[Child psychiatric documentation in child visitation and custody disputes--results of a survey]

Abstract

In the last decade, increasing divorce rates, a joint custodial concept, and a deficient legal situation of non-married fathers have been involuntarily provoking cases of a parent with child custody alienating that child in order to exclude the other parent from visitations and educational participation. Medical certificates are frequently of fateful importance in child custody litigation. In an mail survey conduced in six German cities, N = 133 child psychiatrists were asked about the frequency in which they issue such certificates, what certificates contained, what recommendations were made, and where possible the reasons why the other parent was not included in the diagnostic process. According to the results 74.4% of those surveyed were asked to issue such medical certificates at least once in the year prior to the survey; 42% of the psychiatrists stating that the other parent never or only sometimes participated. The symptoms most frequently certified were behavioural disorders (46%), aggression (34%), problems in school/ADD (28%), anxiety (26%), bed-wetting (23%), depression (21%), and psychosomatic reactions (20%). Outlining the characteristics of alienated children and of alienating parents, of "natural" and of "induced" stress-symptoms in children after parental separation, the article provides physicians and institutions of the health system with support to prevent medical certificates being abused in child custody litigation. Some fundamental guidelines are presented as to what aspects and should be explored and which persons referred to before certificates are issued to parents, social workers or judges of family law courts.