FILED NOVEMBER 18, 2025 In the Office of the Clerk of Court WA State Court of Appeals, Division III
IN THE COURT OF APPEALS OF THE STATE OF WASHINGTON
DIVISION THREE
In the Matter of the Welfare of ) ) No. 40423-4-III I.A.L. and L.J. ) (Consolidated with ) No. 40424-2-III) ) ) UNPUBLISHED OPINION
STAAB, A.C.J. — The trial court terminated the parent-child relationship between
A.B. (the mother) and her children, I.L. and L.J., finding that the Department of Children,
Youth, and Families (Department) made reasonable efforts to determine the mother’s
needs and that all necessary and court-ordered services were either offered or provided.
On appeal, the mother challenges several of the court’s findings, arguing they are not
supported by substantial evidence. Additionally, she contends that the Department failed
to provide timely and tailored mental health services.
Although we agree that some of the challenged findings are unsupported, the trial
court’s ultimate conclusion that necessary services were offered is supported by the
remaining findings. As such, we affirm the termination of the mother’s parental rights. No. 40423-4-III In re Dependency of L.J.
BACKGROUND
A.B. is the mother of I.L. and L.J.
I.L. was born on July 9, 2019. At the time of his birth, the mother tested positive
for methamphetamine and I.L.’s umbilical cord indicated in utero exposure to
methamphetamine. I.L. was removed from his parents’ care in November 2019 after he
sustained a rib fracture during a domestic violence dispute between his parents. The
following year, in January 2020, the mother agreed to orders of dependency and
disposition as to I.L. I.L. was returned to his mother’s care in June 2021 but was
removed again in March 2022.
L.J. was born on February 10, 2021, during his brother’s dependency, and was
removed from the custody of the mother within days after his birth due to her ongoing
substance use and mental health issues. The mother entered into an agreed dependency
disposition for L.J. in April 2021. L.J. was eventually returned to the mother’s home,
contingent on her remaining at Rising Strong, a local drug treatment and housing
program, but was removed from her care a second time in April 2022.
In September 2022, the Department of Children, Youth, and Families
(Department) filed a petition to terminate the parental rights of the mother for I.L. and
L.J.
2 No. 40423-4-III In re Dependency of L.J.
Dependency and Treatment History
During the dependency, the mother’s parental deficiencies were identified as
chemical dependency with a history of substance abuse and mental health issues with a
domestic violence component. To address these deficiencies, the services offered and
provided consisted of chemical dependency assessment and treatment, random urinalysis
(UA) testing, an evidence-based parenting program assessment with treatment, mental
health treatment/individual counseling, and a psychological evaluation with treatment.
At review hearings that occurred between March 2020 and September 2021, the
mother was found to be making partial progress toward correcting the deficiencies that
necessitated the children’s placement in out-of-home care. However, after February
2022, there were no findings that the mother had made any further progress.
During 2019 to 2024, the providers working with the mother included: Grassroots
Therapy Group, Absolute Drug Testing, Partners with Families and Children (Partners),
Rising Strong, Youth, Family and Adult (YFA) Connections, Revive Housing, Northeast
Washington Treatment Association, Discovery Counseling Group, Spokane Addiction
Recovery Center (SPARC), Dr. Kenneth Cole, and Stepping Stones Pediatric Therapy.
Many of these providers offered substance abuse treatment and/or mental health services.
The mother began mental health treatment with Partners in January 2020. She was
diagnosed with post-traumatic stress disorder (PTSD) and established a treatment plan.
She completed the intake assessment on January 14, 2020. Furthermore, she attended
3 No. 40423-4-III In re Dependency of L.J.
three out of four sessions in February 2020, though she was late to most of these
appointments. During her time at Partners, the mother participated in cognitive
behavioral therapy, which the provider described as very similar to dialectical behavior
therapy (DBT). She attended roughly half of her appointments in September, October,
and November and missed all sessions scheduled for December. She was ultimately
discharged the next year in June 2021 due to inconsistent participation.
