Psychological and Parental Competency Evaluations

1. Psychological and Parental Competency Evaluations Helen T. Brantley, Ph.D.

2. Who Is the Client? • For parental competencies, the client may be the Court or Department of Social Services. • For child evaluations, the client is most frequently the Department of Social Services.

3. Who Performs a Psychological Evaluation? • Licensed Practicing Psychologist with Forensic Training • Licensed Ph.D. Psychologist (Licensed Practicing Psychologist) • Licensed Psychological Associate

4. Therapist vs. Forensic Evaluator • Cannot be in both roles for the same person • Differences between therapist and forensic evaluator relationship • Treatment v. Investigative Evaluation • Psychic Reality v. Objective Reality • Interview strategies • Single Source v. Multiple sources • Expert Witness v. Fact Witness

5. What Is the Purpose of a Psychological Evaluation? • Aid the trier of fact • Obtain psychological information in a standardized manner • Use norm referenced information • Determine mental capacity • Help determine psychopathology • Make treatment suggestions

6. Why Are You Asking For A Psychological Evaluation? • What stage are you in the evaluation? • What kind of information is needed? • What are the goals of the evaluation? • What are the issues and can testing help? • Do the attorney, Social Services, and Judge have common questions? • Do the attorney, Social Services, and Judge have different questions?

7. Kinds of Evaluations in Abuse and Neglect Cases • Child Medical Evaluations • Child Evaluations • Child and Family Evaluations • Child Mental Health Assessments • Child Forensic Abuse Evaluations • Sex Offender Specific Evaluations • Adult Mental Health Evaluations • Parental Competency Evaluations

8. Parental Competency Evaluations • Ordered to recommend appropriate treatment for remediating behaviors • Ordered to determine incompetency at point of Termination of Parental Rights

9. Requirements and Guidelines • Ethical Principles of Psychologists and Code of Conduct (APA, 2002) • Guidelines for Psychological Evaluation in Child Protection Matters (APA, 1998) • Specialty Guidelines for Forensic Psychologists (APA, 1991) • Psychosocial Evaluation of Suspected Sexual Abuse of Children, 2nd Ed. (APSAC, 1997)

10. Ethical Principles and Standards • The Child’s Best Interest is paramount • Avoid multiple relationships • Address child protection issues • Address issues in referral questions • Use informed consent • Use multiple methods of data gathering • Maintain appropriate records

11. Contributing Factors in Poor Parenting • Poor physical health • Situational and chronic stress • Evaluation stress • Ambivalence and uncertainty • Lack of parenting knowledge and skills • Mental disorder or disability

12. Three Types of Parental Competencies1 1. Capacity to Care Nurturing, involvement with care givers 2. Capacity to Protect Supervision, tolerance for frustration 3. Capacity to Change Intelligence, reactions to treatment 1Haynes, J.P. (2010). Parenting Assessment in Abuse, Neglect, and Permanent Wardship Cases. In Benedek, et al., Principles and practice of child and adolescent forensic mental health. Washington, DC: American Psychiatric Publishing, Inc.

13. Psycholegal Questions about Parental Competency • Can the parent provide adequate stimulation? • Can the parent respond to the child’s physical and emotional needs? • Can the parent set appropriate limits and relate in a non-punitive way to the child? • Are there specific risk factors related to the parent’s functioning including mental capacity, mental illness, substance abuse, domestic violence?

14. Questions About Parenting and Child Reunification • Is the parent aware of the emotional factors in a child’s return? • Can the parent support the child in negotiating the complex factors involved in reunification? • Including stability, bonding, attachment to foster parent, social needs, academic needs

15. Mental Health Questions for Parental Competency Evaluations • Does the parent have a psychiatric diagnosis? • What is the relevancy of the diagnosis for parenting? • What is the prognosis for this diagnosis? • Can the parent be successfully treated to prevent harm to and promote development of the child in the future? • If so, how? • If not, why not? • How long will successful treatment take?

16. What Information Is Conveyed With a Mental Health Diagnosis? • Severity of the problem • Possibility of remediation • Optional kinds of treatment • Possibility of deterioration or relapse • Impact on functioning both in parenting and in broader context • Current level of functioning

17. What Information Is Not Conveyed With a Diagnosis? • Rarely explains causes of a given behavior • May or may not be related to functioning in parenting • Functioning may vary across time, despite the diagnosis • May be debatable • Not always helpful, but sometimes useful

18. What Should Be In An Evaluation Report? • Court order and identifying data • Sources of information (interviews, tests, records, contacts) • Psycholegal questions • Answers to the psycholegal questions • Additional recommendations • Interview material • Test results • Collateral information

19. Adult Interview • Social Background • Parenting Interview • Domestic Violence • Substance Abuse • Sexual Abuse

20. Social Background Topics • Social History • Educational History • Relationship History • Mental Health History • Medical History • Legal History • Child Protective Services History

21. Parenting Interview • Child’s development • Perceived needs of the child • Knowledge of medical needs • Knowledge of educational needs • Basic nutritional knowledge • Need for child’s protection • Ways protection might take place

22. Parenting Interview (continued) 8. Discipline techniques 9. Perceptions about reunification 10. Reactions to interventions 11. Attainment of new skills

23. Special Topic Interviews2 • Substance Abuse Assessment • Domestic Violence • Physical Abuse • Sexual Abuse • Mental Health Assessment • Medication • Hospitalizations • Investment in treatment 2Sattler, J.M. (1998). Clinical and forensic interviewing of children and families: Guidelines for the mental health, education, pediatric, and child maltreatment fields. San Diego, Jerome M. Sattler, Publisher, Inc.

