Opinion
NOT TO BE PUBLISHED
Super. Ct. Nos. JD224519 & JD224520
NICHOLSON, J.
Mother, Desiree M., appeals from the findings at the Welfare and Institutions Code section 366.21, subdivision (e) hearing, that reasonable reunification services had been provided to her and that returning her children to her care would create a substantial risk of detriment to them. Mother contends the evidence is insufficient to support the court’s findings. This is mother’s second appeal in this case. In the first appeal, she unsuccessfully challenged the juvenile court’s order removing the children from the home at the dispositional hearing. (See In re Tyler H. (Apr. 24, 2008, C055017) [nonpub. opn.]; we take judicial notice (Evid. Code, § 452, subd. (d)) of this court’s records in mother’s first appeal.) The third case was a writ taken from orders at the 12-month review hearing terminating reunification services and setting a section 366.26 hearing (Desiree M. v. The Superior Court of Sacramento County (May 9, 2008, C058123) [nonpub. opn.]). We affirm.
Further undesignated statutory references are to the Welfare and Institutions Code.
BACKGROUND
Mother has had some 23 referrals to Child Protective Services (CPS) in the course of approximately 10 years. On many occasions, she refused to cooperate with social workers. On more than one occasion, she was offered voluntary services and refused the offer.
On February 15, 2006, mother was admitted to the hospital after taking 45 Vicodin tablets. Mother was suspected of abusing prescription drugs. A referral was investigated and substantiated for general neglect of Tyler, age six, and Derek, age 13.
In April 2006, mother reported Derek, then 14 years old, had gotten some pills and came home out of control. He hit mother four times in the back with a broomstick, threatened to kill everyone in the house, threw and broke things around the home, and was yelling about his father’s death. Derek was hospitalized, treated and released to mother. Mother was provided with a follow-up treatment plan for Derek, but did not follow through with the plan.
On June 19, 2006, Derek was again out of control, staying out all night and starting fires at the American River. Mother’s boyfriend, Lawrence, found Derek and brought him home. When they got home, Derek grabbed knives and threatened mother and Tyler, threatened to kill Lawrence, and cut himself several times. He then left the house. After he was found, he was hospitalized as being a danger to himself and others. Following treatment, he was discharged to mother, again with instructions for recommended treatment, including ACCESS counseling and outpatient mental health services. Again, mother did not follow through with the treatment plan.
Based on Derek’s mental state, the Department of Health and Human Services (DHHS) received a referral. During the investigation, DHHS learned mother had not obtained treatment for Derek. Mother told an ACCESS clinician she was “too busy” to have Derek psychologically evaluated and hung up the phone.
During the period between the filing of the petition in June 2006 and the jurisdictional hearing in August 2006, mother continued to refuse to get mental health treatment for Derek. She also refused to drug test, stated it was “unfeasible and unrealistic” for her to participate in services, and threatened to drive her car through the lobby of DHHS if she did not get what she wanted.
In July 2006, mother’s doctor indicated she had been diagnosed with fibromyalgia, anxiety and depression. Her treatment included analgesics and antidepressants. While she had difficulty walking short and long distances, she had no limitations or restrictions on her ability to participate in court-ordered services. She was advised to wean herself off her medications and go into a detoxification program.
Although she had previously been uncooperative regarding services, on August 22, 2006, mother indicated she was willing to participate in services. Mother also reported that she had been diagnosed with lupus. She did not provide any medical support of this diagnosis.
At the August 31, 2006, jurisdictional hearing, the court found both Derek and Tyler were children described by section 300, subdivision (b). Specifically, the court found mother had a substance abuse problem and had taken 45 Vicodin in February 2006 and had been admitted to the hospital. The court also found that Derek’s mental health problems and mother’s failure to obtain treatment for those problems placed both Derek and Tyler at risk. The court continued the disposition hearing to allow mother to participate in two psychological evaluations to determine her ability to benefit from reunification services.
