Concerned About Unconventional Mental Health Interventions?

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

Sunday, September 20, 2015

More on Craig Childress: A Reader Comment and Responses

For reasons unknown to me, this reader comment disappeared from my blogspot page twice when I tried to post it. Because it is a thoughtful and civil statement, I am posting it here--  but since I must still query Childress’ claims, I will follow it with some further comments of my own. Here is the reader’s comment:

“Dear Ms Mercer, I am a parent whose children are living through the profound trauma and dysfunction of parental alienation. I have read quite widely on the subject during the year since our nightmare began. Having encountered Childress' work in the last couple of months, my judgement is that, while it does not provide an answer to every question one can ask, it has taken the theoretical understanding and conceptualisation of parental alienation forwards in huge strides. I think that his work might be looked back on in years to come as ‘game-changing’.

His blog posts are indeed, on occasion, somewhat abrasive towards others in the field of mental health. However, aside from the fact that given the persistent failure of mental health to respond at all effectively to this desperate problem his blunt criticisms might well be considered justified, I suspect that he is deliberately seeking to provoke in order to stimulate debate, raise awareness, project his work into the mainstream discourse - all of which will lead to more work by others on this subject.

I wonder if your slightly snarky initial response to his work might at least in part a reaction to his manner, and that your response to his style might be colouring your response to his substance. As an informed lay person who has read every document on his website, part of his book ‘Foundations’, and viewed every Youtube video he has posted, I can only say that I have found his work to be illuminating, clearly articulated, persuasive and coherent.

The experience of rejected parents has been described as a ‘living bereavement’ and this resonates deeply for me. Work exploring the experience of adult ‘survivors’ of childhood parental alienation (e.g. by Amy Baker), attests to the serious, lifelong effects of parental alienation on child victims. Yet, your post is not imbued with any apparent empathy for the heart-breaking plight of children and parents whose loving relationships are utterly destroyed by parental alienation. That would be welcome in any further blog posts you might publish on the subject.

I note Childress responded to your post on his blog and invited further discussion. I do hope you take up this offer.

Thank you.

P.S. Childress works at the University of Phoenix. He was invited to present lectures by California Southern University. 

It is certainly true that Childress’ Facebook remarks set my teeth on edge. Professional discourse does not usually include statements about the ignorance of those who disagree with one. In addition, I am concerned about the proliferation of references to “attachment” and “trauma” as if these factors can be worked into explanations of every human outcome. As a developmental psychologist, I am very much aware of the potential confounding of variables that can lead to wrong answers to apparently simple questions. As a student of and author on attachment issues, I am also aware of the possibility that claims about attachment may just reflect the fact that “good things go together” in development.

The commenter rather gently chides me for an apparent lack of empathy for families embroiled in the rejection of one parent by one or more children. I am sorry to have given this impression, as I am sure I would have gone through hell and high water to keep in contact with my children if they had been separated from me.

But, strange as it may seem to some readers, it is my real concern for children that has led me to query statements by various mental health practitioners about the effectiveness of treatments they offer. In a series of articles in the journal Research on Social Work Practice, I recently evaluated the plausibility of and empirical evidence for several psychotherapies for children. In my 2014 book, Alternative psychotherapies (Rowman & Littlefield), I did the same for a variety of mental health and educational interventions that make strong claims without real justification.

Some of the treatments I have evaluated are potentially directly harmful and have already injured and killed a small number of children (I am far from suggesting that this is an issue for Childress’ methods, please note!). Others are indirectly harmful, in that they take time and family resources without having a positive effect, and in that they may interfere with the seeking of more effective treatments.

I believe that this work, although not experienced as warm or supportive by families in trouble, can in fact be very beneficial to them by pointing out possible realities of offered interventions that may be presented in an attractive way but that are not likely to be of genuine help. Most psychologists are uneasy about asking pointed questions about practitioners’ theories and methods. I am not--  I was broken in on this by my investigation of the death of Candace Newmaker at the hands of “attachment therapists” (see Mercer, Sarner, & Rosa, Attachment therapy on trial. Praeger, 2003).

