APA guide helps psychological evaluations in child-abuse cases

A new set of guidelines will help psychologists conduct responsible, ethical child-protection evaluations.

By Scott Sleek
Monitor staff

Every day, courts are faced with deciding whether children should be removed from their homes to avoid further abuse or neglect. And they often turn to psychologists to help them make those decisions.

But as more psychologists turn to forensic work, they confront the complex issue of their proper role in those situations. Are they supposed to be completely objective? An advocate for the child? Or are they supposed to also champion the rights of the parents?even those accused of abuse? Even experienced psychologists working in this area recognize the importance and complexity of child-abuse evaluations.

APA has adopted a new set of guidelines that it hopes will help psychologists address these dilemmas when they conduct evaluations in child-abuse cases. The association?s Council of Representatives in February approved the 'Guidelines for Psychological Evaluations in Child Protection Matters,' a 20-page document that psychologists should consider when doing this type of forensic work.

APA?s Board of Professional Affairs (BPA) requested the development of the guidelines in 1995 in response to practitioners? concerns about their appropriate function in child-protection cases. Some say they?ve been surprised, for example, to find that judges or child-protection agencies will ask them to be subjective?to make unsupported interpretations or conclusions about an adult?s parenting abilities or a child?s risk for harm. Others are confused by the complexity of the legal system or may have insufficient understanding of child-protection laws.

'This is an extremely difficult area of practice,' says Catherine Acuff, PhD, immediate past chair of BPA?s Committee on Professional Practice and Standards (COPPS), which crafted the guidelines. 'One of the committee?s concerns was that psychologists will jump into this area of practice without realizing the expanded competence that?s needed. They need more than just good assessment skills.'

The necessary knowledge

In conducting such evaluations, psychologists frequently:

? Assess the child?s psychological state.

? Recommend a therapeutic intervention for the child and/or the parents.

? Consider the effect on the child of being returned to the parents or of being separated from them.

But they also need a solid understanding of forensic practice, as well as laws and regulations that apply to parental rights and child protection, says Acuff, also a member of APA?s Board of Directors. The guidelines urge practitioners to amass this knowledge before conducting child-protection evaluations. But the guidelines should be considered only a pronouncement of preferred professional conduct and not a mandate, Acuff says.

The child-protection guidelines recommend that psychologists:

? Strive to be objective, rather than acting as an agent of any particular party in the case.

? Examine whether the parents have been or can be rehabilitated in cases where the termination of parental rights is being considered.

? Gain specialized competence not only in psychological assessments of children, adults and families, but in forensic practice, child and family development, child and family psychopathology, the impact of separation on the child and various types of child abuse.

? Avoid multiple relationships, such as conducting a court-ordered evaluation of a child or family while also treating them in therapy.

Concerns

In devising the guidelines over the last three years, COPPS sought the input of other APA boards, committees and divisions, state psychological associations, and many individual practi-tioners around the United States. The feedback was incorporated into the final draft that council adopted during its February meeting in Washington, D.C.

Some APA members remain opposed to the guidelines. They say the document is too vague, and they fear it holds psychologists to an abstract standard that increases their vulnerability to accusations of malpractice.

'My concern is that the guidelines could be used, for example, to impeach a psychologist who has done a good evaluation,' says T. Richard Saunders, PhD, who chairs a Div. 42 (Independent Practice) task force on child protection evaluations. 'The document allows an opposing attorney to say that the exam the psychologist used is imperfect. But the exam is always imperfect. How imperfect is a matter for the court to judge.'

Lenore Walker, EdD, a Denver psychologist who is also a Div. 42 member, adds that the document seems to inhibit the use of clinical judgment and flexibility in child-protection matters. And it also doesn?t utilize the recommendations by other APA panels, including two that she chaired, that have offered psychologists guidance on the handling the challenges they face when working as family-violence experts for the courts, she says.

The guidelines are only recommendations and may not be applicable to every case, Robert Brown, PhD, a University of Maryland psychologist and BPA chair, concedes.

But the document will protect psychologists rather than imperil them because it will show the courts, child-protection agencies and other relevant parties the type of conduct they should, and shouldn?t, expect from practitioners conducting these evaluations, say Brown and Steven Sparta, PhD, a San Diego forensic psychologist and COPPS member who helped write the guidelines.

'Frequently, when psychologists are pulled into these cases, they?re given tasks that are extraordinarily complex,' Sparta says. 'The guidelines, I believe, will help psychologists not only review their own practice, but also guide the courts and agencies on what psychologists can and can?t do.'

The guidelines also shouldn?t hamper clinical flexibility, Acuff says. The document states that the recommendations 'should not be construed as definitive or intended to take precedence over the judgment of psychologists.'

Sparta says it is fair to ask whether the guidelines will be used by others in an attempt to discredit the work of a good psychologist.

However, he says, it?s equally fair to ask whether the guidelines can help a psychologist who has done a good job and is being unfairly criticized?

'When a lawyer or client is using an unfair misrepresentation about what constitutes reasonable standards of practice, the guidelines can be a shield and not a sword,' Sparta says.

To obtain a copy of the guidelines, contact the APA Practice Directorate Office of Legal and Regulatory Affairs at the APA address, (202) 336-5886.