The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts...

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The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital

Transcript of The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts...

Page 1: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

The Parenting Coordinator Role

Robin M. Deutsch, Ph.D.

Children and the Law Program

Massachusetts General Hospital

Page 2: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

The Parenting Coordinator•Court ordered neutral to assist the parties to:

• Implement safe and workable parenting plan•Monitor compliance with details of plan•Resolve conflicts in timely manner•Protect and sustain safe, healthy and meaningful parent-child relationships•May be necessary when parental communication is conflictual or ineffective, or to promote safety of vulnerable parties, including children and parents.

Page 3: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

Call for a new role in the ADR spectrum

• Intensive case management

• Small group of chronic high conflict custody situations (10%)

• Court delegated authority

• Immediate resolution of disputes

• Non-adversarial forum

Page 4: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

The tragic legacy of the Litigation Context

• Litigants don’t make good coparents

• Representation - advocacy• Distrust • Sabotage• Win/lose• Chaos• Unilateral action• In the name of the child• Focus on the problem being the other parent -adversaries• Depleted resources - financial,emotional

Matt Sullivan, 2007

Page 5: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

Range of disputes resolved

• Detailed Court order contains areas of decision making

• The PC shall not make any decision which alters award of legal or physical custody

Page 6: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

Call for a new role

• Colorado lawyers and mental health professionals (1992)

• Northern California model derived from mediation and special master statutes (Marin County)

Page 7: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

AFCC takes the lead for interdisciplinary role

• 2001 interdisciplinary Task Force on Parenting Coordination– Described manner in which jurisdictions in US have

used PC– April 2003 report Parenting Coordination:

Implementation Issues, Family Court Review, 41

• 2003 Task Force reconstituted– Review of best practices in US and Canada led to– Model Standards for Parenting Coordination – May 2005 Guidelines approved by AFCC Board

Page 8: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

Objectives of a PC model

• Reduce conflict between parents• Reduce chronic litigation (preserve family

resources)• Raise parents’ skill level in collaborative or

parallel planning and decision making for their children

• Assist parents to co-parent in a way that promotes well being of the children

• Maintain, modify, mediate viable parenting plans

Page 9: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

How ??

• Intensive case management

• Court delegated authority

• Immediate resolution of disputes

• Non-adversarial forum

Page 10: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

When should a PC be appointed?

• Ongoing disagreements between the parents about implementation of parenting plan

• Parties agree to decision maker outside of the Court to reduce cost and burden of continued litigation

• Some states: if history of extreme or unremitting conflict that affects welfare of the children, court can appoint without parties’ agreement

Page 11: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

Does Parenting Coordination Work?

• T. Johnston, 1994: Santa Clara County• 166 cases with 933 court appearances• Following the appointment of a PC, court

appearances for the 166 cases reduced to 37• Vick and Backerman (1996): client satisfaction

and self reported decreased conflict• APA Parenting Coordination Program Argosy

University/Washington DC (2007)

Page 12: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

Parent Coordinators by another name

• Special Master

• Wiseperson

• Ongoing GAL

• Med-arbitrator

• Parenting Referee

• Family Court Advisor

Page 13: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

Statutory Authority

• Statutes in Minnesota, Oklahoma, Idaho Oregon, Colorado, Texas, North Carolina, Louisiana.

• Authorized through related statute in Arizona, California, Georgia, Kansas, New Mexico, Ohio, Wisconsin

• States with Non-Statutory Programs: Florida, Kentucky, Massachusetts, New Jersey, Vermont

Page 14: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

Role Definition

• PC is NOT: – Therapist– Advocate for one party– Coach– Parent Educator– Counsel– Mediator– Custody Evaluator– Judge

Page 15: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

Distinct Role of Parenting Coordinator

• Hybrid role: help implement, modify, mediate parenting plans

• Assess impasses to coparenting

• Educate about child development, communication, conflict resolution

• Mediate disputes

• Arbitrate

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Functions of the PC: Assessment

• Assessment– Review of custody evaluation– Review other evaluations/reports/records– Review court orders, domestic violence protection

orders and other applicable cases involving criminal assault, dv, child abuse

– Interview data leading to Parenting strengths and weaknesses (patterns of behavior, communication), Coparenting Skills, Children’s functioning and needs over time

– Impasses and issues presented by parties

Page 17: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

Functions of the PC: Education

• Education (and coaching)– Child Development and Adolescent needs– Short term and long-term needs of the children and

divorce research– Effects of their behavior and conflict on children– Parenting skills– Communication skills– Conflict resolution skills and collaboration strategies– Perspective taking– Family Issues (new transitions, relationships)

