Transcript

Victoria Harvey: I think psychological evaluations have a wealth of information that they can offer the court. But when they’re ordered in situations where it’s not appropriate or that type of evaluation is not going to garner the information that the court needs, then they really they really don’t do any help. They just our time and money.

Voiceover: You’re listening to the Texas Family Law Insiders podcast, your source for the latest news and trends in family law in the state of Texas. Now, here’s your host attorney Holly Draper.

Holly Draper: Today we’re excited to welcome Victoria Harvey to the Texas Family Law Insiders podcast. Dr. Harvey is a licensed psychologist who attended graduate school at the University of Alabama, where she earned a master’s in both clinical psychology and criminal justice. She earned her doctorate in clinical psychology as part of the psychology and law specialty track in 2010.

Dr. Harvey has experience working in the federal prison system and had the honor of serving our nation’s veterans before entering private practice in 2016. Dr. Harvey conducts child custody and psychological evaluations and provides psychotherapy to adults, including parents going through family law litigation. She also provides expert consultation, including work product reviews and expert testimony on issues related to psychological matters. Thank you so much for joining us today.

Victoria: Thank you for having me.

Holly: So why start by just telling us a little bit about yourself.

Victoria: So as you mentioned, I am a psychologist. And when I first went into the psychological field, I always knew I wanted to be on the forensic side of things. And so I attended the University of Alabama because they had a actual forensic track. So in addition to the clinical classes we took, we actually had classes focused on forensics, and all our placements were on in forensics. Our research was in forensics. So it was a really great opportunity to really build up that forensic knowledge. And it’s actually what brought me to Texas. I came to Texas to work in the federal prison system. We have a women’s federal prison over in Fort Worth. And so I came here to work there, and actually got a chance to work at Seagoville as well, because they have one of the two, I think, still only two sex offender management programs within the federal prison system. So another great opportunity to work with a really unique population.

And then as you mentioned, I went to the Dallas VA Medical Center for my fellowship and had a wonderful opportunity to work on their substance abuse unit. Which even though at the time, I didn’t know that my career would head towards doing the type of evaluations I’m doing now. I know I don’t have to tell you as an attorney who works in family court, we get issues involving substance abuse all the time. Whether it’s allegations, whether it’s someone has a history of substance use. So that has really turned out to be a surprisingly invaluable experience that I had that I did time would serve me so well in the future. And then after that, I stayed on at the VA and had another great opportunity to work inpatient unit, which gave me an opportunity to work with individuals who were in acute crisis.

So individuals who were suicidal or had recently attempted, as well as working with individuals who have chronic long term and severe mental illness. So again, another kind of slice of the population that I got a chance to work with. And then eventually, I went into private practice, and the stars aligned. And I somehow got put in contact with Dr. Blake Mitchell and Dr. Benjamin Albritton, who are two other psychologists who do this type of work. And they were my mentors for a couple of years. And I assisted them with cases before starting to do them on my own. So I took kind of a winding road to where I am. But the more folks I’ve talked to you I realized that that’s not as uncommon as you would think.

Holly: Right. So you mentioned earlier that you were you wanted something that had a forensic track. Can you explain a little bit what the difference is between forensic psychology and clinical psychology?

Victoria: Yeah, so when we talk about forensics, we’re really talking about any time we have the legal system involved. So that can be on the civil side, as well as on the criminal side. And I always say when we’re practicing forensics, we’re kind of a guest in somebody else’s arena, so to speak. So when I’m in a courtroom, I fully recognize that I’m kind of a guest in the courtroom. And so really understanding how those two different areas meet together and where our role is. And especially with evaluations when we talk about the context, how the forensic context can affect the evaluation. So for example, when we do child custody evaluations, we assume that everybody’s going to be trying to put their best foot forward. They may be a little motivated to present things in the best way possible and maybe minimize some of those things that they want to hide.