Amy Howko, with Family Care Northwest (FCNW), received three referrals to
provide the mother with family services in February 2020, September 2020, and January
2021. For her February 2020 referral, the mother was discharged in September 2020 due
to lack of engagement. For her September 2020 referral, she was again discharged in
November 2020 for the same issue. Her third referral was discharged, in May 2021, for
non-participation and lack of engagement. The last discharge was due to the mother’s
engagement with Rising Strong and her desire to focus on that service.
The mother was also placed at Rising Strong in early 2021. She had one positive
UA and despite being offered additional UAs, she denied substance use, refused to
provide a UA, and decided to leave. Mental health services continued to be offered to the
mother after she left Rising Strong, but her attendance wavered.
Lynn Guinn, the clinical supervisor at YFA Connections, did not directly provide
services to the mother but did complete the mother’s mental health assessment. The
4 No. 40423-4-III In re Dependency of L.J.
mother began treatment in September 2021 with a portion of their program, attended only
one session in October 2021, and was discharged on October 22, 2021.
The mother was diagnosed with chemical dependency issues and mental health
needs and was provided co-occurring treatment—mental health and chemical
dependency—with New Horizons Care Center from November 2021 to April 2022.
During her mental health treatment with New Horizons, she was actively using controlled
substances. Additionally, the mother was diagnosed with depressive disorder, but she
needed to address her substance use before dealing with mental health issues because the
treatment would not be effective unless she was sober. The mother informed New
Horizons she wanted medication management but was informed that it would not be
possible with substance use because methamphetamines block certain prescribed
medications. The mother did not complete the program at New Horizons.
Grassroots provided services to the mother from August 2021 to November 2022.
She completed a family assessment and had goals of developing parenting skills.
Grassroots had concerns about the mother’s ongoing drug use and discharged her due to
lack of engagement.
Jaylene Plaff, with Discovery Counseling Group, provided mental health
counseling to the mother. Discovery Counseling Group offered DBT, which the mother
was interested in pursuing. The mother completed the intake and started sessions, but she
was eventually discharged for lack of attendance. Although Discovery Counseling Group
5 No. 40423-4-III In re Dependency of L.J.
received a second referral from the Department for services, they were unable to connect
with the mother, so she was discharged in January 2023.
SPARC provides mental health counseling, including DBT services, and substance
abuse counseling. The mother attended treatment from April 2023 to July 2023. She was
diagnosed with borderline personality disorder and substance abuse. Additionally, she
was set up for co-occurring treatment. However, after she was suspected of using illicit
substances, she refused a request to provide a UA. Immediately following this request,
the mother missed several appointments. The mother did not successfully complete
treatment through SPARC and continued to use illicit substances.
Nicole Breesnee from Partners provided substance use services to the mother from
September to October 2023. After 30 days of sobriety, the mother became eligible for
mental health services, but shortly after her services began, she started missing sessions,
then stopped attending altogether. Breesnee was unsuccessful in her attempts to get the
mother back into treatment.
In September 2023, Doctor Kenneth Cole, a clinical psychologist, completed a
psychological evaluation with a parenting component on the mother. He diagnosed the
mother as having schizoaffective disorder, PTSD, somatic symptom disorder,
methamphetamine use disorder, and borderline personality disorder with dependent
personality traits. Dr. Cole recommended a thorough drug and alcohol evaluation and to
follow through with all treatment recommendations, group meetings, and abstinence from
6 No. 40423-4-III In re Dependency of L.J.
any form of substance use. Dr. Cole recommended mental health treatment specializing
in personality disorders to help the mother’s mood regulation and social difficulties.
Additionally, Dr. Cole recommended genotypic testing to assist with medication
management. Dr. Cole acknowledged that this is an emergent procedure that considers a
person’s mutated genes.
Termination
The Department filed petitions to terminate the parent-child relationship between
the mother and her children in September 2022. The mother’s parental deficiencies were
identified as chemical dependency with a history of substance abuse and mental health
issues with a domestic violence victim component. At the time of the termination trial,
I.L. was removed for 658 days and L.J. for 1,068 days.
