Concerned About Unconventional Mental Health Interventions?

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

Friday, March 24, 2017

Critical Thinking About Child Custody, Especially Parental Alienation Claims

I recently received a document relevant to decisions about a girl who prefers Parent A but has been sent to live with Parent B. She had been ordered to receive treatment for the “parental alienation” by Parent A  that is argued to be the reason for her preference for A over B. The girl, whom I will call Sophie, is 14; the parents have been apart and in high conflict since she was 11. Parent B has asked the court’s permission to move Sophie, along with Parent B and B’s romantic partner, to a neighboring state, where they are now living and where Sophie is attending school.

B has asked a proponent of a treatment for parental alienation  (let’s refer to him as Mr. P. Pat) to comment on Sophie’s present status and to support the argument that B, the partner, and Sophie should all remain together in the new state, and Parent A should be prohibited from all contact with Sophie. Mr. P. Pat argues that Sophie is doing much better now than she was at age 11, when the parental separation began. She is doing well at her school, studying music, and roller-skating This shows, Mr. P. Pat says, that Sophie has benefited greatly from 1. Separation from Parent A, and 2. Her experience of the Pat method of therapy for parental alienation effects. What’s more, Sophie’s improvement is evidence that the problem was indeed parental alienation. Mr. P. Pat also argues that Sophie must not have contact with Parent A because even the slightest contact will undo all the benefits she has received.

Let’s examine these arguments a bit (it won’t take much). Mr. P. Pat is taking advantage of the tendency most of us have to fall for the argument that post hoc  means propter hoc—that if one event follows another, the second one must be caused by the first. For example, if I eat a mango for the first time and I shortly develop a skin rash, post hoc reasoning suggests that the mango caused the rash—maybe I’m allergic, maybe it was contaminated by some agricultural chemical. But, of course, I could have a rash because I’ve contracted rubella, or because I’m allergic to something else I ate in the same meal with the mango, or because I put my arm on a table that had been polished with a furniture polish I’m sensitive to. All those things could have happened before the rash, but post hoc reasoning often chooses just one of the previous events and firmly assigns causation to the chosen possibility.

How does post hoc reasoning apply to Mr. P. Pat’s claims about Sophie? He states that she has received his treatment and that she is doing well (a claim made without any independent evaluation of Sophie, by the way) and that, therefore, the treatment must have caused her to do well (post hoc, ergo propter hoc). Let’s suppose, for the sake of argument, that Sophie is indeed doing well. What alternative hoc factors can we consider to be possible causes of Sophie’s status?

First, we need to think about maturational changes—changes in personality and behavior that normally accompany advances in chronological and developmental age, no matter what experiences the individual is having. The effect of maturation is one that is largely ignored by proponents of fringe beliefs about child development issues, and regrettably is also ignored by laws that classify humans from birth to age 18 as children, without further definition. Between age 11 and age 14, Sophie has passed through some important steps in development. Physically, this would have entailed puberty, with rapid physical growth and changes in appearance as well as reproductive maturation. Cognitively, Sophie would experience advances in executive function and in formal operational thinking, the capacity to think hypothetically and to separate variables from each other. Emotionally, she has moved through a phase of mercurial, “temperamental” responses, including unpredictable crying and anger, to a calmer responsiveness; she has also moved from a period of life in which family relationships are paramount to one in which peer relationships and school events take precedence emotionally. All of these make Sophie a different person than she was at age 11 and make her in many ways easier to deal with than she was a year or two ago.

Other changes have also taken place in Sophie’s life. One is that she and her parents and siblings have moved toward resolving their feelings about the parents’ divorce. To do this, Sophie had to disengage from the parents’ conflict and focus on her own life, a task that would be made much more difficult by insistence on the idea of parental alienation.

In Sophie’s case, her forced separation from Parent A has included separation from a sibling. She now lives alone with B and B’s romantic partner. This change has removed her from all the possible influences of her sibling for good or ill—the sibling may have encouraged or have discouraged Sophie from her positions about A and about B, may have provided comfort when Sophie was distressed about the family situation or may have acted to distress her further, and may or may not have provided a role model for a constructive response to both parents’ wishes.

Sophie has also moved away from a neighborhood and a school where most adults and many classmates were likely to have known about the parental conflict and to have weighed in on one side or the other. She is beginning high school and has much to get used to in a new school setting, distracting her from the family focus she probably had earlier.

This is enough of a laundry list to demonstrate my point that Sophie’s situation is post more than one hoc, yet Mr. P. Pat points to a single factor as the cause of any changes to be seen in Sophie. He has apparently failed to look for evidence for alternative rival hypotheses, either about the initial diagnosis of parental alienation or about the effects of the treatment.

An article by Dr. Madelyn Milchman discusses a better way to handle the task of understanding child or family problems in the context of child custody evaluations. (Milchman, M.S. (2015). The complementary roles of scientific and clinical thinking in child custody evaluations. Journal of Child Custody, 12, 97-128.) Dr. Milchman pointed out that scientific hypotheses are well-formulated only if they are falsifiable – only if it is possible for observable evidence to be used to reject the hypothesis. A hypothesis that appears to be supported by any possible observation is one that cannot be rejected and therefore is not useful for understanding events. In clinical work like child custody evaluation, practitioners are not doing scientific hypothesis testing in the usual sense, but they need to avoid their own biases and presumptions by testing their own preferred hypotheses and possible conclusions about a family. They do this by looking for consistency of evidence and pursuing issues of inconsistencies, and they also do it by formulating alternative hypotheses to see whether the evidence supports one or more alternatives better than it supports their preferred hypothesis.

