Joseph McGill, Robin M. Deutsch, and Robert A. Zibbell, Visitation and Domsetic Violence: A Clinical Model of Family Assessment and Access Planning, 37 Fam. and Conciliation Courts Rev. 315 (1999).

 

     With increasing frequency, courts and legislatures are focusing attention on visitation disputes in which there are allegations of domestic violence. This article explores the requirements for a careful assessment of the domestic violence issues, the parenting capacities of the adults, and the coping skills of the children. It then proposes a decision tree model of access recommendations that incorporates the information gathered from the evaluation procedures.

 

  With increasing frequency, American trial courts are promulgating guidelines for child visitation in divorce cases that include allegations of domestic violence. Of particular concern to the courts is "the risk of harm and potential for continuing abuse through the children ... when making visitation orders" (Irwin, 1996). In Massachusetts, Custody of Vaughn (1996) requires trial judges to make detailed findings of fact regarding the domestic violence and its effect on the child. If physical or legal custody is awarded to the perpetrator of abuse, the judge must indicate how this award advances the best interests of the child.

 

  Vaughn is consistent with research that suggests that high levels of parental conflict, a history of domestic violence in the family, and/or witnessing domestic violence may each, independently, predict maladjustment in children (Famularo, Fenton, & Kinscherff, 1993). In a study of juvenile court  involved children, Famularo et al. (1993) found that witnessing violence was one of three predictors of post traumatic stress disorder in children. In that study, children who witnessed domestic violence or who were sexually maltreated had a much greater likelihood of developing post traumatic stress disorder than did those whose histories of maltreatment did not include such incidents. Studies have also suggested that early exposure to violence tends to decrease prosocial behavior, fosters the understanding that violence is an acceptable form of conflict resolution, and increases the potential for violent behavior (Jaffe, Wilson, & Wolfe, 1988).

 

  Children in homes where domestic violence occurs are at an increased risk for abuse. It is estimated that that there is a 40% overlap between witnessing *316 battering and being directly abused (Appel & Holden, 1998; Finkelhor, 1983). Partners who are being abused may also be psychologically unavailable to their children. This can increase the likelihood of abuse or neglect of their children (Straus & Gelles, 1990). In a review of 29 empirical studies of the effect of witnessing domestic violence on children, the authors concluded that children who witness domestic violence are at risk for difficulties in behavioral and emotional development (Kolbo, Blakely, & Engleman, 1996).

 

  Assessing the impact of family violence on children and creating safe and effective parenting plans is a challenge facing professionals across several disciplines. In this article, we first describe the scope of the investigation that must be undertaken to address the issues of domestic violence and child access. We then discuss a comprehensive assessment of the family and offer a basis on which one may determine parents' access to, and safety planning for, children.

 

ASSESSING DOMESTIC VIOLENCE

 

  A comprehensive evaluation of domestic violence requires two things. First, the evaluator must identify the type and extent of the violence. Second, various systems internal and external to the family must be analyzed and an assessment made regarding what role these systems played in contributing to or perpetuating the violence. Third, the evaluator must assess the effects of the violence on both parents and children.

 

  The evaluator has a number of tools available for gathering information about domestic violence. The evaluator may review police reports and criminal records, conduct structured interviews with family members and significant others, and use instruments designed to assess the nature and frequency of the violence. Three such tools will be briefly discussed here: the Conflicts Tactics Scale (CTS) (Strauss, 1979), the Assessment of Conflict (ACS) (Garrity & Baris, 1994a), and the Domestic Violence Visitation Risk Assessment (DVVRA) (Trial Court, Commonwealth of Massachusetts, 1994).

 

  The CTS is appropriate for use with both victim and perpetrator. This scale measures a range of conflict resolution methods and is divided into three major categories: reasoning, verbal aggression, and violence. The CTS subdivides verbal aggression into passive and active forms, and physical violence into minor, moderate, and severe. These more narrowly defined subcategories allow a more precise understanding of the nature and frequency of family violence. The method selected for scoring the CTS serves to further assess violence. The simplest scoring process totals the respondent's scores *317 in each category. However, this method uses a numerical scoring of a one point increase per type of answer and offers little raw score information based on the frequency of the violence. The recommended scoring method is the frequency weighted method, which provides useful information and a clearer understanding not only of the violent acts but of their frequency over time.