Page 18: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

Functions of the PC: Coordination/Case Management

• Coordination/Case Management– Communication with family members

including extended family, stepparents, and significant other caretakers

– Communication with schools– Communication with therapists– Communication with physicians– Communication with child protection agency– Communication with legal professionals

Page 19: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

Functions of the PC: Intervention and Conflict Management

• Assist parties to work out disagreements regarding the children to minimize conflict

• Assist in interpreting and implementing court-ordered parenting plan

• Utilize Dispute Resolution skills: Negotiation, mediation, arbitration

• Facilitate communication between parties as appropriate (monitor fax, email, written exchanges)

• Techniques tailored to avoid offering opportunity for further coercion

Page 20: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

Functions of the PC: Decision-making

• When parents cannot resolve disputes, PC makes decisions to extent described in court order

• If statute allows, may provide report or recommendations to court

• All decisions made in timely manner and oral decisions followed up by written version

Page 21: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

Scope of Issues to be addressed by PC

– Minor changes or clarification of parenting time/access schedules or conditions including vacation, holidays, and temporary variation from existing parenting plan

– Transitions/ exchanges of the children including date, time, place, and transportation and transporter

– Health care management including medical, dental, orthodontic, and vision care.

– Child-rearing issues– Psychotherapy or other mental health care

including substance abuse assessment or counseling for the children

Page 22: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

– Psychological testing or other assessment of the children and parents

– Education or daycare including school choice, tutoring, summer school, participation in special education programs, other major educational decisions

– Enrichment and extracurricular activities including camps, teams and jobs

– Religious observances and education– Children’s travel and passport

arrangements– Personal possessions of children, including

clothing and equipment

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• Communication between the parents about the children including telephone, fax, email, notes in backpacks etc.

• Communication by a parent with children including telephone, cell phone, pager, fax and e-mail when not in that parent’s care

• Alteration of appearance of the children including haircuts, ear and body piercing, and tattoos

• Role of and contact with significant others and extended families

• Substance abuse assessment or testing for either or both parents or child, including access to results

• Parenting classes for either or both parents.

Page 24: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

Issues not appropriate for Parenting Coordination

• Determination or change in status of physical or legal custody award

• Custody evaluation

• Legal advice

• Family, couple, individual, child psychotherapy

• Consultation to a family member

Page 25: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

Inappropriate Cases

• Non-compliance

• Cases of sole legal custody (physical and legal) where normalization of contact not an option – Incompetence due to mental illness– Incarceration– Ongoing maltreatment concerns

Page 26: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

Implementation of PC role

• Order of the court which has jurisdiction over the case

• Local rule• Order of state Supreme Court Chief Justice

applied to entire state court circuits or counties• State legislature passes law authorizing

appointment• Kirkland, 2007

Page 27: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

Legal authority: components of statue, order or local pattern

• Define parenting coordinator• Basis of authority• Scope of authority• Qualifications• Consent vs. non-consent of parties• Confidentiality• Term of service• Removal/resignation

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• Domestic violence screening

• Fee arrangements

• Quasi-judicial immunity

• Grievance procedures

• Continuing jurisdiction

• Bartlett, 2005; Kirkland, 2007

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Substance abuse issues arise

• Concern about effects of substance abuse on parenting capacities.

• Effect of substance abuse on lifestyle, child care and the parent-child relationship.

• Referral for assessment of patterns of use and risk to child.

• High rate of substance abuse in restraining order violators (1995 Massachusetts Office of the Commissioner of Probation)

Page 30: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

Domestic Violence Screening (separate interviews)

• Fear of violence or violence between parties• Other forms of abusive and controlling behavior• Consider risk to children• A B C’s

– Attitudes toward use of violence, abuse and control– Behaviors or threats of behaviors that are violent,

abusive and controlling– Consequences of violent, abusive and controlling

behaviors or threats

Page 31: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

Assessment

• Dangerousness/lethality indicators• Level of psychological/economic coercion• Mental health problems• Drug or alcohol use problem?• Day-to day decisions• Style of fighting when you disagree• Anger management• Police? Protective order?

Page 32: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

Effect of domestic violence on parents involved in PC process

• Increased risk of depression and post traumatic stress disorder in victims of DV

• Affects parenting • Affects trust, willingness to comply with process,

willingness to disclose concerns• Use of poor coping resources in alleged

perpetrator, e.g. rationalize behavior, minimize, deny, neutralize behavior

• Affects ability to engage in PC process

Page 33: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

LEGAL AND ETHICAL ISSUES IN PARENTING

COORDINATION

Christie Coates, J.D.

