Man Seeks Ban on Therapy He Used on Daughter

Date: 2002-09-29

JACOB SANTINI
The Salt Lake Tribune

Only weeks after his release from prison last winter, Donald Tibbets appeared before the state Legislature to urge lawmakers to ban coercive holding therapy -- the technique he was using on his adopted daughter when she died. Time ran out before the proposal got an airing. So the former Midvale resident, who served 5 years in prison for his 3-year-old daughter Krystal Ann's death, will be back before lawmakers this winter to lobby for some of the toughest restrictions on coercive therapy techniques in the nation.

"It makes me sick to my stomach to even think that I did this," said Tibbets, a former registered nurse.

Once known as rage reduction therapy, the technique in general consists of holding a child down as fingers, fists or elbows are pushed into the abdomen to get the child to vent suppressed rage. It is an outdated, though not illegal, treatment for children diagnosed with attachment disorder. There are no regulated standards or certification that guide therapists using the technique.

"I knew it was controversial," Tibbets said in a telephone interview from his Cheyenne, Wyo., home. "I didn't know it would cause a death."

Coercive therapy has come under renewed scrutiny following the recent death of a 4-year-old Springville girl. Investigators allege that Cassandra Killpack died June 10 after her adoptive parents forced her to drink a fatal amount of water; her hands allegedly had been tied behind her back during the incident.

The Killpacks, charged with child abuse homicide and child abuse, claim they were acting as directed by therapist Larry VanBloem, director of the Cascade Center for Family Growth in Orem -- an allegation VanBloem denies. The therapist also treated Krystal Tibbets.

In a subsequent but separate investigation from the Killpack case, VanBloem and colleague Jennie Murdock Gwilliam acknowledged to the Department of Occupational and Professional Licensing that they used "compression holding therapy" and "deep tissue massage" on some child clients.

The department filed a 14-count licensing complaint accusing the two of ethical and professional violations, including physically and mentally abusing clients, gross incompetence and unprofessional conduct. The two social workers have maintained they are the targets of a witch hunt in which the division misrepresented innocuous client reports.
Rep. Mike Thompson, R-Orem, sponsor of last year's bill, says the new version of his "coercive restraint therapy" legislation would prohibit licensed therapists from performing or suggesting any type of coercive restraint techniques on children.

The bill would result in a ban on compression holding, rage reduction and rebirthing therapies.

"What this is talking about is child abuse," said Thompson, whose bill already has been endorsed by the Child Welfare Oversight Panel.

Thompson's proposal expands licensing repercussions, but does not include criminal penalties since existing child abuse laws would apply. The Department of Occupational and Professional Licensing (DOPL) says the bill would strengthen its ability to go after the licenses of abusive therapists, Thompson said.

A review of action in recent years by DOPL found at least one therapist in the state who has been disciplined for, among other things, using an abusive form of holding therapy.

Therapy administered by Craig Ramsey, a marriage and family therapist, between 1993 and January 2001, involved "restraining clients and administering verbal and physical abuse," according to licensing records. Ramsey's license was placed on probation for five years in January, precluding him from providing "counseling, psychotherapy, or any form of treatment."

In an interview, VanBloem acknowledged that the Cascade center is practicing therapies that probably would violate Thompson's proposal. But, he contends, none of the practices causes pain or restricts a child's breathing or other functions. Sometimes children are restrained to prevent them from hurting themselves or others, he said.

VanBloem declined to detail therapies used or discontinued at his center, saying only that the industry has refined treatment for the reactive attachment disorder over the years.

"We have become milder and milder in our approach in therapy as we've found alternatives that are just as effective," he said.

Tibbets says VanBloem taught him to lie across Krystal, who weighed 35 pounds, and to push his fist into her abdomen -- a contention VanBloem as well as Tibbets' ex-wife denies, according to court records.

Tibbets said on July 7, 1995, Krystal defied him, so he laid her down in the hallway of the family's Midvale home. According to transcripts from his parole hearing, Tibbets pushed his fist into the girl's stomach for 15 minutes. During the session, Krystal vomited before she stopped breathing. She died the next day in a hospital.

In prior treatments, Tibbets said, Krystal would "shut down" and stop reacting to the pressure. Tibbets said he believed that is what she had done when she stopped screaming. "By the time I realized she was in trouble it was too late," he said.

A medical examiner concluded that Krystal died from suffocation and had blunt force trauma to her abdomen.
Elsewhere, the Colorado Legislature unanimously banned rebirthing therapy following the death of Candace Newmaker, 10, of North Carolina, who had been brought by her mother to the state for treatment in 2000. The two therapists who treated her are serving 16-year prison sentences.

Steven Jensen, the lead prosecutor in the Newmaker case, is running for a seat in the Colorado Senate. If elected, he said he plans to pursue a bill requiring therapists to videotape treatment sessions with children.

The new push for stricter regulations in Utah has some worried that if the practices are outlawed, coercive restraint therapies will simply move underground. "These treatments are being done in the dark corners of the mental health system," Christopher Barden, a North Salt Lake psychologist and attorney who testified in the Newmaker case, told a Utah legislative panel earlier this month.

Ronald Federici, a Washington, D.C.-based developmental neuropsychologist who specializes in treating post-institutionalized children, says that lax licensing standards allow therapists to conduct treatments for which they have no formal training or qualifications.

Thompson knows his bill will be opposed by some national groups and families who support holding therapies that don't include inflicting pain on children -- but he is confident the measure will be approved.

Opposition already is forming.

" Who defines what coercive is?" asked Charly Risenmay, the president of Utah-based Safe Adoptive Families for Children at Risk Emotionally (SAFFCARE) and opponent of Thompson's first bill. "Who defines what restraint is?"
While Thompson's bill says "coercive restraint does not include briefly holding, without undue force, a patient in order to calm a patient," Risenmay said she fears that the proposal would prohibit parents from simply hugging or cuddling a child while in therapy.

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