Whereas if you were in a disability assessment or a mental status at the time of the offense, or what we call the insanity defense, you might have somebody who’s motivated to over report symptoms. So really understanding how to interpret tests, how to assess people, what types of information to look for, what is the scope of our evaluations in a forensic setting is much more defined. And we really need to be mindful of those borders, versus when we’re doing a clinical assessment with one of our patients, where they come in, they tell us their story, we may or may not check records, we may or may not really check up and make sure that what they’re telling us is accurate. You know, we kind of just take them at face value. And it’s very different in a forensic setting.

Holly: So how would you describe your current practice?

Victoria: So my current practice is very evaluation heavy, I would say, at any given time, about 80 to 85%, of my practice, is doing forensic evaluations. And so I do custody evaluations and I also do psychological evaluations within family law litigation. So all of those evaluations are ordered by the court or agreed to by the parties. I do have some therapy clients, I think it’s always great to have a variety and have a balance. They give me another perspective on things. And typically I see individuals and adults who are involved in family law litigation. So helping them manage their anxiety, it’s obviously a very stressful situation. And so helping them manage those things, or working with other providers to help them be more effective, even post litigation. So if they’re working in parent facilitation, but they have something that they need to specifically work on to help them be more effective in parent facilitation, I like to kind of be this adjunct helper in other areas.

And then I also consult with attorneys, which is something I absolutely love to do, in helping them understand the mental health aspect of their cases. Whether it is understanding their client’s mental health, sometimes they have a ton of records, and they just go, I don’t know what this means. And I see all these different diagnoses and what’s going on. So helping them sift through that and really understand how their client is functioning and what that means for them. As well as sometimes they come across psychological concepts that they’ve just never heard before. You know, obscure diagnoses and things like that. And so helping them work through that so that they can represent their clients the best they can.

Holly: Today we’re going to talk primarily about psychological evaluations. So as you know, attorneys are our target audience here. So what should family law attorneys be looking for as when a psychological evaluation could be helpful in their case?

Victoria: So I think there’s a number of times where psychological evaluations can be helpful. And one is when somebody has a documented history of mental health concerns. And it may be that they’ve been in an inpatient facility, maybe they’ve been in therapy for a long time. And especially if it’s over the course of a lot of years, sometimes doing a psychological evaluation helps us understand how is this person doing now. Because what they have may be a concern 10 years ago, and maybe it’s still a concern, and maybe it’s not. And I know, sometimes attorneys, when I talk to them, they’re like, my client has this diagnosis.

And then I go through, and I look through the information, and then I go, okay, but they’re doing what we want them to do, they’re going to treatment, they’re managing their symptoms, this really isn’t something that should be that big of a concern. We need to address it, but it’s not necessarily that big of a concern. And so sometimes psychological evaluations can help us understand how somebody is doing now, in the context of maybe a long or extensive or even severe mental health history, and kind of piece that out. The other times that I think it’s really helpful, it’s not uncommon for me to hear a co parent say, I’ve been trying, asking my co parent to get help for years, and they wouldn’t, and ultimately, that broke up our marriage or broke up our relationship.

And so we have a history of dysfunctional behavior and impaired functioning. But the person for whatever reason, has not chosen to go and get the help that they need or get evaluated. And so we don’t know what we’re dealing with. And so that can be really helpful for us to come in, especially and I hate to say it, but when it’s court ordered, and they have to do it, and there’s some motivation behind it. Sometimes you get a little bit more compliance, then we can finally get to the heart of what’s going on to help that person get back on track and become a functioning parent and address those issues that are getting in the way.

Holly: So can you kind of describe what the process is like so you know, as an attorney, I go and get a court order that provides for psychological evaluation of mom or dad or whomever, and they get sent to you. What does that process look like?

