In The Court of Appeals Seventh District of Texas at Amarillo
No. 07-24-00138-CV
IN THE INTEREST OF L.K.M. AND C.C.M., CHILDREN
On Appeal from the 126th District Court Travis County, Texas1 Trial Court No. D-1-FM-20-002499, Honorable Maria Cantu Hexsel, Presiding
June 12, 2025 MEMORANDUM OPINION Before QUINN, C.J., and PARKER and DOSS, JJ.
Amy Axtell (Mother) appeals from a final order modifying conservatorship and
possession of her two children with Jason Paul Miller (Father). Through ten issues,
Mother challenges the trial court’s decisions granting Father primary custody and
exclusive decision-making rights while ordering Mother to undergo psychological
evaluations and limiting her to a step-up possession schedule. We affirm.
1 This appeal was originally filed in the Third Court of Appeals and was transferred to this Court by
a docket-equalization order of the Supreme Court of Texas. See TEX. GOV’T CODE ANN. § 73.001. In the event of any conflict, we apply the transferor court’s case law. TEX. R. APP. P. 41.3. Background
The Relationship and Divorce
Mother and Father had a relationship spanning over twenty years. Throughout this
period, Mother falsely represented to Father, her parents, and others that she was a
cardiothoracic surgeon when she, in fact, did not hold a license to practice medicine,
medical diploma, or an undergraduate degree.
The parties had two children: L.K.M. was eight and C.C.M. was five at the time of
final hearing. Father filed for divorce in May 2020. When Father discovered two months
later that Mother was not a surgeon, she claimed she had obtained an undergraduate
degree and had attended medical school. In August 2020, the parties signed a mediated
settlement agreement. Father subsequently learned that Mother lacked an
undergraduate degree.
The trial court rendered their divorce in January 2021, signing a decree
memorializing the judgment in August 2021. The decree appointed the parties joint
managing conservators with Mother having the exclusive right to designate the children’s
primary residence. Father received a graduated possession schedule. All remaining
rights were shared jointly, with each parent holding independent decisional rights
concerning “day to day” or “routine” medical issues.
The Children’s Deteriorating Behavior
By fall 2020, Father noticed the children becoming increasingly difficult during
exchanges when Mother was present. They refused to get out of the car or had to be
2 physically removed. Despite Father’s suggestions for counseling, the parties could not
reach an agreement. The tension escalated until May 2021, when L.K.M. struck Father
in the throat during an exchange.
In mid-2021, Mother and Father began co-parenting therapy with Jennifer Knight,
and the children entered counseling with Fiona Ryon. Ryon became concerned about
negative comments L.K.M. made about Father that seemed inconsistent with her
behavior toward him. Father reported to Mother, Knight, and Ryon that the children made
negative comments directly to him. Despite professional intervention, the parties
continued to struggle with communication and co-parenting.
The Custody Modification Battle Begins
On March 1, 2022, Father filed for modification, seeking exclusive rights to
designate the children’s primary residence and make medical, psychological, and
educational decisions. According to the evidence, Father’s modification petition was
driven by the breakdown of his relationship with his daughters, growing concerns about
Mother’s pattern of dishonesty, and their co-parenting difficulties.
The final hearing included evidence from multiple professionals who had
conducted evaluations and assessments of the parties and children.
1. Dr. Baker
In June 2022, the parties agreed to a child custody evaluation by Dr. Kelley A.
Baker, who also served as the children’s guardian ad litem. Dr. Baker conducted a
3 comprehensive evaluation that included reviewing over one hundred documents,
interviewing at least twenty collateral witnesses, and making home visits to both parents.
As part of her investigation, Dr. Baker asked each party to identify their concerns
about the other parent’s ability to parent and their relationships with the children. Father’s
concerns included that Mother engaged in behaviors that negatively impacted his
relationship with the children, misrepresented information about the children’s health, and
continued her pattern of dishonesty in ways that could endanger the children. Mother’s
concerns about Father included allegations that he did not properly feed or bathe the
children, did not emotionally engage with them, and exercised poor judgment when they
were sick.
