RESEARCH SURVEY COLLECTIONCalifornia Protective Parent Association and Our Future Charitable Foundation are conducting an ongoing collection of data for a national research project. The project involves cases of children placed by family law courts into the custody of, or unsupervised visitation with their identified abusing parent. PROTECTIVE PARENT SURVEY QUESTIONNAIRE Re: Custody Outcomes of Children Reporting Incest/BatteryNOTE: If you are concerned about secure confidentiality, we suggest you PRINT this survey (from pdf format) and mail it to us by US mail at our CPPA/OCOF address. If you prefer and are not concerned with confidentiality, you may send it online, but be aware it is not on a secured server at this time.
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Please answer all questions appropriate to your case.You may use the space below for comments or questions: Thank you for contributing to this survey.
Please print and mail this survey to: CPPA/OCOF 1731 Howe Ave. #168, Sacramento, CA 95825-9785
Or fax it to: (530) 758-9785 (phone: 800 441-7886)
Or submit it electronically by clicking the “send Request” button below. (Confidentiality respected, but not guaranteed, due to Internet security.)
| Zip Code: | ||
| Phone Number: | ||
| Alternate Phone: | ||
| E-mail Address: | ||
| CASE INFORMATION | ||
| Case Name: | ||
| 1.) Jurisdiction State: | ||
| 2.) Jurisdiction County: | ||
| 3.) Case Number: | ||
| 4.) Year documents 1st filed: | ||
| 5.) Case still in progress? | Yes No | |
| FINANCIAL COST | ||
| 6.) Approximate sum of money paid related to case? | ||
| (Include attorney fees, court filings, mediation, evaluations, supervised visitation, court ordered classes, therapy, etc.) | ||
| 7.) Have you ever had to file bankruptcy as a result of litigation costs? Yes No | ||
| ATTORNEY HISTORY | ||
| 8.) Have you ever been represented by an attorney in this case? Yes No | ||
| 9.) If so, how many attorneys represented you in this case? |
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| 10.) Has your ex-spouse/partner ever had legal representation when you did not? Yes No | ||
| CHILDREN | ||
| 11.) What were the ages of the child(ren) of this relationship at the time of the separation? Girl’s ages: Boy’s ages: | ||
| 12.) What is the approximate percentage of time each caretaker spent caring for the child(ren) before the separation? Mother: % Father: % Relative: % Other: % |
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| 13.) At the time of separation, did the primary caretaker maintain primary physical custody? Yes No | ||
| PRIMARY ISSUES | ||
| 14.) Over which of the following issues were there disputes in your court case? (mark all that apply) Property settlement Spousal support Child support Move away Child custody/visitation Alcoholism Drug abuse/type of drugs: Other: |
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| 15.) Who initiated the litigation? Mother Father |
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| 16.) Were you the victim of domestic violence perpetrated upon you by the other parent? Yes No | ||
| 17.) If so, did your children witness the violence? Yes No | ||
| 18.) Did the violence begin or escalate after separation? Yes No | ||
| 19.) Did your ex-spouse/partner ever threaten to take the child(ren) if you left the relationship? Yes No | ||
| 20.) Were there allegations of child abuse made during your family court litigation? Yes No | ||
| ABUSE ALLEGATIONS | ||
| Complete the information below regarding allegations made during litigation, including who is the identified perpetrator and who first made the allegation (mark all that apply): | ||
| 21.) Physical abuse allegation? Yes No Identified as perpetrator:FatherMotherOther: First allegated by:ChildFatherMotherOther: |
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| 22.) Sexual abuse allegation? Yes No Identified as perpetrator:FatherMotherOther: First allegated by:ChildFatherMotherOther: |
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| 23.) Verbal/emotional abuse allegation? Yes No Identified as perpetrator:FatherMotherOther: First allegated by:ChildFatherMotherOther: |
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| 24.) Neglect allegation? Yes No Identified as perpetrator:FatherMotherOther: First allegated by:ChildFatherMotherOther: |
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| 25.) Other allegation? Yes No Identified as perpetrator:FatherMotherOther: First allegated by:ChildFatherMotherOther: |
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| 26.) What was the age and gender of the first child at the onset of his/her abuse? Boy Girl |
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| 27.) What was the age and gender of the second child at the onset of his/her abuse? Boy Girl |
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| 28.) Did the child positively identify the other parent as the perpetrator? Yes No | ||
| 29.) Was there medical/physical evidence of the abuse? Yes No | ||
| 30.) Was there other corroborative evidence of the abuse? Yes No | ||
