Saturday, July 23, 2011

Q & A: Locating Competent Therapists

This is a question asked of me in a radio interview with the Parental Alienation Awareness Organization:

"Is there a state by state list of therapists that targeted parents can get at?  I know Amy Baker has a list on her site but I know for a fact the therapists were drawn out of a hat because my therapist is a recommendation and she knows nothing about PA other than what she's learned from my case.  After 11 years in the court system I have yet to find that therapist in my area.

I am struck that this process continues in your life after 11 years.  In my view, therapy of parent-child relationship issues that do not involve neuro-developmental problems of the child (such as autism spectrum or ADHD issues) should be successfully resolved in no more than two years.  That 11 years have passed and you are still seeking effective therapy suggests a series of inadequate treatment plans earlier in the process. 

I am aware that parental alienation processes continue across decades with very little change, or even with growing deterioration in the issues, and in my view this reflects a failure of our current mental health and legal systems relative to the effective treatment of the issues.  You should not be continuing to look for a therapist after 11 years, because the issue should have been successfully resolved after no more than two years of appropriate therapy.

Unfortunately, I’m not aware of such a list of competent therapists, and I fully appreciate that appropriate therapy is typically not currently available for treatment of the alienation process. 

My background is not in parental alienation but in the treatment of “normal-range” clinical parent-child problems and I was brought into the parental alienation arena only after entering private practice and encountering the tragedy of the alienation process with a series of clients.  I was so struck by both the family tragedy and the immense wrong done to the child, and also by the nearly complete failure of the mental health and legal systems to stop the destructiveness of the process, that I was motivated to take up the issue from my background in the neuro-development of the brain in childhood and from my background as a graduate-level professor of child psychotherapy and mental health diagnosis and psychopathology.

From my perspective as a child and family psychotherapist, I believe the training of child and family therapists is inadequate to address the needs of the alienation community.  There are simply not the appropriately knowledgeable and trained therapists available to treat children who are victimized by the alienation process. 

In my view, in order to solve this problem of trained and competent therapists, we need to first move beyond the controversy of whether parental alienation exists, and instead move into a professional acknowledgement and recognition of the existence of parental alienation processes.  That has been the focus of my recent efforts, as I strive to define the parental alienation process within existing and accepted treatment and diagnostic frameworks, so that we can hopefully move beyond a discussion of whether it exists into a professional discussion of how do we diagnose and treat the alienation process.

The other element that needs to change, in my view, is that we need to hold mental health professionals accountable to a standard of professional practice that expects that they will be professionally competent in assessing and treating parental alienation processes.  The DSM-IV diagnosis of a Shared Psychotic Disorder exists as a bona fide psychiatric diagnosis and it is entirely appropriate for many of the cases of alienation that are out there.  Accurate mental health diagnoses should not be considered a stroke of good fortune, it should be an expectation of competent professional practice. 

One option for ensuring that all child and family therapists become competent in the identification of parental alienation processes is through the mandated child abuse reporting laws.  In California, where I practice, a requirement of licensure is that all therapists receive training in the mandated reporting of child abuse.  If the diagnosis of a Shared Psychotic Disorder was specifically included and referenced in the child abuse reporting laws as requiring a mandated report, then all therapists would need to be trained in the elements of making the diagnosis as part of their requirement for licensure. This would be one way to increase the availability of trained and knowledgeable therapists.

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