Dr. Baker found no support for any of Mother’s concerns about Father, opining that
Mother’s alleged concerns were not grounded in reality. Dr. Baker testified this was
concerning because Mother’s distorted thinking puts the children at risk—she may
perceive danger when none exists, believe she needs to protect the children when
unnecessary, and make irrational decisions limiting their contact with Father.
In contrast, Dr. Baker found evidence supporting Father’s concerns that Mother
had engaged in behaviors that negatively affected his relationship with the children:
speaking negatively of Father to the children; withholding educational and medical
information from Father; limiting or interfering with Father’s time with the children; sharing
inappropriate information about the marriage and legal matters with the children; and
causing the children to choose or feel guilty for loving Father. These decisions have the
4 potential to place the children in dangerous situations when Mother fails to convey
medical information correctly or refuses to follow doctors’ orders.
Dr. Baker also documented Mother’s continued false representations during the
lawsuit. Although Mother told Dr. Baker that her parents actually knew she had not, in
fact, graduated from medical school, Dr. Baker discovered through speaking with
Mother’s parents that they still believed she was a doctor. Dr. Baker testified this was
significant because it evidenced Mother’s continued pattern of making false statements
after the divorce was rendered.
Mother also lied to Dr. Baker, claiming she had an undergraduate degree from the
University of Utah. Dr. Baker concluded this pattern affected Mother’s decision-making
and judgment, with the potential of placing the children in unsafe situations.
Dr. Baker observed patterns in Mother’s interactions with professionals. Mother
attempted to cease family therapy because she had not been copied on a scheduling
email. Following depositions, Mother attempted to have the children’s therapist (Ryon)
removed from the case. When that therapist recommended one of the children begin
weekly therapy sessions due to serious transitional problems, Mother disagreed.
Dr. Baker also investigated the parties’ communication patterns as part of her
evaluation. When Baker asked Mother how she wanted to communicate with Father,
Mother responded that she does not like communicating with him because his
communications are too frequent, high conflict, accusatory, benefit no one, and are
unconstructive.
5 Additional testimony was presented regarding communication patterns. Father
testified that Mother sometimes waited weeks or a month to respond to messages on Our
Family Wizard, an online platform designed for divorced parents to coordinate scheduling
and communicate about their children. Mother testified that she didn’t like Our Family
Wizard and was apprehensive toward it because she felt that Father had unilaterally
chosen to use it.
In a September 2023 report that was admitted into evidence, Dr. Baker made
eleven specific recommendations to the court, including that the parties remain joint
managing conservators but with Father awarded exclusive decision-making rights in
medical, educational, and psychological decisions and the exclusive right to establish the
primary residence of the children. She recommended Mother be awarded a standard
possession order with Wednesday evening possession during the school term, with
consideration for expanding Mother’s possession schedule after one year if she met
certain conditions, including meeting with a neuropsychologist and psychiatrist and
refraining from making false statements about the children’s medical conditions or
negatively impacting their perception of Father.
Dr. Baker also recommended that Father identify specific medical providers and
that Mother be required to take the children only to those providers; that Mother
immediately notify Father if the children require medical attention while in her care; that
Mother not be allowed to take children from school for medical appointments without
Father’s consent; and that Father manage all extracurricular activities in consultation with
Mother.
6 Dr. Baker supported her recommendations with testimony that she “believe[d] that
the children’s safety and their health are at risk until [Mother] gets a better understanding
of what’s going on for her and some treatment.” Baker expressed concern there had
been a lot of negative influence on the children in regards to Father, putting their
relationship with Father at risk.
Dr. Baker opined that “flipping custody” (from Mother to Father) was the best
solution for the children as it would give Mother time to “get really serious about figuring
out why she does the things she does so that she can change her behavior.” She also
testified:
. . . I really worry about a parent who will make decisions based off of false reality. I think that’s when we put kids the most at risk because they’re not assessing reality correctly and they truly believe that they’re -- protecting their kids[.]
2. Dr. Sherry
Dr. Baker recommended that both parties undergo psychological evaluations. By
agreed order, Dr. Alissa Sherry was designated as the lead examiner to conduct
psychological testing of the parties.