| 31.) What were the child(ren)’s symptoms? (check all that apply) Sexual acting out Depression Stomach/head/other pain Dissociation Overwhelming anger/rage Nightmares/insomnia/sleep disorders Fears/phobias: Eating disorders Regression (bedwetting/leak feces/thumb sucking) Constipation/diarrhea Learning disability Attention deficit Suicide attempt Other: |
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| 32.) Did the child(ren) receive Victim of Crime funding for therapy related to the crime? Yes No | ||
| EX-SPOUSE/PARTNER HISTORY | ||
| 33.) Prior to the separation, did your ex-spouse/partner receive any of the following labels by mental health professionals? (mark all that apply) Schizophrenia Bi-polar disorder Borderline personality Depression Anxiety Post Traumatic Stress Disorder Other: |
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| 34.) Does s/he have a history of alcohol and/or drug use? Yes No | ||
| 35.) If so, is s/he clean and sober? Yes No 36.) Length of time clean and sober: | ||
| 37.) Does s/he have a criminal history? Yes No | ||
| 38.) If so, what was s/he… Arrested for?: 39.) Convicted of?: Description: |
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| PROTECTIVE PARENT HISTORY | ||
| 40.) Prior to the separation, did you receive any of the following labels by mental health professionals? (mark all that apply) Schizophrenia Bi-polar disorder Borderline personality Depression Anxiety Post Traumatic Stress Disorder Other: |
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| 41.) Do you have a history of alcohol and/or drug use? Yes No | ||
| 42.) If so, are you clean and sober? Yes No 43.) Length of time clean and sober: | ||
| 44.) Do you have a criminal history? Yes No | ||
| 45.) If so, what were you… Arrested for? 46.) Convicted of? Description: |
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| ADVISE | ||
| 47.) Did anyone ever advise or insist that you not mention domestic violence or child abuse in family law court? Yes No |
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| 48.) If so, who advised you? Attorney Mediator Advocate Court personnel Other: |
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| 49.) Did your attorney ever tell you that pursuing court action against your ex-spouse/partner could negatively affect your case? Yes No | ||
| CHILD CUSTODY | ||
| 50.) Was custody changed to the other parent over your objection, by an emergency court order, or without your court presence? Yes No |
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| 51.) Was unsupervised contact given to the identified offender despite evidence of violence or abuse? Yes No |
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| 52.) Was unsupervised contact given to the identified alcoholic/drug abuser without drug testing? Yes No N/A |
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| 53.) Was custody changed after you raised any of the following issues? (Mark all that apply) Violence Child abuse Substance abuse Criminal conduct Violations of court order Move-away Spousal support Child support |
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| 54.) Were judicial findings made stating that you were a danger to your child(ren) or that you were an unfit parent? Yes No |
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| 55.) Were you ever placed on supervised visitation? Yes No 56.) If so, length of time: |
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| 57.) Were you restricted from having any contact with your child(ren)? Yes No 58.) If so, length of time: |
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| 59.) Do you believe the other parent attempted to gain increased custody to avoid paying child support? Yes No |
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| 60.) Was financial discovery conducted in your case? Yes No |
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| 61.) Did you give up assets to keep custody? Yes No |
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| COURT MEDIATION | ||
| 62.) Did you participate in court-connected mediation regarding custody? Yes No |
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| 63.) If so, was mediation: Voluntary Court ordered Coerced by threats |
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| 64.) Were you required to meet face-to-face with an ex-spouse/partner who perpetrated violence and/or threats of harm? Yes No |
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| 65.) Did you lose any custody rights or contact with your children as a result of recommendations by a mediator? Yes No |
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| EVALUATIONS | ||
| 66.) Did you participate in court connected evaluations regarding custody? Yes No |
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| 67.) If so, who was evaluated?: Mother Father Child(ren) Others: |
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| 68.) Who selected the evaluator?: Mother Father Court Others: |
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| 69.) Who paid for the evaluator?: Mother Father Court Others: | ||
| 70.) Total amount paid for custody evaluation: |
