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You can search the entire site. or go to the recent opinions, or the chronological or subject indices. Simone H. v. State, Dept. of Health & Social Services, Office of Children's Services (3/7/2014) sp-6870

Simone H. v. State, Dept. of Health & Social Services, Office of Children's Services (3/7/2014) sp-6870

         Notice:  This opinion is subject to correction before publication in the PACIFIC  REPORTER .  

         Readers are requested to bring errors to the attention of the Clerk of the Appellate Courts,  

         303 K Street, Anchorage, Alaska 99501, phone (907) 264-0608, fax (907) 264-0878, email  

                                                                                   

         corrections@appellate.courts.state.ak.us.  



                  THE SUPREME COURT OF THE STATE OF ALASKA  



SIMONE H.,                                               )  

                                                         )    Supreme Court No. S-15149  

                          Appellant,                     )  

                                                         )    Superior Court No. 3PA-10-00163 CN  

         v.                                              )  

                                                         )    O P I N I O N  

STATE OF ALASKA,                                         )  

DEPARTMENT OF HEALTH &                                   )   No. 6870 - March 7, 2014  

SOCIAL SERVICES, OFFICE OF                               )  

CHILDREN'S SERVICES,                                     )  

                                                         )  

                          Appellee.                      )  

                                                         )  



                  Appeal from the Superior Court of the State of Alaska, Third  

                                                                                

                  Judicial District, Palmer, Gregory Heath, Judge.  



                  Appearances:  Renee McFarland, Assistant Public Defender,  

                  and   Quinlan   Steiner,   Public   Defender,   Anchorage,   for  

                  Appellant. David A. Wilkinson, Assistant Attorney General,  

                                           

                  Fairbanks,  and  Michael  C.  Geraghty,  Attorney  General,  

                  Juneau,  for  Appellee.    Margaret  McWilliams,  Assistant  

                  Public     Advocate,       Juneau,     and    Richard      Allen,     Public  

                  Advocate, Anchorage, for Guardian Ad Litem.  



                  Before:  Fabe, Chief Justice, Stowers, Maassen, and Bolger,  

                                      

                  Justices.  [Winfree, Justice, not participating.]  



                  BOLGER, Justice.  


----------------------- Page 2-----------------------

I.       INTRODUCTION  



                                                                                            

                   Simone H. appeals the trial court's order terminating her parental rights to  

                     1  Simone challenges the trial court's denial of her request to have Irving's  

her son, Irving.                                                       



therapy records released to her for use during the termination trial and the trial court's  



finding that the State Department of Health and Social Services, Office of Children's  



Services (OCS) made reasonable efforts to provide services designed to enable Irving's  



                                                         

safe return to her custody.  We conclude that the trial court acted within its discretion in  



                           

denying Simone's request for access to Irving's therapy records and that substantial  



evidence supported the trial court's finding that OCS made reasonable efforts to reunify  



Simone with Irving.  



II.      FACTS AND PROCEEDINGS  



                   Simone is the mother of Irving, who was born in 2003.  Simone has a  



                                                                      

history of engaging in relationships with violent partners, and has mental health and  



                                         

substance  abuse  issues.    In  2009  Simone  began  counseling  with  psychiatric  nurse  



practitioner  Kathleen  Hammaker,  who  also  provided  Simone  with  mental  health  



                                                                                     

medication management services.  Hammaker treated Simone for obsessive-compulsive  



disorder, posttraumatic stress disorder, panic  disorder, and mood disorders, and she  



prescribed Simone various medications.  



                                                   

                  In October 2010, after receiving a protective services report alleging that  



                                                                                                        

Simone had failed to seek medical attention for Irving after he had been injured in a  



bicycle accident, that she was addicted to drugs, and that she had been leaving Irving  



unattended for hours at a time, an OCS specialist and a police officer went to Simone's  



home,  where  they  found  alcohol,  illicit  drugs,  and  drug  paraphernalia.    As  a  result,  



Simone's partner, who had recently been released from jail, was arrested for parole  



         1        Pseudonyms are used to protect the privacy of the family.  



                                                          -2-                                                      6870  


----------------------- Page 3-----------------------

violations.  Simone refused to participate in a drug screen.  OCS took emergency custody  

                                                               



of Irving and filed an emergency petition to have the child adjudicated a child in need  

                                                     



of aid (CINA).  