I hope that the author of the comment quoted above will see my position here. I have been commenting on Childress’ blog, where I am asking him to fill me in on a couple of points: What would be the earliest age at which he would think the issues he addresses would emerge? What is the age of the youngest child he has treated? How does he ascertain whether a rejecting child actually has been abused or frightened by the rejected parent? In what proportion of cases, in his experience, has a case brought to him as a matter of parental alienation actually turned out to turn on abusive behavior? These seem to me to be simple but important questions, and I am hoping for some simple answers.


20 comments:

  1. "I am sure I would have gone through hell and high water to keep in contact with my children if they had been separated from me."

    You're getting warmer.

    "[Other treatments I have evaluated] are indirectly harmful, in that they take time and family resources without having a positive effect, and in that they may interfere with the seeking of more effective treatments."

    O_O

    I'm sorry, were you talking about the family court system here?

    "I believe that this work ... can in fact be very beneficial to [families] by pointing out possible realities of offered interventions that may be presented in an attractive way but that are not likely to be of genuine help."

    I think that's kind of a given. Our common ground is wanting to protect children.

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    1. No, I was not talking about the family court system, wrong-headed as that sometimes is. I was talking about practitioners who claim that they have effective treatments when they cannot produce good evidence that they do. These people may compound the problem by offering advice that is swallowed by the courts.

      As for the common ground of wanting to protect children, I am not too sure about that. It seems to me that PA was originally put forward as a technique for satisfying the wishes of rejected parents. More recently, it has been claimed that children who have been encouraged to reject a parent are troubled when they reach adulthood and therefore PA should be categorized as child abuse, leading to the conclusion that when the preferred parent is thought to be causing the rejection, the child should be separated from that parent.

      The research that led to this claim, by Amy Baker, is very weak indeed. I am far from convinced that encouragement of rejection is abusive (not that it is admirable!) and I would point out that living with a parent with a personality disorder could well result in a "double whammy" (genetic and experiential) for a child, whether there was PA or not. I would also suggest that because of the emotional burden placed on the child (see Linden, 2013), "protective separation" may itself be construed as abusive.

      But the fact is, more information from empirical studies is much needed before we can speak of what is good or bad for a child in a particular situation. This is what needs to be conveyed to family courts-- but the adversarial demands of these conflicts make it most unlikely that such thinking will occur.

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  2. Thank you for this post. It is very important that professionals in mental health, child development, social work raise awareness about the potential harm of coercive treatments against "parental alienation".

    Dr. Childress propose a "treatment plan" called "ABA model" where the child is completely separated from the bonded parent for at least 3 months (that can be prolonged at will). According to the ABA model, the children can earn the privilege to talk to the bonded parent during 2 hours if, for ten weeks in a row (i.e. earliest after 2,5 months) they scored 4 or more in "pleasantness" "communication" (with rejected parent) and "obedience" on a scale of 1 to 7 in at least 6 days a week. If, two days in a week, the child is off for two days on one scale, the count is set to zero, the child will have no contact to bonded parent for further 10 weeks (even if it occurred after 9 weeks of "satisfactory" behavior.

    The rejected parent alone grades the child, the child has no recourse instance. The grading does not have to take into account factors like parenting skills of the rejected parent, etc. The child is at the complete mercy of the rejected parent. Craig Childress thinks this is important for the rejected parent to regain parental authority and respect of the child.

    Dr. Childress endorsed Dorcy Pruter who has no qualification whatsoever in psychology, psychiatry, social work. pedagogy or child development and who proposes a program called "the high road to reunification".

    Dorcy Pruter purports to be herself a victim of "parental alienation". According to her accounts, her father was an alcoholic and perpetrator of domestic violence. Her mother kept her from her father and this is interpreted now by Dorcy Pruter as "Parental alienation".

    I have been following the Tsimhoni case that came to public attention in June 2015. Three children aged 9, 10 and 13 consistently refused to talk to their father for 5 years. The judge threatened the children that if they refused to have a healthy relationship with their father, they would spend the rest of their childhoods in "jail" and she proceeded to condemn them to a juvenile detention facile for civil contempt of court. The children were kept in a group home (without contact to their mother or anyone "from her side") for more than two weeks, they were than sent to a vacation camp (where the mother was allowed to visit once for about 2 hours and once she had to take them to a doctor), then to reunification therapy with Dorcy Pruter (and their father).

