Mending Fences (eBook)

A collaborative, cognitive-behavioral reunification protocol serving the be

Benjamin D. Garber (Autor)

eBook Download: EPUB

2021 | 1. Auflage
278 Seiten
High Conflict Institute Press (Verlag)
978-1-950057-14-6 (ISBN)

Infos

High conflict divorce can leave children polarized within the transitioning family system, aligned with one parent and resisting or refusing contact with the other parent/b. Rather than becoming mired in the bottomless pit of back and forth blame, more and more courts are seeking remedies in the form of reunification therapy. Charged with helping the polarized child to enjoy a healthy relationship with both parents, we know what doesn’t work: individual child therapy cannot remedy a family systems problem. Dyadic interventions with the child and either parent are seldom sufficient. Even family therapies fall short when they are not grounded in well-established, reliable, and valid science. Mending Fences introduces a child-centered, systemically informed, empirically-validated, and experientially-proven collaborative reunification protocol. Focusing on the anxiety inhibiting the system’s healthy functioning, well-respected and long-validated cognitive behavioral exposure methods are fused with structural family therapy to reduce the child’s anxieties about separating from one parent and approaching the other, the aligned parent’s fears of separation and loss, and the rejected parent’s fears of rejection. A common vocabulary across coordinated interventions allows children across the spectrum of ages and abilities to identify and overcome an individually tailored succession of anxiety-inducing events so as to gradually (re-)establish healthy and safe relationships with both parents. The Mending Fences protocol is practical, proven, and effective. The user-friendly discussion is peppered with up-to-date references to the scientific literature and international case law. Application via video conferencing platforms is discussed. Included: Case illustrations, sample court orders and service agreements

Textauszug

CHAPTER 1

THERE IS NO SUCH THING AS REUNIFICATION THERAPY

There is no such thing as reunification therapy.

This has not, however, stopped the phrase from going viral. Professional journals, popular press articles about high conflict divorce, and judicial rulings throughout the English-speaking world all commonly refer to this thing that does not exist as if it was as well-established and familiar as “appendectomy” or “Cognitive Behavioral Therapy” (CBT).

It is not.

The term reunification has historically been relevant only to child protection and removal matters. It describes the steps that courts and child protective workers take to cautiously return a child into the care of a parent who has been found to be abusive or neglectful (Terling, 1999).

Unfortunately, the term has been adopted in the last decade—together with all of its historical baggage—by aggrieved parents, their attorneys, mental health providers, and many courts to describe an imagined or hoped-for therapeutic process intended to repair the broken parent-child relationships that develop in some high conflict, divorcing families.

Although divorce with children can be, and usually is, a relatively smooth process with little long-term negative impact for the kids (Arkowitz and Lilenfield, 2013), a small minority of parents make it into a kind of tribal warfare in which everyone must pick sides. In these circumstances, a child can become strongly allied with one parent (Parent A), and resistant to or rejecting of the other (Parent B). By definition, this child has been polarized within the family system. Reunification therapy generally intends to repair the child’s relationship with Parent B.

The goal is certainly valid and worthwhile. Although psychology and the law agree on very little, the two fields do generally agree that every child should have the opportunity to make and maintain a healthy relationship with both (all) of his or her caregivers.2 Unfortunately, applying the term reunification to this process introduces confounding connotations suggesting that Parent B is abusive or neglectful; deserving of his out status; and in need of remediation, supervision, and/or criminal consequences.

Fiction can be more compelling than reality. Consider, for example, the therapeutic intervention commonly referred to as anger management. Like reunification therapy, there is no such thing. There is no research, professional literature, or best-practice guidelines associated with anger management. There is, however, a very entertaining 2003 movie by this name, which seems to have been mistaken as describing a real professional service. As a result, ever since the movie’s release, psychotherapy offices across the country have been flooded with calls seeking anger management services.

The common-sense idea behind each of these two fictitious therapies is sound. On one hand, of course we should all develop the skills necessary to voice our strong negative emotions in ways that are constructive. On the other hand, of course we want kids to have the opportunity to enjoy a healthy relationship with both parents. The former is most commonly accomplished via CBT interventions (Boxmeyer et al., 2018; Lochman et al., 2004). The latter—the service often referred to as reunification therapy—is best accomplished through a form of family therapy.

