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Mental Health Professionals' Practice of Reintegration Therapy for Parent-Child Contact Disputes Post-Separation

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Mental Health Professionals' Practice of Reintegration Therapy for Parent-Child Contact Disputes Post-Separation Mental health professionals’ practice of reintegration therapy for parent-child contact disputes post-separation: A phenomenological study by Shely Polak A thesis submitted in conformity with the requirements for the degree of Doctor of Philosophy Factor-Inwentash Faculty of Social Work University of Toronto © Copyright by Shely Polak (2017) Mental health professionals’ practice of reintegration therapy for parent-child contact disputes post-separation: A phenomenological study Shely Polak Doctor of Philosophy Factor-Inwentash Faculty of Social Work University of Toronto 2017 Abstract Over the last decade, family courts have seen an increase in the number of parent-child contact problems and allegations of alienation. Children resisting or refusing contact with a parent post-separation pose considerable challenges to the mental health professionals tasked to work with them. Reintegration therapy (RT) has recently evolved to help ameliorate parent-child contact issues and alienation. However, little is known about what consensus exists on RT, or how it is defined and delivered by mental health practitioners. Limited evidence exists on treatment models, or evaluations of RT, and no standards or practice guidelines are available for the treatment of parent-child contact issues. The purpose of this study was to: 1) Explore how RT is defined and practiced among experienced mental health professionals in Canada and the United States; 2) identify underlying theory informing practitioners’ understanding of the issues and on clinical practice in RT; and 3) use findings for practice recommendations to advance knowledge for clinical practice with this population. To this end a hermeneutic, phenomenological design was chosen to elicit thick descriptions for a phenomenological analysis and theme development. A purposive sample of fourteen (14) practitioners was obtained. Initial analysis revealed substantial variance among practitioners’ training, underlying theoretical frameworks, clinical approaches and service ii delivery models utilized. Three distinct themes/subthemes emerged from in-depth analyses representing a measure of consensus among respondents. First, RT is generally viewed as a therapeutic process to help improve family relationships as a whole. Second, participants identified frequently used assessment criteria necessary for determining suitability for RT. Finally, agreement on overall treatment goals for families participating in RT was identified. These study findings illustrate the need for more and better-developed training in RT, integrated theory development, and the creation of best practice guidelines based on scientific and rigorous evaluation preferably using a longitudinal approach. iii Acknowledgments The completion of this journey could not have been possible without the support of many colleagues, friends and family. Each member of my thesis committee has uniquely contributed to my success. I would first like to thank Committee Chair, Dr. Ramona Alaggia of the Factor-Inwentash Faculty of Social Work. Dr. Alaggia’s unwavering guidance, support, mentorship and strong organizational skills were instrumental to my success. Her ability to effortlessly ensure everything and everyone was on schedule for moving me successfully through this process was admirable. I am incredibly thankful to Dr. Alaggia for sharing her wisdom with me on how to balance being a full time practitioner, mother and successful PhD graduate. I am grateful to my committee member, Dr. Michael Saini of the Factor-Inwentash Faculty of Social Work, University of Toronto for the invaluable support, commitment and interest he has given to this project and my research interests over the years. Dr. Saini’s confidence in me encouraged me to embark on this PhD journey. I am incredibly thankful and appreciative for all the stimulating, thought provoking and engaging discussions, which assisted me in coming up with conceptual connections. A special thank you goes to my third committee member Dr. Robin Deutsch of William James College for sharing her expertise with me in the area of parent-child contact problems and the clinical interventions used for this population. Dr. Deutsch’s time and invaluable feedback were essential throughout the writing process. I also acknowledge and am thankful for the comments, questions and contributions made from the Internal and External Examiners, Dr. Ellen Katz of the Factor-Inwentash Faculty of iv Social Work, University of Toronto and Dr. Allan Barsky of Florida Atlantic University School of Social Work. Special thanks and appreciation goes to my fellow classmates for the emotional support they provided me throughout this process. I am grateful to the fourteen participants of this study for taking the time from their busy schedules to share their wisdom and knowledge with me; without them this research would not have been possible. I would also like to acknowledge the late Lorraine Martin who offered me a student placement and employment opportunity at the Office of the Children’s Lawyer (OCL), Ministry of the Attorney General. It was during my time at the OCL when I first learned of the term alienation and clinically encountered cases of parent-child contact problems. I quickly discovered the complexity of these cases from both a clinical and legal standpoint and was captivated by it. This passion and curiosity allowed me to embark on this intellectual journey. As well, I want to thank the founders of the Overcoming Barriers (OCB) organization, Drs. Robin Deutsch, Matthew Sullivan and Peggie Ward, for welcoming me to their team and offering me the opportunity to have learned from them. My experience at OCB provided me with invaluable insight that has shaped my understanding of this challenging area. I want to thank my incredible mentors, colleagues and friends that have also been actively involved in my career development: Dr. Barbara Fidler and Linda Popielarczyk. I am thankful for the invaluable support and mentorship they have given me over the years. I am appreciative to have found such strong and intelligent women that not only provide me with clinical support for these challenging families, but also inspire me to continue learning. A special dedication goes to my dog, Mia, my inseparable companion who spent countless hours, day and night, by my side throughout all my school years. The writing process was never v truly lonely with her by my side. Most importantly, I acknowledge and thank my family. My two brothers, Jonathan (sister- in-law, Jocelyn ) and Guideon: thank you for your unconditional love and support over the years. I want to thank my mother, Diana for being such a wonderful role model who always encouraged me to pursue my dreams and reach for the stars. Thank you for persistently motivating me to persevere by taking one day at a time. My sweet son, Cayden, “mi amorsito” who was born shortly after my thesis proposal was accepted. Cayden is a constant reminder of the importance of work life balance and keeps me consciously aware of enjoying life’s most precious moments. Lastly, to my loving husband, best friend and life partner, Josh. Your continued belief that I could do it without a doubt helped me persevere through this journey. Thank you for coming with me on this journey with love, incredible patience, and understanding. Without your continued support, I would not have been able to start this journey, let alone finish it. You have been the rock by my side I knew I could always lean on. vi Table of Contents Abstract ................................................................................................................................................... ii Acknowledgments ............................................................................................................................... iv Table of Contents ................................................................................................................................ vii List of Tables ........................................................................................................................................... x List of Figures ....................................................................................................................................... xi List of Appendices .............................................................................................................................. xii Chapter 1 ................................................................................................................................................. 1 Introduction and Research Focus ................................................................................................... 1 Introduction ...................................................................................................................................................... 1 Impact of High Conflict .................................................................................................................................................. 3 Strained Parent-Child Relationships Post Separation: A Social Issue ........................................... 4 Prevalence Rates .............................................................................................................................................................. 6 Underlying Legislation .................................................................................................................................................. 8 Legal and
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