Article Summaries

• September/October 2002, The Therapist Magazine
  Disciplinary Actions Against Custody Evaluators
  
  Here is a synopsis of two disciplinary actions against psychologists involved in custody evaluations which were reported in September/October 2002 issue of The Therapist. One is an action due to bias against the mother; the other is an action due to bias towards the mother.
  
  Writing a complaint against a professional who has acted improperly is important, even if they only get a hand-slap. Each professional organization has certain rules of conduct. It's a good idea to always use the correct form and tailor the complaint to the specific rules.
  
  *SMITH, DONALD K. PhD, Psychologist, PSY 11278, Orange CA
  Charge:
  "Respondent has been grossly negligent in the practice of his profession, in violation of section 2960(j). Respondent committed an extreme departure from the ordinary standard of practice for a psychologist. Respondent has been dishonest, corrupt or fraudulent in the practice of his profession, in violation of section 2960(n); incompetent in the practice of his profession, in violation of section 2960(p); and repeatedly negligent in the practice of his profession, in violation of section 2960®…" (p 54)
  
  Disposition of Disciplinary Action effective Nov 14, 2001:
  "By stipulation, licensed revoked, revocation stayed, probation for five (5) years on terms an conditions including successful completion of not less than eighteen (18) hours of combined pre-approved course work each12 month period of probation, in the following areas: Evidence Code section 730, Child Custody and Juvenile Court evaluation and mediation, ethics, or any other course deemed and approved appropriate by the Board or its designee; and an education review. Respondent shall pay the Board its costs of investigation and enforcement in the amount of $2,100. If respondent is licensed as a psychologist, he shall not employ or supervise psychological assistants, interns or trainees during the course of this probation."
  
  According to the September/October issue of The Therapist magazine, Donald Smith, Ph.D. was appointed as a custody evaluator under Evidence Code 730 in January 1995.
  
  • He saw family members 10 times and submitted a report to the court in May 1995.
  • He saw the parents in July/August 1995 for mediation and submitted a "Mediation Report" to the court in August 1995. During mediation, Smith asked the mother if she thought he was doing an adequate job. She "expressed concern that respondent had failed to obtain information, had failed to report certain facts, had accused her of alienating the other parent, had reprimanded and threatened her and had acted generally biased against her." He then asked whether "she was going to 'report' him and stated that his wife is an attorney." (p 53)
    
  • In January 1996 Smith requested a complete reevaluation of their clients from the parents' attorneys. The court then ordered the reevaluation and the report was submitted to the court in July 1996. The report included the statement, "It appears evident from the collateral information that the biological mother is either covertly and/or overtly attempting to subterfuge the relationship between father and son" and "It would appear son's relationship with his mother appears pathological." (p 53-54) Smith recommended that physical custody of the son be changed to the father.
  
  The reasons for this Board's decision are that Donald Smith, Ph.D.:
  
  • Failed to advise the court "in a balanced, impartial manner, of the relevant psychological factors pertaining to the custody issues;"
  • Had a dual relationship in that he acted first as a custody evaluator, then as a mediator, and later as a custody evaluator.
  • Submitted reports to the court, "which were laced with disparaging, pejorative, and prejudicial comments about biological mother, and did so without foundation;"
  • Made a statement damaging to the mother when he stated the mother was "psychotic." "The statement demonstrated a bias or lack of objectivity by respondent. Furthermore, the statement was determined by respondent (Smith) to be false and unfounded by any objective or credible evidence, before the report was written; and respondent knew the inclusion of such a 'rumor' was not necessary as support for respondent's report;"
  • Engaged in threats to the custodial status of the mother when he was "overly specific in his requiring biological mother to see a psychologist, not an MFT" and "personalized his involvement in the case, stating he would 'personally see' (mother's) noncompliance in scheduling an appointment with a licensed psychologist as an 'oppositional act'…" (p 54)
  
  Smith failed to inquire, evaluate, assess or follow up on:
  
