Standard 2.01(a)

Standard 2.01(a) Boundaries of Competence of the APA ethics code requires that psychologists practice –  only – within the domains of their professional competence based on their education, training, and experience. The APA ethics code is not optional for psychologists, it is mandatory, and all professional ethics codes for other categories of mental health professional (e.g., marriage and family therapists, social workers, and licensed professional counselors) also contain standards related to boundaries of competence.

2.01 Boundaries of Competence
(a) Psychologists provide services, teach, and conduct research with populations and in area only within the boundaries of their competence, based on their education, training, supervised experience, consultation, study, or professional experience.

 The domains of competence required for court-involved pathology when a child is rejecting a parent include:

• Attachment pathology (Bowlby & others)
• Delusional thought disorders (DSM-5 & personality pathology)
• Family systems pathology (Minuchin & others)
• Child abuse and complex trauma (van der Kolk & others)
• Personality pathology (Millon & others)
• Court-involved custody conflict

All of these domains of competence are required, based on the psychologist’s education, training, and experience as documented on their vita.

Standard 2.01(c)(d)

Failure to possess the necessary competence in any of these areas would activate the psychologist’s obligations for remediating these deficiencies pursuant to Standard 2.01 sections (c) and (d), typically through consultation with a professional who is competent in the required domain of professional knowledge

(c) Psychologists planning to provide services, teach, or conduct research involving populations, areas, techniques, or technologies new to them undertake relevant education, training, supervised experience, consultation, or study.

The “areas” include attachment pathology, delusional thought disorder pathology, family systems pathology, child abuse and complex trauma, personality disorder pathology, and court-involved custody conflict. It is the incumbent responsibility of the involved mental health professional to seek appropriate consultation for any “area” of competence deficit.

(d) When psychologists are asked to provide services to individuals for whom appropriate mental health services are not available and for which psychologists have not obtained the competence necessary, psychologists with closely related prior training or experience may provide such services in order to ensure that services are not denied if they make a reasonable effort to obtain the competence required by using relevant research, training, consultation, or study.

Psychologists may provide services in deficit domains if they are the only available resource, have closely related experience, and “they make an reasonable effort to obtain the competence required” usually through consultation with a professional who is competent in that area.

These are the required – mandatory – ethical obligations related to boundaries of competence for all psychologists. It is their obligation to ensure their compliance with all Standards of the APA ethics code.

Family Court Professionals & 3.04

With regard to family court custody conflict, I am substantially concerned that the involved mental health professionals are practicing beyond the boundaries of their competence in potentially multiple domains based on their education, training, and experience, and that they have failed their obligation to seek the consultation required to remediate their domains of professional deficit.

As a result of their potential violation and seeming disregard of obligations for competence set forth in Standard 2.01 of the APA ethics code (and other professional ethical standards), I am substantially concerned that the involved mental health professionals have misdiagnosed the pathology in the families seeking their involvement to the significant harm of the targeted parent and child. This seeming violation to Standard 2.01 therefore cascades into a second violation to Standard 3.04 Avoiding Harm.

3.04 Avoiding Harm
(a) Psychologists take reasonable steps to avoid harming their clients/patients, students, supervisees, research participants, organizational clients, and others with whom they work, and to minimize harm where it is foreseeable and unavoidable.

Seeking consultation for areas of professional competence deficit (pursuant to Standard 2.01(c)(d) represents a reasonable step to avoid harming the client/patient from potential misdiagnosis and mistreatment because of the professional’s competence limitations.

It is not the obligation of the client/patient to ensure the competence of the psychologist or other mental health professional, it is the required (mandatory) obligation of the psychologist or other mental health professional to assume this professional responsibility.

