Structuring Parenting Plans to Address Dual Diagnoses

By November 23, 2020Bar Bulletins

June 2020 Bar Bulletin

By Megan Stanley

While there is an overall trend in the court adopting equal parenting schedules, there remain cases in which a parent struggles with RCW 26.09.191 restrictions that require the court to carefully consider limitations necessary to protect the children’s best interests. Among the most difficult cases, are those in which a parent suffers from dual diagnoses.

Dual diagnosis is a term used when a person suffers from interrelated mental health and substance abuse problems.  One of the most frequently correlated diagnoses are bi-polar disorder and addiction.  Individuals with co-occurring conditions attempt to level out their emotional state with drugs or alcohol.

According to a 2010 National Survey on Drug Use and Health, 45% of people with addiction have a co-occurring disorder.[1]  Individuals who have both a mental illness and an addiction to drugs or alcohol present a challenge for family law practitioners and the court in developing a parenting plan that meets the best interests of the children.

When a parent suffers from bi-polar disorder, it can shake the child’s stability as the parent experiences unannounced changes in mood.  In recent years, the Centers for Disease Control and Prevention identified Adverse Childhood Experiences (ACEs) that can impact children’s development.  Substance misuse/abuse, mental health problems by someone in the child’s household along with instability due to parental separation are included in the list of Adverse Childhood Experiences that undermine children’s sense of safety, stability, and the parent/child bond.[2]

In cases with the parents with dual diagnosis, creating a parenting plan that assures safe, stable, nurturing relationships and environments for children will reduce the harmful effects of ACEs.

Having co-occurring disorders, can make addiction recovery more challenging.  Bi-polar individuals may experience periods of intense depression alternating with episodes of heightened activity and an exaggerated sense of self-importance.  This emotional instability can interfere with ones focus on their recovery program, making it difficult to comply with the guidelines of the treatment plan.  The most successful approaches for Dual Diagnosis patients are integrated programs that treat all aspects of the illnesses in a single location.

All too often, the family law practitioner and court’s approach in cases with parents presenting with RCW 26.09.191 restrictions is punitive with strict conditions that render them unable to parent their children if they have any sort of misstep.  Overly restrictive plans do not benefit the children and often increase conflict between parents.  The most successful parenting plans require the parent to comply with a team of treatment providers but allow flexibility in contact with their children depending on compliance.  Creative and flexible plans that support the continuity of the parent/child relationship are best for the children.  It is important to consider that it is the children that suffer the most from the loss of their parental bond and ongoing contact with their parent.

Drafters of parenting plans for a dual diagnosis parent should consider baseline requirements for safe parenting. With new advancements in medications and sobriety monitoring such as Soberlink, parenting plans can be crafted that require compliance with medications and sobriety monitoring during parenting time to allow parents to spend overnight time periods with their children.

Phased in plans that include gradual increases in parenting time based on compliance with treatment along with a reduction of parenting time for failure to comply with treatment and alternatives to in-person visits such as phone calls, video conferencing while the parent resumes treatment allow continuity in the parent/child relationship.  Overly restrictive plans may be more harmful and result in the child experiencing the loss of their parent.

Practitioners should focus on contact and communications the parent can exercise to maintain a close relationship with their children despite their diagnoses and relapses.  These family situations call for compassion and cooperation while ensuring child safety.

If there is a conflict between the parents, practitioners should consider appointment of a parenting coordinator or other neutral professional to monitor the parent’s compliance with treatment, assess the children’s well-being and help parents improve communication and co-parenting.  It is also important to craft the plan in such a way that return to court in the event of relapse is not necessary.  If the plan includes detailed protocols and steps to address relapse, parents can follow the steps and protocols without the need to return to court.

In situations where a parent has a dual diagnosis, more time and thought needs to be invested in creating a parenting plan to address the parent’s particular situation.  Hopefully, being mindful of the specific issues and working to address to address them in advance will result in less conflict in the future, which will benefit the parties’ children.


Megan Stanley is a partner at Integrative Family Law, PLLC. Her practice focuses on complex family law matters.  To schedule a consultation with Megan Stanley or one of our family law attorneys, call 206-859-6800.