t work with high-conflict divorce” is the statement you will hear from clinical psychology).

Only forensic psychology is allowed to render an opinion about custody and visitation issues, and only after having conducted a six to nine-month set of procedures costing between $20,000 to $40,000.  Can you see the financial conflict of interest in this?  It’s pretty blatant.  Forensic psychology is feeding off of vulnerable parents purely for financial gain, and they are preventing any sort of competition from clinical psychology or escape of parents to clinical psychology by threatening the license of clinical psychologists if we express an opinion about custody and visitation.

The Forensic Child Custody Evaluation

A child custody evaluation answers the referral question: What should the child’s custody and visitation schedule be? 

The targeted parent using this approach is seeking to prove “parental alienation” as the justification for a reversal of custody.  The targeted parent is hoping the custody evaluator will “see” the alienation and will make a recommendation for a reversal of custody over to the targeted parent.  Meanwhile, the child and allied parent put on their display for the custody evaluator hoping the evaluator will side with them in seeing the targeted parent as a “bad parent” who “deserves” to be rejected for past parental failures.

The targeted parent is put on the defensive by this process and must prove a negative; that their parenting is NOT “abusive.” So the whole child custody evaluation becomes a procedure to evaluate if the targeted parent is “abusive” and “deserves” to be rejected – with minimal vague attention given to the “parental alienation” concerns of the targeted parent.

There is no inter-rater reliability to child custody evaluations, meaning that two different evaluators can reach entirely different conclusions and recommendations based on the exactly the same data – which means that the results and recommendations from a child custody evaluation are entirely arbitrary and completely dependent on the attitudes, beliefs, and biases of the evaluator – including any personal mommy-issues or daddy-issues, cultural biases, and gender biases the evaluator may bring to the evaluation process from the evaluator’s own family of origin.

No standard constructs and principles of professional psychology are applied to the data of a child custody evaluation.  The conclusions and recommendations are entirely the sole arbitrary opinion of one person – the evaluator.  And, in my review of child custody evaluations as an expert consultant in these legal cases, the conclusions and recommendations from child custody evaluations are almost always wrong.

The forensic custody evaluation industry is a corrupt exploitation of families.  Forensic child custody evaluators are exploiting vulnerable families to financially feed off of these families… $20,000 to $40,000 per evaluation – with no oversight or review of their work for accuracy, knowing that child custody evaluations lack validity.  An assessment procedure cannot be valid if it is not reliable; child custody evaluations have zero inter-rater reliability – the conclusions and recommendations of custody evaluations cannot possibly be valid – that is an established psychometric fact.  The conclusions and recommendations of child custody evaluations are not valid, they are simply the opinions of one person.

The child custody evaluation industry is corrupt at its core, it exploits vulnerable families for obscene financial gouging, a trough to feed, and forensic child custody evaluations are in violation of the APA ethics code, Principle D: Justice.

Custody Evaluation Violation of Principle D: Justice

The conclusions reached by a typical child custody evaluation will usually find a mix of some “alienating behaviors” by the allied parent and some “estrangement” caused by the targeted parent.  Both of these terms are made-up constructs in forensic psychology with no actual grounding in any real forms of pathology.

The typical recommendations from child custody evaluations are to make the current de-facto sole custody of the allied parent (created by the child’s refusal to comply with court-ordered visitation) into the permanent custody arrangement, with “reunification therapy” recommended to fix the child’s relationship with the targeted parent.

A form of therapy called “reunification therapy” does not exist.  The court and all clients should ask for a reference book citation to the type of therapy that is being used by the therapist.  There is no book or article that has ever described a form a therapy called “reunification therapy.”  It doesn’t exist.  Like many things in forensic psychology, the forensic psychology mental health people are simply making stuff up.