24. Purpose of Tests • Create other data points • Relevancy to the psycholegal questions • Objective measure

25. What Kinds of Tests Might Be Used? • Intelligence tests • Adaptive behavior tests • Parenting tests • Substance abuse tests • Tests for domestic violence • Child abuse risk ratings • Objective personality tests • Projective personality tests

26. Acceptability of Tests • Frye v. U.S. (1923)— “general acceptance” • Daubert v. Merrell Dow Pharmaceuticals (1993)—FRE 403, 702—standards of relevance, reliability and legal sufficiency

27. Daubert Standards for Tests • Based on scientific methodology • Reliable • Valid • Norm referenced • Peer reviewed

28. Criteria for Test Use • Daubert and Frye Standards • Standardized for the population • Reliable • Valid • Relevant to parenting • Relevant to unique parenting problems

29. Intellectual capacity as measured by IQ Direct measure of client performance Influenced by education Influenced by emotional factors Does not measure parenting abilities Adaptive functioning Reflects functioning in real world Assess: responsibility, coping Allows for comparative observations by others No more time consuming than IQ Used in conjunction with IQ tests Two Aspects of Mental Capacity

30. Meet Standards Wechsler Tests of Intelligence MMPI-2 MCMI-III PAI PSI Rorschach Child Behavior Checklist Do Not Meet Standards Draw A Person Kinetic Family Drawing Sentence Completion All Tests are Not Created Equal

31. Parent-Child Interaction • Where? • When? • How? • Documentation?

32. Collateral information • People • DSS Worker • GAL • Therapist of Parent • Parenting References • Foster Parents • Therapist of Child • Teachers • Records • Court Documents • GAL & DSS Court Reports • Hospital Records • Previous evaluations of parent • Evaluation of Child • School records • Therapy records

33. Report Writing • Report to the Court • Address referral questions • Relate information to parenting • Use the data to generate intervention recommendations

34. Should The “Ultimate Question” Be Answered? Yes or No! • Consequences of Answering the Question • It is the Judge’s Decision • Risk lack of information from the legal files • Risk misunderstanding of legal issues • Consequences of Not Addressing the Question • Court misses the benefit of the expert’s thinking • Court may not understand what evaluator thought most important

35. References • American Psychological Association. (2002). Ethical principles of psychologists and code of conduct. American Psychologist, 57, 1060-1073. • American Psychological Association (1999). Guidelines for psychological evaluation in child protection matters. American Psychologist, 54, 586-593. • American Psychological Association. (2007). Record keeping Guidelines. American Psychologist, 62, 993-1004.

36. References (continued) • American Psychological Association. (1991). Specialty Guidelines for Forensic Psychologists. Law and Human Behavior, 15, 655-665. • APSAC. (l997. Psychosocial evaluation of suspected sexual abuse of children (2nd Ed.) Chicago: Author • Budd, K.S., Felix, E.D., Sweet. S.C., Saul, A., and Carleton, R. A. (2006) Evaluating parents in child protection decisions: An innovative court-based clinic model. Professional Psychology: Research and Practice, 37, 666-675. • Budd, K.S., Naik-Polan, A.T., Felix, E.D., Massey, L. P. Eisele, H. (2004). Legal use of mental health evaluations in child protection proceedings. Family Court Review, 42, 629-640.

37. References (continued) • American Psychological Association. (1991). Specialty Guidelines for Forensic Psychologists. Law and Human Behavior, 15, 655-665. • APSAC. (l997. Psychosocial evaluation of suspected sexual abuse of children (2nd Ed.) Chicago: Author • Budd, K.S., Felix, E.D., Sweet. S.C., Saul, A., and Carleton, R. A. (2006) Evaluating parents in child protection decisions: An innovative court-based clinic model. Professional Psychology: Research and Practice, 37, 666-675. • Budd, K.S., Naik-Polan, A.T., Felix, E.D., Massey, L. P. Eisele, H. (2004). Legal use of mental health evaluations in child protection proceedings. Family Court Review, 42, 629-640.

38. References (continued) • Child abuse and neglect. (2007). In G. B. Melton, et al. (Eds.) Psychological evaluations for the courts: A handbook for mental health professionals and lawyers. (3rd Ed., pp. 494-538.) New York: The Guilford Press. • Condie. L.O. (2003). Parenting evaluations for the court: Care and protection matters. New York: Kluwer Academic/Plenum Publishers. • Condie, L. O. & Condie. D. (2007). Termination of parental rights. In A. M. Goldstein (Ed.), Forensic Psychology: Emerging topics and expanding roles (pp.294-332). Hoboken, N. J. : John Wiley & Sons, Inc.

39. References(continued) • Haynes, J. P. (2010). Parenting assessment in abuse, neglect, and permanent wardship cases. In E. P. Benedek, et al. (Eds.) Principles and practice of child and adolescent forensic mental health (pp.157-170). Washington, D.C.: American Psychiatric Publishing, Inc. • Hughes, T. (2006). The neglect of children and culture: Responding to child maltreatment with cultural competence and a review of Child abuse and culture: Working with diverse families. Family Court Review, 55, 501-510. • North Carolina General Statute 7B-100, et al.

40. References(continued) • Otto, R.K. & Edens, J. F. (2003). Parenting capacity. In T. Grisso (Ed.), Evaluating competencies: Forensic assessments and instruments, Second edition (pp. 229-308). New York: Kluwer Academic/Plenum Publishers. • Sattler, J.M. (1998) Clinical and forensic interviewing of children and families: Guidelines for the mental health, education, pediatric, and child maltreatment fields. San Diego: Jerome M. Sattler, Publisher, Inc.