The court needs to determine and issue a court order associated with reunification services that outline reunification is an “if” or a “when” scenario. This allows the court to inform the clinician (often referred to by the courts as the reunification therapist) as to whether or not the court is trying to determine “if” reunification will occur between the parent and child or “when” reunification will occur between the parent and the child. Should the court determine reunification between the parent and child is an “if,” a child custody evaluation or guardian ad litem may be necessary. Furthermore, the court needs to determine what the final goal for reunification is. For example, if the court determines that the question about reunification is when, the next step the court needs to determine is what the final goal needs to be. Often clinicians are ordered to begin counseling with the parent and child, and they are told to initiate a stair step visitation schedule. However, that schedule is not clearly defined and/or if a long-term goal is not pre-established, and clinician lacks the court’s guidance on what the court wants to see happen it impairs the clinician’s ability to ensure the efficiency of the reunification process. In some complex cases the court may determine they are not in the best position to determine when a parent may be capable of transitioning to more standard access. The Court of Appeals has held that in these cases the court’s order must be very specific as to: 1.) Identify the third party, 2.) Provide dates and other guidelines for the transition program, 3.) Provide dates when the standard possession order should begin, and 4.) Provide dates by which the third party should report to the court if these matters could not be accomplished as ordered. Moreover, the court may order specific services and/or additional requirements as conditions for parent-child contact to commence.
Often when a family parent-child dyad or family unit is referred to reunification services the court is no longer questioning “if” reunification services should occur and has transitioned to “when” reunification should occur. However, it is important to note that not all parents are capable of taking the steps needed to address the parent-child relational concerns and effectively engage in reunification services due to problems with substance abuse, domestic violence, untreated mental illness, and other challenges that interfere with healthy functioning to the point that those concerns must be the primary focus of treatment in order for the parent-child relationship to move forward prior to reunification services that include parent-child contact occurring. When a parent is impaired because of substance abuse, untreated mental illness, or other individual functioning issues, a reunification therapist may have to recommend that these issues be brought under control as the first step to moving a reunification plan forward. A parent who frightens a child by interacting while impaired (i.e. under the influence or paranoid) only further damages the relationship, which is the opposite of the goal of reunification therapy. Similarly, a parent who lacks insight as to how their past issues of domestic violence, abusive parenting practices, and other problems impact upon their child may do more harm than good in pushing forward. Additionally, the parent who focuses more on blaming others than loving their child may only further damage their relationship with the child. Another factor that can present itself is a non-estranged parent’s contributing to the dynamics of the interaction between the estranged parent and the child, and the goal is for this to be a positive contribution rather than another drain on the child’s emotional supports. To be clear, a parent who is engaged in alienating behaviors (intentional or otherwise) may sabotage the process in ways that are impossible to overcome. In such cases, the court may need look for more radical solutions to negate the toxic influence of the non-estranged parent on the child before repair of the estranged parent-child relationship is possible.
The utmost important factor to be considered is assessing the child’s readiness for reunification services via assessing their current capacity and functioning. There will be emotional challenges during reunification services for the child, therefore it should be expected to see some shifts to include but not limited to regression in the child’s functioning evident by changes in behavioral and/or emotional regulation and/or dysregulation. A child in need of inpatient hospitalization or residential treatment is likely too emotionally fragile to move forward with reunification services at that point. Likewise, there are going to be some children who are more resilient than others, and progress will vary in speed from one child to another, even with children in the same family unit. Therefore, appropriate pacing is crucial while ensuring a certain degree of functioning and emotional well-ness within the child while minimizing clinically significant regression in the child’s mental health and social-emotional functioning. Parents, child protection case workers, guardian ad litems, and the court may disagree over what is “too slow” or “too fast,” we must keep the focus on the child in question.
Clinicians can provide a wealth of mental health information to attorneys and the court; however, they are also often drawn into inappropriately making recommendations regarding conservatorship, possession, and access issues. Clinicians should focus on information gathering targeted at treatment issues and refrain from offering psycho-legal opinions regarding possession and access issues. Therefore, best practice is for clinicians to focus recommendations in reunification therapy on measurable behavioral issues and assessment of interpersonal functioning. Thus, the court should and can avoid asking clinicians to cross into ethical grey areas. If the aforementioned can be achieved it allows for the clinician to be able to structure identifiable scenarios and/or achieved treatment goals that prompt an increase in contact between parent and child as the parent-child relationship improves.