                     OCS developed a case plan for Simone that called for her to participate in  

                                                                      



parenting   classes,   complete  a  family  violence   intervention   program,   complete  a  



psychological  evaluation,  continue  to  engage  in  mental  health  treatment,  obtain  a  

                                                              



substance abuse assessment, participate in drug screens, and participate in family contact     



with Irving.  Hammaker arranged for Simone to begin receiving services from Daybreak,  

                    



an organization that provides case management services including skill development,  



                                                                                                                 

connection  to  service  providers,  transportation  to  appointments,  and  assistance  in  



organizing daily activities to persons who have been diagnosed with mental illness.  



                 

Simone's Daybreak counselor, Polly-Beth Odom, prepared a case plan that was designed  



to facilitate Simone's compliance with OCS's case plan.  Odom, who shared the plan  



                                                                               

with OCS, testified that Daybreak's goals included assisting Simone with mental health  



recovery  and  family  reunification.    She  stated  that  Daybreak  helped  Simone  with  



                          

housing,  social  connections,  budgeting,  life  skills,  safety  monitoring,  and  avoiding  



abusive relationships.  



                                                                                       

                     In  March  2011  OCS  referred  Simone  to  Dr.  Heather  Macomber  for  a  



neuropsychological evaluation because it was concerned about her mental condition.  Dr.  



Macomber  recommended  that  OCS  set  specific  goals  for  Simone  and  that  Simone  



                    

continue  to  receive  psychiatric  care  and  medication  and  participate  in  therapy.    Dr.  



Macomber did not recommend that Simone participate in substance abuse treatment.  



                     Shortly after this evaluation Simone tested positive for methamphetamine.  



                                                                    

OCS thereupon referred her for a substance abuse assessment at Set Free Alaska, which  



                                                                -3-                                                          6870
  


----------------------- Page 4-----------------------

was conducted in June 2011.  Simone did not participate in the intensive outpatient  



                                                                                          2  

treatment that the substance abuse assessment recommended.   



                    In late 2011, OCS considered placing Irving with his paternal grandmother  

                                                                           



in Pennsylvania. Simone then moved to Pennsylvania, over OCS's objection.  Her move  

                                      



temporarily ended her ability to have contact with Irving.  



                                                                 

                    In December 2011, placement with the grandmother was denied under the  

                                                                           3  and the following month Simone  

                                                                                          

Interstate Compact on the Placement of Children, 



returned to Alaska.  She reengaged in counseling and medication management services  

                                                                                                 



with Hammaker and in case management services with Daybreak.  She requested that  



                                                                                       

visits be restarted and, in April 2012, they were.  Several visits were held at the OCS  



facility from April through June, but these visits were again suspended when Simone  



                                                          

stated that she would commit suicide if Irving were not returned to her custody, and OCS  



tried to locate an appropriate visitation supervisor.  



                                                               

                    In May 2012, OCS referred Simone for a behavior health assessment at  



                                                              

Alaska Family Services.  The assessment recommended that Simone engage in Alaska  



Family  Services'  dual  diagnosis  treatment  program  and  in  individual  counseling.  



             

Simone began treatment that month but did not make adequate progress in the program.  



                                           

She tested positive for illicit drugs while in treatment and was inconsistent in taking her  



                                        

prescription medications.  According to the program's clinical director, by the time of  



Simone's discharge from the program in August 2012, her problems were worsening  



rather     than     improving.            Alaska       Family       Services       discharged         Simone        with     a  



                                                              

recommendation that she participate in a residential treatment program.  Alaska Family  



          2         Simone claimed at the termination trial that Set Free Alaska refused to  



accept her into its treatment program because she was taking medications to address her  

                                          

mental health issues.  



