Concerned About Unconventional Mental Health Interventions?

Concerned About Unconventional Mental Health Interventions?
Alternative Psychotherapies: Evaluating Unconventional Mental Health Treatments

Monday, March 30, 2015

Psychology License Revoked? Become a Parent Coach! (The Kali Miller Story)

Every state in the U.S. has a professional licensing board that can grant licenses to clinical psychologists, and can revoke or limit those licenses under certain circumstances. If you Google your own state’s licensing board, you will probably see that dozens of licensees have been disciplined during the last year. The online information given will state whether a license has been revoked, whether corrective action has been required (like further study of ethical issues), or whether supervision of the person’s work by another psychologist is needed. In most of the cases you’ll see, the problem has to do with personal relationships with clients, with financial or billing problems, with drug or alcohol use, or with criminal conduct.

 Only rarely are licensees disciplined because of harm done to clients as a result of incorrect diagnosis or choice of treatment, even when children or other vulnerable persons are in question. In this post, I will describe the events surrounding the revocation of a license in one such case, that of the Oregon child clinical psychologist Debra “Kali” Miller. I’ll also point out that, far from being impressed by the revocation, Miller is starting a new career as a parent coach—such people are not licensed, so she needn’t fear another loss. How do I know she’s not impressed? It’s that she is doing this coaching in association with Nancy Thomas, the self-styled foster parenting expert, and the very person whose methods led to the license revocation.

--  kindly forwarded to me by Linda Rosa) describes the investigation of Miller’s actions by the Oregon Board of Psychologist Examiners, including an Order of Emergency Suspension of her license in March, 2014, and a final order for revocation in September, 2014. Miller appealed these findings, which were recently (March, 2015) upheld by two administrative law judges.

What events culminated in the license revocation? Because psychotherapy for children is confidential and known only to the therapist, the parents, and the children (who are in no position to complain), only the occurrence of real harm to a child is likely to bring treatment methods to the attention of a professional licensing board. In Miller’s case, the precipitating event was the arrival of a twelve-year-old boy (“Client A”) at an Oregon hospital following an attempt to kill himself by strangulation. At the hospital, the boy disclosed that as a result of Miller’s recommendations for treatment, and her diagnosis of Reactive Attachment Disorder, he had received distressing treatment: “Client A reported that his father and step-mother required him to engage in routines that were causing distress, to include being directed to sit in his father’s lap for directed feeding of milk from a baby bottle while maintain eye contact with his father, to crawl on the floor for 20 minutes a day, to urinate into a jar in his room, to be confined to his room for extended time periods with his bedroom door set up with an alarm, and being directed to address his step mother using the term ‘Queen’ before her first name.” Client A’s father said that their therapist had told them to use certain treatments, “having Client A drink from a baby bottle while  being held in his lap, having Client A engage in physical exercises to include crawling on the floor and doing jumping jacks, and directing Client A to in a specified way for time out (‘strong sit’).” In addition, investigation revealed, Client A was examined and recommendations for his treatment were made by unlicensed persons, and he was supervised by unlicensed persons as “respite” for various periods of time.

Client A was diagnosed at the hospital as suffering from depression and was placed in foster care.
Readers of material about Attachment Therapy will recognize in Miller’s diagnosis and recommendations a strong resemblance to ideas and methods promulgated by Nancy Thomas; other material (www.advancedparenting4kids.com ) shows that Miller had been for many years a volunteer worker at Thomas’s “camps” that are intended to cause attachment between children and their adoptive parents. These methods are based on two beliefs, neither one supported by evidence. The first of these is the claim that emotional attachment is brought about by a cycle of recurring infant needs and their gratification by caregivers. The second belief is that a failed step in early development can be created by imitation or reenactment of the needed early experiences. In addition to accepting Thomas’s basic beliefs, Miller also was committed to the idea that Reactive Attachment Disorder, rather than being characterized by the symptoms described in DSM, was a matter of frighteningly violent and angry behaviors, shown initially in disobedience and lack of affection toward adult caregivers. These beliefs of Thomas’s are exactly what led to APA cancelling continuing professional education credits for a presentation by Thomas that had been scheduled to earn CEUs.

