Child custody and child psychiatry.
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Child custody litigation signals parental conflicts that have serious implications for a child's long-term development. The authors describe a family systems approach to child custody decision making--the contextual approach, derived from contextual family theory. A case study analysis and pilot study illustrate the use of the approach with a small group of families who turn to the legal system to resolve custody or visitation disputes. The findings suggest the approach's usefulness in helping families create alternatives to continued disputation. The findings also reinforce the need for further research to test the preventive potential of the approach in reducing returns to court.
These practice parameters are presented as a guide for clinicians evaluating the often delicate and complex issues surrounding a child custody dispute. The historical basis of child custody and the various judicial presumptions that have guided courts are reviewed. The differences between performing child custody evaluation and engaging in traditional clinical practice are emphasized. Issues that are common to all child custody disputes are presented, including continuity and quality of attachments, preference, parental alienation, special needs of children, education, gender issues, sibling relationships, parents' physical and mental health, parents' work schedules, parents' finances, styles of parenting and discipline, conflict resolution, social support systems, cultural and ethnic issues, ethics and values, and religion. In addition, special issues that complicate custody evaluations are discussed, including infants in custody disputes, homosexual parents, grandparents' rights, parental kidnaping, relocation problems, allegations of sexual abuse, and advances in reproductive technology, such as frozen embryos, oocyte donation, and artificial insemination. An outline is provided that describes the complete evaluation process, from assessing referrals and planning a strategy through conducting clinical interviews, writing the report, and testifying in court.
The child and adolescent psychiatrist who performs child custody evaluations assumes an extraordinary responsibility. Operating at the interface of psychiatry and the law, this forensic psychiatrist is often confronted by special factors that can make a normally complicated process even more intricate. This paper examines the forensic psychiatrist's role in dealing with a number of special issues which often arise during child custody evaluations. These issues are: the mentally ill parent, the homosexual parent, stepparents, grandparents' rights, and parental kidnapping. Case vignettes are presented, and guidance for the clinician is provided.
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Clinical efforts in child custody disputes have emphasized preventive measures that address the best interests of the child. Examined herein is the impact of separation and divorce on families and preventive oriented efforts in contested child custody family mediation models. Also addressed are psychological factors in mediation, an identified model of family mediation, and clinical issues in the contested child custody arena.
Psychologists who participate as forensic evaluators in custody and visitation cases involving allegations of child sexual abuse must possess advanced assessment skills and a thorough knowledge of child development, child sexual abuse, and child interviewing techniques. This case study illustrates the types of problems that are inevitable when psychologists violate the boundaries of their role as an independent evaluator and fail to uphold their ethical obligation to be knowledgeable and competent in the area in which they profess expertise.
BACKGROUND: The area of child custody assessments continues to fail to meet the evidence-based threshold now established in clinical practice. This is despite the existence, for many years, of published guidelines governing the practice of custody assessments available from a number of professional bodies. METHODS: This article reviews the potential of attachment theory to contribute to the conceptualization of custody evaluations, clinical assessment, and the development of evidence-based practice. Particular attention is paid to specific instruments used to assess attachment in clinic and non-clinic settings. RESULTS: Guidelines concerning child custody assessments highlight the particular importance of assessing attachment and parent-child relationship quality. However, measures often used in the course of a custody assessment are not backed up with empirical research, and the measures that are supported by empirical research have been slow to influence practice. There may be conceptual and measurement advantages of considering an attachment research-informed custody assessment. DISCUSSION: Attachment theory has obvious conceptual relevance for the child custody context. Further clinical research is needed to demonstrate the usefulness of attachment research measures; research of this kind may shed important light on the development and resilience of affectional bonds.
There has been an increased focus on child custody evaluations involving domestic violence allegations with much criticism of evaluators' training, practices, and procedures. A national survey of 115 child custody evaluators (doctoral and master's level) was conducted to explore these criticisms. Findings revealed adequate training, multiple sources of data collection, and practices/procedures that closely adhere to child custody guidelines. However, robust, specialized domestic violence instruments, tests, and questionnaires were underutilized. Respondents indicated that findings supporting domestic violence allegations had a substantial impact on their subsequent recommendations. Results are discussed in terms of the importance of assessing domestic violence when conducting custody evaluations and the need for developing practice standards in this domain. Generally, results did not support common criticisms of custody evaluation practice.