Reunification therapy (it doesn’t exist) has no impact because the therapist is just making up what they are doing without any grounding in actual forms of psychotherapy.  After a year to two years of failed therapy, a second “update” child custody evaluation will typically be ordered (if the targeted parent’s financial resources have not been entirely depleted).  This second evaluation will take another six months to complete and cost another $10,000 to $20,000. This second evaluation may sometimes now assert that “parental alienation” is occurring (after approximately three years of the child refusing contact with the targeted parent and two years of failed “reunification therapy”) and may – may – recommend a change in custody.

However, some second (or third) “update” child custody evaluations will say that the child’s supposedly “bonded relationship” to the allied and “favored” parent is so extensive and is for so long (since the divorce), that it would be “traumatic” to the child to reverse custody now – even though severe parental alienation has been identified as the cause of the child’s rejection of the targeted parent.  So even in cases of severe “parental alienation,” the recommendations (remedy) from the custody evaluation are not always assured.  They simply make stuff up.  I’ve read their reports.

The recommendations of the custody evaluator are at the sole discretion of this one person – the evaluator – who is not required to know or apply standard information from attachment, family systems therapy, personality disorder pathology, or complex trauma, nor even the DSM diagnostic system of the American Psychiatric Association.  The forensic child custody evaluators believe that they are exempt from applying any of this knowledge to their evaluation – they just decide based on personal ideas and biases.

If the child custody evaluation does not result in the decision sought by the targeted parent, then overturning this child custody evaluation decision becomes an additional burden placed on the targeted parent.

Proving “parental alienation” using a child custody evaluation will usually require an attorney and a long trial.  Trial and attorney’s fees will be exceedingly expensive, and the outcome of obtaining a reversal of custody is only seldom achieved, and only in the most severe and egregious cases of “parental alienation.”

This is the only option that has been available to parents and the courts for the past 40 years.  This legal argument package and approach has been used extensively for 40 years with only occasional success in restoring the child’s bonded relationship with the targeted-rejected parent.  This is the approach recommended by the Gardnerian “experts” who will be more than happy to take your money to testify at trial to prove “parental alienation” – because they’re “experts” – they say so, so it must be true, right?

There are now alternatives.  Alternative legal arguments, alternative goals, and alternative paths to solution.

The Clinical Psychology Legal Argument Package

An alternative approach comes from clinical psychology and involves a treatment focused clinical psychology assessment of the family conflict, to identify the treatment needs of the family for solution.

A clinical psychology assessment answers the referral question:

Clinical Psychology Referral Question: Which parent is the source of pathogenic parenting creating the child’s attachment pathology (rejection of a parent), and what are the treatment implications?

A clinical psychology assessment and diagnosis of pathology can typically be accomplished in around six sessions for a cost of about $2,500.  If desired, the more limited scope and focused nature of clinical psychology assessments of pathology allows for second opinions using the same symptom identification and documentation.

The goal of the clinical psychology legal argument package is to obtain a court order for an appropriate – trauma-informed – clinical psychology assessment of the family conflict, in order to answer the referral question of which parent is creating the child’s attachment pathology, and what are the treatment implications?

Makes sense, right?  There is conflict in the family, each parent is claiming the other parent is responsible, the child is displaying attachment bonding pathology (rejecting a parent) – let’s get a clinical psychology assessment and workup, which parent is causing the child’s attachment pathology, and what are the treatment implications?

That is the legal argument.  Obtaining a trauma-informed clinical psychology assessment of the family conflict is the goal of the clinical psychology legal argument package.

A clinical psychology assessment of pathology documents symptoms, and then applies the standard and established constructs from established domains of professional psychology – attachment pathology – family systems therapy – complex trauma – personality pathology – to the child and family symptoms in a structured, consistent, and standardized way to diagnose pathology.

A clinical psychology assessment of attachment-related family pathology (a child rejecting a parent) can reliably identify which parent is creating the child’s pathology and can identify the treatment implications using the standard and established knowledge of professional psychology (attachment, family systems therapy, personality pathology, complex trauma).

