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Research ArticleRegular Article

Predictors of Custody and Visitation Decisions by a Family Court Clinic

Jonathan M. Raub, Nicholas J. Carson, Benjamin L. Cook, Grace Wyshak and Barbara B. Hauser
Journal of the American Academy of Psychiatry and the Law Online June 2013, 41 (2) 206-218;
Jonathan M. Raub
Dr. Raub is Attending Child and Adolescent Psychiatrist, Natchaug Hospital, Mansfield Center, CT; and Instructor, Child and Adolescent Psychiatry Residency Training Program, The Institute of Living/Hartford Hospital, Hartford, CT. Dr. Carson is Instructor in Psychiatry, Dr. Cook is Assistant Professor of Psychiatry, Dr. Wyshak is Clinical Professor of Psychiatry, and Ms. Hauser is Lecturer in Psychiatry, Harvard Medical School, Boston, MA. Dr. Carson is Clinical Research Associate and Dr. Cook is Senior Scientist, Center for Multicultural Mental Health Research, Cambridge Health Alliance, Boston, MA. These findings were presented in poster format at the 42nd Annual Meeting of the American Academy of Psychiatry and the Law, October 29, 2011, Boston, MA, and at Mysell Lecture and Research Day, Harvard Medical School Department of Psychiatry, March 30, 2011, Boston, MA.
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Nicholas J. Carson
Dr. Raub is Attending Child and Adolescent Psychiatrist, Natchaug Hospital, Mansfield Center, CT; and Instructor, Child and Adolescent Psychiatry Residency Training Program, The Institute of Living/Hartford Hospital, Hartford, CT. Dr. Carson is Instructor in Psychiatry, Dr. Cook is Assistant Professor of Psychiatry, Dr. Wyshak is Clinical Professor of Psychiatry, and Ms. Hauser is Lecturer in Psychiatry, Harvard Medical School, Boston, MA. Dr. Carson is Clinical Research Associate and Dr. Cook is Senior Scientist, Center for Multicultural Mental Health Research, Cambridge Health Alliance, Boston, MA. These findings were presented in poster format at the 42nd Annual Meeting of the American Academy of Psychiatry and the Law, October 29, 2011, Boston, MA, and at Mysell Lecture and Research Day, Harvard Medical School Department of Psychiatry, March 30, 2011, Boston, MA.
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Benjamin L. Cook
Dr. Raub is Attending Child and Adolescent Psychiatrist, Natchaug Hospital, Mansfield Center, CT; and Instructor, Child and Adolescent Psychiatry Residency Training Program, The Institute of Living/Hartford Hospital, Hartford, CT. Dr. Carson is Instructor in Psychiatry, Dr. Cook is Assistant Professor of Psychiatry, Dr. Wyshak is Clinical Professor of Psychiatry, and Ms. Hauser is Lecturer in Psychiatry, Harvard Medical School, Boston, MA. Dr. Carson is Clinical Research Associate and Dr. Cook is Senior Scientist, Center for Multicultural Mental Health Research, Cambridge Health Alliance, Boston, MA. These findings were presented in poster format at the 42nd Annual Meeting of the American Academy of Psychiatry and the Law, October 29, 2011, Boston, MA, and at Mysell Lecture and Research Day, Harvard Medical School Department of Psychiatry, March 30, 2011, Boston, MA.
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Grace Wyshak
Dr. Raub is Attending Child and Adolescent Psychiatrist, Natchaug Hospital, Mansfield Center, CT; and Instructor, Child and Adolescent Psychiatry Residency Training Program, The Institute of Living/Hartford Hospital, Hartford, CT. Dr. Carson is Instructor in Psychiatry, Dr. Cook is Assistant Professor of Psychiatry, Dr. Wyshak is Clinical Professor of Psychiatry, and Ms. Hauser is Lecturer in Psychiatry, Harvard Medical School, Boston, MA. Dr. Carson is Clinical Research Associate and Dr. Cook is Senior Scientist, Center for Multicultural Mental Health Research, Cambridge Health Alliance, Boston, MA. These findings were presented in poster format at the 42nd Annual Meeting of the American Academy of Psychiatry and the Law, October 29, 2011, Boston, MA, and at Mysell Lecture and Research Day, Harvard Medical School Department of Psychiatry, March 30, 2011, Boston, MA.
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Barbara B. Hauser
Dr. Raub is Attending Child and Adolescent Psychiatrist, Natchaug Hospital, Mansfield Center, CT; and Instructor, Child and Adolescent Psychiatry Residency Training Program, The Institute of Living/Hartford Hospital, Hartford, CT. Dr. Carson is Instructor in Psychiatry, Dr. Cook is Assistant Professor of Psychiatry, Dr. Wyshak is Clinical Professor of Psychiatry, and Ms. Hauser is Lecturer in Psychiatry, Harvard Medical School, Boston, MA. Dr. Carson is Clinical Research Associate and Dr. Cook is Senior Scientist, Center for Multicultural Mental Health Research, Cambridge Health Alliance, Boston, MA. These findings were presented in poster format at the 42nd Annual Meeting of the American Academy of Psychiatry and the Law, October 29, 2011, Boston, MA, and at Mysell Lecture and Research Day, Harvard Medical School Department of Psychiatry, March 30, 2011, Boston, MA.
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    Table 1

    Characteristics of the Study Population, by Parent

    MotherFather
    White ethnicity/race8078
    Income more than $20,000/year4328
    At least a high school education5346
    Mental health treatment(s)7560
    Psychiatric hospitalization(s)1511
    Substance use2440
    Arrests1561
    Child protective services3426
    Restraining order(s)2770
    • Data are expressed as percentages of the total study sample (n = 202).