    In september, the judge (Lisa Gorcyca) then proceeded to pronounce a "protective separation" from the mother in an ex-parte hearing (without mother or her counsel present or invited). The protective separation was to go for 90 days counting from august 17 or as long as deemed appropriate. i.e. the children could be threatened that they would not see their mother unless they agreed to speak to their father.

    The "high road to reunification" program does not seem to have been successful, so now the father wants to place one child in a wilderness camp, one in foster care and one with himself.

    children had very good grades before the intervention started (as long as they were with their mother), grades have deteriorated in the "therapeutic" setup.

    This is a very good example of the dangers of the Childress model and other coercive "treatment" of "parental alienation".

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    1. Dear Ora-- thanks so much for all these comments. I hope I have managed to post them in something like the right order. I want to let you know that I plan to forward what you have said about this case to the investigative journalist Kathryn Joyce, who is thinking about doing a piece on PA.

      In another comment, you stated that I should not ask the PA proponents to show an evidence basis for their claims, because the approach is a violation of children's rights to begin with. I agree with you on this last part, but I am afraid that in the courtroom there would simply be a stand-off between those who claim that children must have both parents and those who take a more nuanced approach, and that stand-off would parallel the conflict between children's and parents' rights. (Philip Montague's 2000 paper "The myth of parental rights" is a helpful contribution to that discussion.)

      Rather than asking for a courtroom circus involving everybody's rights, I'd prefer to put the argument on evidentiary grounds, which of course do not support the PA methods or assumptions.

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    2. https://www.dropbox.com/sh/4jy2q37q3axx62a/AAASuO68l7LZn2GoLR705-lPa?dl=0

      Here is the dropbox containing documents regarding this case.

      I recommend the GAL's summary written in nov. 2014 which sums up the visitation situation

      https://www.dropbox.com/sh/4jy2q37q3axx62a/AADXzw7VALrNRolH2bfmMtyva/2014/2014-11-03/20141103_OTHER_GAL'S_REPRT-REC_TO_COURT_FLD_063428249.pdf?dl=0

      https://www.dropbox.com/sh/4jy2q37q3axx62a/AADe22DrYhaF-6Rf2EQz6i8Za/2015/2015-06-24?dl=0

      and the record of the court session where the children were condemned to juvenile detention until majority of age. (I keep asking myself a lot of questions as to the legality of this condemnation). It made quite a splash in early july 2015, so if you google "tsimhoni", you will find quite a lot of articles that were published back then in the international press...

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    3. Ora, thanks again-- would you mind contacting me at jean.mercer@stockton.edu? Kathryn Joyce is interested in being in touch with you, if you are willing.

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    4. http://drcachildress.org/asp/admin/getFile.asp?RID=100&TID=6&FN=pdf

      and here is the link to craig Childress' single case ABA design.

      You do not need to read his book "foundations". I think that this document is enough to prove that he operates outside the realm of professional ethics.

      What I deem particularly interesting in the Tsimhoni case: now that it turned out that the "PA-treatment" failed, they try to back it up with more coercion. i.e. there is no end to what they are ready to do to coerce those children. so, per definition, this program will always be successful, since it goes on until the child's resistance is broken.

      By the way: Warshak and his Bridges program rejected the Tsimhoni case (they were supposed to go to Bridges in May 2015, dates were set, court ordered, but then it turned out that Bridges "could not accommodate them".) (reason was not named).

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    5. PS: I spent a lot of time reading your blog and I enjoy your analytic intelligence and appreciate your warnings against popular myths, unqualified interventions and pseudo-science that can be very detrimental in education, particularly of very vulnerable children.

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    6. I've read the single case paper, etc., and totally agree with you. It may interest you that even the serious PA gang is most uncertain about Childress' acceptability.

      Once again, do please contact me at jean.mercer@stockton.edu so I can put you in touch with Kathryn Joyce.