Dr. Sherry found that Mother had severe issues with perception and thinking that
interfered with her functioning and presented risks to the children’s safety and health.
According to Dr. Sherry, Mother had serious deficits in reality testing, and her behaviors
fell into “quasi psychotic thinking.” Although not caused by a psychotic disorder, these
deficits were severe enough to impair Mother’s functioning, preventing her from
perceiving reality accurately or making good decisions.
7 Dr. Sherry found that Mother’s behavior fit the criteria for pathological lying: “a
persistent and pervasive pattern of excessive lying behavior occurring for longer than 6
months.” Although pathological lying is not a diagnosis in the Diagnostic and Statistical
Manual of Mental Disorders, Dr. Sherry testified that this did not invalidate her findings,
explaining that “there are rules about whether or not something is in the DSM. And some
of those rules don’t have anything to do with whether or not they’re valid concepts in
psychology.”
Dr. Sherry concluded that Mother’s lying serves to receive attention and affection,
potentially reinforcing the behavior. Her report found that because of Mother’s fear of
losing the unconditional love of her children, Mother orchestrates situations where the
children cling to her and reinforce feelings of unconditional love—even at the cost of their
relationship with Father.
Dr. Sherry’s report opined that Mother likely lacks the insight to understand how
her behavior affects the children, making it more likely she will engage in conduct that
jeopardizes their emotional or physical health and safety to create situations where the
children need her. Dr. Sherry noted that Mother’s emotional needs were so intense that
they led her to create an entirely fictional existence for over a decade. This, in turn, places
her at risk of being manipulated by anyone who suggests they can provide her with the
attention she craves, even if it endangers her and her children’s health and safety.
Dr. Sherry recommended that Mother continue weekly therapy focused on
pathological lying, trauma, and cognitive distortions; meet with a board-certified
8 neuropsychologist for evaluation; and consult with a psychiatrist for medication regarding
her cognitive distortions.
As for Father, Dr. Sherry noted that his assessment findings were normative. She
was presented no evidence that Father had ever behaved in ways considered to be
outside the norm of a loving, caring parent.
3. Dr. Thorne
Mother attempted to undermine these findings through rebuttal testimony of Dr.
Stephen Thorne, a licensed psychologist. Dr. Thorne’s testimony was based solely on
his review of Dr. Sherry’s and Dr. Baker’s reports. Dr. Thorne focused his criticism on Dr.
Sherry’s use of the phrase “pathological lying,” which he noted is not an officially
recognized diagnosis in the DSM. He suggested this term could be misleading or
inaccurate. When asked whether Dr. Sherry’s evaluation supported characterizing
Mother as a pathological liar, Dr. Thorne responded that the testing results alone would
not lead him to that conclusion.
Dr. Thorne testified that he would have described the findings differently in his
report. Rather than using diagnostic language, he would have referenced the individual’s
chronic or pervasive history of deception and lying. Despite these methodological
concerns, Dr. Thorne conceded that Dr. Sherry’s characterization did not invalidate the
information in her report. The trial court found that Dr. Thorne testified it was entirely
possible and reasonable to conclude that he might have reached similar conclusions
and/or recommendations as Dr. Sherry had he possessed the same information.
9 4. Dr. Krejci
Mother also called her individual therapist, Pamela Krejci, who had conducted fifty-
two sessions with Mother since June 2022. Krejci testified she had no concerns about
Mother’s parenting abilities. However, Krejci’s knowledge was limited to her direct
interactions with Mother and she had not spoken with the children, Father, or the other
professionals involved in the case.
Krejci testified that she had not seen any evidence in her work with Mother that
Mother was a pathological liar. When asked whether she had any concerns about Mother
remaining the primary parent of the children, Ms. Krejci responded she had none.
The Trial Court’s Decision
Following a four-day hearing in October 2023, the trial court made extensive
findings. It found Dr. Baker and Dr. Sherry credible witnesses who provided reliable and
persuasive evidence. The court additionally found that Father’s testimony was credible,
whereas, Mother’s testimony was not.