The Board of Psychologist Examiners found that Miller had violated a series of ethical standards that licensees must comply with:
  1. Immoral or unprofessional conduct or gross negligence in the practice of psychology
  2. Practicing outside the boundaries of her competence (“Licensee relies upon her own methodology and unreliable sources in assessing whether a child has a diagnosis of reactive attachment disorder and then recommends treatment that poses the risk of harm to the child”)
  3. Failing to use appropriate bases for scientific and professional judgment (“Licensee uses a methodology in diagnosing and treating reactive attachment disorder [RAD] that is not based upon established scientific and professional knowledge in the profession”)
  4. Failing to avoid harm (“Licensee … made specific recommendations… that focus on establishing parental power over the child through psychological aggression and physically challenging demands, which when implemented exposed the child to  the risk of harm”)
  5. Failing to use an appropriate basis for assessments (“Licensee diagnosed Client A with RAD without substantiating the diagnosis with clinical findings in the chart to support her conclusions and recommendations for treatment”)
  6. Failing to obtain informed consent to therapy (“Licensee failed to inform Client A’s father that her methodology in diagnosing RAD and her recommended forms of treatment do not conform to recognized diagnostic criteria or practice recommendations…”)
It was as a result of these violations of ethical standards that Miller’s license was revoked. I congratulate the Oregon Board of Psychologist Examiners for their meticulous work in this investigation and their courage in declaring Miller’s methods improper.

But is the small fact of a revoked license stopping Miller? Not really--  as we see at www.advancedparenting4kids.com/oregon-trainers/kali-miller/ . The license revocation is not mentioned. Instead, Miller is said on this Nancy Thomas-related website to have “transitioned from clinical practice and [to be] bringing her heart for healing to parent coaching and providing consultation for other therapists”—activities that remain under the professional radar and without the restrictions of licensure for meeting ethical standards”. We won’t be finished with regulating potentially harmful child therapies until licensure for coaches and others is required; even then, of course, quacks will find a way to cheat.

I plan in a few days to add to this discussion by a look at Miller’s parent-education material called “Taming Tiny Tigers”.


    

17 comments:

  1. Yes! Happens all the time! Unlicensed, self-proclaimed trauma mamas sell themselves as "parent coaches":

    Christine Moers - makes parenting videos with Daniel Hughes too!
    http://www.welcometomybrain.net/2015/01/25-february-coaching-sessions.html?m=1

    http://christineparentcoaching.com/?page_id=20

    Lindsay Crappo - she's presented at the Parenting in SPACE conference, despite the fact that she:
    (1) adopted 5 unrelated kids from Haiti simultaneously
    (2) disrupted one within mere months
    (3) shipped 2 more off to "ranches" for "kids" with supposed "attachment disorders"
    (4) had plenty of run-ins with CPS due to poorly supervising her kids who have abused their siblings sexually

    http://homeasoftplacetofall.blogspot.com/2012/04/parenting-in-space-2012.html

    Essie wrote / sold a parenting "hard places" book:

    http://theaccidentalmommy.blogspot.com/2014/09/parenting-pandora.html

    Last Mom also has zero qualifications and sells a "hard places" parenting book too:
    http://www.amazon.com/dp/B009W26DW6/ref=as_sl_pc_tf_lc?tag=lamo068-20&camp=14573&creative=327641&linkCode=as1&creativeASIN=B009W26DW6&adid=1VXDBTPM8CXE57QW1NPZ&&ref-refURL=http%3A%2F%2Flastmom.com%2Fcategory%2Ffamily%2Fparenting%2F

    Diana Estulin (no qualifications beyond having adopted 2 Ukrainian kids) ran a series of "hard places" parenting webinars, sold "dear teacher" letters/presentations for advising a kid's school about their child's "attachment disorders":

    http://www.fromsurvivaltoserenity.com/2012/09/about-my-webinar-sessions.html?m=1

    http://www.fromsurvivaltoserenity.com/2014/08/educating-about-rad.html?m=1

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    1. Suzanne,thanks so much for sending these. You obviously know a lot about this issue, and I wish I knew who you were. If you'd like to discuss further, please contact me: jean.mercer@stockton.edu. I am hoping to get APA interested in all this.

