Can Child Psychological Abuse in Family Courts be Diagnosed?

In Why Right to Love Doesn’t Use the Term “Parental alienation”, it was highlighted that the UK Association of Clinical Psychologists (ACP) and the British Psychological Society (BPS) advise that “parental alienation” cannot be diagnosed. They didn’t, however, state what could be diagnosed and this has left traumatised families with a lot of unanswered questions.

Psychological literature and research covers a wealth of mental health conditions, symptoms and diagnoses. Some of these conditions and symptoms appear to be present in families where children reject a parent. Moreover, these mental health conditions and symptoms can be diagnosed and treated by suitably skilled and experienced practitioners. For example:

  • Personality disorders which include Narcissistic Personality Disorder (NPD) and Borderline Personality Disorder (BPD).  Diagnosable under:
  • Maladaptive attachment styles which are described in the attachment theory and the Dynamic Maturational Model of Attachment and Adaptation (DMM). Diagnosable using National Institute for Health and Care Excellence (NICE) approved Adult Attachment Interviews (AAI) as the “gold-standard” for people over 15. Professor Peter Fonagy referred to the DMM as ‘… the most clinically sophisticated model that attachment theory has to offer at the present time.’ (Crittenden 2017, p. ii).
  • Psychological abuse
    • Code QE82.2 in the ICD
    • DSM includes child psychological abuse on page 719 and psychological spouse or partner abuse on page 721.
  • Posttraumatic Stress Disorder (PTSD) or Complex Posttraumatic Stress Disorder (cPTSD)
    • Code 6B40 in ICD for PTSD and 6B41 for cPTSD.
    • DSM includes PTSD on page 271.
  • Adjustment disorder, with mixed disturbance of emotions and conduct is included on page 286 of the DSM.
  • Child Affected by Parental Relationship Distress, included on page 716 of the DSM.
  • Parent-child Relational Problems, included on page 715 of the DSM.
  • Factitious Disorder Imposed on Another (FDIA), code 6D51 of ICD.
  • Induced Delusional Disorder code 6A24 of ICD.
  • Regarding attachment and family systems the following are significant indicators of parent-child boundary violations:
    • Triangulation, where a third party is drawn into conflict between 2 other family members e.g. a child is used as a means to emotionally support one parent or to become the focus of attention so the parents can avoid bigger problems in their relationship.
    • Cross-generational coalition (Haley, 1987 p. 121-124), where two people of a different generation gang up to form a power base against another family member e.g. mother and child against father. These are deemed perverse triangles (Haley J., 1997 p. 31-48) as the child is elevated to a position of power over one of their parents.
    • Enmeshment (Minuchin, 2012 p. 41-42) where a child and parent have become so close the other parent is pushed out and the child has very little differentiation of self.
    • Emotional cutoff where a family member distances themselves either physically or psychologically from another family member e.g. when a child rejects a parent.

Each of these mental health conditions and symptoms have interventions that can be added to a treatment plan. All have massive implications for the mental health, psychological and emotional development of children.

It is clear from the psychological literature that:

  • Narcissism and insecure attachment exists on a scale. Both men and women can be highly narcissistic and or adopt severely maladaptive attachment strategies. One in 20 in the UK suffer from a personality disorder. 57% of the UK population has an insecure attachment style, 34% a severely maladaptive one. This is what is in family courts.
  • Triangulation into spousal conflict is harmful to children, even where it is confirmed that domestic abuse has occurred.
  • Children can be psychologically/coercively controlled to reject a parent.
  • Traumatised people, hurt people. Parenting practices exist on a scale and there is a marked difference between severe abuse where a child protection response is required, sub threshold/problematic parenting which may require some intervention without severing a child’s attachment bond and the perfect parenting that policy makers, social workers and members of the ACP and BPS aspire to. Offering parents therapeutic support and intervention to heal from their trauma would help them support their child better and reduce risk of re-offending with others.

Given all this is covered in existing psychology, and the psychology community has the treatments that can support parents to change in order to improve outcomes for children, you would reasonably expect that psychology holds the solution to a child’s emotional cutoff and future wellbeing. So why would psychologists suggest the risk a child is being psychologically controlled by a parent with a severely maladaptive attachment style to reject a “good enough” parent cannot be diagnosed or warrant a treatment plan?

