Alternative psychotherapies (APs) are psychological
treatments that are unconventional, are without any systematic empirical
evidence about their safety and effectiveness, and in many cases are
implausible in terms of psychological theory or established facts about child
development. Some APs for children are directly harmful, and in the absence of
evidence of their effectiveness we can consider all these treatments to be at
least indirectly harmful-- for example,
to use up families’ resources that would be better spent in other ways.
One possible harm done by APs for children is the
infliction of discomfort either physical or emotional, sometimes with real pain
and sometimes with the infliction of serious fear. Holding Therapy/Attachment
Therapy, sometimes targeting adopted children and aiming at child obedience,
gratitude, and the appearance of love for adopted parents, clearly involves
both physical and mental discomfort caused by therapists. Nancy Thomas
parenting (NTP), although it is not presented as a therapy by its advocates, is
intended to bring about attitude and behavior changes like those that are goals
of psychotherapy, and it too includes unpleasant, painful, and frightening experiences
like being required to sit without moving for periods of time and having food
limited in quantity and variety. Conversion therapy, a form of AP argued by its
proponents to change same-sex orientation to heterosexuality, sometimes shares
characteristics of holding therapy, and according to those who have experienced
it, involves intense and disturbing efforts to change the nature of the treated
person, in part through threats of eternal damnation.
Treatments for “parental alienation”, like Family Bridges
and High Roads, are APs, as they lack empirical evidence of safety and
effectiveness and are implausible as well as being unconventional. Like the
other APs just mentioned, they depend on threats and fear to bring about
certain changes in behavior. Children and adolescents given these treatments
have reported not only distressing experiences during treatment, but also
terror and discomfort when taken from their homes or schools or even from a
courtroom by youth transport service workers who sometimes use handcuffs to
restrain their charges.
How do proponents of APs justify the discomfort and
fear experienced by children and adolescents receiving treatment—especially
given that these methods are without evidence of effectiveness? An argument
given by practitioners of Holding Therapy for many years has been that the
treatment was analogous to chemotherapy for a child with cancer. Of course
chemotherapy is painful, frightening, and distressing, but without it your
child will die. The parallel suggested by these practitioners is that Holding
Therapy is painful, frightening, and distressing, but without it your child
will… perhaps not die, but become a serial killer (if male) or a prostitute (if
female; these fates are apparently considered comparable), or will kill you, or
will go to prison for some or all of the above. This, of course, is thorough
abuse of an analogy, because although many children with untreated cancer do
die, and although chemotherapy has been demonstrated to prevent many of those
possible deaths, the same does not hold for Holding Therapy for treatment of
childhood mental illness, antisocial behavior, or dissatisfaction of adoptive
parents. First, although many serial killers have been shown to have had
disturbed childhoods, it has not been shown that that childhood behavioral
disturbances in general are of necessity followed by serial killing in later
life. Second, it has certainly not been shown that children who receive Holding
Therapy or other APs become less likely to have serious problems later—in fact,
one might well predict that such children become even more likely to have
emotional disturbances because of the resemblance of some AP techniques to
other adverse childhood experiences.
Discussion of “parental alienation” treatments is
beginning to focus on the distress and discomfort experienced by children and
adolescents who undergo them. Advocates of these treatments argue that the
untreated outcomes would be so bad that the discomfort is completely worth the
benefits achieved. They claim, on the basis of very little evidence, that
mental illness will result if a child is alienated from a parent and has no
contact with that person. They argue also, without evidence, that children and
adolescents who avoid one parent already have cognitive problems and disordered
critical thinking.
I have yet to see practitioners of “parental
alienation” treatments bring up the very faulty chemotherapy analogy as
advocates of other APs have done, but no doubt someone will bring it up soon.
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