Like physicians, psychologists are expected to
follow the dictum primum non nocere-- first, do no harm. Ethical principles like
beneficence, respect for people, and justice all seem to me to follow from that
original rule.
Psychologists who teach, do clinical work, or
concentrate on research all have obligations to pay attention to ethical
guidelines and to do no harm. But, of course, there are tasks done by
psychologists where the possibility of doing harm-- and the importance of avoiding harm—is especially great. One of these is child custody evaluation, in which a
psychologist assesses children and parents with an eye to making a
recommendation about primary custody, about visitation, or even about termination
of parental rights. Such recommendations walk a fine line between possible
errors, and always involve some risk of causing harm to the child and/or
interfering with the rights of parents to retain a relationship with a child.
Inaccurate assessments may cast serious aspersions on the characters of
parents and interfere with their professional lives as well as personal
relations with the child or with other people—or, on the other hand, they may
expose a child to continued harm from an abusive parent.
We usually hope that psychologists making custody
recommendations will pay heed to ethical standards and will not deliberately
flout them, even though they may still, being human, make mistakes in their
assessments. Unfortunately, these hopes are not always realized. One story of
an apparently intentional abandonment of ethical principles is told at www.dpdlaw.com/Kleinman.html. In
writing about this situation, I will refer to the psychologist as Dr. X, which
seems a bit fatuous because anyone who reads about this can identify her, but
somehow it seems appropriate to me.
Dr. X specialized in child custody evaluations in
divorce cases, so her job was to assess children and divorcing parents and to
make recommendations to the court about appropriate parenting plans, including
primary custody, visitation, and supporting procedures like psychotherapy. In
one case, when a divorcing mother thought that her former husband might have
sexually abused their toddler daughter, Dr. X conducted play therapy sessions
with the child and used them to put together a report to the court claiming
that the child’s play and statements indicated that the sexual molestation had
taken place. Dr. X refused to let the father speak to the child on the
telephone and told the child that the father did not want to talk to her. She
also told the father that he could speak to the child only if he admitted wrongdoing
and apologized to the child.
The father maintained that he had never molested the
child, and hired another psychologist, the well-respected Dr. David Martindale,
to review Dr. X’s report and the videotapes she had made of the play sessions.
Dr. Martindale concluded that the videotapes did not support Dr. X’s claims and
that she had reported to the court only statements that she had coached or
elicited from the child, and not the child’s actual uncoached comments. In
other words, there was no evidence that the father had been abusive in any way.
A second complainant against Dr. X came into the
picture by accidentally overhearing Dr. X’s name discussed with respect to the
situation just described. She filed her own complaint, which stated that when
she sought Dr. X’s help during a divorce, and when it was known that her former
husband had been treated for sexual addiction, Dr. X suggested that to accuse
the husband of molesting their infant would be an excellent ploy to make sure
she retained custody of the child. She also reported that Dr. X said that she
herself had done this during her divorce and had succeeded in terminating the
father’s parental rights.
Dr. X denied all these allegations, and has argued at
http://thetruthaboutdrkleinman.com
that she is the victim of a politically-motivated attack by father’s-rights
groups. Nevertheless, the court concluded that Dr. X “has engaged in gross and
repeated malpractice which damaged or endangered the welfare of [a child] and
threatened [the child’s] relationship with her father. [She] misused her
influence in a manner that exploited [the child’s] trust and dependency,
resulting in the creation of great distress and confusion for the child… [In
addition, she] created a situation whereby law enforcement would have been
unable to conduct a criminal investigation had such action been appropriate.
She isolated the child from all outside help had it been warranted.” Dr. X was
also concluded to have deliberately misled the court and misrepresented her
training, and in particular to have improperly acted as both therapist and
forensic psychologist. The court recommended the revocation of Dr. X’s
psychology license by her state’s board of professional licensing.
There are several points I would like to make about
this egregious situation, in addition to noting that videotaping of the therapy
sessions was the key to unraveling this set of twisted claims. One important
consideration is the extraordinary ease with which mental health practitioners
can state that if someone denies an action, this is proof positive that they
actually committed it. If it appears that they genuinely believe they did not
do it, the argument becomes all the stronger--
look, he’s even repressed it because it was so bad! Whether the accused
person confesses (perhaps untruthfully and in order to bring an ordeal to an
end) or denies guilt, it doesn’t matter; either outcome is interpreted as
indicating wrongdoing.
Because men are somewhat more likely to approach children
sexually than women are, it is not surprising that fathers are more often the
targets of this strategy than mothers . However, mothers too may be accused of
physical abuse. In one case I’ve recently been observing, the children are in
the custody of a stepmother who has placed them in an unconventional treatment.
The therapist is acting as an evaluator, and the mother has been told that she
cannot have contact with the children unless she admits to having abused them
physically and apologizes to them. Medical records exist that show no evidence
of the children having been abused while in their mother’s care, but part of
the unconventional therapy in use involves extracting from children statements
about their mistreatment by an adult. Although being accused of sexual abuse
carries much greater penalties in our society than accusations of physical
abuse, this mother has already been denied a professionally-related activity because
of her legal situation.
One more point here: as Dr. X’s case shows, it is
considered improper for psychologists to act both as evaluator and as
therapist, and this was one of several concerns that caused the court to
recommend license revocation. As far as I am able to tell, however, there are
no similar restrictions for social workers. The therapist and evaluator in the
case I described in the last paragraph is a social worker, so the mother
appears to have no way to demand correction of this situation. In cases where courts
accept recommendations from other types of mental health professionals, the
same problems may well exist.
Not only do psychology licensing boards need to take
special care about these child custody issues, but other mental health professions
need to set standards and demand that they be observed.
Dr. X is in trouble again for the same thing: http://newjersey.news12.com/multimedia/kiyc-unlicensed-psychologist-marsha-kleinman-1.9672042
ReplyDeleteI've noticed that she claims that she isn't really doing therapy in some contacts she has with patients. This is reminiscent of situations where practitioners say they are working as volunteers in some settings, so the usual rules don't apply. Nonetheless, I think they do apply.
ReplyDelete