Thriving during separation can be difficult when you have a child who refuses to spend time with either you or your co-parent. In this episode, host Jaime Davis discusses the process of reunification therapy with Dr. Tina Lepage, a forensic and clinical pyschologist and founder of Lepage Associates Psychological and Psychiatric Services.
Note: Our Podcast, “A Year and a Day: Divorce Without Destruction”, was created to be heard, but we provide text transcripts to make this information accessible to everyone. All transcripts on our website are created using a combination of speech recognition software and human transcribers and could contain errors.
Jaime Davis: Welcome to Episode 5 of Season 4 of “A Year and a Day.” I’m your host, Jamie Davis. Today, I’ll be speaking with Dr. Tina Lepage about reunification therapy. Dr. Lepage is a forensic and clinical psychologist with over 20 years experience serving clients of divorce and working closely with attorneys, mediators and the family court. Prior to founding Lepage Associates Psychological and Psychiatric Services, she worked as a court psychologist at a domestic relations court. In group private practice for the last 18 years, Dr. Lepage created the Innovative Center for Separating with Civility and Divorcing with Dignity that focuses on therapy and co-parenting, as well as a large forensic testing division that provides hundreds of psychological and custody evaluations annually.
Tina Lepage: Thanks for having me.
Jaime Davis: Tell our listeners a little bit about your practice.
Tina Lepage: Sure. Lepage Associates is a multi-specialty psychology and psychiatry practice. We have a main office in Durham and then offices in Raleigh and Chapel Hill as well. And by multi-specialty, that means that we have variety of doctors here who all specialize in different areas. So with that, we treat all ages and all diagnoses doing both therapy and testing.
Jaime Davis: The theme of this season of the podcast is learning how to thrive in separation and divorce, which can be difficult if you have a child who is refusing to spend time with either you or your co-parent. In those situations, is there anything that can be done to help?
Tina Lepage: Yes, there definitely is. We would approach that from a family therapy perspective and nowadays with these cases that are specific to separation and divorce, we use the term reunification therapy. So reunification therapy is really a form of family therapy where people therapists, who are involved in that have specialized training in trying to help in these situations where children are refusing contact with one parent, what kind of training is required. So people who do reunification therapy, it really is helpful to have specialized training. A lot of people will at minimum, of course, do their own independent study and reading, and maybe take a seminar to come up to speed on reunification therapy and how it’s looked at these days and their approach because there really actually has been a great deal of research. And there are some wonderful resources out there for therapists who want to work in this area beyond that, you can actually do a full semester university course on reunification therapy. There’s one that’s offered in the nation. We’ve actually had all of our therapists here take that course and I’ve taken it myself and just adds a wonderful layer of training for people who are going to do reunification therapy.
Jaime Davis: How does the process of reunification therapy work? Of course, the overarching goal of reunification therapy is to heal the rift between the parent and child. Typically there has been some type of rift. We try to come at that by first, getting the family to get off the blame game because a lot of time there’s finger pointing. The favorite parent thinks it’s the disenfranchised parent’s fault. The disenfranchised parent thinks that the favorite parent is alienating or making the situation worse. Uh, the child has opinions about who’s fault it is. So we try to, um, start by meeting with everybody individually, hearing their perspectives, work with them all on perspective, taking to try to understand how the others are thinking and feeling, and then do the therapy work of trying to heal the rift, whatever caused it. It’s really different from families. There can be a multitude of different things that cause the rift. So it’s not any one thing.
Jaime Davis: Why is it important for a child to repair their relationship with a parent?
Tina Lepage: You know, from the child development literature research and have known of course for a very long time, that it’s incredibly important for children to have a healthy attachment and relationship with both of their parents. So basically if we look at parents, of course, want a happy, healthy child who turns into a happy, healthy adult. And for us, so much of our development is through the relationship with our parents. There’s a lot of things we learned through that relationship. A lot of life that we learn to navigate through having that attachment with them. And then of course there’s the importance of just the emotional bond and the long-term family support that matters as well.