          3         AS 47.70.010-.080.  



                                                             -4-                                                           6870  


----------------------- Page 5-----------------------

Services offered to help Simone enroll in a residential program, but Simone did not take  



advantage of the offer.  



                   In  May  2012,  OCS  petitioned  to  terminate  Simone's  parental  rights  to  



Irving.  During the trial on the petition Simone asked the trial court to compel Irving to  



                                                                                         

testify and to order the release of Irving's therapy records to her.    After  examining  



Irving's therapy records in camera, the trial court denied both requests.  



                                                   

                   On March 12, 2013, the trial court issued an order terminating Simone's  



                                                                                        

parental rights to Irving.  The court found that Irving was a child in need of aid due to:  



                                                                                                             

(1) Simone's history of violent relationships and her failure to seek medical attention for  



                                                       4 

Irving following the bicycle accident;  (2) Simone's history of relationships involving 



                            5  

                                                                                                    

domestic  violence;   (3)  Simone's  history  of  substance  abuse  and  failed  attempts  at  

               6 and (4) the combination of Simone's mental illnesses, her inconsistency in  

treatment;                         



taking  her  prescribed  mental  health  medication,  her  abuse  of  substances,  and  her  

                                  

continued participation in abusive relationships.7  

                                                                         



                   The  trial  court  found  that  OCS  made  reasonable  efforts  to  provide  the  

                                                                    



family with support services designed to enable the safe return of Irving to Simone's  



custody.    These  efforts  included  identifying  the  issues  Simone  needed  to  address,  



facilitating  family  contact,  coordinating  with  her  service  providers,  and  providing  



Simone  with  case  planning  meetings  and  case  plans,  drug  screens,  substance  abuse  



          4        See AS 47.10.011(6) (substantial physical harm to the child or substantial  



risk thereof).  



          5        See AS 47.10.011(8) (mental injury to the child or substantial risk thereof).  



          6        See AS 47.10.011(10) (parental substance abuse).  



          7        See   AS   47.10.011(11)   (parental   mental   illness,   serious   emotional  



disturbance, or mental deficiency of a nature and duration that risks substantial physical  

                                                                                          

harm or mental injury to the child).  



                                                             -5-                                                      6870
  


----------------------- Page 6-----------------------

                                                                                                        

assessments,  and  a  neuropsychological  assessment.                           The  trial  court  also  found  that  



                                                                                                  

Simone had not remedied conduct or conditions under her control that placed Irving at  



                                                                         

risk  of  harm,  and  that  termination  of  Simone's  parental  rights  was  in  Irving's  best  



interests.  



                    Simone appeals, challenging the trial court's denial of her request for access  



                                         

to Irving's therapy records and its finding that OCS made reasonable efforts to provide  



her with family reunification services.  



III.      STANDARD OF REVIEW  



                                       

                   We have not previously determined the appropriate standard for review of  



                                                           

a trial court's ruling on a request that a  child's confidential communications with a  



psychotherapist be disclosed for use in the child's CINA proceeding.  Alaska Child in  



Need  of  Aid  Rule  9(b)(3)(B)  provides  that  such  communications  are  presumptively  



privileged.    Rule  9(b)(3)(D)  prescribes  factors  a  trial  court  must  consider  before  



allowing, limiting, or prohibiting disclosure and use of such communications if requested  



          

to do so by a party.  We will review a trial court's decision on a request for disclosure  



                                                                                                8  

of such confidential communications for an abuse of discretion.     When applying a  



multi-factor  test,  "[t]he  superior  court  abuses  its  discretion  if  it  considers  improper  



          8        See Noffke v. Perez, 178 P.3d 1141, 1144 (Alaska 2008) ("The court's  



discovery rulings are . . . reviewed for an abuse of discretion." ); Booth v. State , 251 P.3d  

                                                        