Victoria: Certainly, and I think that’s such a huge issue that we have. Because when you look at child custody evaluations, we have this statute, and it says you will do X, Y, and Z, and it very clearly spells out what needs to be done. And like you said, when you get an order for a psychological evaluation, a lot of times, that’s really what it says, do a psychological evaluation. And it usually says and Dr. Harvey can do and implement the tools and the steps that she feels are necessary. And so there’s a wide variety, but there are certain things that we should be doing if we are doing a forensic psychological assessment. And one of the first things is we should be getting a full background.

So when someone comes in, everyone gets the very same first question from me, and that is when and where were you born. I start off at the very beginning, because I need to understand all the potential places where we could have have problems emerging, whether it’s physical, whether it’s emotional, all of those things together, I need to understand this person’s trajectory. So we should be getting a full history and not just looking at the person how they are right today. Because that may be misleading. A lot of us employ the use of psychological tests. So there are certain standardized tests. Most of us will use something we call objective tests where there’s not much interpretation in terms of how you score it. It’s just a true false or a computer scores it.

And the testing is helpful, but the one thing that I always tell clients as well as attorneys is that it’s not like a medical test. So we should not be just giving somebody a test. And looking at the results and saying, okay, you have this. Or you are diagnosed with this. Test simply generate hypotheses. They generate things in areas that we should be looking into. It’s another data point amidst hopefully a sea of data points that we’re looking at. Because we also need to be calling collateral sources, we need to be getting their medical records, we need to be getting their psychological records, we need to be getting their criminal records, if they have a police history.

If we feel the need for additional testing, it’s not uncommon for me to send folks out for drug testing or alcohol testing, if I think that that’s something that is in play with their functioning. And so it really is a kind of look into every nook and cranny of people’s lives to really understand their functioning. And so it’s usually quite an extensive evaluation. It’s not uncommon for me to hear attorneys or clients go, wow, this is a little bit more involved than I than I thought. But we really need to be mindful about ruling out things like medical conditions, substance use, and other things that could make a person look disordered when they don’t actually have a mental health diagnosis.

Holly: So what are some limitations to psychological evaluations that we should be aware of?

Victoria: Certainly, I think, probably there’s probably two major limitations. And one is that I think sometimes we get asked to do a psychological evaluation, and then try to use the information more in the way you would custody evaluations. So with psychological evaluations, of course, we cannot make any recommendations about possession, access or conservatorship. And that includes supervision. That’s probably the number one reason I have to send orders back is that it will say Dr. Harvey’s going to do a psychological evaluation and determine whether the person the parent’s visitation needs to be supervised.

And so that is a limitation is that we can only take the information so far. We cannot make recommendations about those areas. And I think the other the other limitation, and I think it can be a limitation and it’s up to us evaluators to not make it a limitation is that these evaluations speak to a parent’s psychological functioning. The tests that we give are not parenting tests. They don’t tell us who these people are as parents. We don’t meet the children. So we have to do a very good job of tying it to parenting and parenting behaviors when we can for that specific person, and really making it specialized to that person. How is, how are there symptoms impacting them.

Versus just general statements like a parent with depression has the risk of, you know, these problems with parenting. Well, that may or may not apply to this parent. And so we really have to make that connection very clear, very explicit for the court. Okay, this person, this is how they’re functioning psychologically. And now how does that affect them as a parent. But when we don’t do that, then we’re really left with a big gap for the court. And they have to make that extrapolation from our data, which can be difficult to do sometimes.

Holly: So you mentioned sending back an order because it had you, talking about supervision or something like that. Do you like to be involved before the order is signed in terms of providing draft language? Or do you have sample orders you like to give attorneys? What do you think is the best way for attorneys to get the right order entered to begin with?

Victoria: So I do like to be involved. I do like to answer questions for attorneys, especially if they have something very specific that they’re looking for. Again, in custody evaluations, we get specific questions. That’s a little bit more unusual in orders for psychological evaluations. But I always encourage attorneys to do that. Write in those specific questions so that I’m certain I’m answering the question that you want answered, or that the court wants answered. There’s nothing worse than getting through with a psychological evaluation, and then going okay, but this didn’t, this didn’t specifically answer what we wanted.