Child Abuse Diagnosis

If the pathogenic parenting of the allied parent is creating significant psychopathology in the child (such as severe developmental pathology, severe personality pathology in the child, or severe psychiatric pathology in the child), then the degree of pathogenic parenting may rise to the level of a confirmed DSM-5 diagnosis of V995.51 Child Psychological Abuse.

If this is the case, then the assessing mental health professional will make a DSM-5 diagnosis of Child Psychological Abuse – consistent with this mental health professional’s duty to protect.  The standard of practice in clinical psychology is to always provide a DSM-5 diagnosis in all cases, and this becomes an especially prominent professional responsibility surrounding the DSM-5 diagnosis of child abuse.

If child abuse is present, the assessing mental health professional who is conducting a clinical psychology assessment will diagnose child abuse.

If a mental health professional makes a confirmed DSM-5 diagnosis of V995.51 Child Psychological Abuse, this diagnosis serves as the professional and legal justification for a protective separation period to 1) protect the child, and 2) allow treatment and recovery of the child from the psychological and emotional damage caused by the abuse. 

Once the child’s healthy development is recovered and stabilized, the pathogenic parenting of the abusive parent can be reintroduced with sufficient safeguards to ensure that the psychological abuse of the child does not resume once contact with the abusive parent is restored.

It is a confirmed DSM-5 diagnosis made by a mental health professional that provides the legal and mental health justification for a limited protective separation period.

It is important to be clear on the distinction of the two approaches.  The protective separation is based on a confirmed DSM-5 diagnosis of Child Psychological Abuse.  If there is a question about this diagnosis, a second opinion can be sought (six sessions; structured data collection and documentation).

This is how diagnosis works.  Document the symptoms.  Apply the diagnostic criteria.  If there is dispute, seek a second opinion that documents the symptoms and applies the diagnostic criteria.

A clinical psychology assessment is NOT assessing for “parental alienation” – the construct of “parental alienation” does NOT exist in clinical psychology.  In clinical psychology, the construct most people are calling “parental alienation” represents a combination of standard family systems constructs: a cross-generational coalition and an emotional cutoff (Bowen; Minuchin; Haley; Madanes).

Clinical Psychology Definition:  The child is being triangulated into the spousal conflict through the formation of a cross-generational coalition of the child with the allied parent against the targeted parent, that is resulting in an emotional cutoff in the child’s relationship with the targeted parent.

The goal of the Clinical Psychology legal argument package is to obtain a proper, trauma-informed, clinical psychology assessment of the family conflict – with its treatment implications.  The goal is to identify the treatment needs of the family.

Different Legal Argument Goals

The forensic psychology legal argument package of “parental alienation” seeks an entirely different goal from the clinical psychology legal argument package.

The forensic psychology legal argument package seeks to prove “parental alienation” in court in order to obtain a court order for a reversal of custody – giving physical custody to the targeted parent and restricting contact with allied and “favored” parent – by proving “parental alienation” to a judge in trial, and then also proving to this judge that a reversal of custody is the only possible remedy.

The clinical psychology legal argument package of psychological child abuse (AB-PA) seeks a court order for a limited-scope trauma informed clinical psychology assessment of the family’s conflict.  If a confirmed DSM-5 diagnosis of V995.51 Child Psychological Abuse is made by the assessing mental health professional, then the issue becomes one of child protection.

The clinical psychology legal argument package moves the assessment and diagnosis of pathology out of the courtroom and returns the diagnosis of pathology to clinical psychology – and to the professional standards of practice in clinical psychology for symptom documentation and the application of scientifically grounded psychological constructs and principles to the symptom data – attachment – family systems therapy – personality pathology – complex trauma.

The goal of the clinical psychology legal argument package is NOT to prove anything in court trial.  It is not to prove who is the better parent and which parent “deserves” the child.  The goal of a clinical psychology assessment is to diagnose pathology in order to identify the treatment needs of the family.  The goal is the resolution of pathology and the creation of healthy, affectionate, and bonded relationships across the family (parent-child, aunts, uncles, grandparents, on both sides of the family) – a healthy family… that’s the goal of clinical psychology.