 

  The ACS consists of five levels of conflict: minimal, mild, moderate, moderately severe, and severe. This assessment relies on the completion of an extensive social and relationship history of both partners. Information thus gathered is used to determine the level of conflict through use of descriptors within each category. However, the evaluator must be well schooled in the area of domestic violence in order to use the form effectively. The evaluator must accurately define and distinguish between types of behaviors. For example, the ACS defines the occasional berating of the parent in front of the child as mild conflict, while categorizing verbal abuse as moderate conflict. However, the evaluator is offered no specific guidelines with which to distinguish these behaviors. Similar to this, the authors categorize occasional quarreling as a mild degree of conflict and loud quarreling as moderate conflict. Garrity and Baris (1994a) include some behaviors not found in the CTS, specifically, family dynamics that triangulate the child into the parental conflict or attempt to control the other parent through the child. Their references to attempts to form coalitions with the child, whether occasional or ongoing, are useful to the investigator in assessing these dynamics.

 

  The DVVRA is the third tool. As with the ACS, evaluators gather information to assess the level of violence through detailed interviews and record reviews. This tool expands upon the CTS and the ACS by including an even broader range of violent and/or controlling behaviors. It advises the evaluator to secure information about the destruction of property, forced sexual contact, the sadistic infliction of pain, and threats to abduct the child. It includes an extensive array of psychologically and economically coercive behaviors, including isolation from family and friends, the sabotaging of friendships, accusations of sexual infidelity, persistent telephone calling, and stalking. Generally, the descriptors used to define behaviors are more specific than those in the ACS, making it easier for some evaluators to categorize behaviors. However, unlike the other two measures, the DVVRA does not categorize varying levels of conflict or violence, offering only a rough continuum of behaviors. Contained in this publication is a categorical breakdown of types of violence based on the work of Johnston (1992): chronic pervasive control reinforced by severe violence, violence associated with psychiatric illness, assertion of control by physical intimidation by the primary caregiver, and isolated violence engendered by separation. To gain a more accurate assessment*318 of the nature and extent of violence in a family, the evaluator should combine the continuum of behaviors presented with the categories in order to use this tool.

 

  Access or visitation planning, however, should usually go beyond an analysis of the nature and extent of violence. The evaluator must also obtain a clear understanding of any other factors that may have contributed to the violence as well as the effects the violence has had on all members of the family, especially the children. Only then can a comprehensive plan be developed to safeguard the children, provide for their emotional healing as well as that of the primary caretaker, and address needed change by the perpetrator.

 

CONTRIBUTORY FACTORS IN DOMESTIC VIOLENCE

 

  Social science research indicates that a number of psychological and social factors contribute to domestic violence. The evaluator should assess these factors in the perpetrator. Psychological factors associated with domestic violence include psychopathology, personality disorders, and depression. Although it is only an occasional factor in domestic violence, psychopathology, or the presence of a major psychiatric illness in the perpetrator, should be explored as a possible causative or contributing factor in family violence. Moreover, the evaluator should consider the presence of those personality disorders that have a high correlation with domestic violence, such as the antisocial (Kempe & Helfer, 1972) and borderline (Prodgers, 1984) personality disorders and passive aggressive personality. The antisocial personality is characterized by a diagnosis of conduct disorder during childhood or adolescence, disregard for social norms, lack of remorse, poor insight, failure to adhere to a life plan, and other traits that indicate a general lack of appreciation or understanding of societal norms. The borderline personality is characterized by impulsive behavior, a history of intense and/or unstable relationships, intense anger with poor control, frequent mood swings, and physically self harming or damaging behavior. The passive aggressive personality has the traits of procrastination, intentional inefficiency, stubbornness, and difficulty in developing or maintaining trust (American Psychiatric Association, 1994).

 

  Bolton and Bolton (1987) noted that depression was the most consistently identified affective disorder in violent families. Many individuals suffering from depression, especially a major depressive episode or chronic depression, experience suicidal ideation. Mohr and McKnight (1971) found that many suicidal parents have a tendency to also be homicidal. Other psychological *319 factors common among those who perpetrate domestic violence are helplessness or hopelessness, poor impulse control, and the inability to experience pleasure.