The court awarded Father exclusive rights to designate the children’s primary
residence in Travis and Williamson Counties, make medical and educational decisions
following written consultation with Mother, and receive child support. Mother was ordered
to undergo neuropsychological and psychiatric evaluations and was awarded a two-
phase step-up possession schedule.2
2 The step-up possession schedule awarded Mother standard possession with Wednesday
weekday possession during phase one, progressing to expanded standard possession in phase two if Mother completed therapy, neuropsychological evaluation, and psychiatric treatment requirements by January 1, 2025.
10 The trial court found that Mother’s pattern of lying since the mediated settlement
agreement impacted her credibility and the consideration of the children’s best interests.
Analysis
Mother presents ten issues on appeal, each challenging the trial court’s exercise
of discretion in modifying the terms of possession, conservatorship, and access.
The standards of review for decisions involving suits affecting parent-child
relationships are well-established and need not be reiterated in detail. Trial courts
possess wide discretion in determining custody, control, possession, support, and
visitation matters involving children. Kramer v. Kastleman, No. 03-13-00133-CV, 2017
Tex. App. LEXIS 10326, at *4–5 (Tex. App.—Austin Nov. 3, 2017, pet. denied) (mem.
op.) We will reverse only if the trial court acted unreasonably, arbitrarily, or without
guiding principles. Coburn v. Moreland, 433 S.W.3d 809, 823 (Tex. App.—Austin 2014,
no pet.). Whether the evidence is legally or factually sufficient is evaluated as part of the
abuse of discretion analysis rather than as independent grounds for reversal. Id.
We give great deference to the trial court’s assessment of witness credibility
because the trial judge directly observes testimony and can perceive nuances not
apparent from the written record. Id. at 823–24.
Modification of conservatorship requires proof that circumstances have materially
and substantially changed since the prior order, and modification would be in the child’s
best interest. See TEX. FAM. CODE ANN. § 156.101.
11 Issues One through Five
In her first five issues, Mother argues the trial court abused its discretion by
granting Father exclusive rights to: (1) designate the children’s primary residence; (2)
consent to medical, dental, and surgical treatment; (3) consent to psychiatric and
psychological treatment; (4) make educational decisions; and (5) receive child support.
Mother concedes that she and Father have had “numerous miscommunications and
disagreements about medical issues,” but believes she was not treated equally at trial—
that Dr. Baker and Dr. Sherry emphasized conduct that put her in a poor light while de-
emphasizing similar conduct by Father.
The evidence shows that Mother’s deceptions extended far beyond her twenty-
year lie about being a cardiothoracic surgeon. During the evaluation process, she
continued lying to Dr. Baker about having an undergraduate degree and falsely claimed
her parents knew the truth about her medical credentials when evidence suggests they
still believed she was a doctor. According to testimony, she made false statements about
the children’s medical conditions and withheld critical medical information from Father.
Dr. Sherry found that Mother had “severe issues with perception and thinking” that
interfered with her functioning and presented risks to the children’s safety and health.
These deficits in reality testing were severe enough to impair Mother’s decision-making
and prevent her from perceiving situations accurately. Dr. Sherry characterized Mother’s
behavior as falling into “quasi psychotic thinking”—not caused by a psychotic disorder,
but serious enough to affect her judgment.
12 Dr. Baker documented how Mother’s distorted thinking affected the children
directly. Mother spoke negatively about Father to the children, withheld educational and
medical information, limited Father’s time with them, and shared inappropriate details
about the marriage and legal proceedings. Dr. Baker warned that Mother’s inability to
assess reality correctly put the children “most at risk.”
Mother relies heavily on Dr. Thorne’s criticism of the “pathological lying”
terminology and therapist Krejci’s opinion that she had no parenting concerns. But Dr.
Thorne reviewed only Dr. Sherry’s and Dr. Baker’s reports without access to the extensive
collateral data they gathered. He acknowledged that he might have reached similar
conclusions if provided the same information. Krejci’s knowledge was limited to her
therapy sessions with Mother, without speaking to Father, the children, or the other
professionals involved.
