Clinical Decision-Making in Parent–Child Contact Problem Cases

Author(s):  
Barbara J. Fidler ◽  
Peggie Ward

This chapter summarizes the continuum along which parent–child contact problems may be conceptualized and differentiated and addresses how legal and clinical interventions may be tailored to the nature and severity of the problem in a particular family. Parent–child contact problems include affinity, alignment, justified rejection, and alienation as well as hybrid cases, each of which can range from mild to severe. Which of these problems is observed in a given family and parent–child relationship depends on numerous factors, including the child’s developmental stage, whether a parent has engaged in parental alienating behaviors, whether and when there was violence between the parents, and whether a parent was abusive or neglectful of the child. The chapter provides an overview of psychoeducational and clinical interventions for mild, moderate, and severe cases. It also explicates protocols for managing initial queries, preliminary screening, clinical intake, and contracting for such interventions.

Author(s):  
C Maré

The family-unit did, in one form or another occur since the beginning of man’s existence. The aim of the unit was to sire children and to provide for them until they reached maturity. To realise this provisional aim, a decision making process was required. The child and her parents’ individual interests can generate conflict where decisions have to be made regarding various questions, for example: which church the child should attend and or whether she should attend any church; which school a child should be enrolled in; with whom the child may associate and with whom not; if the child may use contraceptives, and whether an adolescent female may of her free will request or reject an abortion. Henceforth it must be kept in mind that the decision making process, i.e. family politics, is unique for each parent-child relationship. Various social, economic and cultural factors can influence the handling of conflict in the decision making process. Furthermore, fundamental rights can influence the decision making process differently in respectively the common law parent-child relationship and the customary law parent-child relationship. Central to the latter situation is the fact that fundamental rights recognise individual rights, while customary law is founded in communalism. It is furthermore important to note that the nature of the parent-child relationship is not neutral, but is determined by historical and social elements within the community. There are various statutory provisions in terms of which courts can intervene in the exercise of parental authority and can even terminate it, over and above the fact that the courts possess a common law competence as upper guardian. However, no law expressly grants the court the power to intervene in the parent-child relationship where conflict arises within the decision making process. The courts only have the authority to intervene in the parent-child relationship in the event of physical maltreatment or molestation of a child, in divorce proceedings, and where consent must be granted for a minor’s marriage. Even the family advocate is employed as mediator only in divorce matters. The court as common law upper guardian of minors, will only intervene in the parent-child relationship if it is of the opinion that such a step is in the interests of the child and it will therefor not be done lightly. The current constitutional provisions regarding children in a multi-cultural society has brought about changes in the parent-child relationship. Reading together sections 9 and 28 of the 1996-constitution puts it beyond doubt that any child under the age of 18 years is a person possessing fundamental rights. The state is drawn in as a third party in the parent-child relationship and must ensure that the interests of the child, that is fundamental rights, are guaranteed. Section 28 of the 1996-constitution goes further than section 30 of the 1993-constitution and provides a description for the meaning of parental care. The reference to family care, parental care and appropriate alternative care in the 1996-constitution can be indicative of the fact that the changed relationships wherein children find themselves within the community (other than the nuclear family) are recognised. The constitutional provisions also causes a change of emphasis in the parent-child relationship. The emphasis changes from the parent’s rights and responsibilities to the rights that a child may claim. The child can enforce her rights against the state and her parents. The yardstick which determines whether the child is entitled to its constitutional rights, is in whether such a claim would be in the best interests of the child. If the child approaches the High Court as the common law upper guardian to enforce her rights, or to strike a balance in the decision making process, the state must supply the child with the necessary legal representation. Due to the relevant constitutional provisions, the parent-child relationship can no longer be considered to be regulated merely by rules of authority, but the emphasis has shifted to the promotion of the child’s interests. The best interest of the child must thus be the guiding principle in all legal proceedings. It implies further that the South African family law approach to balancing the decision making process within the parent-child relationship has also changed 


This book focuses on family-based interventions for the continuum of parent–child problems, including affinity, alignment, justified rejection, alienation, and hybrid cases. Reintegration therapy is often recommended for families with these dynamics, but relatively limited clinical writing and virtually no program evaluation data exist to inform the selection of interventions. This book helps fill this gap. In Part I, the authors review a range of topics related to this specialized area of practice: assessment and clinical decision-making, the state of research evidence for outpatient treatment, and special clinical topics such as the management of countertransference among professional teams and the use of experiential therapies to overcome treatment resistance. Part II highlights one whole-family, psychoeducational approach to parent–child contact problems known as the Overcoming Barriers approach. Founders of this program and affiliated clinicians explicate components of this model in chapters on its therapeutic milieu; psychoeducational groups for rejected parents, favored parents, and children; and coparenting and parent–child interventions. The translation of model components to outpatient practice is also discussed, and program evaluation data are presented. Authors emphasize the evolving nature of this one approach, including areas of overlap with other family interventions, and highlight lessons learned from this innovative program.


Author(s):  
Jessica Jablonski ◽  
Sara Martino

In this study the authors examine parent - child communication in Emerging Adulthood. Thirty - seven college students and one or both of their parents completed written questionnaires assessing whether the parent had verbally communicated or did some action to acknowledge the Emerging Adult’s maturity. Communication about changes in the parent - child relationship, as well as the Emerging Adult’s decision - making abilities, obligations to the family, and financial responsibilities were also assessed. The responses to the open ended questions were qualitatively analyzed using grounded theory. The findings indicated that the Emerging Adults’ and parents’ responses were very similar, and the overwhelming majority reported that there had indeed been an acknowledgment from the parents to indicate Emerging Adulthood status, although this was not always verbally communicated; sometimes it was indicated through the parents’ behavior. K


Author(s):  
Shely Polak ◽  
John A. Moran

This chapter describes the status of outpatient clinical interventions for unjustified parent–child contact problems using an ecological systems approach. It starts with a review of the multiple factors found to be associated with the development of parent–child contact problems, which include parenting styles and skills, parental alienating behaviors, cognitive distortions, history of the parent–child relationship, parental psychopathology, interparental conflict, and court involvement. Next, the chapter considers the specific goals of reunification treatment for the alienated child, the rejected parent, and the favored parent. Finally, the chapter critically reviews the state of outcome evidence for a range of outpatient and intensive reintegration interventions. Key clinical and theoretical components of each intervention are highlighted, noting both components that the interventions share and those that distinguish them.


2011 ◽  
Vol 20 (4) ◽  
pp. 121-123
Author(s):  
Jeri A. Logemann

Evidence-based practice requires astute clinicians to blend our best clinical judgment with the best available external evidence and the patient's own values and expectations. Sometimes, we value one more than another during clinical decision-making, though it is never wise to do so, and sometimes other factors that we are unaware of produce unanticipated clinical outcomes. Sometimes, we feel very strongly about one clinical method or another, and hopefully that belief is founded in evidence. Some beliefs, however, are not founded in evidence. The sound use of evidence is the best way to navigate the debates within our field of practice.


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