The case proceeded to trial in January 2024. The trial court heard testimony from
21 witnesses over the span of four days, including the mother, Department social
workers, treatment providers at Grassroots, YFA Connections, Partners, Discovery, and
SPARC, Dr. Cole, and several others testifying to the facts set forth above.
The mother testified at the hearing about her life, including trauma, chemical
dependency issues, and her efforts to overcome them. While acknowledging that one of
the parental deficiencies listed in the dependency order was chemical dependency and a
history of substance abuse, she testified that “I don’t believe that’s an issue.” Rep. of
Proc. (RP) at 53. She also acknowledged that one of the deficiencies listed was mental
7 No. 40423-4-III In re Dependency of L.J.
health issues and admitted that this was an issue in her life but did not agree that her
mental health was a deficiency. Nevertheless, the mother indicated that the Department
was not taking her mental health seriously because it was not providing active
communication or referrals to places she could call.
The court found by clear, cogent, and convincing evidence that all services
ordered under RCW 13.34.136 had been expressly and understandably offered or
provided. Additionally, all “necessary services capable of correcting [the mother]’s
parental deficiencies within the foreseeable future have been and were expressly and
understandably offered and provided.” Clerk’s Papers (CP) at 984.
The court noted that after several years, the mother still denied she had substance
abuse issues and, while she was aware of her mental health difficulties, she refused to
follow through with any treatment that would assist her in moving forward to gain her
children back.
The court found that the Department had extreme difficulties in keeping the
mother engaged despite all the services that had been offered to her to help work through
her barriers. Many providers testified that they would tailor a program to fit what the
mother wanted but could not keep her attending. Furthermore, early in the case, the
children were returned to the mother because she had made some progress. However,
I.L. was injured due to the mother’s continued toxic relationship with his father and the
8 No. 40423-4-III In re Dependency of L.J.
children were again removed. Since removal, the mother made no significant efforts to
repair her parental deficiencies.
Additionally, the court found that the Department made more than reasonable
efforts to determine the mother’s needs and respond to them. It tried different programs,
counselors, and treatment agencies to inspire her to correct the issues that caused her
children to be removed. The services that were reasonably available and understandably
offered were rejected.
Finally, the trial court found that the services offered—chemical dependency
treatment, mental health services, including Eye Movement Desensitization and
Reprocessing and DBT—would have corrected her parental deficiencies and allowed
reunification with the children. The Department tried numerous agencies hoping that the
mother would find one that she could complete. However, she refused to follow through
with any of these programs and the deficiencies remained.
The trial court terminated the mother’s parental rights, finding that all six statutory
factors were met. The mother appeals.
ANALYSIS
1. CHILDREN’S BRIEF
The children, I.L. and L.J., through their attorney, note that the children are too
young to provide a stated interest. They do, however, provide analysis of their legal
interests, including their “right to an intact family unit when possible, the right to a
9 No. 40423-4-III In re Dependency of L.J.
healthy, safe and stable home, and the right to permanency and a ‘speedy resolution’ of
dependency and termination proceedings.” Children’s Br. at 1-2. The children
acknowledge these rights and interests but recognize that they lead to conflicting
conclusions. Therefore, they do not endorse any specific outcome in this case.
The children do, however, point out that the order terminating the mother’s
parental rights fails to acknowledge the sibling relationships as required by RCW
13.34.200(3). This provision requires that “[a]n order terminating the parent-child
relationship shall include a statement addressing the status of the child’s sibling
relationships and the nature and extent of sibling placement, contact, or visits.” Id.
Here, the mother testified that she had four children, and the two other children
were not in her care. The termination order acknowledged a half sibling to I.L. and L.J.
but did not mention the mother’s fourth child.
While the court’s termination order failed to fully comply with RCW
13.34.200(3), the error was harmless. As the children’s brief notes, the requirement to
acknowledge siblings ensures that the relations are considered when deciding on a
termination petition, but the failure to address sibling relations in a termination order is
not fatal. In re Dependency of J.D.P., 17 Wn. App. 2d 744, 487 P.3d 960 (2021).
