The world of CCE’s has undergone a drastic change since March of 2020, when the world closed down due to COVID-19. We are far from the early days of the pandemic when we discovered the viability of conducting child custody evaluations (CCEs) safely and reliably using videoconferencing (VC) and other remote technology. VC had previously been used in other clinical and forensic populations to provide useful and reliable data with valid and trustworthy results. Milfred D. Dale, Ph.D., J.D., addressed these new technologies in his seminal article, “Making the Case for Videoconferencing and Remote Child Custody Evaluations (RCCES): The Empirical, Ethical, and Evidentiary Arguments for Accepting New Technology.” (Dale, M. D., & Smith, D. (2021) Psychology, Public Policy, and Law, 27(1), 30–44. https://doi.org/10.1037/law0000280.)
As a mental health professional who had been conducting CCEs for thirty-five years, I was deeply interested in these questions from both practical and theoretical perspectives. In the summer of 2020 I determined to conduct a survey of mental health professionals (MHPs) to learn how they were implementing technology into their CCEs, and what they were discovering in the use of the new methods.
The First Survey:
This first survey, completed in October of 2020 and looking at data from the prior summer, addressed basic questions, such as the number of CCEs started and completed and plans to return to the office. This involved only MHPs in the San Francisco Bay Area. I made four key findings:
- The overall number of evaluations was substantially lower than during a similar time period pre-Covid.
- Evaluators wholeheartedly embraced the remote videoconferencing techniques.
- Evaluators planned to continue to use the remote techniques.
- Approximately 20 percent of the evaluators had returned to the office using in-person meetings, 55 percent were using a “hybrid” approach using in person meetings together with remote techniques, and 25 percent had not returned to in-person work, and planned to use only VC methods until there was a vaccine and clear path to safety.
Overall, my survey found that while the pandemic brought many unfortunate results to our society, forensic practitioners used the crisis as an opportunity for significant and positive change as to how we do our work and how we can best assist the populations we serve.
I used these results in an earlier article I wrote entitled “Whither the State of CCEs?” published in the California Continuing Education of the Bar in November of 2020 https://drkenperlmutter.com/publications/uploads-2021-09-2-pdf/) and in a presentation (itself done with an audience using remote methods of videoconference!) to the San Mateo County Bar Association, “COVID, Zoom, and the New Frontier: Preparing Your Clients for Remote-Child Custody Evaluations.”
The results of this initial survey could not address the quality of the first batch of remote CCEs and whether they were reliable, valid, trustworthy and of help to the decision makers (i.e. attorneys, parents, the judiciary). I thus planned to conduct a follow-up survey to ascertain the reception, implementation, and effectiveness of remote CCEs at a later date, which I have now completed, and which led to this new article.
The Second Survey:
In 2021 I decided to conduct a follow-up survey to answer questions raised by the first. My goal was to learn more about the effectiveness, and possible limitations, of the VC CCE methods and resultant work products, and to obtain data about how they were received and implemented by decision makers.
I commenced the survey in the summer of 2021 and examined the time period from March 2020 through that point. I sought to quantify the number of remote CCEs started and completed during that period. I posed questions in three main areas: a) how the CCE reports were received and the type of forensic results following the publication of the evaluations; b) how the process was experienced by the evaluator and the clients; and c) how and using which methods did evaluators plan to return to their offices in the upcoming months, including COVID-19 protocols and vaccination compliance. Each of the eight Bay Area practitioners who completed the survey agreed to be interviewed telephonically to answer follow-up questions.
The results of the second survey were published in the January 2022 AFCC-CA newsletter Insights, and entitled “Update on Child Custody Evaluations During the Pandemic: Practice, Process and Viability.” (https://drkenperlmutter.com/publications/update-on-child-custody-evaluations-during-the-pandemic-practice-process-and-viability/.)
The objective data and interviews revealed the following findings/conclusions:
- The number of evaluations had increased substantially.