So in the absence of specific questions, we’re just going to provide a general overview of someone’s psychological functioning. So I do encourage attorneys to ask those questions. And to put those in the order. And I have definitely offered templates and wording, things that are helpful, especially in things that I think on an attorney side, make sense. And then when I get it, I go, okay, this doesn’t make sense. So one of the most common things is, parties will be ordered to pay for each other’s evaluations, which is really difficult. Because the information that I use from one person I use not only for their evaluation, but I also use it they become a collateral source for the other evaluation.

So figuring out where to divide those fees becomes almost impossible. So that’s one thing, I always tell attorneys, I say, if you want people to pay half just divided 50-50, that tends to work out easier. But it is helpful to have a dialog. And then once I work with attorneys a couple of times, we usually know kind of what needs to be in there. But my understanding from my perspective is that it’s easier to get those cleared up, rather than to get a new order, get it back to the judge get it signed, that tends to be more time consuming.

Holly: Oh, absolutely 100%. On our side, it helps a lot when we can get specific guidance from professionals. Be it a mental health professionals or otherwise, about what exactly they want in that order. So we don’t have to go back and try and deal with it later.

Victoria: Yeah, and everyone’s different. So again, I think once you start working with individuals, and you kind of know what they want, maybe those conversations are less than less, but everybody has different wording that they want. And especially with the different professions. So some of us are psychologists, some people are licensed professional counselors, some people are social workers. And so we have different things specific to our profession that we might be looking for in an order.

Holly: So what all should be covered in a psychological evaluation?

Victoria: Yeah, so as I said, we really want to have a broad view. And without getting too psychological, getting into that, that that mire a little bit much. One of the things that I remind folks is we’re looking for patterns of behavior. And that is really important. And in order to establish patterns of behavior, both across time and across situation, we really need to again, assess someone’s functioning over the course of their life, and also in other areas than just their marriage in their relationship with this person. And so I look at how do they function in their job? How did they function in school? How are they functioning in their other social relationships? Their past history? Again, we really want to reach out into all those areas of their lives to see can we see patterns that don’t just involve this couple. Because sometimes we know they are fire and gasoline, but everywhere else in their life, they’re functioning great.

But they just know how to push each other’s buttons and really get each other going. And within that relationship, they look really disordered, but outside of that they’re doing okay. And then there are other times where we have people who are disordered in the relationship, but they’re disordered in almost all of their relationships. We find problems at work, social relationships. So we really want to be getting getting as much data from as many different sources as possible to get a complete view of this person. And then we use our testing data to again, help us generate hypotheses about certain characteristics and maybe the presence of certain disorders, before we make a determination about whether someone meets the criteria.

Holly: So you mentioned getting data from a lot of different sources. If we are seeing psychological evaluations based entirely on self reporting, are those going to be reliable?

Victoria: I would have big, big concerns about that. Because I can’t tell you how many times someone comes in and they tell me their story. And I’m kind of like, oh, wow, I really, I kind of don’t know why I’m doing this evaluation, this person seems to be doing well. And then I talk to their co parent and I talk to other people who know this person, I get their records, and I realized they have left out some really significant events and some really important information.

And the final step in my evaluations, after I’ve gathered all the data is I bring them back in and we start talking about those things. And I say, okay, this is what your records say. Help me understand or tell me more about that, because we didn’t cover that before. And when you rely on self report, I mean, it’s only as good as your reporter. And again, when we start looking at a forensic context, and we look at motivation to minimize problems, or just ignore problems, you know, you can, you can really miss some valuable information that would help you understand this person’s true level of functioning.

Holly: So you mentioned a little bit ago that psychological testing is one part of an evaluation. What are some the advantages and disadvantages to conducting psychological testing?