Mother was referred for her psychological evaluations to Dr. Janice Nakagawa and Dr. Cyrus Moazam. She cancelled two appointments with Dr. Moazam. She was late to her appointments with Dr. Nakagawa and, during the appointments, was repeatedly on her cell phone, which she refused to turn off. At her second appointment with Dr. Nakagawa, mother informed the doctor she had to leave early. Mother was late to her rescheduled appointment and hostile to the doctor when she could not reschedule for the following day.
Mother followed a similar pattern with the social worker, having to schedule and reschedule appointments to discuss her case plan several times. When she finally did show up for her appointment, she was an hour late.
On November 27, 2006, mother was advised if she “continue[d] to refuse to cooperate with the [psychological] evaluations, the Court can draw an adverse inference from [her] refusal to cooperate . . . and can make findings contrary to [her] interest . . .” The court also informed mother it was tired of her excuses for failing to comply with court orders.
Mother completed her psychological evaluations by January 2007. Dr. Moazam concluded mother was “self-centered, dissatisfied, demanding of attention, complaining and generally negative and pessimistic. She tends to use her somatic complaints to control and manipulate others. . . . She seems to be highly skilled in frustrating and sabotaging the help of others. She may develop physical complaints in response to stress and may use her complaints to avoid responsibility.” Dr. Moazam also noted the prognosis for psychological or medical intervention was guarded. He concluded she needed to complete parenting classes and be educated on how to care for, and interact with, her children. In particular, she needed to increase her skills in setting limits for her children. He also recommended she participate in individual and conjoint counseling to resolve the parent-child problems. He noted while it was important for her to complete the classes and programs of her reunification plan, “it is also important for her to treat her substance abuse problems by attending a rehabilitation program and participate in Narcotic[s] Anonymous group. Frequent random testing is imperative to assure sobriety.”
Dr. Nakagawa concluded mother was minimizing problems with her children. She was testy and obstreperous. She had problems keeping appointments and her “defense was to a take a challenging, blaming stance, conveying that this evaluator was uncooperative in completing the assessment. The theme of others not cooperating or working with her was likely a defense mechanism she may overly use to her detriment.” She was “melodramatic or self-dramatizing.” While mother would be “difficult and even vexing” for anyone to work with, she clearly loves her children and is committed to reunifying with them. Dr. Nakagawa concluded it was important for mother to complete parenting classes and engage in both individual and family counseling. Based on the results of these evaluations, DHHS recommended mother receive reunification services.
On November 17, 2006, mother was referred to Wanda Baxter for therapy. Baxter reported back to the social worker on December 7, 2006. Baxter advised that halfway through the assessment, mother refused to sign the consent to release information for treatment services. Baxter indicated mother was unlikely to benefit from her services, as she required more comprehensive treatment. Accordingly, Baxter recommended mother be referred to an interdisciplinary treatment team in order adequately to address her needs. On December 9, 2006, the social worker referred mother to Strategies for Change, which is an interdisciplinary program. Strategies for Change was specifically selected because it could “deal with [mother’s] additional psychiatric needs as was recommended by her psychological evaluations.” By February 28, 2007, mother had only completed two of the three required assessments with Strategies for Change, but was scheduled on that day to complete the third assessment.
The therapist working with mother at Strategies for Change was a marriage and family therapist (MFT). The reports of both Drs. Moazam and Nakagawa had been provided to the MFT and the social worker believed it was more appropriate for the MFT to determine mother’s course of treatment than for the social worker to do so.
Mother began participating in counseling sometime in March 2007, approximately three months after the referral was made and shortly before the section 366.21, subdivision (e) hearing was scheduled.
The hearing was originally set for March 12, 2007.
Mother was referred to parenting classes and provided with information about those classes. As of the date of the section 366.21 hearing on April 27, 2007, mother had not participated in parenting education.