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    Table 2

    Physical Custody Status (Before Clinic Evaluation) and Custody and Visitation Recommendations Made After Clinical Evaluation

    MotherFatherJoint
    Custody before clinic evaluation662113
    Recommended custody after clinic evaluation*55 (65)36 (37)9
    • Data are expressed as percentages of the total study sample (n = 202).

    • ↵* Percent for which visitation was recommended for the noncustodial parent.

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    Table 3

    Significant Predictors

    Odds Ratio (95% CI)*
    Analysis 1: Mother has sole physical custody before the clinic's recommendation
        Mother has had psychiatric hospitalization(s)0.24 (0.07–0.79)
        Mother has a history with family protective services0.25 (0.10–0.65)
        Mother has an income less than $20,000 per year0.28 (0.11–0.70)
        At least one parent reports communicating with other parent about child0.4 (0.16–0.98)
        Both parents characterize their separation and divorce as hostile3.1 (1.2–7.5)
        Father has a history of arrests5.7 (2.23–14.54)
    Analysis 2: Mother has sole physical custody as recommended by the clinic
        Father has a high school education or less0.35 (0.14–0.86)
        Mother has a history with family protective services0.35 (0.14–0.87)
        Mother has past or present substance use0.37 (0.14–0.98)
        Both parents characterize their separation and divorce as hostile2.95 (1.25–6.98)
        Father has a history of arrests4.53 (1.88–10.92)
    Analysis 3: Father has sole physical custody before clinic's recommendation
        At least one child has had mental health treatment0.28 (0.09–0.88)
        Father has a history of arrests0.31 (0.11–0.92)
        Mother has an income less than $20,000 per year8.18 (2.29–29.26)
        Mother has a history with family protective services9.82 (2.88–33.42)
    Analysis 4: Father has sole physical custody as recommended by the clinic
        At least one child has had mental health treatment0.36 (0.13–0.98)
        Father has a history of arrests0.37 (0.14–0.97)
        At least one child has a psychiatric diagnosis3.31 (1.01–10.91)
        Mother has a history with family protective services3.46 (1.28–9.34)
    Analysis 5: Joint physical custody before the clinic's recommendation
        Mother has a history of mental health treatment0.12 (0.02–0.76)
        Father has a history of arrests0.22 (0.06–0.75)
        At least one parent reports communication7.6 (1.67–34.47)
    Analysis 6: Joint physical custody as recommended by the clinic
        Father has a history of arrests0.23 (0.06–0.81)
        At least one parent reports communication4.08 (1.01–16.35)
    Analysis 7: Father has visitation rights as recommended by the clinic
        Father has income less than $20,000 per year0.23 (0.06–0.97)
        Mother has income less than $20,000 per year3.95 (1.49–10.43)
    • Predictors determined in multivariate logistic regression models of current custody and recommendations for custody and visitation after clinical evaluation (n = 183), except for analysis of paternal visitation rights (n = 124), which was conducted only among families in which the mother had sole custody. Each analysis pertains to a multivariate logistic regression model on the listed outcome variable. Covariates for each regression model included the following 11 covariates: race/ethnicity; income; level of education; any past or present outpatient mental health treatment; any past psychiatric hospitalizations; any past or present substance use; any history of arrest; any history of family protective service involvement; whether both parents characterize their separation and divorce as hostile; whether at least one parent reports communication with the other parent on at least one aspect of their child's or children's functioning; and whether at least one child involved in the custody dispute had had mental health treatment as reported by at least one parent.

    • ↵* Odds ratios are only those significant at the p <.05 level in the logistic regression models.

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Journal of the American Academy of Psychiatry and the Law Online: 41 (2)
Journal of the American Academy of Psychiatry and the Law Online
Vol. 41, Issue 2
1 Jun 2013
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Predictors of Custody and Visitation Decisions by a Family Court Clinic
Jonathan M. Raub, Nicholas J. Carson, Benjamin L. Cook, Grace Wyshak, Barbara B. Hauser
Journal of the American Academy of Psychiatry and the Law Online Jun 2013, 41 (2) 206-218;

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Predictors of Custody and Visitation Decisions by a Family Court Clinic
Jonathan M. Raub, Nicholas J. Carson, Benjamin L. Cook, Grace Wyshak, Barbara B. Hauser
Journal of the American Academy of Psychiatry and the Law Online Jun 2013, 41 (2) 206-218;
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