Victoria: So psychological testing can be really helpful to us in again, providing another data point that maybe supports that a person is doing well, or supports that a person is not doing well. But it also helps us compare them against the group that the test is normed on so that we can understand, okay, this person is really struggling, but to what extent compared to the general population. What’s really interesting is that we actually on many of the tests that are commonly used in family courts, we actually have normative groups of people going through child custody litigation.

So what’s interesting is, if we don’t compare it to that group, someone may look really defensive. They may look like they’re minimizing things. But then when we compare them to people in the same situation, where we would expect people to have a little bit more defensiveness and really want to put their best foot forward, that actually fall within what we would expect. And so it is really important to make those comparisons and help us understand how is this person functioning relative to other people? Because, again, our perception and a co parent’s perception may be guided by a lot of other things. And this gives us a more standardized and a more objective view of where concerns are, and how significant are those concerns.

Holly: So I know one of the hot button topics in the world of psychological evaluations relates to diagnoses, and whether or not there should be diagnoses made as part of a psychological evaluation. Where do you stand on that and why?

Victoria: So it’s funny that we’re actually talking about this because this is a hot topic right now on the listserv that I’m on. My email was blowing up over the weekend, because this topic comes up over and over again. And I am on on the position of I do think diagnoses are helpful. But I do also understand the concerns that the the side that says we shouldn’t be giving diagnoses, I definitely understand their concerns. And the two complaints that I hear most of all from them are, one that diagnoses tend to be more prejudicial than they are probative. And that we should be focusing on behaviors rather than diagnoses. And the funny part is, I absolutely agree with them.

Also think that those are two issues that we as evaluators can address in our reports, and mitigate those concerns. Because I do think there’s a lot of value in diagnosis, in terms of what treatments we’re going to recommend and how do we, if somebody does have a diagnosis, how do we manage their symptoms? What things need to be in place to get this person on the right track or to stay on the right track? I think those things are very, very helpful. So I think the pros outweigh the cons. But I also think that it’s up to us as evaluators to make sure that we address those concerns and mitigate those concerns as much as possible.

Holly: So can a psychologist make the same type of diagnoses that a psychiatrist could make?

Victoria: Yes, yes. So we can make the same diagnoses. The main difference between psychiatry and psychologists. So psychiatrists go to medical school, and they focus on medication and medication management. Whereas psychologists, we go to graduate school, and we don’t prescribe medications. There’s, I think, a handful of states where psychologists can, but Texas is not one of them. And so anytime somebody needs medication or medication might be indicated, I as a psychologist will recommend that they go see a psychiatrist for a medication evaluation. But yes, we function off of the same diagnostic manual and can make the same diagnoses.

Holly: So I know there’s some cases where people are requesting psychiatric evaluations as opposed to psychological. What are the differences between those two types of evaluations?

Victoria: You know, I think sometimes it’s somewhat of an arbitrary difference. And I think some of it is based on not a full understanding of the differences between the two fields. Because the evaluations themselves are going to look and should look very similar. I will say that psychologists tend to be trained more in the assessment instruments, where as psychiatrists typically will make diagnoses based off of clinical interviews, and those types of self report gathering information.

Whereas again, we as psychologists will use assessment instruments a little bit differently. But other than that, the end result is ultimately hopefully the same, which is clarifying the diagnostic picture. We just go about it two different ways. A different lens of looking at things. So again, psychiatrists are going to be looking at it through more of a medical lens, and we’re going to be looking at it through more of a psychological and mental health lens.

Holly: So let’s say that the opposing side is requesting both. What would you recommend an attorney argue against the need for both?

Victoria: If opposing counsel were arguing and saying, we really want to have a psychiatric evaluation, and a psychological evaluation, I would really want them to explain in detail, what is going to be the additive value. What is a psychiatric evaluation going to add on top of what is already done in a psychological evaluation. Assuming that the psychological evaluation includes all of the elements that I talked about earlier. What is going to be the added value. And again, sometimes it’s simply a misunderstanding of what the professions do, or attorney might be concerned that a psychologist can’t recommend medication, and again, we can’t.