Jaime Davis: Do you ever run into a situation where a child may be resistant to participating in the process.
Tina Lepage: Absolutely. And that might almost be the norm if we look at resistance at different levels. So some children are mildly resistant and then some children are highly resistant and everything in between, but since there has been a rift and there is a child refusing to see a parent, they’re not always keen on coming in and starting the family therapy work. So the beginning of reunification therapy is really about working with each individual to get them ready for the family sessions. We don’t just throw them into a room together in family therapy and say, okay, you’re here for reunification therapy. So now you’re going to be in a room together and we’re going to start doing family therapy. Our goal is to make sure that when we get to that point, those family therapy sessions are productive and successful. And in order to help ensure that we do prep work ahead of time.
So we do individual sessions with that child to get them ready, to be effective in that session at saying what they need to say and working through what they need to work through with the parent. And we do the same thing with both of the parents. We work with them. We work with the favorite parents so that they are supporting the process in an effective way, which oftentimes they think they are, but there’s still so many things they can learn to support the process. And we work ahead of time with the disenfranchised parent to make sure that they’re going to come in to the family sessions, ready to do the work and hear their child’s concern and be open to things that they need to change or do better to heal the rift. So there’s a lot of prep work up front with that resistance to make sure that when we do the family therapy, it’s going to be successful.
Jaime Davis: What types of things might you do for prep work for a child to get that child ready to meet with the disenfranchised parent?
Tina Lepage: There is work around forgiveness. So there are sometimes things a child sees or hears in a separation or divorce process that upsets them a great deal. And they are angry at that disenfranchised parent. And so sometimes there’s work around that.
Sometimes there’s work around dealing with their anxiety because oftentimes the longer they go without seeing a parent, the more anxious they are about seeing them. So this, they built that this anticipatory anxiety around seeing their parent. Sometimes there’s psycho-education. For example, we’ve had cases where a parent who used to be, for example, alcoholic has been clean and sober for a few years and a child is still refusing to see them. And so we might do some psycho-education around, um, alcoholism and why that parent might currently be, um, somebody good to still have in their life, even if they were not behaving as such a great parent in the past. So those are sort of a few of the things. Again, they really, they really differ family by family, depending on what the rift was.
Jaime Davis: How does that prep work differ if you think that the favored parent may be engaging in some alienating behaviors? Like maybe they’re trying to intentionally or not make the child feel like they don’t want to visit with the other parent.
Tina Lepage: So one thing that we’ve really learned over the past decade or so of doing reunification therapy, and I say, we meaning certainly here at the practice, but just the broader community is how important looping in the favorite parent is. I think early on in reunification therapy, there was always a focus on the disenfranchised parent and the child as if, as long as the favorite parents said, okay, of course I want them to have a relationship with the other parent that that meant that they were supporting it.
And what we find with favored parents is they oftentimes don’t realize the subtle ways in which they’re not supporting it. They have their own anxiety usually about, well, what does it mean to push this child to go if they don’t want to go, or sometimes they’ve sided with the child consciously or unconsciously and think the child is right about not, um, having a relationship with the other parent. So there is always work, frankly, to do with the favored parent, just to help them be part of the solution. We try to get away from finger pointing and blame, and who’s part of the problem. But we try to talk to parents about how they can be part of the solution of their child, having a good relationship with both parents, which is ultimately in a child’s best interests and good doesn’t mean perfect. I might say part of growing up and learning for kids is learning that your parents aren’t perfect and you can have a good, healthy relationship with somebody, even if they’re imperfect with boundaries in place.
Jaime Davis: Does the process differ based on the age of the child?
Tina Lepage: It definitely differs like any therapy would, depending on the age of the child. So we’ve had children as young as preschool. And of course with them, we’re incorporating a play therapy model. And even just talking about family and relationships and those types of things, we’re using different language, that’s at their developmental level.