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    7. Thanks so much for the kind words!

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  3. http://drcachildress.org/asp/admin/getFile.asp?RID=1&TID=3&FN=pdf

    Look, here is the piece I was referring to, where Craig Childress criticisms behaviorism, and I think he gets it right. I can't understand how the same person can, at the same time, advocate an intervention according to his ABA design...

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    1. I was puzzled by what you mention, but I think this is simply a misunderstanding. ABA does mean applied behavior analysis, a behavioristic method, of course. But ABA or ABAB can also mean a research design in which a child (or other participant) is given treatment A (or no treatment, to get a baseline measure) for a period of time and the targeted behavior is assessed; then treatment B is given; then back to treatment A and perhaps treatment B again. The assessments are compared to see whether the behavior of interest occurs at different rates in the A or in the B condition. A is repeated so it can be seen whether a behavior that was reduced in condition B returns to baseline levels or not after B is removed. This is a common design for studying single cases, but of course the strength of conclusions depends on how carefully it was carried out.

      Does that answer your question?

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    2. Thank you for your explanation concerning the ABA method.

      What I meant was: Childress writes in his criticism of behaviorism that it breaks his heart when the mother giving a time-out should walk out of the room, while the child is trying to hang on to her, since this signifies rejected for the child. Very well. The same person recommends that children (of any age) should be separated for three months and more from the parent they are bonded to. How does this fit?

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    3. Bizarre, I agree-- especially since children are usually convinced that a parent could help them if he or she wanted to, and therefore presumably feel rejected even when that parent has not made the decision to separate from them.

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  4. Even worse: the courts force the custodial parent to enforce visiting "rights" of the other parent. So the courts think that the attached parent should (physically) force a child into a car (or out of a car) to meet the rejected parent. This also happened in cases where the rejected parent was abusive (but somehow the court was not convinced or thought that visitation should take place anyway).

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    1. You do have to wonder whether judges really think through what it means to make a child go for a visit when he or she truly does not want to go. Given that there are some situations where visiting would be a good idea but the child resists (for whatever reason), some period of supervised visitation in a public setting would seem to be a good way to ascertain the nature of the child's resistance and the advisability of pushing the point; just ordering that the child visit is not the only option. However, this approach would only be very helpful if the supervising, observing person had some idea of what to look at and how to record what was happening. In my limited experience, people who supervise visitation don't usually have these abilities.

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    2. I think you are at the core of the problem here: the courts often mean well, but they are not equipped. So they value the rejected parent's "visiting right" higher than the child's civil rights or psychological situation.

      Therefore, I think it would be useful to establish a charter of children's inalienable civil rights that have to be respected in this context, because the child clearly is the weakest link in the setup.

      i.e. it should be said clearly that it is not allowed to drag, shove, push, extort children against their will so that they will comply with visitation schedules.

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    3. I am not sure that even the U.N. Convention on Children's Rights covers this, and of course the U.S. is not a signatory to the convention anyway.

      In a 2000 article, Philip Montague argued strongly against the concept of parents' rights, but his reasoning seems to have been ignored for the most part.

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  5. Update on Dorcy Pruter.

    She is involved in litigation in federal court in Wyoming. Her sworn testimony indicates that Randy Rand is involved in her unlicensed "coaching, a psychologist who is unlicensed in the State of California and was disciplined by the Board for "discipline him for unprofessional conduct, gross negligence, violation of laws governing the practice of psychology, and dishonest."

    Dorcy Pruter is not licensed and governed by no Code of Ethics. In her sworn testimony in Wyoming litigation she discusses attempting to obtain "life story rights" as a form of payment.

    As a person without board certifications, there is nothing to stop Dorcy Pruter from selling her experience. These unlicensed 'disciples' of Childress and Randy Rand are a serious danger to families.

    There is some indication that Randy Rand, a person who is no longer licensed, is a driving force behind Dorcy Pruter.

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    1. Whoa! So much for confidentiality, when "life story rights" are a factor.

      Have you got some sources you can pass on to me? I'll try to look up some of this as well.

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