Mother was also ordered to submit to random drug and alcohol tests. Her participation had been sporadic until December 2006 and January 2007. She continued to test positive for hydrocodone, oxycodone, or benzodiazepine. These are prescription medications which mother had on file with Specialized Treatment and Recovery Services (STARS). The social worker did not share the psychological evaluations with the STARS worker. However, she did discuss with the STARS worker mother’s personality type and that there might be some behavioral problems with mother.
On February 2, 2007, mother was ordered into Dependency Drug Court, scheduled to start on March 12, 2007. She performed an intake on February 6, 2007, and was referred to Strategies for Change for outpatient substance abuse counseling. As of March 1, 2007, mother was noncompliant with her substance abuse counseling, as she had attended only four of the six required meetings.
On March 12, 2007, mother was found minimally compliant at her first Dependency Drug Court hearing. By her next Dependency Drug Court hearing on April 1, 2007, she was found noncompliant. In her first reporting period, between February 15, 2007, and February 28, 2007, mother had no failures to test and attended five out of six required support group meetings. In the next period, between March 1, 2007, to March 14, 2007, mother had missed one of her five scheduled tests and had attended none of her six required support group meetings. In the period between March 15, 2007, and March 31, 2007, mother had no failures to test, but she had missed four of six required support group meetings and failed to attend her intake appointment.
Tyler and mother had weekly visits, during which there were problems regarding mother having inappropriate conversations with Tyler. In addition, mother was late for some visits and others had to be cancelled because mother was not abiding by the visitation contract. One visit was cancelled because mother and her friend, Bob S., became argumentative and confrontational with the social worker. Bob S. was ultimately banned from the agency. Mother requested her visits be reduced from two hours per week to one hour per week. While Tyler appeared to look forward to visits, he also looked forward to them ending and prompted his mother to leave visits early.
Derek had been placed briefly in a group home. However, within two to three hours, he was AWOL. As of March 12, 2007, his whereabouts remained unknown. Mother reported she received telephone calls from Derek and the social worker believed mother knew Derek’s whereabouts.
The social worker reported the risk of returning the children to mother was high, given that mother had made only limited progress in her plan and had only recently become more compliant with the plan. The social worker recommended mother be offered another six months of reunification services.
The court found there was a risk of returning the children to mother’s custody. The court found it particularly troublesome that mother had been noncompliant with her drug counseling as of March 31, 2007, because of four missed support group meetings and a failure to attend the intake appointment. This was particularly significant because this was in large measure a substance abuse case, and “when the mother is missing her intake, the very initial processes of substance abuse treatment that’s being offered to her, the conditions have not been ameliorated to a level where the children can safely been [sic] returned.” Accordingly, the court found in missing those appointments mother had not ameliorated the conditions which led to the removal of the children.
The court found the services had been “more than reasonable, and . . . have been very tailored towards working with” mother. The court noted “the psychological evaluations and the lack of progress in substance abuse treatment reveal the glaring issues in this case that demonstrate that while we start with the premise that we’re returning these children to the care and custody of their mother, her lack of cooperation certainly establishes that risk would remain separate and apart from progress on her physical issues.” Accordingly, the court found reasonable services had been provided and ordered additional services.
DISCUSSION
I
There is Substantial Evidence of Reasonable Reunification Services
Mother contends there was not substantial evidence to support the finding that DHHS provided reasonable services, in that DHHS had not adequately assessed mother because no one had spoken with mother’s treating physicians, or addressed treatment problems for pain disorders with mother’s physicians, and they had not provided mother with cognitive behavioral therapy as recommended by the psychological evaluators.
We must determine whether there is substantial evidence supporting the juvenile court’s finding that reasonable services were provided. (In re Joanna Y. (1992) 8 Cal.App.4th 433, 439.) In reviewing the reasonableness of the reunification services, we “recognize that in most cases more services might have been provided, and the services which provided are often imperfect. The standard is not whether the services provided were the best that might have been provided, but whether they were reasonable under the circumstances.” (Elijah R. v. Superior Court (1998) 66 Cal.App.4th 965, 969.) A court-ordered reunification plan must be tailored to fit the circumstances of each family and be designed to eliminate the conditions that led to the juvenile court’s jurisdictional finding. (In re Dino E. (1992) 6 Cal.App.4th 1768, 1777.)