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| 71.) Did you lose any custody rights or contact with your children as a result of recommendations by the evaluator? Yes No |
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| CHILD’S ATTORNEY | ||
| 72.) Did your child(ren) have an attorney/guardian? Yes No |
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| 73.) If so, was he/she court appointed?: Yes No |
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| 74.) Who selected the child(ren)’s attorney?: Mother Father Court Others: |
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| 75.) Who paid for the child(ren)’s attorney?: Mother Father Court Others: |
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| 76.) Total amount paid for child attorney: |
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| 77.) Did this attorney aggressively advocate for the safety of your child(ren)? Yes No |
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| SYSTEM SUPPORT | ||
| 78.) Was the other parent ever Arrested and/or Prosecuted for spousal or child abuse? Yes No |
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| 79.) Was Child Protective Services ever contacted to intervene in your case? Yes No |
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| 80.) If so, did they protect your child? Yes No |
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| EVIDENCE | ||
| 81.) Did any court related professional ignore, minimize, or refute evidence of abuse in your case? Yes No |
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| 82.) If so, who? Mediator Evaluator Attorney for minor Judge Other: |
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| 83.) Did any court related professional label you with any of the following? Parent Alienation Syndrome Alienator Folie a duex Munchhausen’s Syndrome by Proxy Delusional Schizophrenia Bi-polar disorder Borderline personality Depression Anxiety Post traumatic stress disorder Other rare/unscientific label: |
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| 84.) In your case, was Richard Gardener, MD.: An expert witness A consultant Quoted Other: |
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| PROCESS | ||
| 85.) Do you believe you were discriminated against for your attempts to protect yourself and/or your child(ren)? Yes No |
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| 86.) If so, do you believe this occurred due to: Unethics among court-related professionals Unethics between ex-spouse/partner & court-related professionals Financial/social status of your ex-spouse/partner Gender bias Other: |
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| 87.) Were evaluator or mediator recommendations ever provided to the court less than 10 days before a hearing? Yes No |
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| 88.) Were you prevented from seeing evaluations or reports that resulted in custody decisions?: Yes No |
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| 89.) Were you ever denied the ability to adequately present your case (unable to present/examine witnesses, etc.)?: Yes No |
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| 90.) Were hearings resulting in custody decisions held without your knowledge or ability to be present (ex parte)?: Yes No |
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| 91.) Were hearings regarding custody and visitation ever conducted without a court reporter present?: Yes No |
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| 92.) Were you ever threatened that talking publicly could result in damage to your case?: Yes No |
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| 93.) Were court transcripts complete and accurate?: Yes No |
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| 94.) Were court transcripts denied or delayed? Yes No |
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| 95.) If so, how long were the transcripts denied? |
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| 96.) Have you ever been incarcerated in a jail or mental health facility due to the family law case?: Yes No |
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| CURRENT CUSTODY ARRANGEMENT | ||
| 97.) What best describes your children’s current custody arrangement? (mark all that apply) Primary with protective parent, supervised with perpetrator Primary with protective parent, UNsupervised with perpetrator Joint custody Full custody with perpetrator parent Supervised visitation with protective parent No contact with protective parent Other: |
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| 98.) Are you able to protect your child(ren)? Yes No | ||
| 99.) Do you believe your child(ren) are still being abused? Yes No | ||
| 100.) Did your child(ren) continue to report abuse after custody was changed to the identified abuser?: Yes No | ||
| 101.) Did you stop reporting suspected child abuse for fear your contact with your child(ren) will be terminated?: Yes No | ||
| Do you give us permission to contact you for further information? Yes No | ||
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