- All evaluators believed that the remote CCE process worked well for the families, and actually decreased parents’ anxiety about their interviews.
- The final reports and findings were well received by attorneys, and there were indications that the attorneys were less likely to challenge the findings and more likely to resolve their matters.
- The evaluators participated in fewer trials than they had pre-pandemic, and those trials were all done by video conference, with no personal appearances. Evaluators who participated in video conference trials (and depositions) found those experiences positive and to some extent easier than when done in person.
- The “hybrid model” (i.e. use of both office and videoconference interviews) was used by all evaluators. The most common process was to complete individual interviews with videoconference methods (on a secure platform) and to conduct parent-child interviews and observations in person. These in person methods occurred at parks near parents’ homes, in their backyards, and some inside the homes. The hybrid model was uniformly embraced by evaluators not only as the preferred modality (as compared to conducting in office, but masked, interviews) but the one they believed allowed them to have most confidence in their work. All evaluators used a variety of COVID-19 protocols in all settings. These included having parents complete Covid Health Questionnaires (similar to those one would complete at a physician’s office) in advance of in-person interviews and home visits; using social distancing and masks; increased screening for vaccination status (including disclosing their own); and conducting in-person interviews only with adults who had been vaccinated.
I had hoped to get some sense of how and when these evaluators would return full-time to the office. The data did not reveal a clear pattern of a uniform plan. The evaluators’ comments suggested a great deal of trepidation, likely due to the fact that during the period when they replied, the pandemic went from easing (May of 2021) to worsening (July of 2021) due to the new Beta variant. By the end of the summer, three of the evaluators stated they had stopped taking new cases, and two of those three surmised they would cease doing evaluations completely. However, a majority of evaluators indicated that the pandemic did not dissuade them from continuing their work. They were committed to continuing the hybrid model and figuring out how to do their work in a safe and secure manner that would yield accurate, valid, and reliable data. Thus, while a few evaluators had completely suspended their work, the majority had chosen some kind of middle ground and continued to complete evaluations or begin new ones using a variety of methods.
It was clear that this was not work for the faint of heart and required great attention to detail, rigorous application of consistent methodologies, and a willingness to examine all that one does in order to be assured of the reliability and validity of the final work product. I opined that perhaps it would not be until mid-2022 before there would be a full return to the office. It was a concern that the aging population of child custody forensic mental health professionals would be very cautious about health risks.
Further, at that time there were no best practices guidelines to apply to the use of these new methods in CCEs. This concern has been corrected with the 2022 publication of the new AFCC “Guidelines for Parenting Plan Evaluations in Family Law Cases.” That document has a new section titled “Virtual Evaluations” which provides guidance on “use of technology, virtual interviews with children, and reporting virtual components.” These guidelines, while very helpful, are by no means comprehensive.
The Third Survey:
During the fall of 2022 I determined to conduct another updated survey entitled “Remote-Child Custody Evaluations ~ Current Practices.” This survey was sponsored and sent by AFCC-CA in November of 2022 to all previous participants, as well as the newly formed AFCC-CA “List of Professionals” who conduct CCEs. Thus, the survey was sent to approximately 80 mental health professionals. The survey consisted of 10 questions including both basic identifying information and some to provide an in-depth look to compare the professionals’ work from the period 2017 through 2019 to the period starting January 2021 through October 2022. The Survey also looked at COVID office protocols and remote / virtual protocols.
Results and Implications: A total of 25 mental health professionals responded to the third survey. Of those, 18 were conducting CCEs. Of those, 95 percent had been in practice for 11-20 years (and most for over 20 years). A total of 72 percent were licensed psychologists. The most popular practice for CCEs was the hybrid model, endorsed by 81 percent of the respondents. Some 13 percent used only their office and 6 percent used only remote/virtual methods.