2. CHALLENGED FINDINGS OF FACT AND CONCLUSIONS OF LAW
The mother contends several findings of fact and conclusions of law are not
supported by substantial evidence. Each argument is addressed in turn.
10 No. 40423-4-III In re Dependency of L.J.
Assignments of Error (AOE) 5B
The mother argues that the trial court’s finding that YFA diagnosed her with
schizoaffective disorder is not supported by substantial evidence and the State concedes.
We agree with the parties that this finding is not supported.
Despite several mental health evaluations, Dr. Cole was the only provider to
diagnose the mother with schizoaffective disorder. However, Dr. Cole acknowledged in
his testimony that the mother’s recent methamphetamine use could have interfered with
her diagnosis.
In its memorandum decision, the trial court found that YFA Connections had
diagnosed the mother with schizoaffective disorder. This finding was not repeated in the
findings of fact included in the final order on termination. Regardless, the finding that
YFA Connections diagnosed the mother with schizoaffective disorder is not supported by
substantial evidence.
AOE 5C
The mother also challenges the finding that Grassroots worked with the mother
from August 2021 to November 2022. The Department contends this assignment of error
relates only to the dates of service-provider involvement, but the mother does not discuss
the purported errors in her brief. As such, the Department contends we should decline to
consider the undeveloped argument. We agree with the mother.
11 No. 40423-4-III In re Dependency of L.J.
The specific finding the mother challenges, and related assignment of error,
concerns the dates that the mother received services from Grassroots. Additionally, the
mother devotes a portion of her brief to this challenge. As the mother asserts, the correct
dates that Grassroots provided services to the mother were from August to November
2021 rather than November 2022. Consequently, the assignment of error as written is
unsupported.
AOE 5D
The mother challenges the trial court’s finding that she was referred to Circle of
Security for treatment byAlison Sandeen from the Department. The Department states
that this assignment of error relates to prior involvement of the dependency proceeding
and that the mother does not discuss the purported error in her briefing. We agree with
the mother.
Based on the record before this court, the mother was asked whether Circle of
Security was suggested by her social worker. The mother responded that it was not, but
she had asked about it because it was offered at Rising Strong. Additionally, Sandeen did
not mention Circle of Security in her testimony. As such, this finding is not supported by
AOE 5E, 6B, 6C, 6F
The mother argues that the evidence does not support a finding that she denies she
has substance abuse issues. She contends that she acknowledged substance abuse was
12 No. 40423-4-III In re Dependency of L.J.
her way of coping with or treating her mental health issues. We disagree with the mother
and conclude that substantial evidence supports these findings.
The mother specifically testified that she did not believe chemical dependency was
the issue for her. Further, she explained that chemical dependency treatment was not
something that she would seek to do or ever intended to do. Instead, she asserted that her
issues were mental health related, including the need to properly cope with trauma, and
triggers for her PTSD. Although the mother believed her substance abuse issues were
secondary to her mental health struggles, she asserted several times that she did not
believe chemical dependency was the issue for her. This finding is thus supported by
AOE 6E
The mother contends substantial evidence does not support the trial court’s finding
that Meredith Hipperson provides DPT services. Instead, she states the testimony
demonstrated that some counselors at Hipperson’s agency provide DBT but did not
specify which ones. This finding is not supported by substantial evidence.
Ms. Hipperson was asked whether SPARC offers DBT therapy to which she
responded “[n]ot a group, but some of the counselors will incorporate it into their work.”
RP at 185 (emphasis added). Although this demonstrates that some of the counselors at
SPARC provided DBT therapy, Hipperson’s testimony did not indicate or specify that
she provided those services. Consequently, this finding is unsupported.
13 No. 40423-4-III In re Dependency of L.J.
AOE 6H
The mother contends that substantial evidence does not support the finding that
she testified social workers went above and beyond to assist her. Instead, she asserts that
she noted her dissatisfaction with multiple social workers.