The trial court found Dr. Baker and Dr. Sherry credible while finding Mother’s
testimony was not credible. The court specifically found that Dr. Thorne’s testimony “did
not provide sufficient evidence to discount the accuracy of [Dr. Sherry’s] psychological
evaluations and opinions.” On this record, we find that a reasonable factfinder could have
credited the testimony of Father, Dr. Baker, and Dr. Sherry over the limited rebuttal
evidence. “We defer to the trial court’s resolution of factual disputes and related credibility
determinations; we may not substitute our judgment for the trial court’s judgment in those
matters.” Spence v. Davis, No. 03-22-00179-CV, 2023 Tex. App. LEXIS 564, at *5 (Tex.
App.—Austin Jan. 27, 2023, no pet.) (mem. op.).
13 The evidence supports the trial court’s finding that Mother’s distorted perception of
reality creates concrete risks: she may withhold critical medical information, make
healthcare decisions based on false premises, or continue to damage the children’s
relationship with their father. Mother has not shown that the trial court abused its
discretion. Issues one through five are overruled.
Issues Six and Seven
In her sixth and seventh issues, Mother argues the trial court abused its discretion
by ordering her to undergo a neuropsychological evaluation and meet with a psychiatrist
for evaluation, treatment, and possibly medication. Both requirements are tied to
Mother’s opportunity to obtain an expanded possession schedule.
We find the trial court’s orders directly served the children’s best interests and are
consistent with expert witness recommendations. Dr. Sherry agreed that Mother had
“severe issues with perception and thinking” that interfered with her functioning and
presented risks to the children’s safety and health. She emphasized that if Mother wished
to modify her behavior, it was crucial that she undergo evaluation by a board-certified
neuropsychologist to obtain comprehensive feedback and engage with a psychiatrist to
better understand her actions. Dr. Baker echoed both recommendations.
The process serves the children’s interests by providing Mother a clear pathway to
increased possession while ensuring their safety during Mother’s recommended
treatment process. Mother does not show that the trial court’s orders constituted an
abuse of discretion. Issues six and seven are overruled.
14 Issues Eight through Ten
In her final three issues, Mother argues the trial court abused its discretion by
ordering a two-phase, step-up possession schedule that requires her to meet certain
conditions before obtaining an expanded standard possession order.
Trial courts have discretion to establish conservatorship terms, including the
frequency and duration of visits and any necessary limitations. In re L.M.M., No. 03-04-
00452-CV, 2005 Tex. App. LEXIS 7191, at *28–29 (Tex. App.—Austin Aug. 31, 2005, no
pet.) (mem. op.); TEX. FAM. CODE ANN. § 153.193. Such restrictions “may not exceed
those that are required to protect the best interest of the child.” TEX. FAM. CODE ANN
§ 153.193. When ordering terms other than the standard possession order, the trial court
may consider the child’s age, developmental status, circumstances, and needs; the
circumstances of both parents; and any other relevant factor. Id.
Mother again relies on the testimony of Krejci and Dr. Thorne to argue for an abuse
of discretion. We have noted above that the trial court was within its discretion to discount
the testimony of these professionals.
Mother characterizes the step-up order as a “severe limitation” requiring “rigorous
preconditions.” But the trial court’s restrictions followed the express recommendations of
Dr. Baker and Dr. Sherry. Dr. Sherry concluded that Mother likely lacks insight into how
her severe perception and thinking issues affect the children, making it more likely she
will engage in behavior that jeopardizes their emotional and physical health to create
situations where they need her. Both experts recommended that Mother engage with a
neuropsychologist and psychiatrist before expanded possession could be considered.
15 Dr. Baker specifically recommended a standard possession order with Wednesday
evening visits, with consideration for expansion after one year if Mother met certain
conditions: meeting with both a neuropsychologist and psychiatrist, refraining from lying
about medical conditions, and refraining from negatively impacting the children’s
perception of Father. Dr. Baker testified that “flipping custody” would give Mother time to
“get really serious about figuring out why she does the things she does so that she can
change her behavior.”
In light of the evidence presented, the trial court did not abuse its discretion in
modifying the decree’s possession requirements.
Mother’s eighth, ninth, and tenth issues are overruled.
Conclusion
Having overruled each of Mother’s issues, we affirm the final order of the trial court.
Lawrence M. Doss Justice