The child refusing custody visitation with a parent following divorce is not a legal-custody issue, it is a psychopathology-treatment issue.  The first step to a solution is to diagnose the source of the child’s symptom display.  This is accomplished through a proper trauma-informed assessment of the family relationships.

Custody Resolution Method

The Custody Resolution Method from Dorcy Pruter is a method for compiling data from emails, texts, written reports, declarations, and documents based on structured categories of symptom features.  This data compilation of large data sets produces a summary data profile of frequencies for the categories of interest.

The Custody Resolution Method (CRM) simply compiles and organizes large amounts of documented data into easily recognized categories, revealing the patterns in the data.

These compiled CRM data profiles are then further tagged by an independent psychologist consultant to CRM for issues of psychological concern evidenced in the data profile and data set, and a consultant’s report on the compiled data is provided to CRM.  The compiled data profiles and data analysis is then provided by CRM to the attorney-client and parent-client, who can then provide this data summary to the court in support of the legal argument package being sought.

These compiled data profiles from the mountains of emails, OFW, texts, letters, documents, declarations, mental health reports, etc. can be used by the client-attorney and client-parent of CRM to support the clinical psychology argument package being presented to the court by the attorney and parent; that a treatment focused clinical psychology assessment is warranted and needed.

The CRM compiled data profiles and consultant psychologist’s report on the compiled data can also be used to support the DSM-5 diagnosis of Child Psychological Abuse made by a mental health professional, or can be used to challenge the absence of a Child Psychological Abuse diagnosis that was NOT made by a mental health professional.

Data is data, and data speaks.  CRM is simply what the data says, it is simply a procedure (data tagging of “archival data”) for compiling large data sets into organized categories for ease in understanding and interpretation.

Before data compilation into categories, the  voice of data is masked in chaos.  Compiling the data into frequencies for pre-specified and pre-defined categories brings clarity to the voice of data from out of the chaos.  Data speaks.  The scientifically based data compilation procedures of the Custody Resolution Method bring clarity to the data for all to see.  It’s simply what the data says, and for court, it’s evidence.

Dr. Childress:  Director of Psychological Services; CRM

Dr. Childress is the Director of Psychological Services for the Conscious Co-Parenting Institute; Custody Resolution Method.  My role with the Custody Resolution Method is to provide leadership and professional protocols for a team of six to eight independent consultant psychologists for the Custody Resolution Method data profiles.  I will be the psychology interface between these independent psychologist consultants and the client, Dorcy Pruter and the Custody Resolution Method.

My role is to develop the professional protocols for psychology tagging of the data and the structure for the professional consultant’s reports generated for the client, the Conscious Co-Parenting Institute; CRM.  As the Director of Psychological Services for CRM, I will co-sign all consultant reports, so if there is testimony required about any aspect of CRM or the reports generated, as Director of Psychological Services for CRM Dr. Childress will be available to provide that testimony support.

If one of the consulting psychologists wants to gain experience in court testimony for their own professional development, they can ask to testify in support of their reports and I will provide whatever mentorship support they wish regarding the procedures of court testimony for a clinical psychologist.  I will also be providing training seminars for the consulting team of psychologists in attachment pathology, family systems therapy, personality disorder pathology, and complex trauma.

The goal of CRM is not to “win” a court battle – it’s to make “winning” unnecessary because everyone has reached stipulated agreements for a clinical psychology solution to the family conflict.  It’s about finding solutions that work.

The goal of clinical psychology and CRM is to reach collaborative agreements that keep the family OUT of court.

And also,… if court involvement is needed (which is often probable with parental narcissistic and borderline pathology), then the goal of CRM and clinical psychology is to provide the court with reliable, valid, and documented evidence that leads quickly out of the court system and returns the family to a defined (written) treatment plan from clinical psychology… treatment that solves the family conflict pathology for the child.

