For attorneys

Legal consultation

Psychiatric consultation for attorneys representing children in foster care and in Children in Need of Assistance (CINA) proceedings. If you represent a child, a parent, or a local department in one of these matters and need a psychiatrist’s perspective, please contact me here.

Why a psychiatrist in a CINA case

Children who come into care arrive with histories that the court must understand quickly and that the record rarely explains well: trauma, disrupted attachments, sleep that has never been regular, symptoms that look like defiance or inattention and are something else, medications started and stopped across placements. Attorneys are asked to make arguments about a child’s needs, a parent’s capacity, and the fit of a proposed placement or service plan, often on the strength of a school report and a caseworker’s summary. A trained psychiatrist with experience in how these children move through the child-welfare system can translate that record into what it means for this child, and say plainly what is known, what is not, and what would help.

What I offer

Record review

Review of medical, psychiatric, educational, and placement records, together with the child’s birth and early developmental history, the family of origin, the family’s cultural values and norms, and the educational attainment of the child and the family, including the family’s own experience with and understanding of mental health care. The result is a written summary of the psychiatric picture, the quality of the evidence behind each diagnosis, and the questions the record leaves open.

Consultation to counsel

Plain-language explanation of diagnoses, medications, and treatment recommendations; help framing questions for other experts, treating clinicians, and school personnel; and an assessment of whether a proposed service plan is realistic for the child described.

Psychiatric evaluation

Where appropriate and permitted by the court, direct evaluation of the child, including sleep, trauma, substance use, and developmental history, with a report addressed to the questions counsel and the court need answered. Adolescents ages 15 and older now; younger children from July 2027.

Treatment and placement recommendations

Specific, feasible recommendations about therapy, medication review, school supports, and the clinical features of a placement that would serve the child, written so that a service plan can be built from them.

Testimony

Where retained for that purpose, testimony by affidavit, deposition, or in court, within the limits of what the evidence supports.

Jurisdictions and terminology

The same proceeding carries different names in the places I practice. In Maryland, a child alleged to have been abused or neglected and to need court intervention is a Child in Need of Assistance (CINA) under Title 3, Subtitle 8 of the Courts and Judicial Proceedings Article. In the District of Columbia, the equivalent is a neglect proceeding in the Family Court of the Superior Court. In New York, it is an Article 10 abuse or neglect proceeding in Family Court. I am glad to work with counsel in any of the three.

Relevant experience

I am a trained psychiatrist, and my experience with children in the child-welfare system predates my medical training. I served on the Community Council of the Tree House Child Advocacy Center of Montgomery County, Maryland, the county’s center for children who have experienced sexual abuse, physical abuse, or neglect, where forensic interviewing, medical evaluation, mental health treatment, and victim advocacy are brought together under one roof. My name appears among the Council members in the Tree House 2014 Annual Report, shown at the top of this page. That work gave me a practical education in how abused and neglected children move through the child-welfare and court systems, and in the gap between what a child needs and what the record shows.

My research at the National Institutes of Health has focused on how sleep and adversity in childhood shape later mental health, including a first-author study of sleep disparities among American children by race, ethnicity, and family income. I am familiar with the way psychiatric findings are used, and misused, in dependency proceedings, and with the questions attorneys most need answered when a child’s mental health is at issue.

Further detail on Dr. Giddens’s work in this area will be added here.

Practical matters

• Consultation is available to counsel for children, parents, and local departments, and to guardians ad litem and CASA programs.
• Work is undertaken under a written engagement that sets out scope, fees, and timelines. Court-appointed and reduced-fee arrangements are considered case by case.
• Consultation to counsel does not create a treatment relationship with the child. Where a child needs treatment, I will say so and help identify it.
• Records should be sent only after an engagement is in place and through a secure channel that we will agree on; please do not send records by ordinary email.

Contact me here