 

  Moving beyond the psychological processes of the perpetrator, the evaluator should also examine the perpetrator and family's wider social system. There are a number of environmental and societal risk factors associated with abuse in families, including unemployment, use of illegal drugs, spouses of different religious backgrounds, and a history of domestic violence in the family of origin that was witnessed by the perpetrator (Gelles, Lackner, & Wolfner, 1994). Assessment of the presence or influence of alcohol on family interactions is an important contextual factor. The relevance of the presence of substance abuse within the family in which domestic violence has occurred is highlighted by a recent report by the Office of the Commissioner of Probation of Massachusetts. This study of civil restraining orders in Massachusetts indicates that more than 50% of restraining order violators have a drug and/or alcohol abuse problem (Adams & Powell, 1995). This is not surprising given that marital violence is directly related to information processing, decision making, and behavioral choices. Other social factors found to have a correlation with domestic violence include multiple environmental stressors such as underemployment and unemployment, stress in the workplace, a belief system that incorporates corporal punishment or physical abuse as effective means of shaping behavior, and social isolation of the perpetrator and/or family.

 

  None of these contributing factors are exculpatory. However, a thorough understanding of them permits an evaluator to make specific recommendations for further treatment or to design interventions that may safeguard the children and decrease the possibility of future violence. For example, the evaluator may recommend that the batterer not only attend a program for abuse perpetrators but participate in a parenting class to learn more effective means of influencing a child's behavior. Involvement of the aggressor in other forms of self help groups, such as Alcoholics Anonymous, can decrease isolation. In addition, psychiatric treatment to relieve depression or mitigate the impact of psychopathology may also serve to interrupt the cycle of violence and further safeguard the children.

 

EFFECTS OF DOMESTIC VIOLENCE ON CHILDREN

 

  The third factor that requires investigation is the effect of violence on the children. Children living in homes where there is violence between adults are two to three times more likely than other children to be abused (Jouriles, *320 Murphy, & O'Leary, 1989; McCloskey, Figueredo, & Koss, 1995; Straus & Smith, 1990). Even if they are not the direct targets of the violence, the children suffer as witnesses to aggression between their parents (Berry, 1996). Children who have witnessed domestic violence present a variety of emotional factors, sense a lack of control over their life circumstances, and experience feelings of hopelessness and helplessness. Children from violent families may experience depression, anxiety, and an increase in somatic complaints, or they may externalize their distress through aggression and delinquency. Sibling relationships may be compromised by family violence, and intersibling aggression may result from prolonged exposure to violence (Moore et al., 1990). Peer relationships may be problematic, and these difficulties, if left untreated, may contribute to further personal adjustment problems.

 

  Children from violent homes are at greater risk for experiencing severe forms of corporal punishment and intense verbal aggression from parents than are children from nonviolent homes (Jouriles & LeCompte, 1991; McCloskey et al., 1995; Straus, Gelles, & Steinmetz, 1980). In addition, mothers, who are typically the primary caregivers post separation, may experience depression if they are victimized. This may disrupt their ability to attend to and monitor the behaviors of their children (Jouriles, Barling, & O'Leary, 1987). A thorough investigation of the children's and caregivers' responses to the violence may produce recommendations for treatment of the children and the caregiver and may be incorporated into the report to the court. Such recommendations may have a significant impact on the postdivorce adjustment of the children.

 

  Although witnessing violence between one's parents is associated with poorer adult psychological and social functioning (Henning, Leitenberg, Coffey, Turner, & Bennett, 1996), it is not clear that there is a direct, linear relationship between witnessing violence and diminished adult psychological and social functioning. Recent research has focused on variables that may mediate the effects of witnessing parental violence on short term and long term development and functioning. These variables include conflict resolution strategies that do not expose the child to verbal aggression and conflict, and perceived parental caring and support (Henning et al., 1996). Parenting capacity is clearly an area to consider when assessing the impact on the children of witnessing parental violence.

 

ASSESSMENT OF PARENTAL CAPACITIES

 

  Research on family violence suggests that partner abuse, specifically wife abuse, results in significant stress on the woman, who may respond with increased *321 physical and psychological symptoms as well as diminished competence in child management behaviors (Jaffe, Wolfe, & Wilson, 1990). The combination of exposure to traumatic events, the stress on parenting, and decreased parental effectiveness results in increased stress for the children. Therefore, consideration must be given to the possibility that parenting capacities have been directly compromised by the violence perpetrated on that parent and that without that stressor more effective parenting can be fostered. An important component of this assessment should be a consideration of the primary parent's coping responses. In the case of battered women who describe extreme anxiety and other stress related dysfunctional behaviors, children are more likely to be described as having adjustment problems in the clinical range (Wolfe, Jaffe, Wilson, & Zak, 1985). However, there is some literature that suggests that the mental status of the primary parent in these circumstances may not mediate the effects of violence on the children (McCloskey et al., 1995; Richters & Pellegrini, 1989).

