Psychodiagnostic Terms in Family Court: Uses, Abuses, and Alternatives

Saposnek and Berstein’s 2025 article examines the pervasive use and potential misuse of psychodiagnostic labels in family court. The authors explore how these labels, both formal and informal, can lead to bias and discrimination against individuals, affecting legal proceedings and family dynamics. They discuss the limitations of current diagnostic systems and the shift towards more dimensional understandings of mental health. The article highlights the legal rights of individuals with mental health conditions and provides practical tools for family court professionals to focus on observable behaviors rather than relying on potentially stigmatizing labels. Ultimately, the authors advocate for a more humane and behavior-focused approach in family court to mitigate the negative consequences of diagnostic terminology.

Listen to the AI Podcast of this article:

Briefing Document: The Uses and Abuses of Psychodiagnostic Terms in Family Court Cases

Source: Saposnek, D. T., & Berstein, D. (2025). The uses and abuses of psychodiagnostic terms in family court cases: Beyond labels to the humanity beneath. Family Court Review, 1–21. https://doi.org/10.1111/fcre.12851

Date of Publication: 2025

Authors: Donald T. Saposnek, Ph.D., and Dan Berstein, MHS

Abstract: This article examines the history, uses, and abuses of psychodiagnostic terms in family court settings, where they are frequently employed by disputing parties and professionals. The authors explore the limitations of categorical diagnostic systems and the shift towards more dimensional approaches. They highlight the legal rights of individuals with mental health problems to avoid discrimination and provide practical tools for divorce practitioners to move beyond biased assumptions associated with diagnostic language.

Main Themes and Important Ideas/Facts:

1. Prevalence and Misuse of Psychodiagnostic Labels in Family Court:

• Psychodiagnostic labels are common in family court, used by parties to attack each other and by professionals aiming to assist.
• In high-conflict separations, spouses often demonize each other by imputing clinical or quasi-clinical labels like “Borderline,” “Narcissist,” or “Sociopath” to discredit their former partners.
• This negative labeling has serious implications for stigma, the validity of the terms, family functioning, and the well-being of children.
• Quote: “For couples who experience a particularly traumatic separation… it is common for them to demonize their former partners as ‘crazy,’ ‘violent,’ and ‘abusive.’ They often impute formal clinical or quasi-clinical diagnostic labels, such as saying the other party is a ‘Borderline,’ a ‘Narcissist,’ or a ‘Sociopath,’ in efforts to discredit each other.”

1. Negative Consequences of Diagnostic Labeling:

• Stigma and Discrimination: Diagnostic labels can lead to stigma and discrimination by all stakeholders, including parties, advocates, and professionals (judges included).
• Bias and Assumptions: Labels are often wrapped up in biased assumptions that can lead to unfair treatment.
• Impact on Legal Decisions: Judges may unwittingly use diagnostic labels in discriminatory ways when assessing parental fitness, despite laws in some states protecting parents from losing custody solely based on a psychiatric disability.
• Impact on Mediation: Stereotypes associated with mental health labels can lead to mediator bias, diminished neutrality, and the perception that a labeled person is not competent to mediate.
• Impact on Children: Children can be negatively labeled by therapists and parents, potentially leading to a “Self-Fulfilling Prophecy” where they manifest the symptoms of the alleged disorder.
• Loss of Custody: Parents with mental illness are particularly vulnerable to losing custody, with some studies showing loss rates as high as 70% to 80%.
• Quote: “Though diagnostic terms have many helpful uses, they are flawed and can result in inadvertent discrimination by all stakeholders in family court, including the parties, their advocates, and all the divorce professionals, including judges.”

1. Limitations and Evolution of Psychodiagnostic Systems:

• Current categorical systems like the DSM (Diagnostic and Statistical Manual for Mental Disorders) are binary (you either have a disorder or you don’t) and can be overly simplistic, similar to asking if someone is “normal” or “abnormal.”
• The field is evolving towards dimensional systems, which view psychological disorders on a continuum and integrate multiple levels of knowledge (e.g., genetics, neurobiology, cognition).
• The National Institute of Mental Health (NIMH) Research Domain Criteria (RDoC) project is a key initiative in this shift, focusing on dimensions of observable behavior and neurobiological measures.
• However, dimensional systems are still flawed and not yet ready to fully replace categorical models.
• Quote: “Since its inception, the major psychiatric diagnostic system—DSM…has been a categorical system, in which you either have a mental disorder…or you don’t…As such, it is not actually much more sophisticated than asking the overly-simplistic binary question of whether a person is normal or abnormal.”
• Quote: “This NIMH initiative, called the Research Domain Criteria (RDoC) project…was intentionally designed to shift our thinking from conventional, categorical diagnostic systems, like the DSM, to a dimensional system that views each psychological disorder on a continuum, from normal to abnormal…”

