A proper risk assessment for possible child abuse looks at both sides.
When a child is rejecting a parent, the first rule-out is that this parent is abusively maltreating the child resulting in the child’s rejection of the parent.
The first focus for the assessment is on the parenting practices of the targeted-rejected parent. Are they abusive-range parenting or is this a normal-range parent?
That is the first question to answer – definitively. If the answer returned is that the targeted-rejected parent is abusively maltreating the child, then that becomes the focus of the treatment. Nothing else moves forward until child abuse is resolved.
This is a key and first assessment in any risk assessment for possible Child Psychological Abuse (DSM-5 V995.51). Is the targeted-rejected parent abusively maltreating the child?
I recommend that the assessing mental health professional use the Parenting Practices Rating Scale to document their professional judgment based on their assessment of the parenting practices of the targeted-rejected parent.
Parenting Practices Rating Scale
Level 1 Abusive-Range Parenting and Level 2 Severely Problematic Parenting by the targeted-rejected parent would represent abusive-range parenting that should become the focus of treatment.
Level 3 Normal-Range Problematic and Level 4 Normal-Range Healthy would both be normal-range parenting and would not be considered abusive maltreatment of the child.
If the parenting practices of the targeted-rejected parent have been determined to be normal-range by the assessment, then the diagnostic question surrounding the child’s attachment pathology shifts to the other parent, the allied parent.
At this point the risk assessment is for a possible shared persecutory delusion (ICD-10 F24), a thought disorder with the allied parent from unresolved trauma that distorts their thinking and perception regarding current situations, and that they are then imposing this false and distorted belief system onto the child. i.e., a shared persecutory delusion.
The American Psychiatric Association provides a definition of a persecutory delusion:
From the APA: “Persecutory Type: delusions that the person (or someone to whom the person is close) is being malevolently treated in some way.” (American Psychiatric Association, 2000).
Google malevolent: having or showing a wish to do evil to others.
Does the child (and allied parent) have a fixed and false belief that the targeted parent has a “wish to do evil” to the child?
In the flagship journal of the AFCC, Family Court Review, Walters and Friedlander noted the association of attachment pathology in court-involved family conflict and the potential delusional beliefs of one parent toward the other:
From Walters & Friedlander: “In some RRD [resist-refuse dynamics] families, a parent’s underlying encapsulated delusion about the other parent is at the root of the intractability (cf. Johnston & Campbell, 1988, p. 53ff; Childress , 2013). An encapsulated delusion is a fixed, circumscribed belief that persists over time and is not altered by evidence of the inaccuracy of the belief.”
Walters and Friedlander cite a 2013 essay-article from me posted to my website:
Childress, C. A. (2013). Reconceptualizing parental alienation: Parental personality disorder and the trans-generational transmission of attachment trauma.
A delusion is a a fixed and false belief that is maintained despite contrary evidence. A persecutory delusion is a fixed and false belief in supposed “victimization.”
The assessment for delusional thought disorder pathology is a Mental Status Exam of thought and perception.
NCBI Clinical Methods: Mental Status Exam
From NCBI: “The inability to process information correctly is part of the definition of psychotic thinking. How the patient perceives and responds to stimuli is therefore a critical psychiatric assessment. Does the patient harbor realistic concerns, or are these concerns elevated to the level of irrational fear? Is the patient responding in exaggerated fashion to actual events, or is there no discernible basis in reality for the patient’s beliefs or behavior?”
From NCBI: “Of all portions of the mental status examination, the evaluation of a potential thought disorder is one of the most difficult and requires considerable experience. The primary-care physician will frequently desire formal psychiatric consultation in patients exhibiting such disorders.”
I have that “considerable experience” from 12 years of annual training in the assessment of delusional thought disorder pathology while I was with a major NIMH research study on schizophrenia.
9/85 – 9/98 Research Associate
UCLA Neuropsychiatric Institute
Principle Investigator: Keith Nuechterlein, Ph.D.