369, 373 (Alaska App. 2011) ("[T]he 'abuse of discretion' standard of review applies to  

                                                                                                                 

situations  where  the  law  allows  or  requires  the  judge  .  .  .  to  reach  a  decision  by  

considering and weighing various factors . . . .").  Whether the privilege applies would  

                                                                          

be a legal question that is not raised in this case.  See Griswold v. Homer City Council,  

310 P.3d 938, 940 (Alaska 2013).  



                                                             -6-                                                       6870
  


----------------------- Page 7-----------------------

factors . . ., fails to consider statutorily mandated factors, or assigns disproportionate  

                                                                            

weight to some factors while ignoring others."9  



                    Whether  OCS made reasonable efforts to provide services to reunify a  

                                                              10  We review the trial court's factual findings  

                                                                                        

family is a mixed question of fact and law. 



                                                                                 11  

for  clear  error  and  its  legal  determinations  de  novo.                          A  factual  finding  is  clearly  

                                                                         



erroneous if, after reviewing the record in the light most favorable to the prevailing party,  

                                                



                                                                                                          12  

we  are  definitely  and  firmly  convinced  that  the  finding  is  mistaken.                                  Conflicting  

                                                                                            



evidence is generally not sufficient to overturn a trial court's factual findings, and we  

                                                      



will not reweigh evidence when the record provides clear support for the trial court's  

                                                                                                    

ruling.13  



IV.	      DISCUSSION  



          A.	       The Trial Court Did Not Abuse Its Discretion In Denying Simone's  

                    Request For Disclosure Of Irving's Therapy Records.  



                    CINA Rule 9(b)(3) governs the introduction of evidence that is subject to  

                               



the evidentiary privilege for communications between a psychotherapist and a patient.  

                                                                                     



          9         Iverson v. Griffith , 180 P.3d 943, 945 (Alaska 2008) (applying this standard  



of review to a child custody decision); see also In re M.K., 278 P.3d 876, 881 (Alaska  

                                                                                         

2012) (applying the same standard to a guardianship appointment).  



          10        Sherman B. v. State, Dep't of Health & Soc. Servs., Office of Children's  

                                   

Servs., 290 P.3d 421, 428 (Alaska 2012) (citing Christina J. v. State, Dep't of Health &  

            

Soc. Servs., Office of Children's Servs., 254 P.3d 1095, 1104 (Alaska 2011)).  



          11	       Id. at 427-28 (citing Christina J., 254 P.3d at 1103-04).  



          12        Barbara P. v. State, Dep't of Health & Soc. Servs., Office of Children's  



Servs., 234 P.3d 1245, 1253 (Alaska 2010) (quoting Brynna B. v. State, Dep't of Health  

                                   

& Soc. Servs., Div. of Family & Youth Servs., 88 P.3d 527, 529 (Alaska 2004)).  



          13  

                                                                

                    Sherman B., 290 P.3d at 428 (quoting Maisy W. v. State, Dep't of Health  

& Soc. Servs., Office of Children's Servs., 175 P.3d 1263, 1267 (Alaska 2008)).  



                                                              -7-	                                                       6870
  


----------------------- Page 8-----------------------

                                                                 

The rule states that the privilege "applies to the child unless the child or the child's  



guardian ad litem waives the privilege, or the party seeking disclosure shows that the  



                                                                                                                       14 

                                                                                                                           The  

need for the requested disclosure outweighs the child's interest in confidentiality." 



rule  provides  that  the  trial  court  must  consider  the  content  and  nature  of  the  



                                                                                                                        15 

                                                                                                                            the  

communication, the purposes of the CINA statutes as expressed in AS 47.05.060, 



                                                              16  

                                                                                       

purposes of Alaska Rule of Evidence 504,                         whether other effective means to obtain the  



information  are  available,  and  whether  the  public  interest  and  need  for  disclosure  



outweigh  the  potential  injury  to  the  patient  and  the  patient's  relationship  with  the  



              17  

therapist.        The rule specifies that the trial court may inspect the requested records in  