Mother complains that DHHS did not speak with her treating physicians regarding her medical condition or her need for medications associated with those conditions. Mother also complains that DHHS and the court treated her use of prescription medication “as a routine substance abuse case without addressing her pain management needs and psychological issues.” The record belies mother’s claims.
Mother provided DHHS with some medical documentation from her treating physician, which indicated there were “no restrictions or limitations on her ability to participate in court ordered services.” Mother’s treating physician also advised her to wean off of her medications and go into a detoxification program. Then, in her initial therapy assessment with Wendy Baxter, mother refused to sign the consent for medical information to be released. Thus, the information mother allowed DHHS to have showed there were no medical restrictions on her ability to participate in services and that she should go to a detoxification program to wean off of her medications. To the extent mother felt there should have been further discussions with her treating physician regarding her condition and need for medication, it was solely within her power to facilitate those discussions by signing the consent form. She cannot now complain that DHHS did not do what she did not authorize them to do.
Mother also complains she was not referred to an appropriate therapist. Mother was initially referred to Wanda Baxter, a licensed clinical psychologist. She indicated that mother needed a more comprehensive approach to treatment, and recommended a referral to an interdisciplinary treatment team to address her medical, psychiatric and emotional problems. Mother was immediately then referred to Strategies for Change, a multidisciplinary agency able to provide appropriate services for mother. The Strategies for Change MFT was provided with the psychological evaluations of Drs. Nakagawa and Moazam and the recommendations made therein. There is no indication in the record that the MFT was not qualified to provide treatment and would not follow those recommendations, as appropriate, in the context of the actual therapy being provided. Nor is there any indication in the record that Strategies for Change was not able to provide appropriate services for mother’s needs. Finally, it was appropriate for the MFT working with mother to determine the appropriate course of treatment, including whether to utilize cognitive behavioral therapy.
“The agency supervising the children must identify the problems leading to the loss of custody, offer services designed to remedy these problems, and maintain reasonable contact with the parents to assist in areas where compliance provides difficult, such as transportation.” (In re Joanna Y., supra, 8 Cal.App.4th at p. 438.) “A reunification service plan should be well defined, specific, and tailored to provide services that will lead to the resumption of a family relationship.” (In re Mario C. (1990) 226 Cal.App.3d 599, 603-604.)
Here, the problems which led to the loss of custody were mother’s abuse of prescription drugs, her repeated failures to get mental health treatment for Derek, and her failure to protect Tyler from abuse by Derek. The reunification plan was designed to remedy these problems. It provided for a variety of counseling services for the children, including domestic violence counseling. In addition, the social worker referred mother for drug testing, referred her to parenting classes, referred her for psychological evaluations, referred her to Strategies for Change for ongoing counseling, provided education regarding the “emotional safety, social and developmental needs of the children,” referred mother’s fiancé for a kinship evaluation, and arranged and supervised visitation between mother and the children. The social worker was in regular contact with mother and was quick to address issues as they arose, as demonstrated by the speedy referral to an alternate counseling facility.
The record demonstrates mother was provided with a wide array of referrals for each aspect of her case plan. Contrary to mother’s claims, substantial evidence reveals DHHS provided mother with reasonable reunification services. Further, the services offered were reasonably geared to overcoming mother’s problems that caused the dependency and were appropriate under the circumstances. (See In re Jasmon O. (1994) 8 Cal.4th 398, 424-425; In re Christina L. (1992) 3 Cal.App.4th 404, 417.)
Mother’s failure to utilize the services offered is entirely consistent with the characteristics chronicled by Drs. Moazam and Nakagawa.
