Responding to Severe Parent–Child Rejection Cases Without a Parentectomy: A Blended Sequential Intervention Model and the Role of the Courts

There have been significant developments over the past two decades that have expanded our understanding of the dynamics of parent–child contact problems post‐separation, which have resulted in some changes in judicial processes to respond to these cases. One significant advancement is a more sophisticated differentiation of the nature and severity of contact problems, which better assists legal and mental health professionals to provide more suitable legal and clinical interventions. However, the issue of innovative court processes has received limited attention. The authors describe a subgroup of families within the “severe” category, for whom an expanded intervention model, referred to as a Blended Sequential Intervention is proposed. This approach involves a reversal of care with court mandated therapeutic support for the rejected parent and child, but also involves the favored parent in the therapeutic plan from the outset, and is intended to avoid a permanent “parentectomy” of the child from either parent. The authors discuss how the courts should respond to these cases, and posit that until all therapeutic treatments are exhausted, interim orders should be preferred to final determinations, and judges should maintain oversight. The authors discuss the critical role of judicial leadership in working with lawyers and mental health professionals to manage and address the issues in these high conflict cases.     

Behavior on the ward of personality-disordered inpatients and chronically psychotic inpatients during a three-year stay in a Dutch forensic psychiatric hospital

To gain insight into the behavior of a group of personality-disordered patients and a group of chronically psychotic patients during their stay in a Dutch forensic psychiatric hospital, data on these patients were collected biannually for seven years. Three aspects of the patients’ behavior were examined: the prediction of institutional behavior shortly after admission, changes in the patients’ behavior on the ward during their stay in hospital, and the prediction of these changes. In the personality-disordered patients, observed irritation/anger and aggressive behavior on the ward turned out to be positively related to psychopathy, the PCL-R lifestyle and antisocial facets, and the neuroticism domain. A positive relationship was also found between aggressive behavior on the ward and trait anger. In the chronically psychotic patients, a positive relationship was found between irritation/anger and the PCL-R interpersonal and lifestyle facet. During a stay of three years, the aggressive behavior of both patient subgroups, which was already low at the start, did not decrease further, but their prosocial behavior increased. In the personality-disordered patients, relatively high scores on the antisocial facet of the PCL-R indicated an increase in prosocial behavior, whereas in the chronically psychotic patients no relationship was found between any PCL-R facet and behavior change. Effect studies on treatment programs for forensic psychiatric inpatients have to contend with the problem of a low base rate of institutional aggression. Therefore, we advise that such studies focus not only on a decrease in negative behaviors but also on an increase in positive behaviors.     

Secondary Traumatic Stress in the Courtroom: Suggestions for Preventing Vicarious Trauma Resulting from Child Sexual Abuse Imagery

The internet and social media have added to an increase in sexual imagery. As a result, law enforcement, judicial officers and court ordered counselors will be exposed to an increase of images. While not every individual will experience post‐traumatic stress symptoms, it is anticipated there is risk for impact. The impact of viewing images can include an increase in vicarious trauma symptoms, burnout, and a possible decrease in impartiality. This paper offers suggestions for self‐care in the services of preventing collateral damage.