          14        CINA Rule 9(b)(3)(B).  



          15  

                    AS 47.05.060 provides:  



                              The purpose of this title as it relates to children is to  

                                                                        

                    secure for each child the care and guidance, preferably in the  

                                                         

                    child's  own  home,  that  will  serve  the  moral,  emotional,  

                                                                                  

                    mental,  and  physical  welfare  of  the  child  and  the  best  

                                                                                                

                    interests of the community; to preserve and strengthen the  

                    child's family ties unless efforts to preserve and strengthen  

                    the ties are likely to result in physical or emotional damage to  

                                                              

                    the child, removing the child from the custody of the parents  

                          

                    only as a last resort when the child's welfare or safety or the  

                                                                                           

                    protection of the public cannot be adequately safeguarded  

                    without removal; and, when the child is removed from the  

                                 

                    family, to secure for the child adequate custody and care and  

                                                                               

                    adequate planning for permanent placement of the child.  



          16        Evidence  Rule  504  governs  application  of  the  psychotherapist-patient  



                                                                      

privilege in civil and criminal cases generally.  The rule "is designed to encourage those  

with mental or emotional problems to seek help."  Alaska R. Evid. 504 commentary.  



          17        CINA Rule 9(b)(3)(D).  



                                                              -8-                                                        6870
  


----------------------- Page 9-----------------------

                            

camera  and  that  the  court  may  allow,  limit,  or  prohibit  disclosure  and  use  of  the  

communications.18  



                                                                 

                    The rule as originally drafted did not allow invocation of a psychotherapist- 



                                                19 

                                                                                                      

parent privilege in a CINA case.                     In 2001, we amended the rule to presumptively apply  



                                                                                               

the   privilege   to   communications   between   children   and   their   therapists,   while  



                                                                                                            

presumptively denying application of the privilege to communications between parents  



                              20                                                      21 

and their therapists.             Both presumptions are rebuttable.  



                                                                                             

                    The impetus for the amendment was a concern that, while the former rule  



allowed evidence of "child abuse and neglect [to] be reported and evidence relating to  



                                                                       

the parent [to] be available to the court[,] . . . when the rule was adopted the 'victim's'  



                                                                      22  

                                                                                    

loss of confidentiality was not contemplated."                            At its meeting on January 8, 1998, the  



                                                                                             

CINA/Delinquency Rules Committee noted that the primary intent of the proposed rule  



                                                                           

change was "to encourage children to participate in therapy by protecting the counseling  



                     23  

relationship."            



                    The  committee  noted  that  policy  concerns  dictated  that  different  rules  



should govern applicability of the privilege for children and for parents,  



          18        Id .  



          19        Former CINA Rule 9(b) (amended 2001) provided, in relevant part, "The   



. . . psychotherapist-patient privilege [and] Evidence Rule 504 . . . do not apply in child               

in need of aid proceedings."  



          20        Alaska Supreme Court Order No. 1442 (May 24, 2001).  



          21        CINA Rule 9(b)(3)(B), (C).  



          22        Memorandum from Fairbanks Superior Court Judge Niesje Steinkruger to  



Court Rules Attorney Christine Johnson (May 9, 1996).  



          23        Minutes, Alaska CINA/Delinquency Rules Comm. (Jan. 8, 1998).  



                                                                -9-                                                         6870
  


----------------------- Page 10-----------------------

                   because the parent and the child are in therapy for different  

                                                                 

                   reasons.    The  parent  usually  receives  therapy  to  fix  the  

                                                                              

                   behavior which is the basis of the case.  The parties and the  

                                                            

                   court need to know how the parent has progressed in order to  

                   make decisions about disposition.  The child, on the other  

                   hand, is usually in  counseling to fix a harm that has been  

                   done to the child.  Although it may be helpful for the parties  

                                              

                   to know what the child says in therapy, this disclosure may  

                                 

                   reduce the chances that the therapy will succeed.[ 24]  