 

  Adequate parenting capacities are important mediators of developmental risk to children who have been exposed to ongoing violence. The baseline parenting capacity is to provide adequate food, shelter, clothing, and health care for children. The consistency of that care can be affected by the presence of family violence. Particularly in the cases of classic battering, a woman may avoid leaving the house if she has visible signs of having been battered. Basic caretaking tasks might be compromised. Those basic caretaking tasks may be reconstituted after a parent separates from the other parent. In a safer setting, a parent has the opportunity and responsibility to provide for the children's basic needs consistently and predictably. Depression, other psychiatric illness, and substance abuse need to be ruled out as factors contributing to dysfunction as well.

 

  The ability to keep children safe from harm is clearly suspended when children are witnesses to and/or the subjects of violence at home. How parents attempt to protect their children from these exposures should be assessed. Children who witness their parents engaged in physical conflict tend to perceive their parents as less caring than do children who have not lived with that stressor (Henning et al., 1996). The first level of protection comes from an understanding that family violence is a problem for the children. The evaluator should determine if the parent understands that it is acceptable that his or her children are learning that violence is a way to get what one wants, manage stress, regulate emotion, and resolve conflict. Further assessment focuses on the parent's ability to meet the children's needs. Children exposed to physical conflict between their parents are more likely exposed to verbal conflict as well, and long term social and emotional functioning is worse with *322 this double exposure (Henning et al., 1996). Assessment questions focus on the parent's repertoire of strategies for managing anger and conflict.

 

  Some parents who engage in physical and/or verbal aggression attempt to engage the child in the conflict. The parenting capacity of separating one's own needs from the needs of thechild is quite limited during these occurrences. In these cases, the parent's hostility for the spouse is not submerged, and the child is enlisted as a partner to endure, witness, and participate in the hostility and abuse. Evaluation of the parent's capacity to separate the child's views and needs from his or her own will help the evaluator assess that parent's capacity to parent in the face of the special emotional needs the child may have as a result of interparental conflict.

 

  As well as understanding that violence is problematic for a child, can that parent take the child's perspective and respond to the child's needs? Domestic violence affects children in serious ways. For infants, exposure to noises, tensions, and rapid shifts in posture or physical stance can precipitate irritability, sleep disturbance, and inability to settle themselves. Exposure to domestic violence at early ages compromises children's sense of safety and security as their needs may be unreliably or unpredictably met by the caretakers whom they are supposed to trust. Long term exposure to violence for preschoolers interferes with the process of reaching out and exploring and developing independence. In addition, preschoolers exposed to family violence have relative deficits in interpersonal sensitivity, or identifying the feelings of another (Hinchey & Gavelek, 1982; Rosenberg, 1987). Symptoms of whining, withdrawal, muteness, and sleep disturbance may be related to the domestic violence. For school age children, the symptom picture may be mixed. Living with high conflict may result in aggressive, oppositional, controlling, and anxious behaviors, or both undercontrolled and withdrawn constricted behaviors (Davis & Carlson, 1987; Jaffe, Wolfe, Wilson, & Zak, 1986; Wolfe et al., 1985). Distracting and intrusive thoughts and fears may interfere with attention and concentration. Children of this age may learn that conflict is resolved through violence and that rules may be arbitrary and unpredictable.

 

  Parenting capacities are a critical domain for assessment in order to make appropriate recommendations about coparenting and visitation arrangements. Of primary concern is whether parents recognize the problem and have an understanding of the impact of the conflict or violence on their children. Risk factors include (a) an absence of strategies for managing conflict or protecting the children from it, (b) incapacity to take responsibility for self or children, and (c) misuse or inadequate acceptance of resources or support to contain the conflict and respond appropriately to the children's needs. These factors suggest that the children will remain at risk for further exposure *323 to high conflict or violence and will be vulnerable to poor social and emotional functioning in adulthood.

 

ASSESSMENT OF THE CHILD

 

  Evaluation of the child requires data from multiple sources. From the parents, information about the child's presence during conflictual events is necessary. Conflictual events include tension at transitions, exposure to negative comments about the other parent, and observation of physical aggression.