Dr. Moazam concluded mother was “self-centered, dissatisfied, demanding of attention, complaining and generally negative and pessimistic. She tends to use her somatic complaints to control and manipulate others. . . . She seems to be highly skilled in frustrating and sabotaging the help of others. She may develop physical complaints in response to stress and may use her complaints to avoid responsibility.” Dr. Moazam also noted the prognosis for psychological or medical intervention was guarded.
Dr. Nakagawa concluded mother was minimizing problems with her children. She was testy and obstreperous. She had problems keeping appointments and her “defense was to a take a challenging, blaming stance, conveying that this evaluator was uncooperative in completing the assessment. The theme of others not cooperating or working with her was likely a defense mechanism she may overly use to her detriment.” She was “melodramatic or self-dramatizing.”
The problem is not that inadequate services were offered, but that mother failed to utilize and/or benefit from them. “It is . . . well established that reunification services are voluntary, and cannot be forced on an unwilling or indifferent parent.” (In re Christina L., supra, 3 Cal.App.4th at p. 414; see also In re Ronell A. (1996) 44 Cal.App.4th 1352, 1365.)
II
There was Substantial Evidence that Returning the Minors to Mother’s Custody would be Detrimental
Mother contends the trial court erred by failing to order the children returned to her custody. We disagree.
“At the review hearing held six months after the initial dispositional hearing, the court shall order the return of the child to the physical custody of his or her parent or legal guardian unless the court finds, by a preponderance of the evidence, that the return of the child to his or her parent or legal guardian would create a substantial risk of detriment to the safety, protection, or physical or emotional well-being of the child. The social worker shall have the burden of establishing that detriment. . . . The failure of the parent or legal guardian to participate regularly and make substantive progress in court-ordered treatment programs shall be prima facie evidence that return would be detrimental. In making its determination, the court shall review and consider the social worker’s report and recommendations and the report and recommendations of any child advocate appointed pursuant to Section 356.5; and shall consider the efforts or progress, or both, demonstrated by the parent or legal guardian and the extent to which he or she availed himself or herself to services provided.” (§ 366.21, subd. (e).)
The court denied mother’s request to return the children to her because it found she had not made sufficient progress in her dealing with her substance abuse issues. Specifically, the court noted that she was noncompliant in her Dependency Drug Court, because she had missed support groups and failed to attend her intake appointments for substance abuse treatment. The record supports this finding.
In section 366.21, subdivision (e), “the Legislature has determined that the failure of a parent or guardian to participate regularly in any court-ordered treatment programs is sufficient, in the absence of other evidence, to support a finding that a return to parental custody would create a substantial risk of detriment to the child. Since court-ordered treatment programs are tailored by the court to remedy the circumstances that required removal of the child from parental custody, it is reasonable to conclude that in the absence of contrary evidence the failure to participate in such programs is sufficient to establish that the circumstances still exist. [Citation.]” (In re Heather B. (1992) 9 Cal.App.4th 535, 561.)
At best, the evidence shows that mother only partially complied with the court-ordered programs. As so specifically and vividly anticipated by Drs. Moazam and Nakagawa, mother’s behavior demonstrated she was resistant to complying with the court-ordered reunification. This resistance was amply demonstrated by her conduct in scheduling and rescheduling the psychological evaluations, which ultimately required a strong warning from the court. The resistance was also demonstrated by her delay in starting therapy, some three months after she was referred to Strategies for Change, and only shortly before the scheduled six-month review hearing. Mother tested positive on several drug tests. She was uncooperative in Dependency Drug Court. She did not attend her intake assessment for drug counseling. She did not complete her initial therapy assessment. She did not begin parenting classes. She was late to visits. She missed other visits altogether. Frequently, she had to be reordered to comply with the visitation contract. In short, mother failed to rebut the prima facie evidence that she did not participate regularly and make substantial progress in her reunification plan. Accordingly, substantial evidence supports the trial court’s finding.
DISPOSITION
The orders of the juvenile court are affirmed.
We concur: DAVIS, Acting P. J., HULL, J.