Like scientists, clinicians cannot “prove” a hypothesis beyond the shadow of a doubt. The job is to try to disconfirm a hypothesis and to accept it only when the evidence does not disconfirm it.  For the clinician, this involves thinking about other causes that can explain evidence that is consistent with the preferred hypothesis. In Sophie’s case, the preferred hypothesis, that treatment has changed her behavior toward her parents, is weakened by the existence of a list of other factors that may have worked individually or together to alter her attitude. Clinicians also need to think about evidence that is inconsistent with a preferred hypothesis. In Sophie’s case, such evidence might be revealed by an assessment by a psychologist who has not been involved in her treatment (and ideally, one who is not committed to the idea of parental alienation). According to the documents I have seen, this possibility has been refused by Parent

9 comments:

  1. The other variable that is extremely important in how this child is doing based on my own research of the aftercare in "parental alienation" cases:

    1. Is the teen still under the threat if she is not perfect, her sibling and parent will go to jail?

    2. Is she under the threat she will be sent to a residential facility?

    3. How harmful is removing siblings from each other?

    4. If she is still being threatened, as soon as the threat is gone, will she run?

    And you hit the nail on the head. There is no evidence or valid literature, that any one single factor is the causation of why they claim "parental alienation".

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    1. One of my concerns here is that this sort of treatment drives teenagers to seek independence as soon as they "age out"-- they have learned to avoid contact with some adults who under other circumstances might have given them helpful guidance in their young adulthood -- by insisting on draconian measures, the "targeted " parent and any psychologists in the picture have removed themselves from any possibility of being helpful to the young person whose best interests are at stake.

      I wonder how proprietors of wilderness programs or residential treatment centers like the idea that their programs are used as threats!

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    2. I have a feeling they do not mind they are used for threats. I wonder how many times they are actually sent? That makes more money for the transport business who runs deep with the facilities.

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  2. Curious as to your thoughts on this:

    https://aeon.co/ideas/if-babies-were-randomly-allocated-to-families-would-racism-end

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    1. Sorry to take so long to answer this! I see the logic of his argument, except for the fact that babies and little children are so cute that adults tend to respond positively to them all. As they get older, and especially as they reach puberty, attitudes tend to change to reflect whatever biases a person has with respect to adults of a particular "race". That author is assuming that once you really know someone of another "race" you can no longer be prejudiced against that group, but it may not be that simple. Look at people who fall in love with and marry someone of another "race" or religion and then spend their marriage hassling the partner about how bad other people like him or her really are.

      I do appreciate the author's rejection of prenatal attachment, though.

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  3. the other sibling(s) sure does ruin the logic of alienation, I gotta say. It's one of these, isn't it - 95% of the time the one with the power to win the court case is the powerful, probably abusive one all around, and that it's the one whose parentage has traditionally been in question, the one with a penis?

    Call me a cynic, this all smells like men and their fundamentalism winning, like so much else these days.

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    1. You may well be right, but this is a claim the PA people have been rejecting for many years. Unfortunately they don't publish much in the way of data so we can't tell whether mothers and fathers are equally "targeted".

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    2. Sorry for such getting to this post so far afterwards. I would like to offer a counterpoint. I think it is fair to say that if there was an allegation of "parental alienation" with Sophie, then it must have stemmed from some clear lack of contact or significantly diminished contact between Sophie and Parent B. I cannot see or have heard of any other reason for Parental Alienation to be taken to court. If you have information to the contrary, I would be very interested in it. Assuming you have none, I think it is safe to assume then that there must be evidence of marginalized relationship with Parent B and evidence to suggest that Parent A is not truly part of the solution to repair that relationship, otherwise there is no case to begin with. In previous arguments, Dr. Mercer, I believe you have suggested that the targeted parent COULD be contributing to the alienation dynamic and therefore deserving alienation (something that alienating parents and opponents of PA have claimed many times over). In this case, if that is true, then wouldn't Sophie be expected to be doing terribly—because the parent was contributing to the problem? If there was another cause (for the diminished relationship) to consider, don’t you think BOTH parents would be working together towards a solution to repair ANY relationship between parent and child? I say this because, working to disconfirm the hypothesis of the therapy as being successful (because all the other changes--maturational, etc) does not mean ultimately that parental alienation isn’t the cause. It only possibly disconfirms the success of the therapy (and therefore PA) when you are looking ONLY AT SOPHIE's changes. If you are looking at the entirety of the family systems dynamic, it may very well account for everything, including Sophie’s changes. However, there is much information we don’t know about this case (because you did not include it) to really debate this topic thoroughly. Bottom line, there are few facts here to thoroughly discuss and conclude this topic of Mr P Pat’s reasoning as being post hoc. Unless you include details on on the entirety of the family’s dynamics, then I think it is pointless to try and refute Mr. P Pat claims regarding the success of the therapy for Sophie.

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    3. Of course it COULD happen. I would not deny that possibility, no matter how remote it might be-- such things happen even in intact marriages.

      But the burden of proof about the treatment (a different issue than whether PA can happen) is on Mr. P. Pat, not on me.

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