The initial intake phase is primarily administrative consisting of obtaining referral information to include but not limited to a court order outlining the various necessary guidelines for reunification services, completion of all agency intake paperwork by all involved parties, determining financial responsibility and setting up autopayments for services not covered by the client’s insurance plan. The initial assessment phase occurs next and primarily consist of clinician gathering biopsychosocial history associated with the family unit, identifying what deficiencies are present in the family functioning, and determining what interventions and/or professional services are necessary to treat them. Understanding current functioning in the context of historical issues for the family is critical in figuring out how to move forward with treatment planning and the reunification process. The next phase is the comprehensive treatment plan phase in which a comprehensive treatment plan is developed that outlines the various treatment goals, treatment objectives, and identifiable scenarios and/or achieved treatment goals that prompt an increase to the next level of contact between the parent and child. The clinician will outline a stair step approach to reunification of the parent and child that includes transparent and clearly outlined treatment goals and objectives and what scenarios prompt an increase in parent-child contact and/or decrease in parent-child contact. Please note movement between the steps, forward or backward, is automatic, based on various conditions (i.e. a negative urine analysis or successful completion of domestic violence programming), while at other times transitions might only occur after an assessment of progress on some factor or a combination of factors. After the treatment plan has been developed, agreed upon, and signed by all parties, reunification services will move forward as outlined within the treatment plan. The clinician will report back to attorneys, the court, and other individuals/entities involved in the reunification process (i.e. child protections case worker or guardian ad litem) throughout the reunification process.
Both parents will need to be informed of the court’s order and be able to express their understanding of the court order, allowing the clinician to observe non-compliance of the court order and/or reunification process. Additionally, it is required that a release of information be signed for all attorneys and/or other involved professionals, ensuring the clinician is able to report any issues of non-compliance to the court and other professionals if necessary. Multidisciplinary coordination of care and transparent communication is vital and assists in negating the reunification process from becoming ineffective and/or stationary, resulting in collateral barriers to achieving the pre-determined final goal.
Having such a predetermined treatment plan with the guidance of the court order in place allows the clinician managing the reunification process freedom from having to make decisions regarding possession or access. Rather, with the steps outlined within the comprehensive treatment plan and court order, the clinician can report back on behavioral progress of the parent which then serve as the identifiable scenarios and/or achieved treatment goals that prompt an increase in contact between the parent and child. This approach allows clinicians to assess what they were trained and licensed to assess, behaviors and interpersonal functioning. As with many areas in life, these are behaviors that have consequences, but the clinician is neither responsible for the parent’s behaviors or the resulting consequences, only assessing what those behaviors are. Examples of identifiable scenarios that would prompt a parent to move up to the next level of parent-child contact in the stair step plan may include but are not limited to completion and/or mastery of insight-oriented requirements, skill-related requirements, participation related requirements, time-related requirements, or some combination of all of these as predetermined and outlined in the treatment plan. Examples of identifiable scenarios that would prompt a parent to move down a level in parent-child contact in the stair step plan may include but are not limited to parental noncompliance, relapse, or other behavioral problems, one possible consequence is that instead of plateauing at the current parenting time plan the parent returns to an earlier level. This might mean returning to the step immediately previous to the current step, starting over from the beginning, or somewhere in between as to be determined by the clinician on a case by case basis to ensure each family’s individualized needs are addressed.
Reunification services involve both clinical time that if often covered by most health insurance plans and non-clinical time that is not covered by health insurance plans. All clinical time is billed to insurance whenever possible; however, the parent(s) and/or entity that is financially responsible for fees associated with the reunification services will be responsible for any co-payments and non-clinical fees associated with the parenting assessment process. Non-clinical reunification services fees are billed at $200.00 per hour rate. The parent whom is working reunification with their children will be financially responsible for paying all fees associated with reunification services. Should there be a standing court order that outlines an alternative break down of financial responsibility specific to reunification services, the break down outlined in the standing court order will be honored however it is not the agency’s responsibility to bill separate parties to accommodate an alternative break down of financial responsibility and therefore the agency will bill one individual and/or entity and the parent(s) and/or entities involved will need to determine how to accommodate the alternative court ordered break down of reunification service fees not covered by insurance. A copy of the standing court order is required to be submitted at the time of intake and services will be unable to move forward without a copy of the standing court order on record at Birchlawn Place Counseling Center, INC. Payments are due at the time services are rendered and parents are required to make the payment in office prior to the start of their reunification appointment and/or upon the request for the clinician to complete a clinical consultation with other involved entities and/or individuals (i.e. attorneys) or prior to drafting and releasing any clinical summaries to the courts. Should an entity (i.e. Department of Human Services/Child Protections) be financially responsible for reunification service fees, the entity is required to make payments on the 15th and 30th of each month on the account balance and pay the account balance in full at time of payment.