The history of this rule amendment is thus consistent with our observation when we first  



recognized  the  existence  of  a  common  law  psychotherapist-patient  privilege:    "in  



balancing  injury  to  the  [psychotherapist-patient  relationship]  by  fear  of  disclosure,  



                                                                                    

against the benefit to justice by compelling disclosure, the scales weigh heavily in favor  

of confidentiality."25  



                   In this case, Simone asked the trial court to provide her with access to  



records  of  Irving's  sessions  with  his  psychotherapist  for  her  to  use  in  the  trial  to  



                                          26  

terminate her parental rights.                After examining the records in camera the trial court  



                                                         

denied  Simone's  request.    The  court  found  that  the  requested  records  "only  affirm  



[Irving's] need for permanency," and that their disclosure would cause Irving undue  



emotional and mental stress, would constitute an invasion of his privacy, and would  



undermine his therapeutic relationship with his current and future counselors.  



          24       Id .  



          25       Allred v. State , 554 P.2d 411, 418 (Alaska 1976).   In 1979 we codified the   



psychotherapist-patient privilege in Evidence Rule 504.   Alaska Supreme Court Order  

364 (May 29, 1979).  



          26  

                                                                                                          

                   Irving's guardian ad litem refused to waive the privilege in regard to the  

requested records, as allowed by CINA Rule 9(b)(3)(F)(ii).  



                                                           -10-                                                      6870
  


----------------------- Page 11-----------------------

                    Simone  argues  on  appeal  that  Irving's  therapy  records  could  contain  

                                                                                                              



evidence that Irving was having difficulty bonding with his foster family and that there             



                                            

was no evidence that Irving would suffer harm if the records were disclosed.  But we  



have examined the therapy records ourselves and confirmed that they do not contain the  



                                                                                                     

information that Simone was seeking.  And the trial court's finding that disclosure could  



undermine  Irving's  relationship  with  his  counselors  was  based  on  the  informed  



recommendation  of  Irving's  guardian  ad  litem.    We  conclude  that  the  trial  court  



                                                                                                          

considered the relevant factors and that the order denying disclosure of these records was  



not an abuse of discretion.  



          B.	       The Trial Court Did Not Deny Simone Due Process By Relying On  

                    Irving's Therapy Records In Reaching Any Decision In This Case.  



                                                                 

                    Simone argues that the trial court denied her due process by relying on  



Irving's therapy records in making decisions in this case without providing Simone  



access to the contents of the records.  She relies on the trial court's statement in the order  



                                                           

denying  release  of  the  records  that  "the  records  only  affirm  [Irving's]  need  for  



                                                                                           

permanency."  But CINA Rule 9(b)(3)(D) required the court to consider "the content and  



                                   

nature" of the records to determine whether disclosure should be allowed.  We read the  



                                                                                            

trial court's conclusion as a statement that the records did not contain the type of material  



that Simone was requesting.  After reviewing the record, we agree with the trial court's  



conclusion that the therapy records did not contain information that would support an  



                             

attack on Irving's relationship with his foster parents; they only contained information  



that supported Irving's need for permanency.  



                                                                                                      

                    Moreover, Simone makes no showing that the therapy records played a role  



in the trial court's decision to terminate Simone's parental rights.  The trial court did not  



discuss or even mention the therapy records in its order terminating Simone's parental  



rights.  The trial court's best interests finding was based entirely on its evaluation of  



                                                              -11-	                                                        6870
  


----------------------- Page 12-----------------------

                                                                                                   

factors involving the actions of Simone and Irving's father and the demonstrable harm  



Irving suffered while in their care.  We thus conclude that the court did not consider  



these records in a way that could compromise Simone's right to due process.  



          C.	        The Trial Court's Finding That OCS Made Reasonable Efforts To  

                                                                                                                      

                     Reunite Simone With Irving Was Supported By Substantial  Evidence.  