 

  Tension at transition can range from parents restrained from having contact with each other, thus indicating to the child that one or both parents are dangerous, to witnessing parents provoke, lash out, or assault one another. Exposure to negative comments can be subtle, for example, "Make sure your father does not come up to the door if he knows what's good for him," to more overtly threatening, "I'm going to kill your mother." Threats to take the child from the other parent can strike fear into the child's heart.

 

  If a child has witnessed violence between the parents, certain information is necessary to understand what the child may have processed and how the child has encoded the events in memory. This information includes the child's whereabouts during these events, the communication between the child and each parent subsequent to theseevents, and whether the child has previously disclosed this information to anyone.

 

  Parents can also provide useful information about the child's eating and sleeping patterns, peer relationships, and behaviors at home and school. Completion of a child behavioral inventory such as the Child Behavior Checklist (CBCL) (Achenbach & Edelbrock, 1991) by each parent provides information about the child's emotional and behavioral functioning. Scores that are in the clinical range of significance indicate that the severity and/or frequency of the targeted behaviors require some form of therapeutic intervention. What needs further determination is whether the presence of these symptoms is related to the level of conflict between the parents or to exposure to violence, which may have been traumatizing to the child. In many studies where children exposed to family violence have been compared to children who have not witnessed interparental violence, results of the CBCL indicate a significantly higher score on both the internalizing and externalizing behaviors of the former group (Kolbo et al., 1996; McCloskey et al., 1995).

 

  Information from the child includes the reports of exposure to parental aggression; the experience of anxiety, depression, or fearfulness; the presence of aggressive, violent themes; and the child's report of coping skills. Coping *324 skills are defined as the child's attempts to gain control or a sense of mastery over the abusive situation witnessed or efforts to protect self, siblings, or parents. Radovanovic (1993) found that children who had more coping strategies and who could use cognitive redefinition, that is, thinking positively and flexibly, had better adjustment by parent report.

 

  Children may attempt to intervene in the conflict, thus distracting the parents and refocusing attention on themselves. This, like avoidance, can be a functional form of coping with this major stressor. However, it can compromise the development of the child's self esteem, self confidence, and ability to proceed along a normal developmental trajectory.

 

  Information from the child's school and school records can indicate whether the child's school performance has been affected on particular days or during particular periods of time. This source may also have information about parents' participation or involvement in the schooling of the child. The composite of information about the child is used to assess the level of dysfunction or maladjustment the child is experiencing as a result of the conflict or violence between the parents. The child's level of stress in relation to his or her coping skills must be considered in making determinations about parenting and access plans.

 

PRELIMINARY ISSUES IN MAKING ACCESS RECOMMENDATIONS

 

  Once the evaluation determines the existence, frequency, and intensity of any alleged domestic abuse; its impact on the children; and the capacities of the parents to support the children, there remains the challenge of making recommendations to the court regarding parental access to the children. There are, however, some minimum protective considerations general principles that serve as a framework within which individualized plans will be made. First, parenting plans need to be based on the unique fact pattern of the family. One should assign priority to creating a situation in which "the children must be safe and feel safe in the care of their parents" (Garrity & Baris, 1994b, p. 88) while attempting to preserve whatever positive aspects of parent child relationships are possible (Johnston, 1992). Moreover, "the well being of the children must be the primary consideration over and above the parents' right to visitation" (Garrity & Baris, 1994a). Thus, there is a balance that must be struck between the children's need for physical and emotional security, the parent victim's safety needs, and the abusing parent's rights to access to the children (Massachusetts Continuing Legal Education, 1996).

 

  *325 Second, where custody is in dispute and domestic abuse has been confirmed, preference should be given to that parent who has not perpetrated violence or abuse and who can provide a violence free environment for the children (Johnston, 1992). If violence has been mutual, close evaluation is necessary to determine whether or how much of the violence of the victim was defensive or retaliatory (Custody of Vaughn, 1996).