1. Legal Rights of People Labeled with Mental Health Conditions:

• Individuals labeled with mental health problems have rights under the Americans with Disabilities Act (ADA) to protection from inappropriate inquiries, screening, and disparate treatment.
• They are also entitled to reasonable accommodations.
• Parental fitness, capacity, and safety should be based on observed behaviors, not solely on a mental health diagnosis.
• Parties can choose to disclose their mental health condition for help or understanding, but should not be pressured to do so.
• Quote: “People who have mental health problems, or who are perceived to have them, have legal rights and protections to not have to experience invasive questions, screening, or disparate treatment.”
• Quote: “Having a psychiatric disability should not be a reason someone is deemed unfit as a parent, unable to have capacity to participate in processes, or a risk of harm and violence. Instead, parental fitness, capacity, and safety screenings and assessments should be based on observed behaviors.”

1. Tools for Overcoming Biased Assumptions:

• The article provides three practical tools for family court practitioners:
• A Brief Guide to the Rights of People Labeled with Mental Health Conditions: Outlines ADA protections and the importance of focusing on behavior rather than labels.
• Checklist for Converting Diagnostic Labels to Useful Information: A three-step checklist to reflect on the label being used, identify underlying assumptions, and focus on relevant behavioral information.
• Sample Script for Responding to Accusations of Mental Health Labels: Provides an example of how to shift the focus from labels to specific, observable behaviors in a neutral and empowering way.
• The goal of these tools is to help practitioners translate vague and stigmatizing labels into objective and observable behaviors relevant to the specific challenges presented.
• Quote: “There are practical ways to resist assumptions about diagnostic labels and to convert the labels into objective and observable behaviors, using only relevant information about the specific challenges they present.”

1. Importance of Focusing on Observable Behaviors:

• Instead of focusing on whether a parent fits a diagnostic label, the focus should be on harmful parenting behaviors as observed in their actual actions (e.g., inconsistent presence, inappropriate discipline).
• This approach helps to de-stigmatize individuals with psychological problems and allows for a more accurate assessment of risks to children.
• Quote: “It is these harmful parenting behaviors, as observed in the actual behaviors of a parent, that should be the focus, rather than making conjectures about whether a parent fits the criteria for having a certain diagnosis or mental health condition, and then forming assumptions that the person will engage in harmful behaviors.”

Key Points for the Family Court Community:

• Be aware that our understanding of psychological dysfunction is evolving towards dimensional systems.
• Recognize that diagnostic terms, while sometimes helpful, are flawed and can lead to unintentional discrimination.
• Understand and respect the legal rights of individuals with mental health problems to avoid inappropriate inquiries and disparate treatment.
• Utilize practical tools to challenge assumptions associated with diagnostic labels and focus on objective, observable behaviors relevant to parental functioning.
• Shift the discourse from stigmatizing labels to specific behaviors to better assess risks and promote the well-being of children and families.

Implications for Practice:

Family court professionals (including judges, mediators, attorneys, and evaluators) should:

• Receive training on the limitations and potential harm of psychodiagnostic labels.
• Develop skills in identifying and addressing biases related to mental health.
• Prioritize the assessment of specific, observable behaviors over reliance on diagnostic labels.
• Educate parties about the pitfalls of using diagnostic terms as weapons.
• Employ strategies to reframe discussions around concrete behaviors and their impact on children.
• Be mindful of the legal rights of individuals with mental health conditions under the ADA.

This article serves as a crucial reminder for all involved in family court to move beyond potentially harmful labels and focus on the “humanity beneath” by prioritizing objective observations and respecting the rights of individuals with mental health challenges.

The Complete Article

Wiley Online Library Link to Complete Article

                       

Donald T. Saposnek, Ph.D

Donald T. Saposnek, Ph.D., is a clinical-child psychologist, a child custody and family mediator and a national and international trainer and consultant in child psychology and mediation since 1977. He is the author of the classic text, Mediating Child Custody Disputes: A Strategic Approach, and co-author of Splitting America: How… MORE >

                       

Dan Berstein

Dan Berstein, MHS is a mediator and trainer known for his work in mental health communication, accessibility, and challenging behaviors. Through his company MH Mediate, Dan provides tools, trainings, and resources to help all kinds of mental health stakeholders talk about mental health, resolve conflicts, and address challenging behaviors in… MORE >