Area: Longitudinal study of initial-onset schizophrenia. Received annual training to research and clinical reliability in the rating of psychotic symptoms using the Brief Psychiatric Rating Scale (BPRS). Managed all aspects of data collection and data processing.
Dr. Childress Domains of Specialized Expertise
Most (all) mental health professionals working with court involved family conflict lack the “considerable experience” needed for a Mental Status Exam of thought and perception (i.e., practice beyond the boundaries of their competence – Standard 2.01).
In an effort to be helpful from my background and experience, I have provided a three item checklist that can reliably identify the family pathology created by a shared persecutory delusion, along with 12 Associated Clinical Signs that are often co-occurring with this delusional thought-disorder pathology.
Diagnostic Checklist for Pathogenic Parenting
I have also provided an Outcome Measure, the Parent-Child Relationship Rating Scale, in which daily ratings made by the targeted parent are sent to the treating family therapist along three scales, 1) Affection (attachment), 2) Cooperation (emotional regulation), and 3) Social Involvement (mood & arousal).
Parent Child Relationship Rating Scale
I’m not going to fight about it. In the court system surrounding child custody litigation, everyone fights about everything. I’m not participating. I’m treatment not custody, I’m a clinical psychologist not a “forensic” psychologist.
I would never be a “forensic” psychologist. The standards of practice in “forensic” psychology are substantially beneath those in clinical psychology.
The Parenting Practices Rating Scale, the Diagnostic Checklist for Pathogenic Parenting, and the Parent-Child Relationship Rating Scale are for your benefit, not mine. I’m just trying to be helpful.
I know what I’m doing already. I can conduct an MSE of thought and perception and rate the delusional belief on the 7-point scale of the Brief Psychiatric Rating Scale (BPRS), the “oldest, most widely used scales to measure psychotic symptoms.”
I have described the pathology in detail in my book, Foundations.
I have described the assessment protocol for attachment related pathology surrounding divorce.
Assessment of Attachment Pathology
I have described for you a Strategic family systems intervention of a Contingent Visitation Schedule.
Contingent Visitation Schedule
I have described a Response-to-Intervention single-case ABAB design for assessment and remedy with court-involved child custody conflict.
ABAB Single-Case Assessment & Remedy
I have described an AB-PA pilot program for the family courts.
Pilot Program for the Family Courts
I’ve done my part. It’s not my job to educate other psychologists, it’s their job to already know.
2.01 Boundaries of Competence
(a) Psychologists provide services, teach, and conduct research with populations and in areas only within the boundaries of their competence, based on their education, training, supervised experience, consultation, study, or professional experience.
2.03 Maintaining Competence
Psychologists undertake ongoing efforts to develop and maintain their competence.
2.04 Bases for Scientific and Professional Judgments
Psychologists’ work is based upon established scientific and professional knowledge of the discipline.
The established scientific and professional knowledge of the professional psychology is:
Attachment – Bowlby and others
Family systems therapy – Minuchin and others
Personality disorders – Beck and others
Complex trauma – van der Kolk and others
Child development – Tronick and others
Self psychology – Kohut and others
ICD-10 & DSM-5 diagnostic systems
In 2017 I presented directly to the national convention of the AFCC informing them regarding the nature of the pathology and their ethical obligations.
In 2018 I hand-delivered a Petition to the APA signed by over 20,000 parents notifying the APA of the ethical violations surrounding forensic psychology.
If you’re a psychologist working with court-involved child custody conflict, it’s not my job to educate you – it’s your job to already know.
I have mandatory professional obligations – required not optional.
1.04 Informal Resolution of Ethical Violations
When psychologists believe that there may have been an ethical violation by another psychologist, they attempt to resolve the issue by bringing it to the attention of that individual, if an informal resolution appears appropriate and the intervention does not violate any confidentiality rights that may be involved.
