An Interdisciplinary Case Management Protocol for Child Resistance or Refusal Dynamics†

• Author: Francine Cyr,Élisabeth Godbout,Karine Poitras
• Date: 01 April 2020
• Published date: 01 April 2020
• DOI: http://doi.org/10.1111/fcre.12487

AN INTERDISCIPLINARY CASE MANAGEMENT PROTOCOL FOR

CHILD RESISTANCE OR REFUSAL DYNAMICS

†

Francine Cyr, Karine Poitras, and Élisabeth Godbout

High-conflict parental separation cases associated with child’s estrangement or contact refusal take an unusually large amount of

court time and generate high emotional costs for parents and children. This paper reports on a study of a research-based pilot pro-

ject and protocol, called the Parenting Conflict Resolution (PCR), which is intended to reduce parental conflict, improve inter-

parental communication, and support or rest ore the parent–child relationship. The protocol was developed at the Superior Court in

Quebec City (Canada), and involves single judge case management, and lawyers’commitment to have the child’s best interests as

their primary consideration and to guide their clients to trust the process. The assigned judge and lawyers have the ongoing

involvement of a mandated psychotherapist, taking a family systems approach with the case. The PCR also requires the parents to

participate in a psycho-educational, introspective group program to work on co-parenting and communication skills. Ongoing com-

munication between the professionals involved in the PCR is required to ensure cohesionand accountability. This pilot project was

implemented with 10 high-conflict families, 6 of which presented with the child’s resistance or refusal to see one parent. A qualita-

tive data study was undertaken into the experiences of all the participant s. The most salient result is the resumption of parent–child

contact in all six contact refusal cases. Discussion highlights key elements to successfully address these cases: (a) interdisciplinary

program delivery, (b) systemic understanding of the contact problems, (c) focus on the child’s best interest, (d) single judge

assigned to the case, (e) lawyers’support of the parents’participation, and (f) psychotherapist repor ting to the court.

Key Points for the Family Court Community:

Child’sestrangement or contact refusal takes an unusually large amount of Court time.

Need for innovative and out of the box solutions.

Implementation of a psycho judicial case management (Quebec, Canada).

All the 6 cases who presented with child’s resistance or refusal to see one parent (between 4 months upto 2½ years)

resumed contact.

Key features to successfully address these cases.

Keywords: Access Problems; Child Refusal; Psychojudicial Case Management.

When parents divorce or separate, the entire family must adapt to a series of transitions that can

end up draining personal and financial resources. The majority manage to adapt within two years

(Johnston, Roseby, & Kuehnle, 2009), although some family situations are characterized by intense

ongoing parental conflict with the children caught in the middle (Henry, Fieldstone, Thompson, &

Treharne, 2011; Sullivan, 2008). These so-called “high-conflict situations”are worrisome for legal

and psychosocial professionals, who often feel powerless to help their clients.

Even though this umbrella term of high-conflict designates a broad spectrum of realities

(Birnbaum & Bala, 2010), a separation is generally considered to be high-conflict when the parents

have been separated for at least two years but are still involved in ongoing anger, hostility, or mis-

trust, recurrent verbal and/or physical abuse, recurrent litigation to settle custody disputes, or con-

Corresponding: francine.cyr@umontreal.ca

†

This pilot project was initiated on request of the Ministry of Justice of Quebec, which provided the project funding; the

research was financially supported by the Federal Government, the Quebec Bar, and by SHHRC-CURA Grant Séparation

parentale Recomposition familiale.

FAMILY COURT REVIEW, Vol. 58 No. 2, April 2020 560–575

© 2020 Association of Family and Conciliation Courts

tinuous dysfunctional coparenting (Johnston et al., 2009; Levite & Cohen, 2012). It has been

suggested that cases which involve a rupture or a fragilization of the bond between the child and

one of the parents (often called parental alienation cases) lie at one extreme of a spectrum of high-

conflict family situations (Birnbaum & Bala, 2010).

I. LITERATURE REVIEW

The impasses that are often encountered in high-conflict family situations point to the fact that

legal systems, in their current form, do not always provide sustainable solutions that meet the chil-

dren’s best interests. It is critical to accurately identify high-conflict families and offer them opti-

mally adapted psycho-legal services in order to reduce conflict and improve interparental

communication; unless there are on-going safety concerns, it is important to preserve or restore

parent–child relationships in a timely manner (McIntosh, 2006; Neff & Cooper, 2004; Ward, 2007).

However, some authors highlight that a child’s individual therapy is unlikely to resolve a parent–

child contact problem and may well exacerbate it (Fidler, Bala, & Saini, 2011), and reunification

therapy involving only the rejected parent and the child is also likely to fail (Fidler et al., 2011;

Pruett & Drozd, 2019). It has been recommended that assigning a single judge to these cases and

establishing a framework for the legal process are promising avenues to deal with high conflicts and

resistance and refusal dynamics (Bala, Fidler, Goldberg, & Houston, 2007; D’Abate, Cyr, &

Quigley, 2019; Martinson, 2010; Trussler, 2007). It is further recommended that a psychosocial

intervention should be combined with appropriate legal management (Fidler & Bala, 2020;

Fidler, Bala & Saini, 2013). In the present article, we report on a psycho-legal case management

protocol that we developed in Quebec City (Canada) for high-conflict cases, with a focus on cases

involving child resistance refusal dynamics. We will highlight factors found to be most important

for the judges, lawyers, parents and family therapists in the re-establishment of the child–parent

contact.

A. ACCESS PROBLEMS AND THE RELEVANCE OF INTERVENING

Access problems are a major area of concern for parents (Poitras & Drapeau, 2014; Polak &

Saini, 2015), as well as for children who are going through demanding transitions between the two

parents’homes. The fears of parents who experience a child’s resistance or refusal are often justi-

fied, since these access problems can lead to the loss of parent–child contact and the developmental

consequences that may be severe and chronic, and endure in adulthood (Bloch, Peleg, Koren,

Aner, & Klein, 2007; King & Sobolewski, 2006; McLanahan, Tach, & Schneider, 2013; Peacey &

Hunt, 2008; Saini, Johnston, Fidler, & Bala, 2016). However, research shows that even when there

is parental conflict, continued involvement of two parents who each have good parenting abilities

and who have developed a meaningful relationship with the child is a strong predictor of child’s

adjustment to parental separation (Drapeau et al., 2014).

Further, one of the strongest predictive factors of a family dispute resulting in a trial is the fact

that there are access problems or children resisting contacts (Poitras, Bala, & Birnbaum, 2019). Cli-

nicians and researchers observe that these high-conflict families challenge traditional interventions

(individual therapy, family mediation, litigation), and advocate for the development of innovative

approaches to address the needs of children and parents involved (Cyr, Poitras, Godbout, & Macé,

2017; Sullivan, 2017).

B. TREATMENT FOR RESISTANCE AND REFUSAL CASES

There are many reasons why a child may resist or refuse contact with a parent, and an assess-

ment of the forms and pathways of strained parent–child relationships is an essential part of

Cyr et al./INTERDISCIPLINARY CASE MANAGEMENT 561