It’s 9:30 in the evening and I’m still working on something. I’m taking a break and talking to you, I might work to about 11 before getting to bed.
Once I get into something, I’m in a zone for a while. I’m doing a line-by-line on a 40-page forensic custody evaluation. I didn’t want to do a line-by-line, but once I saw… I had to.
I was hoping I could simply extract quotes this time. I’m getting pretty fluent in what I do. But I couldn’t, the ignorance is too dense. It’s always the same ignorance, and I always have the same response.
Those are my notes – my line-by-line de-construction of a forensic custody evaluation. it’s time consuming. I’m almost at the end of this one… at this point my responses are a lot of cut-and-paste of my earlier responses.
Once an issue is an issue, it remains the same issue over-and-over. and we always wind up at the same place – violations to 2.04 leading to violations in 9.01 – and we still need a proper risk assessment for child abuse to the appropriate differential diagnosis for each parent.
Diagnosis guides treatment. What’s the diagnosis? They didn’t provide a diagnosis. THEN we STILL need a diagnosis. Grrrrrr, that makes me so grumpy with them. You’re a doctor – tell me what the diagnosis is. Grrrrr…
But the diagnosis is kinda obvious from the symptom reporting. Diagnosis is a pattern-match of the symptoms to the diagnostic criteria. If you tell me the symptoms, I can get you almost all the way to a diagnosis… but I didn’t personally collect the symptom information.
There are things we do, questions we can ask as we collect the symptom information that confirms one diagnostic pattern or another. When I haven’t personally conducted the clinical interview, I don’t have that second-level “follow-up” question to confirm diagnostic patterns.
But the symptoms they report are pretty clear. If they don’t provide a diagnosis, that means whatever the diagnosis turns out to be… they missed it. They said there was nothing there – no diagnosis means there’s no diagnosable pathology (like child abuse or delusional thought disorders) present.
Because if there was child abuse present, or a persecutory delusion created in the child, they’d diagnose that and tell the court… right?
So the fact that they didn’t put any diagnosis means that there’s no diagnosable pathology present. But that’s not true. Unless everything is normal for the family – i.e., no pathology – then there’s some sort of pathology in the family creating a pretty bad problem.
And whatever that pathology turns out to be… the forensic custody evaluator missed it – whoosh – because they said there was nothing and there was something, whatever it turns out to be.
Missed diagnosis = misdiagnosis. They misdiagnosed the pathology, they said through no-diagnosis that there was no child abuse present when there was. They said through no-diagnosis that there was no presecutory delusion and there was. They misdiagnosed the pathology because whatever it is… they said it wasn’t there.
I’ll be doing a Checklist of Applied Knowledge for this one. It’s my typical approach if it helps bring clarity to the professional failure. The Checklist of Applied Knowledge documents their compliance or seeming violation to Standard 2.04 Bases for Scientific and Professional Judgements.
Maybe they applied some esoteric knowledge not on the Checklist of Applied Knowledge, they can answer to what established knowledge they applied as the bases for their professional judgments – it just wasn’t what’s on the Checklist – family systems – attachment – trauma pathology – personality pathology – child development – self psychology.
None of that. And… they applied none of nothing. I’m just not going to fight about their ignorance – so I developed a data documentation instrument, the Checklist of Applied Knowledge to help in my review of their reports.
It’s like my grading sheet. I’m looking for these constructs in the student’s answers so that when the student is upset they got an F and want to argue about it, I point to what I graded on and it wasn’t there.
Nothing personal… that was simply an ignorant answer. It contained no established knowledge, just your personal opinions. It’s not doctor-level work – Standard 2.04.
If they didn’t apply the established knowledge, do they even know the established knowledge needed for competence? – that’s Standard 2.01 Boundaries of Competence. No, they don’t.
Did they misdiagnose the pathology because they are practicing beyond the boundaries of their competence in violation of Standard 2.01 of the APA ethics code?
Line-by-line I take their report apart. Ignorant statement after ignorant statement, they are so dense I can’t do it paragraph-by-paragraph. Every sentence is a sentence of ignorance.
Google ignorance: lack of knowledge or information
I’m not being mean, I’m just describing them using English words. They are ignorant by definition of the English language. It’s not my fault they’re ignorant. I’m not making them stupid, they’re accomplishing that all on their own.s
I’m just pointing it out, and I better get back to pointing it out, I’m almost finished – I hope.
Craig Childress, Psy.D.
Clinical Psychologist, CA PSY 18857
GreatCosmicMothersUnite 