And that differs from a child who’s eight to 10 years old, where we might still be incorporating games and structure, but we’re using a higher level of talking about relationships. They’ve had their own friendships for years and can kind of understand examples of what goes wrong in relationships and the desire to fix those and why that’s beneficial. And then of course you have teenagers who are smack in the middle of figuring out their own identity and talk therapy is an approach with them. And they are sort of thinking through what this all means to them on a higher level than the younger children.
Jaime Davis: How long does reunification therapy take?
Tina Lepage: Typically I will say it takes longer than people often want. Um, so we do try to encourage the disenfranchised parents to have patience, which is hard for them because by the time they come to therapy, they’ve already not seen their child for some period of time, you know, weeks and months. And sometimes in some cases we’ve had even years, but it takes time because of that prep work up front and trying to ensure that the family sessions are going to be productive. Now, having said that all cases are different. So there are certainly some cases that go rather quickly, where everybody is truly on board with healing, the rift, and those cases can move along. In a matter of weeks, the cases where kids are really entrenched and not wanting to see the parent, we have to take the time to do that prep work upfront in order for it to be successful. And those cases can take more in the line of months for things to truly be healed.
Jaime Davis: So about those cases where the child is truly entrenched, and you mentioned there needs to be more prep work upfront. Can you walk our listeners through an example of what that might look like? What are the types of activities you might engage in with the child to get them ready?
Tina Lepage: Sure. And the way that we have set it up here is we actually have modules that we’ve created to go through with families. And we can go through them more quickly with people who are moving along, but in the folks who are entrenched, we basically have more modules that we can pull from to work on. So the beginning modules are going to be describing reunification therapy and talking about everybody’s role in it and what they can do to help the process and why the process is important.
There is a bigger psycho-educational piece that continually gets looped in of why it’s important to have this relationship for children who are entrenched. There is the work I mentioned before on forgiveness. Typically, kids who are entrenched really do feel like there’s some wrong. That’s been done that they need to have an apology for. And so we do apology work with the parent, but I’m sort of describing right now, what we do with the child, with the parent, we do talk about how to come to and give a good sincere apology. And then we work with the child on how to be open to that. There is work on how to redevelop trust. When somebody in a relationship has hurt you and hurt your feelings.
There is sometimes for a child, um, some anger management work. If the child is particularly angry, not all children have that facet. There is, there are always activities on how to reduce anxiety for when you see the parent, because these children tend to have built up a good bit of anxiety.
We work with children on communication skills and how to communicate their thoughts and feelings. Oftentimes they’ll write letters in the office with their therapist to sort of ready themselves for what they want to communicate to their parent. And then once they work through the communication and all the things they want to say and a good appropriate way to say those things, they sort of organize them as things that they want to tackle first and things that they want to have. Wait until later, sometimes kids will want to tackle the big stuff first, but try to start with smaller things first so that there can be some successes in those, in that new communication along the way. So a lot of work on communication, and those are, I guess, some, some examples of what that prep work looks like.
Jaime Davis: How does the prep work differ with the parents? What types of things might you work on with the disenfranchised parent to get them ready?
Tina Lepage: With the disenfranchised parent, oftentimes the work in the beginning is so there’s some similarity to what I work with the child in terms of, of course, helping them understand reunification therapy and, and their role in it and what they can do to make it better. We do a lot of perspective taking work with that parent in how they can understand their child’s perspective and why their child is so upset because often disenfranchised parents come in with the perspective of I’ve done nothing wrong. Why should I be rejected like this? Why is my child refusing to see me? It’s not my fault. And the child is just being belligerent or difficult and, or the favorite parent is allowing that and promoting it. So very other focus. So we need to get them to be self-focused because they can only control themselves. So all they can bring to this process is what they can do better. So we talked to them about perspective, taking, tying to understand the child’s perspective. And then again, big pieces around communication. How can they hear what the child has to say, not be judgmental, say their own piece and what they need to talk about, and then really do the work on how do they need to communicate differently or engage with that child differently, going forward to make things better.