Page 34: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

PARENTS’ RIGHTS

Most basic and fundamental of rights

Guaranteed and protected by the US Constitution

Other countries . . .

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• PARENTS HAVE A FUNDAMENTAL RIGHT TO MAKE DECISIONS ABOUT THEIR CHILDREN WITHOUT THE INTRUSION OF THE STATE

• (SEE TROXELL V. GRANVILLE)

Page 36: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

• PRIVACY

“Zone of privacy” exists in marital relationship.

Individual right of privacy

Page 37: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

• PARENTS MUST CONSENT TO GIVE UP THEIR AUTHORITY TO MAKE DECISIONS TO THIRD PARTIES (OTHER THAN TO THE STATUTORY AUTHORITY OF THE COURT)

Informed consent necessary.

Except in Oklahoma, Court cannot order decision-making by PC without agreement of the parties.

Page 38: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

DUE PROCESS

• RIGHT TO BE HEARD

• RIGHT TO HAVE NOTICE

PROCESS MUST BE FAIR!

Page 39: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

COURT’S ROLE

• Parens Patriae Doctrine

• Court retains authority and responsibility to review decisions/work of the PC

Page 40: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

Key Ethical Issues

• Are You Acting As A Licensed Professional?

• Acting for Court or On Own?

• Informed Consent

• Are You Subject to “Psychotherapist” Law?

• Application of Ethics Codes

Page 41: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

Be Aware of :

• Multiple roles

• Informed consent

• Confidentiality

• Ex parte communication

• Bias

• Record keeping

• Fees

Page 42: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

Standards of Practice

• AFCC Guidelines for Parenting Coordination (afccnet.org)

• Standards of profession of origin still apply, but may conflict

• Insurance

• Grievance process

Page 43: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

Sources of Guidance

• Professional Ethical Standards and Codes, including, but not limited to:

– 2003 Revision of the APA Code

– Rules of Professional Responsibility for Lawyers,

– Social Work, LMFT, etc.

Page 44: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

Sources of Guidance

Review your profession of origin’s code for requirements regarding

– Competence– Bases for Scientific/Professional Judgments– Multiple Relationships– Conflict of Interest– Third Party Requests for Services– Informed Consent

Page 45: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

Sources of Guidance

• Note: If Acting In Role of Psychologist:– 6.01 of APA… Seems To Require Records Be

Created of Professional Activity– 9.01 “Bases for Assessment” May Not Apply

Directly if Parenting Coordination Does not Involve “Assessment,” But It Is Unclear

– Section 10 Standards Applying to Therapy Will Not Be Applicable To Role of Parenting Coordinator

– R. Deutsch, Ph.D.

Page 46: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

Sources of Guidance• Professional Ethical Standards and Codes, including

the 2003 Revision of the APA Code:– Psychological Services Delivered To Or

Through Organizations– Discussing the Limits of Confidentiality– Documentation of Professional and

Scientific Work and Maintenance of Records

– Fees and Financial Arrangements– Bases for Assessments

R. Deutsch, Ph.D.

Page 47: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

Acting As Licensed Professional?

• “This Ethics Code applies only to psychologists’ activities that are part of their scientific, educational, or professional roles as psychologists.” (APA Ethics Code, 2003)

Page 48: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

Acting As Licensed Professional?

• “Areas covered include but are not limited to the clinical, counseling, and school practice of psychology; research; teaching; public service; policy development; social intervention; development of assessment instruments; educational counseling; organizational consulting; forensic activities; program design and evaluation; and administration. . . .These activities shall be distinguished from the purely private conduct of psychologists. . . .”

Page 49: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

Acting As Licensed Professional?

• If Acting as Parenting Coordinator Is Professional Activity Within Scope Of Licensure, Then Legal and Ethical Duties That Arise from Licensure Will Attach.

• Key Point: Process of Informed Consent For Provision of Services Is Crucial, Especially When Important Ethical Questions Remain Ambiguous

Page 50: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

Acting As Licensed Professional?

• Pragmatically: You Do Not Want To Be The Test Case in your state. Presume That Relevant Legal and Ethical Standards Apply To Activities As a Parenting Coordinator

• Is There Any Good Reason To Not Adhere To Relevant Ethics Codes In Role of Parenting Coordinator To Guide Good Practice?