Dr Craig Childress a registered Clinical Psychologist in the United States of America, documented and published a diagnostic model which he is using to diagnose child psychological abuse in family courts (Childress, 2017).  Therefore, child psychological abuse and intimate partner violence using the child as a weapon can be diagnosed. Are psychologists in the UK not capable of doing the same? Why is identifying a parent with a severely maladaptive attachment strategy and understanding how it may drive family dysfunction, not important information for a court to have in fact finding?

Progress had previously been made in case law to ensure families where children were rejecting a parent had input from an expert witness but thanks to the intervention of the ACP and BPS, or the lack there of, the situation in UK family courts is likely to stay the same or get worse. Re C (‘Parental Alienation’; Instruction of Expert) [2023] EWHC 345 (Fam) suggests judges can identify cases where “good enough” parents have been rejected by their children due to psychological/coercive control. Many “good enough” parents and psychologists could provide evidence that they cannot. Even the long, expensive and emotionally harrowing judicial appeals process confirms they cannot.

Responses to Freedom of Information requests have uncovered that Cafcass Family Court Advisers (FCA) get ‘…no specific training on child psychological abuse, family systems or personality disorders.’ Cafcass advised that ‘attachment theory, and trauma informed practice are covered in Knowledge Bites available only to staff.’ Cafcass also advise ‘…there is no one assessment protocol that is used to assess a child for child psychological abuse in the context of parental separation under the CIAF… we do not have a specific practice aid to assess a parents sensitivity or ability to mentalise for their child… we do not have a specific practice aid to check for maladaptation of a child’s attachment style.’ There is no evidence that judges are trained in these matters. This is failing children at the first hurdle and it can’t give any confidence to parents worried their children are being subjected to psychological abuse.

In addition, under current proposals, family courts will only look for either DA or child psychological abuse. How then, will the courts deal effectively with scenarios where both parents have severely maladaptive attachment strategies that are harming their child?

There seems to be a lack of clinical research about what psychological conditions and dynamics are present in private law cases. It is strange the field of psychology doesn’t want to investigate an area that is clearly prime for research or to provide support to resolve family dysfunction. Is it because there aren’t enough adequately skilled, qualified or experienced resources to meet demand? Is it because psychologists don’t like to diagnose pathology? Is it because psychologists think that psychological assessment of families is harmful, in which case should psychological assessment in every context stop? Is it that putting the treatments in place is perceived be too expensive in the short-term vs long-term benefit and cost reduction?

Family members in family court are experiencing mental health issues, both victims and perpetrators. How likely is it that children who have experienced Domestic Abuse, which includes psychological control, can continue normative development without therapeutic support for the family? How do perpetrators of clinically significant abuse or parents with subthreshold problematic parenting change, without the offer of a treatment plan?

If psychologists cannot identify psychological dysfunction and cannot diagnose psychological abuse, then should we ask, what’s the point of psychologists? Why should the family court entertain psychological assessment at any stage in the proceedings if diagnosis is not possible? Why should parents trust psychologists to assess their families if they can’t diagnose or offer a treatment plan?

If psychology are telling the public they are not part of the solution, what should “good enough” parents struggling to maintain a relationship with their child do, leave their children under the sole influence of a severely abusive, psychologically controlling parent and cross their fingers that everything will turn out ok? Early intervention is always better.

Without qualified, skilled and experienced psychologists who are capable of diagnosing the psychological pathology that is driving the family dynamics and providing a treatment plan to help parents, the family court has no real solution. It will continue to fail children at the first hurdle and it is playing Russian roulette with the lives of parents and children.

Book References

Childress, C. A., 2017, Strategic Family Systems Intervention for AB-PA: Contingent Visitation Schedule. Claremont, Oaksong Press.

Crittenden, Patricia M., 2017, Raising Parents. Taylor and Francis. Kindle Edition.

Haley, J. (1977). Toward a theory of pathological systems. In P. Watzlawick & J. Weakland (Eds.), The interactional view. New York: Norton.

Hayley, Jay, 1987, Problem-Solving Therapy, 2nd Edition. San Francisco, Jossey-Bass.

Minuchin, Salvador, 2012, Families and Family Therapy. New York, Routledge.