  • "Confirmed, multiple acts of child abuse (kicking minor) by father upon son, or to inquire and evaluate as to the effects of such acts upon son, who respondent actually knew did not want to be placed with father" and failed to comply with Penal Code 11166 (reporting child abuse);"
  • "Strong evidence of physical abuse and/or violent sex crimes perpetrated by father directed toward adult females, in and out of the home;"
  • "The known alcoholic nature of father and his admission that he continues to drink, or the effect of such known status on son, who respondent knew did not want to be placed with father;"
  • "The morals, parenting and rational conduct issues presented by the father's personal involvement, as a high school teacher, with his female student who began living with (father) shortly after attaining legal majority;" and
  • "The known stable and credible results of son while in the sole physical custody of biological mother, including three (3) years academic performance in GATE, social and athletic involvement, in a non-drinking and productive environment in which son was secure and happy prior to the instigation of custody proceedings.." (p 56)
  
  Smith also:
  
  • "Used improper tests to derive personality descriptions for the mother…;"
  • Used "irrational and improper 'clinical observations' or collateral material' to over-ride objective criteria…;" and
  • Required mother to submit to and pay for an unwarranted alcohol/drug evaluation. (p 56)
  
  *****************************************************
  
  *STONE, JOHN SPENCER Ph.D. Psychologist, PSY 5217 Berkeley, CA
  Charge:
  "Cause for disciplinary action exists pursuant to Business and Professions Code section 2960(j) for being grossly negligent in the practice of psychology. Cause for disciplinary action exists pursuant to Business and Professions Code section 2960(h) for willful, unauthorized communication of information received in professional confidence, and Title 16 California Code of Regulations 1396.3 for violating test security. Cause of disciplinary action exists pursuant to Business and Professions Code section 2960(I) and Title 16, California Code of Regulations section `396.2 for misrepresenting himself to the court and the Medical Board. Cause for disciplinary action exists pursuant to Business and Professions Code section 1960® for engaging in repeated acts of negligence." (p 56)
  
  Disposition effective August 10, 2001:
  "By decision, license revoked, revocation stayed, probation for five (5) years on terms and conditions including suspension of license for ten (10) days, monitored practice, education review, successful completion of not less than eighteen (18) hours of additional coursework each year of probation, and successful completion of a course in laws and ethics as they relate to the practice of psychology. Respondent shall pay the Board its costs of investigation and enforcement in the amount of $5,640.61. If respondent is licensed as a psychologist, he shall not employ or supervise psychological assistants, interns or trainees during the course of this probation." (p 56)
  
  According to the September/October 2002 The Therapist magazine, John Stone, Ph.D. was retained by another custody evaluator to perform the limited role of conducting psychological testing and assessment.
  
  • He conducted testing of parents in November 1992 and provided the results to the principal evaluator who the submitted a report to the court in December 1992;
  • Stone released testing information to the parents' attorneys without a release from the parents and/or court order;
  • He submitted an unsolicited, unauthorized letter to the court in March 1993, stating incorrectly that he was appointed to perform the evaluations, and recommending legal custody to the wife;
  • He engaged in multiple professional roles with the family by being a consultant engaged to perform testing in 1992, as a forensic expert called by the wife's attorney in the July 1993 trial, and as a therapist to the wife in 1995 - 1996; and
  • In 1997 he misrepresented himself as a "neutral court-appointed child custody evaluator" to the Medical Board. (pp 57-58)
  
  Visit www.camft.org for more information on this article or about the magazine.
  
  
  
• September 24, 2002, The Boston Globe
  How Child Abuse & Neglect Damage the Brain
  By Josh Kendall, Globe Correspondent
  
  For 7 -year-old Zachary Risotti, feeling safe and cared about is a new experience. At 2, Zachary was taken to the emergency room because of a suspicious cigarette burn under his left eye. Six months later, he was back in the hospital with a burn on his right forearm. Suspecting abuse, the state Department of Social Services removed him from his home, but he bounced around three foster homes before he was finally adopted in July 2000.
  