Options: Forensic or Clinical Psychology

There are now two main paths, and three options.  The primary choice is which legal argument package the attorney and parent choose to present to the court:

1.)  The Forensic Psychology legal argument package seeks to prove “parental alienation” at trial, with the ultimate goal of obtaining court orders for a reversal of custody to the targeted-rejected parent.

2.)  The Clinical Psychology legal argument package seeks a court order for a limited-scope, trauma-informed assessment from clinical psychology to answer the referral question:

Referral Question: Which parent is the source of pathogenic parenting creating the child’s attachment pathology, and what are the treatment implications?

The Custody Resolution Method offers a third alternative that simply allows the data to speak for itself, a neutral compiling of all documented data for presentation.  These CRM data profile reports will contain input on solutions from professional psychology, with the goal of supporting a healthy separated family of shared love and bonding following divorce.

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

Director of Psychological Services
CCPI; Custody Resolution Method

 

Standards

To my professional colleagues in forensic psychology, I have this statement from clinical psychology.


Cardiologist: If you go to a cardiologist for the diagnosis and treatment of your heart problems, the cardiologist is expected to know everything there is to know about heart disease – everything – and then to stay current on developments by reading professional journals.

Oncologist: If you go to an oncologist for the diagnosis and treatment of your cancer, the oncologist is expected to know everything – everything – there is to know about the diagnosis and treatment of cancer, and then to remain current on developments by reading professional journals.

Clinical Psychologist: In clinical psychology, if we work with attachment pathology we are expected to know everything – everything – about the attachment system, and then we remain current on developments by reading professional journals.

Clinical Psychologist: A clinical psychologist working with trauma pathology is expected to know everything – everything – about trauma, its diagnosis and treatment, and then to remain current on developments through professional journals.

Clinical Psychologist: In clinical psychology, if we work with personality disorder pathology we are expected to know everything there is to know about personality disorders, their origins, diagnosis, and treatment, and then we remain current on developments through professional journals.

Clinical Psychologist: In clinical psychology, if we conduct family therapy we are expected to know everything – everything – about family therapy, then we remain current on developments through seminars and by reading professional journals.

To my professional colleagues in forensic psychology, I would assert that these same standards of practice apply to you; that your client is court-involved is not relevant.  These standards of professional practice still apply to you.

To my colleagues in forensic psychology… if you think these standards of professional practice don’t apply to you because you are somehow “special” and “exempt” from standards of professional practice, please explain why that is.  Why is forensic psychology exempt from standards for knowledge?

Because if you are not exempt from standards of professional practice for knowledge and competency, then you have a lot of reading to do.

Primary Literature:

Bowlby: attachment
Ainsworth: attachment
Research on attachment
Minuchin: family systems
Bowen: family systems
Haley: family systems
Madanes: family systems
Satir: family systems
Kernberg: personality disorders
Beck: personality disorders
Millon: personality disorders
Linehan: personality disorders
van der Kolk: trauma (complex)
Perry: childhood trauma
Briere: childhood trauma
Fonagy: parent-child relationship
Stern: parent-child relationship
Tronick: parent-child relationship

That is the primary literature every forensic psychologist should know. 

If not, why not?  To my professional colleagues in forensic psychology… tell us why you are exempt from knowledge?

Dr. Childress knows all of that.  Is it too much knowledge?  Is it too hard for you?  Do you think you don’t need knowledge to do what you do?  Does it require too much effort and you’re simply too lazy?  Tell us why you are exempt from knowledge because you are a “forensic psychologist”?

Because if you are not exempt from knowledge as a standard of professional practice, then you have a lot of reading to do… quickly.  Because your client, the one you’re seeing next week, needs you to know all of that before your next appointment.

Those are called standards of professional practice.  Welcome to the world of clinical psychology.

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