Although the mother explained her dissatisfaction with some social workers, she
testified to her satisfaction with several others. For example, she testified that she had
social workers who would discuss with her ways to overcome her struggles and would
get down to a “human level” with her. This made them relatable, helpful, and the mother
explained “very motivated to keep [her and her] family together.” RP at 206. The
mother also expressed her satisfaction with several other social workers that worked with
her during her dependency. Although the mother expressed dissatisfaction with many
social workers, there was also evidence of her satisfaction with others. As such, this
finding is supported by substantial evidence.
AOE 5G
Finally, the mother contends that substantial evidence does not support the trial
court’s finding that her parental deficiencies prevent her from providing basics such as
health, safety, and nurturing for her children. In doing so, she asserts that Ms. Sandeen
testified that the mother does not typically struggle in her capacity as a parent.
Substantial evidence supports this finding.
14 No. 40423-4-III In re Dependency of L.J.
Dr. Cole’s psychological report specifically notes that the mother’s mental health
disabilities are likely to negatively affect her parenting decisions due to impulsivity,
impaired decision-making skills, poor executive functioning, anti-social attitudes, and
difficulty regulating emotions and behavior. For these reasons, Dr. Cole opined that the
mother’s mental health challenges would likely make child-centered decisions very
difficult and that did not meet the children’s needs to develop physically and
psychologically in a healthy and safe environment. Furthermore, although Dr. Cole
determined she was capable of adequate parenting for at least a brief period, he felt it was
highly likely she would have significant difficulty consistently maintaining an
environment conducive to the physical and psychological needs of her children.
Although we conclude that several findings of fact are unsupported by substantial
evidence, the errors are harmless because they do not impact the ultimate conclusion that
the Department provided the mother with necessary services as set forth below. See In re
Welfare of C.B., 134 Wn. App. 336, 347, 139 P.3d 1119 (2006).
3. ORDERED AND NECESSARY SERVICES
The mother contends that the Department failed to provide timely mental health
services, asserting that essential services, such as a psychological evaluation and tailored
mental health treatment, were delayed to the detriment of reunification prospects.
Specifically, she contends that a psychological evaluation was not performed until less
than four months prior to trial despite early indications that the mother had complex
15 No. 40423-4-III In re Dependency of L.J.
mental health needs requiring more specialized attention. She points out Dr. Cole
provided a new diagnosis of schizoaffective disorder and recommended DBT treatment
by a qualified mental health professional and contends such services were never offered
or provided.
The Department responds that it offered necessary mental health services, but it
was the mother’s refusal to engage in treatment that accounts for the outcome. The
Department points out that the mother was offered a psychological evaluation on two
previous occasions during dependency proceedings, but she refused to participate. While
the Department acknowledges that Dr. Cole’s psychological evaluation resulted in a new
diagnosis of schizoaffective disorder, it maintains that Dr. Cole’s treatment
recommendations did not substantively differ from the services that had already been
offered or provided to the mother.
A. Standard of Review
As an appellate court, our role in reviewing a trial court’s decision to terminate
parental rights is to “determine whether substantial evidence supports the trial court’s
findings of fact by clear, cogent, and convincing evidence.” In re Dependency of M.L.W.,
28 Wn. App. 2d 252, 260, 535 P.3d 491 (2023); In re Parental Rights of K.M.M., 186
Wn.2d 466, 477, 379 P.3d 75 (2016). Evidence is considered substantial “if, when
viewed in the light most favorable to the prevailing party,” which here, is the
Department, “it is such that a rational trier of fact could find the fact in question by a
16 No. 40423-4-III In re Dependency of L.J.
preponderance of the evidence.” M.L.W., 28 Wn. App. 2d at 260. Deference to the trial
court is particularly important because termination proceedings are highly fact specific.
Id. As such, we will defer to the trial court for “witness credibility and persuasiveness of
the evidence” unless they are not supported by “clear, cogent, and convincing evidence.”
Id. at 260-61.