  By then, Zachary already bore psychological scars of child abuse. At 3, he had the communication skills typical of a toddler half his age. He avoided eye contact, fidgeted constantly and expressed his frustration by sitting in a corner and crying. But intensive mental health and support services as well as a loving family have given Zachary a second lease on life. ''Today he's happy, very sociable and doing well in school,'' said his adoptive mother, Kathryn Risotti of Marlborough.
  
  Until recently, mental health clinicians could only speculate on the ways that abuse and neglect damage a child's developing brain. But a series of ground-breaking studies in neuroscience conducted over the last decade are allowing researchers to pinpoint the actual changes in children's brains caused by traumatic experience.
  
  These new neurobiological findings show that trauma - physical abuse, sexual abuse and neglect - dramatically affects both the structure and chemistry of the developing brain, thus causing the behavioral and learning problems that plague about three-quarters of the children mired in the child welfare system. But the good news is that these brain changes aren't necessarily permanent. In fact, timely interventions - as in the case of Zachary - can help rewire the brain and put psychological development back on track. As Department of Social Services Commissioner Harry Spence put it: ''Neuroscience has helped to clarify our mission. We must do more than just protect children after the brain damage has been done. We must also provide loving environments because they are fundamental to healing on a physiological level.''
  
  Dr. Martin Teicher, an associate professor of psychiatry at Harvard and director of the Biopsychiatry Research Program at McLean Hospital in Belmont, has been at the forefront of this new line of research. In one of the first major studies in the field published in The Journal of Neuropsychiatry and Clinical Neurosciences in 1993, Teicher linked abuse to brain wave abnormalities. Reviewing the records of 115 consecutive admissions to a child and adolescent psychiatric hospital, Teicher found brain wave abnormalities in 54 percent of patients with an abuse history, but in only 27 percent of nonabused patients. And 72 percent of the patients in the sample with a history of both physical and sexual abuse had these neurological abnormalities.As a rule, Teicher said, the greater the severity of the abuse, the greater the impact on brain function. And the relationship of the perpetrator to the child also matters: ''Sex abuse by a family member is worse than abuse by a priest or a baby-sitter.''
  
  Several studies now document that abuse damages key brain structures such as the cortex, which is associated with rational thinking, and the hippocampus, which helps process memories and emotions. Both brain regions are critical for learning. In a study published in the same journal in 1998, Teicher and his colleagues used brain scans to compare 15 child victims of severe abuse with 15 healthy volunteers. The left cortex of the abused group was underdeveloped. Likewise, studies by Dr. Douglas Bremner of Yale and Dr. Murray Stein of the University of California at San Diego have found that the left hippocampus is smaller in abuse victims.
  
  Abuse also damages the amygdala, an almond-shaped cluster of nuclei located in the brain's emotional control center that enables us to respond quickly to danger - say, to step out of the way of a swerving car. But repeated abuse causes the amygdala to signal danger even when there is no apparent threat. Dr. Bruce Perry, a neuroscientist who heads the nonprofit research center, the Child Trauma Academy in Houston, said: ''A maladaptive amygdala makes an abused child recoil in fear at the drop of a hat.''
  
  This negative impact on developing brain structures is associated with changes in brain chemistry. Overwhelming stress early in life also alters the production of both the stress-regulating hormone cortisol and key neurotransmitters such as epinephrine, dopamine and serotonin, the chemical messengers in the brain that affect mood and behavior.These biochemical imbalances can have profound implications. For example, abuse typically lowers serotonin levels, leading to depression and impulsive aggression.
  
  Dr. Bessel van der Kolk, the internationally known expert on psychological trauma who serves as Medical Director of the Trauma Center in Allston, is now studying how treatment can undo these neurobiological effects. One of 12 treatment sites across the country recently selected to receive a grant under a new federal program called the Child Traumatic Stress Initiative, the Trauma Center educates schools and communities throughout northern New England on state-of-the-art treatment methods for traumatized children. Van der Kolk said he is convinced that Prozac-type drugs, which affect the neurotransmitter serotonin, can often improve a child's functioning or quality of life. But he insisted that medication is only part of the answer. ''Positive experiences that contradict a traumatized child's negative expectations are critical to helping the brain to readjust itself. For example, just saying to a child that you are sorry the event happened changes brain chemistry.'
  