Dr. Childress Domains of Competence

I am competent in all the required domains based on my education, training, and experience as documented by my vita. For clarity in examining the competence of the involved mental health professionals, I recommend focusing on two central areas:

1. Attachment pathology
2. Delusional thought disorders

Based on my education, training, and experience, I hold professional competence in both domains, i.e., attachment pathology and the diagnostic assessment of delusional thought disorders:

Domain of Competence: Attachment Pathology

A child rejecting a parent is an attachment pathology (i.e., a problem in the love and bonding system of the brain, i.e., the attachment system). A symptom of a child rejecting a parent would represent a “disorganized” attachment, i.e., the child has no organized strategy to bond to the parent, which is typically the product of abusive or psychotic-range parenting.

I have extensive competence in the domain of attachment pathology in childhood, with specialty training in Early Childhood Mental Health (ages 0-5), considered a restricted sub-specialty domain of professional practice because of the large amount of developmental brain system knowledge required. Early Childhood Mental Health (ages 0-5) is the domain of professional competence for attachment pathology.

My formal training in attachment-related pathology began under the supervision of Dr. Marie Poulsen, a nationally recognized expert in early childhood psychology, during my predoctoral internship at Children’s Hospital Los Angeles. I am trained in two specialized early childhood diagnostic systems: DC:0-3, which is stronger in diagnosing attachment-related pathology, and the DMIC, which is stronger in diagnosing autism spectrum disorders.

• DC:0-3R Diagnostic Criteria: Orange County Early Childhood Mental Health Collaborative.

• DMIC: Diagnostic Manual for Infancy and Early Childhood.

Regarding the treatment of attachment pathology, I am trained in two evidence-based attachment-focused interventions: Watch, Wait, and Wonder for infants, and Circle of Security for preschool-age children.

• Watch, Wait, and Wonder: Nancy Cohen, Ph.D. Hincks-Dellcrest Centre & the University of Toronto.

• Circle of Security: Glen Cooper, MFT, Center for Clinical Intervention, Marycliff Institute, Spokane, Washington.

I am also Certified in Parent-Infant Mental Health from Fielding Graduate University

• Certificate Program: Parent-Infant Mental Health: Fielding Graduate University, 1/14/08; 1/15/08.

My direct clinical experience in the diagnosis and treatment of attachment pathology is through my role as Clinical Director of a multidisciplinary assessment and treatment center serving children ages zero to five in foster care. Our primary referral source was Child Protective Services,

10/06 – 6/08: Clinical Director
START Pediatric Neurodevelopmental Assessment and Treatment Center
California State University, San Bernardino
Institute of Child Development and Family Relations

Clinical Director for an early childhood assessment and treatment center providing comprehensive developmental assessment and psychotherapy services to children ages 0-5 years old in foster care.

Domain of Competence: Delusional Thought Disorders

I have established competence in the diagnostic assessment of delusional and psychotic-spectrum thought disorders, established through over a decade of direct clinical research involvement and diagnostic reliability training under the supervision of nationally recognized experts in schizophrenia and psychosis. During my tenure on a major NIMH- research project in schizophrenia with Dr. Nuechterlein at UCLA, I received annual diagnostic reliability training for twelve consecutive years on the Brief Psychiatric Rating Scale (BPRS), one of the most widely used and empirically validated instruments for assessing psychotic symptoms, including hallucinations, delusions, disorganized thought, and affective disturbance.

9/85 – 9/98   Research Associate
UCLA Neuropsychiatric Institute
Principle Investigator: Keith Nuechterlein, Ph.D.

Area: Longitudinal study of initial-onset schizophrenia. Received annual training to research and clinical reliability in the rating of psychotic symptoms using the Brief Psychiatric Rating Scale (BPRS). Managed all aspects of data collection and data processing.

Dr. Nuechterlein is a leading national expert in schizophrenia research and a core investigator in the UCLA Aftercare Program, one of the longest-running and most respected research programs in psychotic disorders in the country. Diagnostic reliability training was conducted to an inter-rater reliability standard of r ≥ .90, to the gold-standard ratings of Drs. Joseph Ventura and David Lukoff, the Co-Directors of the Brentwood/UCLA VA Diagnostic Unit.

Craig A. Childress, Psy.D.
Clinical Psychologist
WA 61538481 – CA PSY 18857