B. Termination of Parental Rights and Necessary Services
RCW 13.34.180 sets forth six statutory factors that must be demonstrated by clear,
cogent, and convincing evidence when terminating a parent’s rights. In re Dependency of
A.N.C., 24 Wn. App. 2d 408, 414-15, 520 P.3d 500 (2022). Under those standards, and
relevant to this appeal, are that “services ordered under RCW 13.34.136 have been
expressly and understandably offered or provided and all necessary services, reasonably
available, capable of correcting the parental deficiencies within the foreseeable future
have been expressly and understandably offered or provided.” RCW 13.34.180(1)(d)
(emphasis added).
Services that are necessary and services that are ordered are not always
synonymous; a court may determine that services are necessary even if they have not
been ordered. In re Parental Rights of I.M.-M., 196 Wn. App. 914, 921, 385 P.3d 268
(2016). Necessary services are those services that are “needed to address a condition that
precludes reunification of the parent[s] and child.” A.N.C., 24 Wn. App. 2d at 416. The
services must “be tailored to the parent’s needs” because “parents face different
17 No. 40423-4-III In re Dependency of L.J.
challenges and require different assistance.” Id. If, however, “it is determined that the
efforts to cure parental deficiencies have been unsuccessful and additional services will
not remedy those deficiencies in the foreseeable future, . . . a termination petition [will]
be filed.” In re Dependency of A.W., 53 Wn. App. 22, 28, 765 P.2d 307 (1988).
C. Mental Health Treatment
The mother contends that the court erred in finding that all ordered services and all
necessary services reasonably available and capable of correcting her parental
deficiencies were expressly and understandably offered or provided. More specifically,
she argues that the psychological evaluation was untimely, and the mental health services
offered to the mother were not tailored to meet her specific needs.
Among other requirements, the mother was ordered to complete a chemical
dependency assessment, participate in random urinalysis testing, engage in individual
counseling with a domestic violence component, and follow any recommendations made
by the service providers.
We begin by noting that the court did not order the mother to participate in a
psychological assessment. Nor did the court find that a psychological assessment was a
necessary service. Nevertheless, the record demonstrates that a psychological evaluation
was discussed with the mother on two prior occasions: first in 2021 when her dependency
with I.L. began, and second, in the beginning of 2023, but the mother refused to engage.
18 No. 40423-4-III In re Dependency of L.J.
As such, the mother’s argument that she did not timely receive the recommendation for a
psychological evaluation fails.
We also reject the mother’s contention that the DBT recommended by Dr. Cole
had not been provided in a manner specifically tailored to her needs. The court found
that DBT had been offered to the mother. Moreover, many of these providers had
attempted to tailor programs to fit what the mother wanted but despite these efforts, the
mother refused to engage. Significant evidence supports these findings.1
At the termination hearing, the mother was specifically asked whether she had
been offered DBT through a Department referral. Despite answering no, she informed
the court that she had DBT at Rising Strong because it was required. She explained that
she participated in groups and graduated from the mindfulness and emotional regulation
part before she left. Furthermore, because she “already graduated the first two,” she
stated she would only need the third part of DBT.
Pam Brown, the vice-president of behavioral health services at Catholic Charities,
also affirmed that the mother received DBT. She explained that the mother participated
in and attended group sessions of DBT while at Rising Strong. Additionally, she testified
1 Findings of fact are determinations of “whether the evidence show[s] that something occurred or existed” while conclusions of law are determinations “made by a process of legal reasoning from . . . the evidentiary facts.” Moulden & Sons, Inc. v. Osaka Landscaping & Nursery, Inc., 21 Wn. App. 194, 197 n.5, 584 P.2d 968 (1978). Where a conclusion of law is mislabeled as a finding of fact, this court reviews it as a conclusion of law. Willener v. Sweeting, 107 Wn.2d 388, 394, 730 P.2d 45 (1986).
19 No. 40423-4-III In re Dependency of L.J.
that DBT is generally once a week and lasts about a year, so most residents stay for a
year or longer to get through the entire series. However, the mother was discharged in
June of 2021 and was therefore only able to complete 11 sessions.