Page 51: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

Confidentiality

• No traditional confidentiality as in mediation, law or psychotherapy

• Written reports to the court?

• Arbitration Awards?

• Testifying?

Page 52: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

(G-V.) Confidentiality

• Not a confidential process

• PC shall report child abuse or if a family member a serious risk to harm him/herself, another family member or third party.

Page 53: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

Confidentiality Issues• Exceptions To Confidentiality For Professional

Interactions With a Licensed MHP Include:– Client Consent for Disclosure– Emergency Disclosures– Duty To Warn/Protect Third Parties– Mandated Reporting (Children, Elders, Etc.)– Contemplation or Commission of Crime or

Harmful Act (Social Workers, Allied Health/Human Only)

– Client Failure to Pay for Professional Services

Page 54: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

(G-VIII.) Informed Consent

• Authority and power of PC.

• Review the role with the parents at the first session

• Not giving legal advice or psychological services

Page 55: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

Informed Consent

• Clarification of Process of Resolving Disputes

• Disclosing Areas of Parenting Difficulty

• Nature of Any Confidentiality And Any Limits

• Nature of Any Testimonial Privilege and Limits

Page 56: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

Informed Consent In Parenting Coordination

• Reporting of suspected child abuse or neglect whether mandatory or voluntary reporter

• Reporting to law enforcement or other authorities if PC has reason to believe any family member appears to be at serious risk to harm self or other.

Page 57: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

PC is not:

• Therapist

• Advocate for one party

• Counsel

• Mediator

• Custody Evaluator

• Judge

Page 58: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

MULTIPLE RELATIONSHIPS

• Multiple Relationships vs. Multiple Roles– PC shall not become a custody evaluator, even

after term of involvement with family with consent of parties, because of differences in role and potential impact of role change

– Custody evaluator must be CAUTIOUS about becoming PC – note differences in role

Page 59: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

– Therapist, consultant, coach may not become the PC

– PC may not become therapist, consultant, coach

– PC may not become one client’s lawyer

– One client’s lawyer may not become the PC

Page 60: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

Challenges of Remaining Impartial and Objective (J. Kelly)

• The polarized thinking of each parent about the other parent can be unsettling.

• Egregious behaviors, ignoring decisions, failing to pay fees can make PC angry.

• Some personality disorders turn us off.• Be aware of own behavior that alert PC

to lack of impartiality.

Page 61: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

Maintaining Impartiality

• Self awareness• Act objectively and appear impartial, even if don’t

feel impartial• Be the child’s advocate• Provide written rationale for decisions• Respect your clients – listen to both sides• Mediation training and experience• Consultation group

Page 62: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.
Page 63: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

Conflicts of Interest

When relationship between PC and participants or subject matter of dispute compromises or appears to compromise PC’s impartiality

PC discloses potential conflicts of interest as soon as possible after becoming aware of potential conflict

Page 64: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

– With written agreement PC can serve, but if impartiality impaired, PC shall withdraw

– PC shall not create conflict by providing services to parties not directly related to PC process

– Use care in making referrals (no commissions, rebates)

Page 65: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

Document Your Work

• Take good notes.

• Keep your file organized.

• Document your decisions and their agreements in writing

• Establish early on the role of the attorneys.

Page 66: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

Inappropriate Cases

• Non-compliance

• Cases of sole legal custody (physical and legal) where normalization of contact not an option – Incompetence due to mental illness– Incarceration– Ongoing maltreatment concerns

Page 67: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

Special needs of pro se or pro per party

• Detailed overview and clarification of PC appointment, process, and contract

• If one party has attorney and other is pro se, clear expectations about communications with attorney are communicated (preferably in writing)

• Purpose is to avoid perception or reality of bias

Page 68: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

Boundary Challenges

• Pull for alignment

• Challenge to authority

• Appeal for reprimand

• Role blur

• Unreasonable demands

Page 69: The Parenting Coordinator Role Robin M. Deutsch, Ph.D. Children and the Law Program Massachusetts General Hospital.

Basic Guiding Principles• “Law of No Surprises” For Parents, Court, Attorneys

or Others Involved in Your Activities

• Clarity About Role, Client, Understanding of Your Legal and Ethical Obligations

• Informed Consent As A Process (Not A Moment) That Is Crucial, Detailed and Ongoing

• Use Of Appropriate Consultation, Reliance Upon Codes, Standards, and Best Practices

From Robert Kinscherff, Ph.D., J.D. 4/03