                                                                                                                

                     Before a trial court may terminate parental rights to a child the court must  



find that OCS provided timely, reasonable efforts to provide family support services to  



                                                                                                                     27  

                                                                                                                         Simone  

the parent designed to enable the safe return of the child to the family home. 



argues that OCS did not incorporate the recommendations contained in Dr. Macomber's  



                                                                                       

neuropsychological evaluation into her case plan, that OCS did not provide her with  



substance abuse treatment appropriate to her circumstances, and that OCS improperly  



deprived her of contact with Irving.  But our review of the record supports the trial  



court's finding that the efforts OCS provided for Simone were reasonable.  



                                                                                                                        

                     The record suggests that Simone's behavior complicated OCS's efforts to  



                                                                    

provide  her  with  both  mental  health  and  substance  abuse  services.    OCS  initially  



                                                 

arranged for Simone to receive a neuropsychological evaluation, but two weeks after the  



evaluation was performed she tested positive for methamphetamine, thus causing the  



                                                      

focus of her case plan to shift from mental health treatment to substance abuse treatment.  



                        

OCS arranged  a substance abuse assessment that recommended intensive outpatient  



                                                                      28  

treatment, but Simone declined to participate.                            



          27	       AS 47.10.086(a); AS 47.10.088(a)(3).  



          28        According  to  Simone,  Set  Free  Alaska  refused   to   accept  her  into  its  



treatment program because at the time she was taking medication to treat her mental   

health conditions.   The record provides no corroboration for Simone's claim, nor does  

it indicate that she informed OCS of this situation so that OCS could assist her in locating         

an alternate treatment provider.   



                                                               -12-	                                                         6870
  


----------------------- Page 13-----------------------

                      In May 2012, OCS referred Simone for a behavior health assessment at   



Alaska  Family  Services.    That  assessment  noted  that  Simone  was  "in   denial  of  her  



substance abuse problems" and recommended that she enroll in Alaska Family Services'              



dual diagnosis treatment program.  On appeal, Simone complains that the treatment she                             



received at Alaska Family Services was deficient because it consisted of group therapy       



sessions,  and  did  not  incorporate  individual  therapy,  which  Dr.  Macomber  had  



recommended.  



                                                

                      But the clinical director of Alaska Family Services testified that Simone's  



                                               

program incorporated both  individual and group therapy components.  The director  



                                                                                      

testified that Simone's participation in group therapy did not increase during her time in  



                                                                                                                       

the program because she never began functioning at a high enough level to allow such  



                                                                                               

participation.  Simone failed to successfully complete the program because she did not  



                                       

seek out required sober supports, she continued to use illicit substances, and she was not  



consistent in taking her prescription mental health medications.  



                                                                                              

                      Simone's conduct also complicated OCS's efforts to provide visitation.  



OCS provided Simone and Irving consistent contact until Simone chose to move to  



                                                                                                          

Pennsylvania against OCS's wishes.  On her return to Alaska, it took OCS a couple of  



months to reestablish regular visits, but once contact was reestablished Simone again  



                                                                                                        

disrupted the program by threatening to commit suicide if Irving were not returned to her  



                                                                                           

custody.  OCS was still looking for another appropriate facility to host visits at the time  



of the termination trial.  



                                                                      

                      The trial court also found that OCS provided Simone with many additional  

                            29    These  findings  are  not  contested.                       We  affirm  the  trial  court's  

                                                                                              

support  services.  



           29         The court found that OCS helped Simone identify issues she needed to
  



address,  facilitated  family  contact,  coordinated  with  Simone's  service  providers,
  

                                                                                                                      (continued...)
  



                                                                   -13-                                                                 6870  


----------------------- Page 14-----------------------

conclusion that OCS made reasonable efforts to enable Irving to return to Simone's  



custody.  



V.     CONCLUSION  



               We therefore AFFIRM the superior court's order terminating Simone's  



parental rights.  



       29(...continued)  



provided  case  planning  meetings  and  case  plans,  offered  drug  screens,  and  referred  

Simone for substance abuse assessments and a neuropsychological assessment.   



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