 

  Third, as addressed earlier in this article, victims of violence often suffer from diminished parenting, which may be evident at the time the violent relationship is terminated. Special considerations should be given to allowing that parent to reconstitute him  or herself before determinations that have long term implications are made (Johnston, 1992). Even with therapy, some psychological problems may be resistant to short term improvement, such as the presence of substance abuse or a serious mental disorder that demonstrably diminishes parenting capacity. Third parties (e.g., family, close friends), if they are available and appropriate, should be given preference for temporary custody if a parent has been either moderately or severely abusive (Johnston, 1992). In some instances, abusive spouses will have circumscribed their partners' friendship or family networks, thus limiting the range of useful alternatives (Trial Court, Commonwealth of Massachusetts, 1994). If there are no other available, appropriate persons, and the violence or threat is not recent (and the children were not victims themselves), then custody should go to the abusive parent, perhaps with a referral to the child protective agency for services, a treatment appropriate to deal with the nature of that abuse, and a parenting program. Johnston and Campbell's typology adopted by the Association of Family and Conciliation Courts suggests that all abuse is not alike and that the kind of treatment needed for an abuser should vary with the nature and circumstances of the abuse (Massachusetts Continuing Legal Education, 1996). If the children were themselves mistreated by the victim of domestic violence, or the domestic violence was recent, ongoing, and the children continue to witness the abuse, then foster care (or willing and capable relatives of the victim), perhaps with a care and protection petition, might be indicated until the abused partner recovers enough capacity to parent effectively and protect the children. These are, of course, arguable solutions, as foster care has its own share of difficulties (Mnookin & Weisberg, 1995). Where ongoing conflict and a potential for violence exists, access plans approaching shared physical custody should be discouraged (Depner, Leino, & Chun, 1992; Johnston, Kline, & Tschann, 1989).

 

  Fourth, where access is the primary issue, all arrangements for parent child contact should be made with the goal of limiting the child's exposure to potential violence and to ensure the safety of the parent victim. Where ongoing conflict and a potential for violence exists, and the child manifests stress *326 reactions to transitions, the frequency of the exchanges should be minimized (Johnston, 1992). If the violence in the family was both ongoing and severe and threatened to continue after the separation (for some women, this period can be the most dangerous), the location of the victim parent and child may need to be kept secret until that danger is no longer likely (Zorza, 1995).

 

  Fifth, supervised access should be arranged where there is an indication of quite recent or current violence or threats to inflict serious harm (American Bar Association, 1994). Removal of supervised access would require termination of violence or threats, successful completion of an approved course of counseling for the ending of violence, and some level of reasonable comfort for the children. One would have to establish that there was no pattern of involvement of the children in the conflict, such as occurs when one parent denigrates or threatens the other.

 

  Last, because the emotional andphysical safety of children are paramount, a suspension of parental access would result from the failure of the alleged perpetrator to contain violence or threats to commit violence (or to kidnap the child), repeated noncompliance with the rules of supervised visitation (whether or not in an approved center), or significant distress on the part of the child as part of the visitation process (despite counseling to minimize these reactions).

 

FROM CLINICAL ASSESSMENT TO PARENTING PLAN

 

  The evaluation of the family should generate data about family protective factors, such as parent and child strengths, and about family vulnerability factors, such as parent and child weaknesses, including the nature of parental conflict, history of possible violence, contributory factors (such as substance abuse), and external variables (such as extended family support). Research on clinical judgment would suggest that the linear addition of reliable factors gathered from clinical investigation may be the simplest valid method of prediction (Dawes, 1994; Grove & Meehl, 1996). However, there is currently insufficient data to permit any evaluator to base recommendations on any formula. The decision trees (see Figures 1, 2, and 3) are a suggested clinical approach to basing parenting plans on a few variables that can be reliably assessed through the methods discussed above.

 

  The developmental assessment should result in an understanding of the child's coping abilities. Dividing these abilities into two categories, adequate and inadequate coping, would allow for some estimate of the current coping ability of the child. For example, a CBCL (Achenbach & Edelbrock, 1991) T *327 score below 60 would indicate adequate coping, whereas a score above 60 would signify inadequate adaptive skills. This manner of behavioral survey would also serve as a check on the reporting elsewhere of any post traumatic stress disorder symptoms that would be explored in greater depth through various interview formats. As an alternative, a clinical determination of coping ability could also be made from interview and collateral data. Inadequate coping would trigger a referral for child therapy. Depending on the level of conflict or existence of domestic abuse, it might also warrant a more restrictive type of access arrangement, as it would suggest that the child could not handle much more stress. One should explore the specific symptoms in some detail in the developmental evaluation as they might offer some clue as to the nature of problems and causation.

