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Child Psychology Blogs

Concerned About Unconventional Mental Health Interventions?

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

Monday, May 13, 2019

The Burden of Proof for Parental Alienation Claims (and Other Alternative Psychotherapies)

Most people know that in legal systems that derive from the British common law, an accused person is held to be innocent until proven guilty. The burden of proof is on the accuser and the prosecutor—the accused person should not have to prove that he or she is innocent of wrongdoing, and of course in many cases it would be impossible to prove that something does not exist or did not happen.

It’s less well known that the idea of the burden of proof also applies in scientific investigation. The assumption is always that an effect (like the outcome of a psychological treatment, for instance) does not exist, and anyone who claims that it does must provide strong evidence that it does. The burden of proof that “something happened” is on the people who claim that it did. Others do not have the job of proving that there is no effect of a treatment or other event, and once again, as with the legal system, it can be impossible to show that there is no effect.

Unfortunately, rather than accepting and working on the burden of proof that their treatments are safe and effective, proponents of alternative psychotherapies all too often rely on “proof by assertion”. They repeatedly state that their diagnoses are correct and meaningful, or that their treatment methods are effective, and rely on this repetition to convince not only people in general, but courts in particular. Proof by assertion does not yield evidence that a diagnosis is correct or that a treatment has good outcomes, but as the advertising industry knows, it can be hard to resist repeated claims, especially for anyone who has good reason to want to believe them. If those claims are obfuscated by reference to apparently scientific terms or methods, so much the more likely that they will be convincing.

Proponents of parental alienation (PA) concepts and methods have made rather a specialty of proof by assertion combined with obfuscation. Consider the diagnostic methods that are used, first of all. These range from “scales” created by Craig Childress for the rating of normal parent and child behavior to the use of various more or less standardized tests (some of these, like the MMPI, are quite standardized; others, like the Bricklin, much less so). Tests for any behavioral or emotional disorder must be reliable (that is, give about the same results every time), but they must also be valid. A valid test is one that tests what it is claimed to test, and there must be evidence that a test does this before it is used for decision-making. The whole point of a psychological test is that it should be able to determine quickly information that would otherwise be time-consuming and difficult to obtain. But unless such a test’s result is highly correlated with the information obtained in the more difficult way, the test cannot be considered valid.

To show that any test for PA is valid, it would be necessary to demonstrate that the test gave the same results as would be obtained by interviews and observations of a family in which a child was rejecting contact with a parent. By definition, PA is present when a child rejects contact with one parent, that rejected parent has not behaved abusively, AND the preferred parent has worked to create alienation by manipulating and exploiting the child’s thoughts and feelings. Thus, anyone who claims that a psychological test or set of tests validly diagnose PA would have the burden of proof of showing that the tests are highly correlated with information that includes the three factors just mentioned—including observational evidence that the preferred parent’s actions have created rejection that would not have occurred otherwise. It is certainly true that there could be cases in which all three of those factors are present, but we cannot assume that psychological tests are valid measures of PA until someone systematically demonstrates that this is the case. An adequate test of PA must be able to discriminate between child rejection of a parent with and without the intervention of the preferred parent, but none of the tests in use have been shown to do that. In reality, the tests used to claim PA are “validated” against the opinion  of one or more PA proponents rather than against empirical evidence—in other words, not validated at all.

PA treatments (including Family Bridges, etc.) have been claimed to be effective by their advocates, but as was the case with diagnosis, no one has accepted the burden of proof and done the work needed to demonstrate this. (Once again, this is the job of those claiming the effectiveness of a treatment; it is not the job of others to show that it is not effective.) Given the nature of the family situations and treatments, it is probably too much to ask that PA treatment advocates do randomized controlled studies, but it would be quite possible to do controlled clinical trials in which outcomes for children receiving PA treatment are compared to outcomes for children of similar characteristics who receive no treatment or some conventional form of psychotherapy. The burden of proof is not carried unless there is a well-defined, transparent standard of comparison presented. Published research on PA treatments so far has compared children’s attitudes and behavior before treatment to their own attitudes and behavior ; this is not adequate because there is rapid developmental change in adolescence and because even low-conflict families go through many changes following divorce, with or without psychological treatment.

When attorneys and family court judges meet arguments about PA diagnoses and treatments, they need to think about the right questions to ask and to realize that the burden of proof on these topics is on those making the claims, not on those who deny the claims.

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