This book describes a form of family therapy known as Multi-Modal Systemic Therapy (MMST) and recommends it as the best choice among possible therapeutic interventions when reunification therapy has been ordered. MMST is just what it sounds like: a systemic (as opposed to an individual, dyadic, or a family) intervention conducted by a team of skilled professionals integrating multiple, simultaneous, and interwoven treatment modalities in support of the singular goal of assisting participants to modify maladaptive, undesirable, and unhealthy structures (roles and rules) and patterns of interaction (dynamics) in the best interests of their child.3

Dynamics Must Not Be Confused with Diagnoses

A diagnosis describes a constellation or pattern of thoughts, feelings, or behaviors within an individual that has been consensually deemed (albeit often culture-specific) to constitute pathology. A dynamic describes a pattern of thoughts, feelings, or behaviors that repeats or persists between individuals with no necessary connotation of pathology.

Diagnoses describe illness. Dynamics describe relationships.

This distinction is important for a number of reasons. The idea of diagnosis (and, indeed, the idea of mental illness) is derived from medicine. It carries with it the implication that a person’s distress and dysfunction can be understood and treated exclusively within that person. In this paradigm, the provider’s job is to identify a pattern of symptoms, correlate the observed pattern with similar patterns observed in other individuals, and, on that basis, to diagnose an illness and prescribe a treatment.

For better or worse, most mental health professionals are trained to practice in the medical model. Thus, depression and anxiety are approached in much the same way as Lyme Disease and thyroid cancer—survey internal symptoms, then match the results to established patterns so as to diagnose illness and provide individual treatment accordingly. What’s missing here? The answer is that the medical model neglects the individual’s interpersonal existence entirely. The medical model routinely fails to consider if and how relationship dynamics may have caused, exacerbated, and/or may be sustaining the problem (Rosenbaum et al., 2019).

Nowhere is this oversight more glaring and destructive than when a child presents for care with mood or behavior problems. To presume that the child’s distress and/or dysfunction is necessarily and exclusively caused by diagnosable pathology is to actively do harm to the child. This is commonly illustrated when a child’s adaptation to a chaotic and conflicted family environment is mistakenly diagnosed as attention deficit hyperactivity disorder and medicated accordingly (Garber, 2001; Schwarz, 2016). The same myopia is evident, albeit louder and more inflammatory, in the now-defunct call to codify the systemic dynamic often known as parental alienation as a diagnosis in the Diagnostic and Statistical Manual (Bernet, 2013; Lubit, 2019).

Compounding this problem is the health insurance industry’s insistence that payment depends first and foremost on the identification of an individual as the patient (as opposed to a couple, parent-child dyad, or family system), and on the diagnosis of that patient with a specific illness. Thus, mental health providers are financially incentivized to conceptualize and treat every presenting problem as individual pathology. Without an identified and properly diagnosed individual patient, health insurance companies will not pay professionals to treat family dysfunction, co-parenting issues, or for providing reunification therapy.

True, destructive systemic dynamics can cause diagnosable pathology in individuals. Many children caught up in their parents’ selfish conflicts suffer anxiety and depression with concomitant school failure, substance abuse, physical pain, and social implications. Getting proper mental and physical health, along with academic supports for these conditions, may be critically important—even life-saving—but individual care is seldom sufficient. At best, individual treatment can be compared to throwing a buoy to a drowning man. It might help keep him afloat, but what he really needs is to get out of the water. That’s the job of family or systemic therapy. And at worst? At worst, individual diagnosis and treatment confirms what the scapegoating family has been saying all along: the problem is not ours, its hers. In short, “[i]n the absence of participation of the other family members, individual child therapy often serves to reinforce the child’s cognitive distortions and problematic behavior. Further, individual therapy identifies the child as the problem or the one who is responsible to fix the problem” (Fidler and Ward, 2017, p. 31).

Even if we get beyond confounding historical connotations, the distinction between diagnoses and dynamics, the risks of stigma, and the need to treat the system rather than the individual (or either of the two bifurcated families), there remains one further reason to reject the phrase reunification therapy. That is, the phrase suggests that there is only one relationship in need of repair.

Experience teaches that therapies that work exclusively to repair the rupture between the child and Parent B (that is, the family rather than the superordinate system) are doomed to failure. No matter the cause of the rupture, the problem doesn’t exist in the dyad or even in the reconstituted family—it exists in the entire system. Mom might throw up her hands and complain that she did nothing, the problem is completely between the child and his father. Not true. If Mom is part of the child’s emotional world, then she must be part of both the problem and its solution. Systems are, after all, complex,...

Produkt-Details

• Erscheint lt. Verlag: 7.10.2021
• Vorwort: Bill Eddy
• Sprache: englisch
• Themenwelt: Recht / Steuern ► Privatrecht / Bürgerliches Recht
• ISBN-10: 1-950057-14-3 / 1950057143
• ISBN-13: 978-1-950057-14-6 / 9781950057146