 

  The parenting plans suggested by the decision trees represent a continuum of choices, with the range being from lesser to greater restrictiveness, much as special education prototypes are defined. The goal is to create the least restrictive or "least detrimental" (Goldstein, Freud, & Solnit, 1979) plan appropriate to the needs of the children and the interests of the parents. In these plans, the range of access can vary from normalized, overnight and weekend contact to daytime only access, to short visits, and on the other end, to a suspension of contact between child and parent. The level of restrictiveness can span a continuum of totally unsupervised contact, to supervision by family or friends, to professional supervision of visitation, including therapeutic supervision where clinical intervention is necessary to repair a parent child relationship. The spectrum of services supplied to the family would run the gamut of traditional therapy for children and/or parents, to batterer's treatment groups, substance abuse counseling, parenting education, and possibly, the installation of a parenting coordinator or special master to monitor the family for the court and make interim recommendations as needed.

 

INTEGRATION OF EVALUATION MODEL AND DECISION TREES

 

  Decision trees require logical connections at the branching points. The pathways are not rigidly set because the research data to support that approach are not available. However, they do offer some systematic and understandable maps for the parents to appreciate how they can reach a more normalized postseparation and divorce arrangement and create peace for their children. Parents might also be able to envision the steps they will need to take to reach their goals. One might conceptualize these connections as choice points or filters that require certain data to be sifted in order to decide *328 which route to select. The decision trees in Figures 1, 2, and 3 require the evaluator to use the data from the assessments to categorize several factors that research has shown to be related to the well being of children after separation or divorce. Although this may diminish some of the richness and uniqueness of the family information in a clinical sense (and seem sterile to the clinician), it should increase the reliability and reproducibility of clinical decisions, assuming, of course, that the classifications reflect real differences among people, which only research can inform. The evaluation data allow the clinician to answer the following filter questions in a systematic (and repeatable) way:

    1. What is the level of conflict? (low/moderate/high)

    2. Was the child a witness? (yes/no)

    3. Was the child a victim? (yes/no)

    4. What is the parenting capacity of the adults? (adequate = +/ inadequate = )

    5. Is the child currently "caught" in the conflict? (yes/no)

    6. What is the current level of the child's coping skills? (adequate = +/ inadequate = )

 

  As a general rule, the greater the level of conflict, the more recent it was, and the more it has involved the children, the more restrictive would be the resulting recommendation for access. The degree of restrictiveness of these arrangements can be mitigated by the absence of children being either victims or witnesses or by the adequacy of the children's ability to cope. The general skills of the parents can be considered separately from the specific issue of whether they involve the children in the conflict, but generally adequate care by a parent would be considered a protective mediating factor. A court appointed monitor, such as a parenting coordinator (Garrity & Baris, 1994a), can serve to modify the restrictiveness of access over time. That professional would structure clear time intervals for reassessment and clarify for the family the kinds of issues under review through that form of family oversight. The status of the various criteria at the next review can enable the parenting coordinator to gauge the safety and security of the children, on which he or she would base subsequent recommendations. The decision trees in Figures 1, 2, and 3 include these factors in a logical sequence that can make access determinations more reliable and systematic.

 

  In the end, after thorough evaluation, the determinations of the nature and extent of the violence, the parenting capacities of the adults, and the psychological status and coping skills of the children are all a mixture of clinical judgment and the limited science in this area. The decision trees are, likewise, clinical tools to create a logical sequence of recommendations for child access in separating or divorcing families in which domestic violence has *332 played a part. As research in this field provides more answers about how children cope with family aggression, it will be possible to create more detailed plans to provide for their security and healing.

 

TABULAR OR GRAPHIC MATERIAL SET FORTH AT THIS POINT IS NOT DISPLAYABLE

TABULAR OR GRAPHIC MATERIAL SET FORTH AT THIS POINT IS NOT DISPLAYABLE

TABULAR OR GRAPHIC MATERIAL SET FORTH AT THIS POINT IS NOT DISPLAYABLE

 

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  Joseph C. McGill, LICSW, is a licensed independent clinical social worker on the staff of the Child and Family Forensic Center and an instructor in psychiatry in the Department of Psychiatry at the University of Massachusetts Medical Center in Worcester.

 

  Robin M. Deutsch, Ph.D., is a licensed psychologist and director of training in the Children and the Law Program at Massachusetts General Hospital, Boston. She is an instructor in psychiatry in the Department of Psychiatry at Massachusetts General Hospital and Harvard Medical School and is in private practice in Wellesley, Massachusetts.

 

  Robert A. Zibbell, Ph.D., is a licensed psychologist in private practice in Framingham, Massachusetts. He is also an associate in psychiatry with the Child and Family Forensic Center at the University of Massachusetts Medical Center, Worcester.