  'Dr. Alexandra Cook, who directs Children's Services at the Trauma Center, also stressed that interpersonal experiences such as psychotherapy can change neurobiology. For instance, Cook began treating a girl she calls ''Sally'' when she was 5, right after her father had been sent to jail for sexually abusing her and the family had relocated to Massachusetts. Sally was prone to temper tantrums, and she was crying for three hours a day. ''I hypothesized that the abuse, plus the stress of testifying at her father's trial and the move had led to a cascade of chemical changes in her brain and body,'' Cook said. ''Her amygdala couldn't stop firing.''
  
  To stabilize Sally, Cook helped her find constructive ways to discharge her overwhelming emotions. So, when Sally would run laps around the table in her office, Cook did not discourage her. Cook then suggested that Sally try ''messy painting,'' an activity involving splattering water colors on paper. After about four months of weekly sessions, Sally was much calmer and could move from stabilization to memory processing, the next phase of therapy. Cook said she believes that the therapy improved the circuitry in Sally's brain because she never saw such acute distress again. Some animal studies do show that new experiences can actually regenerate brain cells, but the ''research on humans is not there yet,'' said Dr. Glenn Saxe, chairman of the Department of Child Psychiatry at the Boston University School of Medicine.
  
  Unfortunately, traumatized children such as Zachary and Sally who receive specialized treatment services remain the exception rather than the rule. According to the US Department of Health and Human Services, a million children are abused each year, and researchers estimate that fewer than 10 percent are benefiting from appropriate interventions. ''There is a huge disconnect between what science says we should do and the services we are now providing for maltreated children,'' said Dr. Jack Shonkoff, dean of the Heller School at Brandeis University and a co-author of a comprehensive recent study published by the National Research Council and the Institute of Medicine called ''From Neurons to Neighborhoods: The Science of Early Childhood Development.''
  
  Yet, the window for psychobiological change never slams shut. The new neuroscientific findings have upended the deterministic view that brain development is essentially over by age 3. Although the most rapid period of brain growth occurs during early childhood, the brain continues to change throughout adulthood. But the more time that elapses between the abuse and the onset of treatment, the more entrenched are the neurological abnormalities. Strong Oak, codirector of the Survivors Project, a drop-in center for adults in Greenfield, who runs psychoeducational groups on overcoming the biological effects of trauma, said: ''The brains of adult survivors are fragmented and resemble a hard drive on a computer that has crashed.''
  
  This story ran on page C1 of the Boston Globe on 9/24/2002.
  © Copyright 2002 Globe Newspaper Company
  
  
  
• August 18, 2002, Los Angeles Paper (Reuters)
  Catholic Church Abuse Scandal
  
  The Los Angeles Archdiocese under Cardinal Roger M. Mahony for many years kept information from police and allowed clerics facing prosecution for sexual abuse to flee to foreign countries, The Los Angeles Times reported on Sunday.
  
  Citing internal records and interviews, the newspaper said that Mahony, at the same time, had been more aggressive than many U.S. bishops in dismissing members of the clergy implicated in the growing clergy sex abuse scandal. The cardinal, who leads 5 million Catholics in the nation's largest archdiocese, has recently taken a stance as an outspoken reformer on a mission to oust all sex offenders from the priesthood.
  
  But the Times said its investigation showed that during the last decade Mahony had quietly removed 17 priests who had either admitted to, or been credibly accused of, molesting minors.
  
  Officials at the Los Angeles Archdiocese and the public relations firm recently hired to assist the archdiocese could not be reached for comment on Sunday.
  
  But the Los Angeles Times quoted Mahony as saying, "I want the truth out. I want this thing dealt with."
  
  He said he wanted it known that "we haven't been just sitting around, either, for 15 years."
  