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    2. Here's a video of unqualified/unlicensed Lindsay Crappo leading a "hard places" parenting seminar:

      https://m.youtube.com/watch?feature=youtu.be&v=ZXQOHKGwff4

      Check out Lisa Qualls, who is unqualified yet also gets PAID to teach parenting classes / writing books about "hard places" kids.

      You may recall that she treated one if her adopted girls particularly poorly -- Dimples/Kalkaiden (not homeschooled, not allowed to go on family vacations, spent pretty much every weekend/after school at "respite" as a prelude to exiling the kid to a Ranch for Kids in Montana for 18+ months).

      Onethankfulmom.com

      Dimples/Kalkaiden was tragically killed in a car accident a few months back. Lisa survived and immediately solicited cash from strangers to buy a replacement car/cover funeral expenses.

      --

      I'm just appalled by the behavior of awful, awful adopters -- no more, no less. I really appreciate that you blog about SO much of the crap that parents really ought tone arrested for subjecting kids to!


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    3. Thanks for sending these bits. Very regrettably, it's not against any law to do these things to your children, and parents' rights groups are always waiting to support parents in whatever they choose to do.

      I am amazed at the lack of interest professional groups show in credentialing for "coaches" of various kinds. I've come across the idea that licensure would somehow give coaches credibility-- but surely they already have that among people who believe that personal experience is superior to any form of professional training. I would be very happy to see some minimum training required before the term "coach" was used-- but that would probably just mean that a new term like "adviser" or "trainer" would be invented.

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  2. Yes, the Oregon Board of Psychologist Examiners issued a self-congratulatory press release about this case, but they neglected to ask a real court for a real injunction to prevent Miller from practicing, and contented themselves with pulling her psychologist's license. The upshot is that she can still practice as before, with the only change being that she has to stop using the title "psychologist."

    This is not only pathetic and inadequate in itself, but it took the Oregon Board of Psychologists ELEVEN YEARS from the time of the first complaint against Miller to issuing their ineffective, pro-forma ruling.

    If someone is harmed by a psychologist, they need to cut out the middleman and sue the psychologist directly, and remember to ask the court for an injunction while they're at it.

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    1. Robert, your comments are only too well taken. In fact, the Oregon board simply did a far better job than most such boards do-- but they have no power to do anything except revoke the license.

      There is a very serious problem about punishing wrong treatment by bringing a suit against the practitioner: although an adult patient may do this, child patients cannot do it themselves, and they have usually been placed in an inappropriate treatment by parents who believe in the treatment and want it to continue. The "natural" protectors of the child, the parents or guardians, who would ordinarily be expected to defend against inappropriate treatment, are in these cases committed to the wrongdoing and are most unlikely to report it unless there is sufficient harm done to attract attention, in which case they may blame the practitioner. Even then, in Client A's case, the parents themselves had done so many of the harmful actions that they could hardly argue that what happened was all Miller's fault-- a reasonable person would have known that these were not appropriate ways to treat the child.

      By the way, the situation is even worse when employees of the state have been involved in the mistreatment. They can't be sued for their recommendations.

      Legal changes are needed-- but they will be fought tooth and nail by "parents' rights" advocates and by practitioners of alternative psychotherapies.

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  3. All of these "therapists" find the levers that work for taming of animals and humans. Of course there are short-term effect. People like animals have reflexes. People like animals have senses. But people are much more complex than animals. Sorry that I write platitudes. But if so many "physicians" see no difference between children and animals .... then have to explain to people why the long term, these methods will not work. The child will grow wiser and not forgive adopters. Children may forget and forgive "therapists" ... but they will not forgive parents (adoptive parents), because these methods are well thought-out, premeditated, daily humiliation. I even rule out hunger, cold and pain. It can endure and survive. But systematic humiliation ..... it's overkill.
    If filmmakers would have done a talented film (based on real events) on this subject ....... people to see and shuddered.