As regards the time it took to complete the evaluations comparing pre- to post-COVID time frames, 39 percent said it took about the same time, 22 percent said it took more or much more time, and 39 percent said it took less or much less time. Looking at the specific number of months that evaluators were spending on CCEs starting in 2021, 17 percent took two to three months, 33 percent took three to four months, 22 percent took four to five months, six percent took five to six months, and 22 percent took over six months. In this breakdown, only 17 percent reported that their CCEs were taking more time than prior to 2021, while 83 percent estimated that their CCEs took the same number of months (no one reported that the process took fewer months).
I looked at the methods (i.e. “protocols”) used to combat the transmission of COVID. Respondents endorsed as many items as applied to their practice. Only three said they used “no” protocols. Seven required all participants to be “fully masked.” Four required participants to be vaccinated. Ten used
HEPA filters and six used other methods.
Finally, I looked at what remote/virtual methods the evaluators were using. Eighteen did individual interviews with the biological parents and 11 did conjoint interviews with those parents. Three did conjoint interviews with the parent and their current spouse/partner. Three did interviews with three or more family members together. Seven did home observations. As regards children one interviewed children younger than age five, eight interviewed children ages 6-10, 12 interviewed children ages 11-15 years, and 1 interviewed children ages 16 to 18 years.
Findings / Conclusions:
We can draw several conclusions from this modest survey. This highly experienced group of MHPs was definitely making full use of the virtual/remote CCE methods that they had never used before the pandemic. There were definite signs that the majority were making a return to the office using the hybrid approach. After what we saw of a severe fall off in the number of evaluations done in 2020, starting in 2021 CCEs were being completed in similar numbers to 2017-2019. And those CCEs were being completed in less or the same amount of time compared to 2017-2019. That is a very good sign for the field of CCEs.
Evaluators who returned to the office continued to be vigilant in protecting themselves and their clients. It was interesting that only a small number of practitioners required that clients be immunized. It was quite encouraging that evaluators made full use of the remote technology to conduct their interviews. As time has passed it appears that those who used the hybrid model may have continued to do the individual interviews virtually while doing all other interviews in the office.
Finally, the Survey clearly indicates that the MHPs using these virtual methods found them to be valid and reliable methods for use to conduct CCEs. Thus, not only have they embraced the new technology, they found that evaluations so conducted could be of service to the families they evaluated. Future surveys may look at how the decision makers (i.e., judges, attorneys and parents) found both the experience of the remote methods and the usefulness (i.e., reliability and validity) of CCEs.
In 2023 both the Survey and anecdotal evidence suggest that many evaluators have returned to the office and that the majority of them plan to augment their practices with these new videoconference methods. Clearly this is a remarkable change and development none could have seen in 2019. Dr. Dale appears to have been on point when in 2020 he optimistically looked at MHPs embracing the R-CCE methods and indicated the Pandemic has “temporarily and permanently changed the landscape of mental health service delivery, including the conduct of child custody evaluations.” He showed great insight when he suggested that “the child custody community-for example, courts, attorneys, evaluators, and families-should accept RCCEs as a valid alternative that, when properly done, can help resolve custody disputes.” There is no doubt our field has been positively and irrevocably changed.
Kenneth Perlmutter, Ph.D. is a licensed psychologist in private practice in Palo Alto, CA for over 40 years. His work focuses on various aspects of forensic child custody matters and specializes in working with families in unique, complex, high conflicts cases. His primary work involves Parenting Plan Evaluations and Brief Focused Assessments. He has extensive experiencing serving in the roles of custody mediator, parenting coordinator and co-parent counselor. He enjoys consulting with attorneys as a reviewing expert, both disclosed and non-disclosed, and as a confidential consultant to attorneys and their clients. He is a Board Member of AFCC-CA and member of the Mentoring Outreach Committee. This committee focuses on the recruitment and monitorship of mental health professionals to serve as child custody evaluators. Additionally the committee is developing new language and guidelines regarding the requirements (specifically to define “materially assist”) for child custody evaluators as stated in Rule of Court 5.225. His website is: https://drkenperlmutter.com.