Trauma‐Informed Interventions in Parent–Child Contact Cases

• Date: 01 April 2020
• Author: Leslie Drozd,Chioma Ajoku,Robin Deutsch
• Published date: 01 April 2020
• DOI: http://doi.org/10.1111/fcre.12483

SPECIAL ISSUE: PARENT-CHILD CONTACT PROBLEMS: CONCEPTS,

CONTROVERSIES, & CONUNDRUMS

INTERVENTIONS

TRAUMA-INFORMED INTERVENTIONS IN PARENT–CHILD CONTACT

CASES

Robin Deutsch, Leslie Drozd, and Chioma Ajoku

Parent–child contact problems may arise in the context of high conflict separation/divorce dynamics between parents. In cases

where there are parent–child contact problems and children resist or refuse contact with one of their parents, there may also

be incidents of child maltreatment, intimate partner violence, or compromised parenting that can be experienced by a parent

or child as traumatic. The circumstances around separation and/or post-divorce often result in intense stress for families. In

this paper we distinguish between the stressful circumstances that may arise as a result of highinter parental conflict and pulls

for alignment from a parent, and the real or perceived trauma as a factor which contributes to resistance or refusal of a child

to have contact with a parent. Interventions to address both trauma responses and the resist-refuse dynamics are differentiated

and discussed. After screening and assessment, the intent is to treat trauma responses with short-term, evidence-based ther-

apy, either before or concurrent with co-parent and family intervention.

Key Points for the Family Court Community:

Parent-child contact problems may have many causes. When children resist contact with a parent the multiple factors

including trauma, that result in this problem must be explored.

Assessing the impact and symptoms of interparental conflict and trauma on children and coparents, including emo-

tional dysregulation resulting in feelings of being overwhelmed or needing to avoid is necessary to proceed with a

family intervention

For family intervention to be successful It is necessary for each family member to be able to manage distressing emo-

tions without feeling overwhelmed or numb and to be able to process information accurately. These issues may result

in one of the treatment components that can occur before or at the same time as the family intervention.

Delaying contact with a parent generally results in more negative characterization, anxiety and polarization and is

generally not recommended. Instead safe, structured contact to begin the process of desensitization should occur once

the parent and child have basic skills of coping with and managing distressing thoughts and feelings.

Keywords: Alienation; Divorce; High-Conflict; Parent–Child Contact Problems; Parent–Child Relationship; Resist-Refuse;

Stress; Trauma.

I. WHAT IS TRAUMA?

The role of trauma should be considered in any strained parent–child relationship as it can pre-

cede the resist-refuse dynamic and/or the intense conflict between the parents and within the family

system. Or, the circumstances themselves can exacerbate or elicit a trauma or a stress response in

the child or in one or both parents. Thus, a multifactorial systematic assessment of the many issues

that may contribute to these strained parent–child relationships is essential. These factors may

include developmental influences, temperament, anxious parent–child relationships, alignments with

Correspondence: drrobindeutsch@gmail.com

FAMILY COURT REVIEW, Vol. 58 No. 2, April 2020 470–487

© 2020 Association of Family and Conciliation Courts

a parent, gatekeeping behaviors, compromised parenting behaviors, exposure to high conflict or inti-

mate partner violence between parents, and/or abuse or neglect.

Cases where a child resists or refuses contact with a parent are challenging for the court, clini-

cians, and attorneys. Often these cases require enormous resources. The common cross-allegations

of alienation from one parent against abuse, violence or compromised parent from the other typi-

cally result in polarization of the family and the systems around them. Often the court and clinicians

try to determine the cause of the trauma response and/or the veracity of the reported symptoms in

an effort to find an unequivocal solution to the problem. The literature often describes these parent–

child problems in binary terms—it is abuse/violence or alienation (Drozd & Olesen, 2004, 2010;

Fidler & Ward, 2017; Kelly & Johnston, 2001). In fact, however, many of these cases are multifac-

torial (Johnston & Sullivan, 2020) or hybrid (Friedlander & Walters, 2010) and require attention to

traumatic experiences as well as to alienating behaviors.

Trauma is an event outside of normal experience. It is exposure to an actual or threatened death, seri-

ous injury, or sexual violence via directly experiencing or witnessing a traumatic event or learning that a

traumatic event occurred to someone close, that causes a natural emotional reaction. Trauma can be a

response to a single incident (acute), repeated over time (chronic), or the result of varied, repetitive, and

prolonged exposure to traumatic events that are often invasive and interpersonal in nature (complex).

“Trauma”as used herein includes both the objectively traumatic event that fits Criterion A in the Diag-

nostic and Statistics Manual V (DSM V)

1

, as well as traumatic experiences in which symptoms of

trauma are present without meeting the specific criteria set forth in DSM V Criterion A.

Acute trauma involving a single traumatic incident can include exposure to a serious incident of inti-

mate partner or community violence; an experience of being severely injured by a vehicle, acquaintance,

stranger, parent or caregiver, or other accident; or molestation. Chronic trauma is repeated and pro-

longed, such as exposure to repeated acts of domestic violence or abuse. Chronic trauma can also result

from multiple acute traumas, occurring on e after the other. Complex trauma is exposure to varied and

repeated traumatic events or experiences that often occur during childhood (or adolescence) and are due

to the action, or inaction, of a caregiver. One example of complex trauma would be a child who was

exposed to domestic violence and abuse and/or neglect during 4 years of their childhood (varied and

repeated traumatic events from caregivers). Some examples of chronic trauma would be trauma that

results from years of workplace sexual abuse or years of physical abuse by a romantic partner. The dif-

ferences between chronic and complex trauma, however, can often be minimal. The main differentiation

is that complex trauma involves varied and repeated invasive trauma by someone close to the victim that

often begins in childhood or adolescence, whereas chronic trauma involves either a single type of

repeated trauma or exposure to multiple incidents of acute trauma that occur one after the other. The fre-

quency and severity of the incidents leading to chronic and complex trauma symptomology may vary.

Any trauma has potential physiological effects, including neurobiological and neurohormonal

changes. Generally, however, one finds long lasting sequelae in complex and chronic trauma, as

opposed to a single incident trauma. These changes are associated with impairments in memory,

learning, mood modulation, as well as heightened sensitivity to stressors, and chronic activation of

physiological stress responses with increased frequency/intensity of experienced fear and anxiety.

According to Van der Kolk (2005):

Isolated traumatic incidents tend to produce discrete conditioned behavioral and biological responses to

reminders of the trauma, such as are captured in the PTSD diagnosis. In contrast, complex childhood

trauma interferes with neurobiological development and the capacity to integrate sensory, emotional and

cognitive information into a cohesive whole. Developmental trauma sets the stage for unfocussed and

irrelevant responses to subsequent stress…. (p. 403).

Developmental trauma, as described by van der Kolk, is complex trauma that occurs from signif-

icant and severe chronic traumatic events, experienced in childhood and adolescence, that have been

perpetrated by a caregiver or individual that is expected to be a source of “security, protection, and

stability”(Lawson & Quinn, 2013). The stress can be emotional, physical, sexual, or secondary

Deutsch et al./TRAUMA-INFORMED INTERVENTIONS 471