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    1. Actually, there is a young filmmaker who wants to do as you suggest. I hope this will work out.

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  4. I find it interesting that self-proclaimed trauma mamas whose kids have been home for years yet remain horrifically badly behaved tend to seek advice from other trauma mamas with equally horrendously behaved, non-improving-at-all kids.

    Why not seek advice from some a/mom or a/dad whose approach actually seems to be working?

    http://www.beyondthepicketfencedream.com/2014/07/the-no-consequences-confusion.html

    I loathe LOATHE loathe this business of putting words in a kid's mouth -- as trauma mama 'Alex Chase' does. It's patronizing and infantalizing. Even adopted kids with mental health issues are entitled to their own feelings... and may well say 'yes amommy' to whatever feeling amommy has decided they're feeling just to make the pointless, painful conversation stop. Also? Any kid bopping his siblings with a wiffle ball bat loses the privilege of playing wiffle ball until such as a time as he's demonstrated an ability to not physically assault people with a wiffle ball bat.


    The sit next to and snuggle amom/adad immediately following a misbehavior? Presumably works for a tactile, talky kid... not so much for a non-tactile, needs-some-space kid. (I was the latter, despite being neither adopted nor traumatized. Had my parents attempted to physically hold me in their lap and talk to me, I'd've shoved them, hard, to get to my room to have some quiet/peace/space. I'm convinced a good portion of the 'aggressive' behaviors trauma mamas claim to see in their akids are a direct result of the forced snuggling thing).


    http://homeasoftplacetofall.blogspot.com/2015/04/dear-church-do-you-want-to-know-why.html

    Lindsay Crappo's disrupted several of her kids and has constant CPS involvement due to failing to supervise her remaining kids, providing 'em with opportunities to sexualyl abuse each other yet again. This is an a/mom you want to seek out advice from, why, exactly? She's the poster girl for 'if you can't be good example, you'll just have to serve as a horrible warning'.

    http://the30dayjourneyforhope.blogspot.com/2015/04/reactive-attachment-disorder-discussion.html

    The ever-popular lament from an adoptive mom who doesn't get why her 'shipping your adopted kid off to an unlicensed facility with no on-site licensed healthcare professionals' does not seem to be helping her (seemingly legitimately) mentally ill girl. How many times can an amom keep doing the same thing over and over (Christian boarding school! No medical staff!), getting the same result (mentally ill kid who is not getting better or getting worse) and not decided to do something ANYTHING differently this time? How is it not abuse to FAIL TO TREAT YOUR KID's SEVERE ILLNESS for YEARS and YEARS!

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  5. No words:
    http://onemorelightofmine.blogspot.ca/2015/04/spring-cleaning.html?m=0

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    1. Very sensible-- if the child doesn't know what to do or how to do it, tell them "do it or else!". That should solve the problem.

      Why is it that these people who are convinced that the children are as immature as toddlers, don't use the same methods one would use with a toddler-- e.g., do it together, use picture reminders? Well, I know the answer: It's because Authority Must Be Respected, on pain of hellfire.

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    2. I have NEVER EVER met a 4 year old who is capable of making "good, appropriate decisions" consistently. It's developmentally impossible!

      Because they're FOUR.

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    3. I'm not so sure I know many adults who are consistent about that!

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  6. A whole documentary about "attachment disorders" and the Nancy Thomas approach to parenting:
    http://talesfromourhouse.blogspot.com/2015/04/my-name-is-faith.html

    Scary stuff

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    1. Thanks, I had forgotten this one-- must pass on to young filmmaker I mentioned.

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  7. How absolutely ludicrous, that you yourself who has never been licensed to see patients clinically, feel qualified to make such judgements and accusations. All theory, no practice means you have no creditibility whatsoever.

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    1. Of course most of the information in this post came from decisions by the Oregon professional licensing board, most of whom in this case are clinical psychologists. Do you also find them not "creditible"?

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