The mother next received mental health and chemical dependency services
through New Horizons that began in December 2021. Patricia Shropshire, a clinic
supervisor who works at New Horizons, testified. She explained that the clinicians at
New Horizons were able to offer DBT and that the mother did receive DBT during her
time there before her discharge in June 2022. However, on cross-examination,
Shropshire clarified that the therapy was not certified DBT but what was provided
required the mother to practice “mindfulness and DBT homework per se to help with her
emotional regulations.” RP at 240.
Jaylene Pfaff, a behavioral therapist at Discovery Counseling Group, testified that
DBT is utilized at their facility. Pfaff explained that, while treating the mother, she
offered DBT and cognitive processing therapy techniques. The mother completed the
intake and started classes but was eventually discharged for non-attendance. Discovery
received a second referral for her and attempted to reengage, but they were unable to
connect with the mother, and she was again discharged in January 2023.
In July 2023, the mother was referred to treatment at SPARC. While not as a
group, some of the counselors would incorporate DBT into their sessions. The mother
was set up for co-occurring treatment and individual therapy but after it was suspected
20 No. 40423-4-III In re Dependency of L.J.
the mother was using, she refused a UA, missed several appointments, and then stopped
attending.
The mother next argues that prior to Dr. Cole’s psychological evaluation, it was
unknown that she had schizoaffective disorder. While this may be true, the treatment
recommended for the diagnosis was DBT training by an experienced mental health
provider. The trial found that the services offered to the mother, including DBT, would
have corrected her parental deficiencies, but the mother refused to follow through with
any of the programs offered.
The mother contends that Dr. Cole recommended group or individual DBT by a
qualified mental health professional, which she asserts was not provided. The mother’s
argument rests on the premise that a qualified mental health provider equates to a
“certified” DBT provider. However, the mother did not raise this argument below and
the record does not demonstrate that a qualified mental health professional specializing in
personality disorders equates to the need for certification in DBT. Although the mother
asked whether one of the providers was aware they could become DBT certified in
Washington, she failed to demonstrate it was required. Consequently, this argument fails.
Next, the mother asserts that she was not provided medication management based
on genotypic testing as recommended by Dr. Cole. This argument fails because the
mother was provided with medication management and genotypic testing was not found
to be a necessary service. The record demonstrates that the Department provided support
21 No. 40423-4-III In re Dependency of L.J.
for medication management. For example, the mother engaged in medication
management during her time at New Horizons. Likewise, the Department offered a
standing referral for medication management with a nurse practitioner after she was
discharged from New Horizons, but the mother did not engage.
Additionally, the mother’s continued substance use impacted whether some
providers were able to provide medication because methamphetamine use affects portions
of the brain that would not allow certain medications to work effectively. Furthermore,
the Department attempted to set the mother up with a counselor that could provide
medication management, but a UA was needed to engage with this provider and the
mother had trouble doing UAs and refused alternative forms of testing.
Finally, the mother contends that, had appropriately timed mental health treatment
been provided, she would have been successful in reunification with her children. She
grounds this assertion on her partial compliance in 2021. The record does not support
this argument. Instead, the record demonstrates that the Department made a concerted
but ultimately an unsuccessful effort to persuade the mother to participate in all court-
ordered and necessary services from 2021 to the termination hearing, as set forth above.
Substantial evidence supports the trial court’s finding that the mother was
expressly and understandably provided all court ordered services and all necessary
services reasonably available and capable of correcting the mother’s parental
22 No. 40423-4-III In re Dependency of L.J.
deficiencies, and these services were tailored to the mother’s individual circumstances
and provided in a timely manner.
Affirmed.
A majority of the panel has determined this opinion will not be printed in the
Washington Appellate Reports, but it will be filed for public record pursuant to RCW
2.06.040.
_________________________________ Staab, A.C.J.
WE CONCUR:
_________________________________ Murphy, J.
_________________________________ Cooney, J.