This summary is presented as a guide for clinicians evaluating the often delicate and complex issues surrounding a child custody dispute. The historical basis of child custody and the various judicial presumptions that have guided courts, as well as the differences between performing child custody evaluation and engaging in traditional clinical practice, are reviewed in the complete document. Issues that are common to all child custody disputes are presented, including continuity and quality of attachments, preference, parental alienation, special needs of children, education, gender issues, sibling relationships, parents' physical and mental health, parents' work schedules, parents' finances, styles of parenting and discipline, conflict resolution, social support systems, cultural and ethnic issues, ethics and values, and religion. In addition, special issues that complicate custody evaluations are presented, including infants in custody disputes, homosexual parents, grandparents' rights, parental kidnapping, relocation problems, allegations of sexual abuse, and advances in reproductive technology, such as frozen embryos, oocyte donation, and artificial insemination.
This article describes a child custody case centered on the fitness of the mother, who was involved in an SM relationship with her live-in boyfriend. Although the investigation confirmed that no child abuse had occurred, that the child was unaware of the mother's sexual interests, that there were no incidents of inappropriate sexual activities in front of the minor, and that the child was doing well, the court severely limited the mother's visitation and custody arrangements and ended her alimony. Practitioners of alternative sexual lifestyles have not fared well in child custody hearings, and this case is no exception. The present case indicates how the family court system can be biased against sexual minorities in general and SM practitioners in particular. In addition, the present case demonstrates how the DSM diagnostic criteria can be misused in dealing with alternative lifestyle practitioners. Recommendations for further education of the court and for future research are made.
Although most states mandate considerations of intimate partner violence (IPV) in child custody proceedings, little is known about how often a preexisting history of IPV is effectively presented to the courts in dissolution cases and, when it is, what effect it has on child custody and visitation outcomes. This retrospective cohort study examined the effects of a history of IPV, further categorized by whether substantiation of that history existed and whether the court handling the custody proceedings knew of that history, on child custody and visitation outcomes. The findings from this study highlight several issues of concern regarding the reality of child custody among families with a history of IPV. These include two primary concerns: a lack of identification of IPV even among cases with a documented, substantiated history, and a lack of strong protections being ordered even among cases in which a history of substantiated IPV is known to exist.
The MMPI-2 is commonly used in the psychological assessment of parents within child custody evaluations. Due to the interface of mental health practitioners with non-mental-health professionals in the context of child custody cases, careful attention must be paid to the potential misunderstanding or misuse of data from psychological testing. While traditional clinical lore has maintained an expectation of clinically significant defensiveness on the MMPI-2 with this population, the research data does not support this view. Despite empirical findings that identify patterns of elevations on the MMPI-2 validity scales with parents involved in child custody disputes, these patterns have been demonstrated to reach statistical but not clinical significance. That is, MMPI-2 profiles that contain elevations on scales L or K that either invalidate or notably suppress clinical scales are not to be expected in the child custody population. False causal attributions contributing to the potential mischaracterization or loss of important data related to personality functioning within this population are identified and discussed. Potential dangers associated with such false causal attributions are reviewed.
This study tested the hypothesis that a parent undergoing a child custody evaluation will bias his or her report of the children's symptoms in a direction that supports the parent's aim in the litigation. Parents in 196 court-ordered child custody evaluations rated their children using the Achenbach Child Behavior Checklist. Additional families undergoing evaluations of visitation disputes (N = 34) and custody/visitation disputes complicated by sexual abuse allegations (N = 15) were used as comparison groups to test alternative explanations of the findings. Results were strongly supportive of the hypothesis that parental bias was present and quantifiable.
Given awareness of research, a focus on the present, sensitivity to multiple life events, and preference for active interventions that characterize the social learning tradition, behavior therapists are well equipped to expand their work into the child custody context. However, therapists need to be aware of the multiple potential roles they may be asked to play in child custody cases. All therapists must make clear whether they are functioning as an evaluator, a mediator, or a therapist. These roles overlap somewhat in function, and on occasion the same psychologist may successfully fulfill more than one role. However, the wise course of action is for the therapist to define a single role from the outset of the case and to remain in that one role throughout. Although a social learning background is an excellent starting point, therapy with child custody cases requires specialized knowledge about the emotional, practical, and legal aspects of divorce. Self-education is an especially important precursor to working in the child custody context, because perhaps the single most important intervention with divorcing and divorced families is to educate them. Given the lack of institutionalized guidance on how to handle both the emotional and the practical aspects of divorce, families often turn to therapists for direction. To provide such direction, therapists must educate themselves about the various emotional, social, practical, and legal aspects of divorce. We hope that this chapter is but an initial step that the reader will take toward that goal.
This article reviews briefly the history of child custody decision making and describes current custodial arrangements in the United States. It examines both the manner in which parents and courts make decisions regarding custody and access, and the changes in visiting patterns in recent decades. The author discusses the impact of reforms in the law and the implementation of newer dispute resolution and educational interventions, and then makes recommendations for policy and practice.
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