Jaime Davis: Do you have any advice for a parent who thinks their child might benefit from reunification therapy?
I think if they think that the child and family would benefit for me reunification therapy, a first step can be to, for example, reach out to a practice like ours that does a good bit of this. Typically I will talk to somebody for a few minutes if they want to know more about the process and describe it. And I imagine other practices would do the same if they call people that do reunification therapy. There’s a good bit of information online at, that people can read about to see what reunification therapy might mean for their family. And they might want to have a consult or, or get to know a couple of therapists and see who they think might be a good fit for their family.
Jaime Davis: Now it’s time for the final four. When I ask each guest the same four questions so that our listeners can get to know a little more about the guest.
What are your self-care go tos?
Tina Lepage: Going outdoors is my big one. I love to be outdoors. Whether it’s walking or hiking or being with my dogs, just anything outdoors I think is really uplifting. So that’s a big one for me. And then exercise and movement, just getting away from the desk, getting away from the zoom calls, moving my body. Those are, those are the big things for me. And of course, spending time with friends, love to spend time with friends and talk. And of course it’s been tough in COVID, but whether that be zoom or sitting outdoors, um, you know, uh, sitting apart from each other outdoors, at least there’s some social connections still.
Jaime Davis: What have you discovered about yourself during the pandemic? I kind of laugh and say, I’ve become somebody now has this sort of crunchy granola perspective of the importance of just human energy and being in the same room together. I don’t know that I realized how important that was before, but I get tired of zoom calls. And when I’m on a zoom call, as much as I enjoy laughing with friends and talking and doing book clubs and whatever used to be done in person, you know, that’s now being done online, but I really learned that there’s just something I really experienced something of an energy when people are in the same room together, I’d almost rather be outdoors, huddled under a heater with masks sitting apart than I would be on a zoom call.
Jaime Davis: Absolutely. I agree with you a hundred percent on that one. Have you acquired any strange pandemic habits?
Tina Lepage: Well, my husband would probably say my strange pandemic habit is that I kicked him out of the house once one day a week, because there’s just too much, um, tripping over each other. So I never realized how, when you’re married and have a child, you still have time alone in the house at sometimes because people come and go and he would go to his work place and I would come to my office. So his work was online. Whereas I came back to my office sooner, but that still meant he was always, always at home. So after, after a few weeks I told him it would be nice if he went to his office for a few hours once a week.
Jaime Davis: When this is all over, where would you like to travel?
I think when this is all over, I would like to travel somewhere far away because it’s been so confining. Even for this summer, we started making plans because we will travel, I think this summer. Whereas of course, last summer, all travel plans were canceled. So we initially thought about maybe trying to go to Europe or something like that, but are still a little anxious that countries may not be letting people in even if we have, you know, the vaccine, how will they track that? So I think it will be nice when that anxiety is gone to go somewhere far away. So I don’t know anywhere specific, but probably just somewhere out of the US um, even though we love vacationing in the US too, and that’s what we’ll do this summer.
Jaime Davis: Well, it sounds wonderful. I hope you’re able to take your trip soon.
Dr. Lepage, thank you for joining me today. If any of our listeners would like to contact you, what is the best way for them to reach you?
Tina Lepage: We have all of our contact information on our websites. So if they go to lepageassociates.com, they’ll find everybody’s email address there that works at the practice, mine included, phone numbers, etc. So the website is probably the go-to for people, and then they can call or email, and either way to contact me is fine with me.
Jaime Davis: I hope you have enjoyed this episode of “A Year and a Day.” If you have any questions or comments, I would love to hear from you. You can email me at firstname.lastname@example.org. As a reminder, while in my role as a lawyer, my job is to give folks legal advice. The purpose of this podcast is not to do that. This podcast is for general informational purposes only, should not be used as legal advice, and is specific to the law in North Carolina. If you have questions before you take any action, you should consult with a lawyer who’s licensed in your state.