  "We've learned a lot the hard way ... What I'm trying to do is learn from all of my mistakes and try to make sure this never happens again," he told the newspaper.
  
  The newspaper said the archdiocese had worked over the last 15 years to keep the abuse problem from the eyes of the public and the police.
  
  It found that five parish priests fled the country and one disappeared after learning complaints had been lodged against them about sexual abuse.
  
  Two of the clergymen left after a top aide to Mahony informed them of the allegations and a third was told to join the priesthood in the Philippines.
  
  Of the six, two are still fugitives, the Times said.
  
  Police complained in two cases that church officials had hampered criminal investigations by refusing to cooperate, the paper said.
  
  Two convicted sex offenders were allowed to continue serving as priests for years before Mahony dismissed them in February in response to the growing furor over clergy sex abuse, the newspaper said.
  
  
  
• June 26, 2002 Los Angeles Times;
  Custody Decisions Biased Toward Men, NOW Says
  Many women claim to have unjustly lost their children
  
  The state's family court system is biased toward men in child custody rulings, the California chapter of the National Organization for Women said in a report released Tuesday.
  
  The 134-page report details the findings of a three-year study based on questionnaires from women who say that they unjustly lost custody of their children. The study found that women often were denied custody even when children were abused by the father in part because men often can afford better legal representation, said Helen Grieco, California NOW executive director.
  
  NOW's conclusions were announced at a news conference after attorneys for the organization filed a legal brief in a state appellate court in Los Angeles supporting a mother who says that she was denied a fair trial when a judge granted her ex-husband full custody of their daughter, who is 15.
  
  Idelle Clarke, of Sierra Madre charges that a 1998 court decision ordering Clarke's daughter to live with her ex-husband was based on his allegation that Clarke brainwashed her daughter into saying that he sexually abused her. Clarke said her daughter had told three judges her father molested her.
  
  Clarke's struggle is common, Grieco said. She said the fathers' rights movement during the 1980s created a backlash against women. "We've been two steps behind, trying to do damage control," Grieco said.
  
  The three-member appellate court panel is likely to decide the Clarke case in about two months.
  
  Clarke said the last time she saw her daughter, it was from a stage at the girl's eighth-grade graduation two years ago. "She was wearing cargo pants and a battered T-shirt while everyone else was in formal wear," Clarke said.
  
  Clarke, who is representing herself in court, said she will appeal to the state Supreme Court if she loses her appeal. "I'm a mother," she said. "I can't quit asking for help."
  
  full story: http://www.latimes.com/la-000044722jun26.story
  
  
  
• February 1992, Pediatrics, Vol. 89, No. 2
  Genital Injuries Resulting from Sexual Abuse:
  A Longitudinal Study
  By John McCann, MD; Joan Voris, MD; and Mary Simon, MD
  
  Abstract: Three children who incurred genital injuries as a result of sexual assaults were followed up on a longitudinal basis to document the anatomical changes which ensued. The subjects, who were 4 months, 4 years 5 months, and 9 years of age, were followed up for periods ranging from 14 months to 3 years. A multi-method examination approach and a 35-mm camera mounted on a colposcope were used to examine and record their injuries. Signs of the acute damage disappeared rapidly, and the wounds healed without complications.
  
  Following the resolution of the acute injuries, the changes created by the trauma remained relatively stable throughout the prepubertal years. The most persistent findings were irregular hymenal edges and narrow rims at the point of the injury. Over time the jagged, angular margins smoothed off. Disruption of the hymen exposed underlying longitudinal intravaginal ridges whose hymenal attachments created mounds or projections. There was little apparent scar formation. Even the injuries to the posterior fourchettes healed with minimal scar tissue and left only the slightest evidence of the trauma. With the onset of puberty, the hymenal changes in the oldest subject were obscured by the hypertrophy of this membrane. An examination technique which used a Q-tip to separate the redundant tissues demonstrated that the signs of trauma had survived.
  
  Pediatrics 1992;89:307-317; child sexual abuse, hymen, sexual abuse, prepubertal genital injuries, healing process.
  
  
  

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