But what we would do is recommend that someone go see a psychiatrist and have the report have the report given to the psychiatrists, they can read that and make their recommendations based off of that. And of course, if they have any additional questions, they can ask that of the of the client. But I would really want them to specify in detail what is the added value because there’s so much overlap, it’s hard for me to imagine a scenario where that’s really going to be worth the time and the cost that it’s going to take to do both.

Holly: So most of our discussion centers really around the parties involved in litigate, family law litigation. But sometimes we see requests for psychological evaluations of children. Are there any differences or special considerations when you’re doing a psychological evaluation of a child?

Victoria: Yes. So evaluations of children are very, very different. It’s really a different skill set altogether. And not just a different set of tests. We do have to use a whole different set of tests for children that are normed, on on on their peer groups. As well as there’s a whole different set of diagnoses that are available for children that are not available for adults. So it really is a very specialized section and unfortunately, we don’t have a lot of folks that do these types of evaluations, there’s a handful. I know myself, when I have concerns about a child, I may make some general, if I’m doing a custody evaluation, and I have concerns about the child, I may make some general statements. But if I really have concerns, I’ll refer that child for more specific testing. That’s outside of the scope of a child custody evaluation, just because it is it’s a whole different skill set. And it’s a whole different type of assessment.

Holly: So we’re just about out of time, but one of the questions I like to ask all my guests on the podcast is, if you could give one piece of advice to family lawyers, what would it be?

Victoria: Wow, um, I think probably my, my main piece of advice is to really be mindful about which evaluations you’re asking for. Because I think sometimes what happens is, an attorney has a really great experience with either a psychological evaluation or a custody evaluation. And then it becomes very tempting to want that in all their cases. In these cases and these types of evaluations really need to be a good fit for each other. I think psychological evaluations have a wealth of information that they can offer the court.

But when they’re ordered in situations where it’s not appropriate, or that type of evaluation is not going to garner the information that the court needs, then they really, they really don’t do any help. They just are time and money. And so I think it’s really important to be mindful to kind of take a step back. And rather than have kind of a knee jerk reaction of, oh, you know, opposing side wants this evaluation. So we’re gonna ask for this evaluation or those kinds of decisions that it’s really helpful because when used in the right situation, I think these evaluations can be so so helpful to the clients and to the court, and, and really offer a lot of value.

Holly: I know you do custody evaluations, in addition to the psychological evaluations. If psychological evaluations are part of a custody evaluation, do you think it’s critical to include both parties in that?

Victoria: And do you mean evaluate both parties?

Holly: Right.

Victoria: Yes, absolutely. So again, because these people don’t exist in isolation, and they, most of the problems and a lot of the problems that we see, everybody’s kind of contributing to it. And so sometimes, if you just evaluate one person, you’re really missing an important component of the story and understanding how the functioning is going. So anytime I evaluate just one party, I do always include the other party as a collateral source. But I don’t, I can’t really make many opinions and recommendations about that person, because I’m not evaluating them in the same way. And sometimes I really wish I had, I really wish that I had been ordered to evaluate both, because I feel like that’s an important component to the problems that the court is seeing. But again, I have to follow the order. And so if it only orders one person to be evaluated, then sometimes we only get half the story.

Holly: So where can our listeners go if they want to learn more about you?

Victoria: Um, so I am a part of Blake Mitchell and Associates. And so we have our website, and it has everyone on there with our contact information, as well as it speaks to some of our specialty areas and the types of work we do. And that’s probably the easiest way to get in touch with me.

Holly: What is that website?

Victoria: Um, it is mitchellphd.com.

Holly: Perfect. Well, thank you so much for joining us today. And for any of our listeners out there who enjoyed this podcast, please take a second to leave us a review and subscribe to enjoy future episodes.

Voiceover: That Texas Family Law Insiders podcast is sponsored by the Draper Law firm. We help people navigate divorce and child custody cases and handle family law appellate matters. For more information, visit our website at www.Draperfirm.com