1.05 Reporting Ethical Violations
If an apparent ethical violation has substantially harmed or is likely to substantially harm a person or organization and is not appropriate for informal resolution under Standard 1.04, Informal Resolution of Ethical Violations , or is not resolved properly in that fashion, psychologists take further action appropriate to the situation. Such action might include referral to state or national committees on professional ethics, to state licensing boards, or to the appropriate institutional authorities.
There are apparent ethical violations by other psychologists that are not properly resolved by informal resolution, and these ethical violations by forensic psychologists have substantially harmed and are likely to substantially harm many people, including the children they work with.
I have notified the AFCC directly. I have notified the APA directly. What “further action appropriate to the situation” is required?
I have educated the parent-consumers on both the pathology and their rights guaranteed to them by the mandatory ethics code of the American Psychological Association.
Come 2022, I will be actively helping parents and their attorneys proceed with malpractice litigation against the involved “forensic” psychologists. Malpractice lawsuits require an attorney, and are expensive for that reason, and may not be practical for many.
Consumer complaints to their state licensing boards is an appropriate response for violations to ethical Standards of practice. Complaints made to licensing board are free to the consumer. There is a reason for ethical standards of practice, there is a reason they are mandatory, not optional. There is a reason psychologists must become licensed – so that they are under the jurisdiction of a formal licensing board for potential ethical violations and malpractice.
Board complaints should not be filed frivolously and without cause. They are not meant to harass, the board provides oversight regarding legitimate grievances and concerns.
In many-many cases in the family courts, there are legitimate grievances and concerns as I describe in the Petition to the APA signed by 20,000 parents. There has been no response from the APA. They don’t care about you and your children. The APA is in active cover-up for the unethical practices in forensic psychology.
APA Complicity with Child Abuse
I have notified the AFCC regarding the issues. I have notified the APA regarding the issues.
Beginning in 2022, I will be encouraging parents to file licensing board complaints when these complaints are justified by the psychologists’ violations to Standard 2.04 Bases for Scientific and Professional Judgments and Standard 9.01 Bases for Assessment, and for multiple failures in their duty to protect.
9.01 Bases for Assessments
(a) Psychologists base the opinions contained in their recommendations, reports, and diagnostic or evaluative statements, including forensic testimony, on information and techniques sufficient to substantiate their findings. (See also Standard 2.04, Bases for Scientific and Professional Judgments .)
If the forensic psychologist has not relied on the established scientific and professional knowledge of the discipline as the bases for their professional judgements, then the opinions contained in their recommendations, reports, and evaluative statements are NOT based on information sufficient to substantiate their findings.
Note the specific citation reference in Standard 9.01 Bases for Assessment to Standard 2.04 Bases for Scientific and Professional Judgments.
State licensing boards are controlled by the forensic psychologists. They exempt themselves from all ethical standards of practice… because they can.
Parents will want to make their state licensing boards cover-up for the forensic psychologists over-and-over again – for exactly the same violations – Standard 2.04 – Standard 9.01 – Standard 2.01 (vitae) – and failure in their duty to protect on two separate grounds, 1) failure to protect the child from psychological abuse by the pathological parent, and 2) failure to protect the targeted parent from Intimate Partner Violence (IPV), i.e., from spousal emotional and psychological abuse by the other parent using the child as the weapon.
DSM-5 V995.51 Child Psychological Abuse
DSM-5 V995.82 Spouse or Partner Abuse, Psychological.
If an apparent ethical violation has substantially harmed or is likely to substantially harm a person or organization and is not appropriate for informal resolution under Standard 1.04, Informal Resolution of Ethical Violations, or is not resolved properly in that fashion, psychologists take further action appropriate to the situation. Mandatory, not optional.
You are more powerful than you know. Do the right thing. Live to who you are, live to your standards. Let the world take care of the world… you do the right thing.
Knowledge gives you power. Knowledge belongs to everyone. Use knowledge to solve pathology.
Ignorance solves nothing.
Craig Childress, Psy.D.
Clinical Psychologist, CA PSY 18857