Different Hats Worn by Psychologists

Different Hats Worn by Clinical Psychologists:

In Relation to Family Courts

Jan D. Hembree Ph.D.

Clinical psychologists differentiate between several practices of clinical psychology which interface with the practice of law. At the outset of providing services, clinical psychologists have to decide which role is the appropriate one to perform with any given client. The relevant roles are: 1) therapist, 1a) child or adult therapist, 1b) marital therapist, 1c) family therapist, 2) psychological evaluator, 2a) child custody evaluator, 2b) parental capacity evaluator, 3a) parenting coordinator or 3b) parenting consultant.

It is important to understand the differences in these roles because the presumption is that a clinical psychologist cannot don more than one hat for any given client. Thus, once they have selected which role to perform for a given client, they should not act in a second capacity for the same client. This avoids conflict of interest perceptions. For this reason, it is imperative that the clinical psychologist establish which role he is to play at the beginning of a case and to make sure that his client and the client's attorney are aware of the chosen professional role and the associated role expectations for each of these roles.

The following is a short description of these differing roles and the role expectations. Note - that once child abuse or neglect is suspected, then the psychologist is duty-bound by law to report his suspicions to the proper authorities regardless of the role chosen. Two, if the psychologist perceives that any of the clients are a danger to themselves or others, then the psychologist will consider breaching confidentiality for the sake of protecting the threatened person.

1) THERAPIST

For the sake of this article, when the clinical psychologist practices "psychotherapy," he practices what is typically known about psychotherapy, i.e., the patient sits in the therapist's office to talk over his problems with the express goal of ameliorating them. Descriptions of these problems are covered in a diagnostic manual, currently called the DSM IV-TR. The therapist is expected to make a judgment about the diagnosis or psychological (emotional) problem. Treatment protocols for these diagnostic problems are the substance of training and continuing education and are not necessary for this article. The patient could be an adult, a child, a couple, a family, or a combination (only one person is designated as the "identified patient" for insurance purposes). The therapist is expected to keep a medical record on the patient per HIPPA regulations, and to maintain confidentiality of the patient's attendance and contents of the discussions per practice guidelines and by law. Except pursuant to a court order, only the patient can waive their rights to confidentiality of this information. The therapist is expected to be a trusted confident whose goal is to put the patient's best interests in the forefront.

2) PSYCHOLOGICAL EVALUATOR

A clinical psychologist is trained in the practice of psychological testing where objective measurements are used to make unbiased judgments about the nature of the patient's possible problems. The psychological examiner either reviews with the client the results of the testing and/or he sends a written report to the appropriate solicitor. In this circumstance, there is no treatment offered by the evaluator, only a fitting diagnosis.

A "custody evaluation" is an extensive evaluation with specified guidelines for the purpose of aiding the courts in making a determination about a custody dispute. "Parenting evaluations" are requests for a more restricted diagnostic evaluation of each parent regarding their competency to parent. An evaluator could also test a child to see if there is a diagnostic or mental health problem.

3) PARENTING COORDINATOR

A judge can order a set of parents to see a psychologist as the Parenting Coordinator (authority is given to the psychologist to arbitrate conflict) or as a Parenting Consultant (no authority is given). The role of Parenting Coordinator is being used by judicial systems across the nation and different states have used different titles depending on the state legislation that governs the practice. This role has been labeled variously as "coparenting consultant," "coparenting therapist," "family therapist," "Master Specialist" (Arizona), "coparenting advisor," "therapeutic gatekeeper," "coparenting arbitrator," "coparenting mediator," or "decision maker." The label seems to vary with the knowledge or understanding of the judge and the attorneys in domestic courts, and varies according to the state in which it is utilized. The term "parenting coordinator" seems to be the best (used in Maryland, D.C., and North Carolina).

Limited Authority: Judges appoint Parenting Coordinators to act as an extension of their judicial authority. That is, the parenting coordinator is supposed to make decisions as an arbitrator when there is a conflict between the parents. This decision making authority is meant to reduce the frequency and number of reappearances in court (see Parenting Coordination and Court Relitigation: A Case Study, by Henry, Fieldstone, & Bohac, included in the handouts) rather than have the parents return to court to have the judge settle their dispute. These decisions by the PC are to follow current court orders and are not meant to supersede the court orders already established. Since not all details can be predetermined in a court order, the arbitrator is required to settle conflict between parents regarding issues related to the health, welfare, and educational needs of the children, but not custody. Some judges expect that the coparenting coordinator will follow the court orders just as they are written, and some judges expect the parenting coordinator to make decisions which may or may not be covered in the court orders. The intent is to aide the parents in making good decisions about their children and to also keep the parties out of court since using the court system inappropriately is frequently the way high conflict parents manage to settle their disputes. The intent of the parenting coordinator is to educate and advise the parents about good parenting practices, however most of these families really need someone to settle an immediate dispute, such as whether a pick up time is 4:00 or 4:30. Authority to make decisions regarding the children will be described and proscribed by the judge's court orders, and the psychologist will take these court orders at face value. The psychologist needs to decide what steps to take should the parents refuse or obfuscate the direct orders of the parenting coordinator and to have this agreed upon by the respective attorneys before the professional service begins. Preferably, this would all be in writing and signed off by the parents and the attorneys at the outset of the case.

Immunity: It is important to the psychologist to have the parents court-ordered to attend parenting sessions because maybe the psychologist will be better protected against civil suits. In high conflict cases, there is a greater chance of a civil suit or a complaint to the regulatory board by one of the parents. The court order helps protect the psychologist from claims of breach of confidentiality. It does not protect the psychologist from claims of incompetence.

4) PARENTING CONSULTANT

In lieu of a statute defining Parenting Coordinator, one could use the title of "Parenting Consultant." (I use this label to explain what I do when parents are court ordered to see me.) Hopefully by using this title, there is a distinction from the role of a psychotherapist. This role takes specialized skill because if the situation is such that the parents are not able to communicate, then they will have difficulty parenting their children well enough to minimize the detrimental effects of divorce. (My background as a therapist for both adults and children helps in my determination about child issues.)

The court-ordered parenting consultant meets with the parents and children as frequently as necessary to help the parents with achieving effective parenting skills. He may look and sound like a psychotherapist, but he is not a psychotherapist in this role; he may look and sound like a family mediator, but he is not that either. The difference is that the parenting consultant is not an advocate for either of the individual parents plus he is working with the judicial system towards the goal of helping the children. Parents should be well informed of this.

If the court orders parents into coparenting consultation, then the psychologist would report to the courts information such as the dates of attendance, content of sessions, and the degree of the parents' cooperation in the process. If the parenting consultant has also met with the children, he could also discuss the children's behavior and their needs and could report that to the court as well. What the parenting consultant cannot do is make a diagnosis about either parent or any child and he cannot render an opinion about custody. If the court wants either of these two answers, then the parenting consultant must refer the parents to another psychologist who can do an objective unbiased psychological evaluation. The parenting consultant also cannot render treatment services. If he thinks treatment is appropriate for any of the family members, then he would make a referral to an appropriate treating mental health care provider.

(I employ the following guidelines when I have a court-ordered coparenting case) --

Set of Operational Principles

1. Talk with both parents by phone before meeting with them

2. Require copy of the court order to see exact language

3. Talk with each attorney & the GAL to gain their perspective of expectations

4. Make decision about suitability of case

5. Take position of neutrality and make clear to all parties that the psychologist -

a. does not advocate for either parent

b. does advocate for best interest of child

6. Presumption of no confidentiality

7. Practice of confidentiality

a. Try not to tell one parent what the other parent has said to the psychologist

b. Try not to tell one attorney what the other attorney has said to the psychologist

8. Try to meet with both attorneys in the beginning of the case at the same time to discuss history, gain information about legal problems, explain procedures

9. Try to meet with both parents and children as soon as possible

a. May have to meet with each parent individually if they are not yet able to meet together

b. Meet the children with each parent separately at first

10. Review with parents procedures regarding

a. Confidentiality practices

b. Fees

c. Meetings

d. Reports to attorneys or courts

e. How this will work

f. What happens if it doesn't work

g. Meet with parents and any others to gain information about history of case

h. Write up contract with these details to have parents to sign at second session which will help clarify purpose and procedures

References

Association of Family and Conciliation Courts Task Force on Parenting Coordination (2006). Guidelines for parenting coordination. Family Court Review, 44, 162-181.

Henry, Fieldstone, & Bohac, 2009. Parenting Coordination and Court Relitigation: A Case Study. Family Court Review, Vol. 47, No. 4, October.

Jan D. Hembree, Ph.D., M.A.T., M.S. Clinical Psychopharmacology

2940 North Lynnhaven Rd, Suite 110, Virginia Beach, VA 23452

Cell Phone & Confidential Voice Mail (757) 409-0800

Fax (757) 498-1048

Email: hembreephd@aol.com