High Road ABA: Clinical Data Discussion

Discussion of Twelve Clinical Data Points in the High Road Single-Case ABA Data

C.A. Childress, Psy.D. (2019)

Parent-Child Relationship Rating Scale (PC-RRS)

Affection (Aff):  Attachment networks – blue line

Cooperation (Co):  Emotional regulation – gold line

Social Involvement (SI):  Arousal and mood regulation – silver line


High Road Workshop Data

The PC-RRS data from the two-days of the High Road workshop represent a truly remarkable rocket into a joyful, healthy, and happy child by the end of the 2-day workshop.  The exit level data points are in the superior range.  The child’s affection is 5.5, his emotional system is 6, and his mood is 6.   He is immensely happy.

Of note is that this is a 2-day High Road workshop.  Typically, Ms. Pruter’s High Road recovery workshops are 4-days.  The actual recovery of the parent-child bond typically occurs sometime during the second day of the workshop, and then there are two additional days of recovery stabilization, structured through the workshop protocol, that takes place following the recovery of the parent-child bond of love and affection. 

The data from the workshop reflects a typical half-way point of the workshop; the recovery point.  Based on the data from the High Road workshop, the recovery of healthy child development occurs in the context of a very happy child.  Affection and attachment bonding networks are glowing wonderfully warm and positive, emotional systems are happy and alive, and mood is wonderful. The child is relaxed and happy during the recovery of healthy authenticity.  This data provides a remarkable insight into the recovery process from complex trauma.  Seeking additional information from Ms. Pruter about this recovery process and how she accomplishes such relaxed joy in the child is recommended.

In the interpretation of the follow-up clinical care data for this initial ABA with the High Road protocol, it is important to note that the typical High Road workshop is an integrated intervention of 4-days, and the protocol is structured for a 4-day recovery.  The additional two days of the High Road recovery workshop are important.  That Ms. Pruter conducted the recovery in two-days was a feature of her response to trauma and the needs of the case for immediate response when the child became available for her workshop.

The child’s supremely relaxed happiness reflected in the day-2 recovery data from the High Road workshop is a product of the workshop, it is not the actual set points of the child’s regulation systems.  They might become his set points if the child spent enough time with Ms. Pruter, but two days is not likely to alter the regulation set points of his nervous system created by three-years of continual psychological child abuse by his pathologically narcissistic father. Once the workshop is over, the child will (if recovered) return to his established neurological set points for these three regulatory systems (attachment; emotions; arousal-mood).

If the child’s ratings on the PC-RRS from the workshop are merely a product of the workshop, then the child’s functioning will collapse into disorganization and chaos once the recovery workshop ends.  The initial data into the clinical care period reflects the stable set-points for the three regulatory networks (attachment systems, emotional systems, arousal-mood systems).   She recovered the child’s authenticity.

(1)  Set-Point for Social Involvement

It is reasonable to expect a drop in functioning evidenced on the PC-RRS data from the end of the HR workshop to entry into my clinical care a week and a half later as a natural function of his return to his established regulatory set-points, and this expected drop to set-points is reflected in the data.  The entry points into my clinical care reflect the set-points for these three regulatory systems of the brain: attachment systems (Aff-3), emotional systems (Co-4), and arousal-mood systems (SI-6). 

Of first note is the separation of the SI system from the other two.  The SI (arousal-mood) system is two points higher than the next regulatory system, and is in the upper-range of regulation – a 6.  This suggests anxiety, and likely sustained anxiety/stress, that has elevated the set-point for this regulatory system.  The elevated set point also suggests that the child may use better-than-average social skills as an avenue for acquiring nurture, and as a vehicle for anxiety regulation.

A 6 set-point for SI regulation is too high.  The child’s nervous system is in a chronic up-regulated state from the years of trauma exposure.  The down regulatory systems of the brain are the sadness emotional networks.  The 6 set-point of SI suggests inadequate counter-regulation from the down-regulatory systems of sadness.  The child has unprocessed sadness.  Sadness is metabolized through the attachment networks.  The next clinical focus becomes the attachment system.

(2)  Set-Point for Attachment

The set-point for the attachment networks upon entry into follow-up clinical care is 3.  This is in the normal-range, but the Aff ratings also took the largest drop from the second day of High Road recovery to the stabilization.   This may reflect the absence of the final two days of the workshop protocol.  I have reviewed the protocol, and I understand how it achieves its effectiveness.  The final two days are important regulatory stabilization days for the newly activated attachment networks.  The 3 as a set-point for the attachment networks likely reflects the absence of the final two days of the workshop. 

The entry set-points into follow-up recovery care represent the half-way set-points in these regulatory systems achieved by the High Road workshop, a snap-shot of the regulatory networks set-points at the time recovery of authenticity occurs.  Of note in this regard is the higher regulatory set-point for emotional regulation systems (Co:4) than attachment systems (Aff:3).  I have some hypotheses as to why this set-point configuration would occur at the mid-way point of the workshop. 

Notice in the workshop data how Co (emotional networks) aligns with SI (the anxiety of trauma), in the context of a meteoric rise in affectionate bonding (Aff; attachment networks), I would offer the suggestion that during the recovery process the emotional systems lay on the trauma networks, and the trauma networks receive the elevated glow of attachment bonding (love) from the attachment networks of the child’s brain.  It is my professional opinion that we are watching the extraction of complex trauma – not healing – extraction of damage to the neurological networks of the brain.

In healthy child structures, the set-point for attachment networks (Aff) is above the set-point for the protest behavior (Co), and the two systems are entrained.  In the entry data into clinical care, the set-point hierarchy is inverted, and the two systems are not entrained.  Based on the speed by which clinical intervention achieved both a reversal of attachment and emotional set-points and entrainment of the two systems, it is likely that this early disruption represents the missing two final days of the High Road workshop. 

Additional entry data from clinical care following the full 4-day recovery workshop would be extremely helpful in interpreting this 2-day workshop data.  The recovery of attachment bonding with the full 4-day workshop protocol is anticipated to be more robust.

(3)  Co-2 Tiffy with Sad

My active clinical intervention does not begin until data point (5).  At the first Co drop to 2, I had not applied any clinical interventions of note.  In my first session I had done some stabilization, but it was mostly entry work.  My second session was with the mother (that released the ratings from their High Road stabilization). 

One interpretation of entry level stability is that both mother and child were afraid to do anything.  The recovery was great and they didn’t want to do anything to mess it up (reflecting the missing two days of the High Road workshop that are designed to address this “deer-in-the-headlights” experience).  Once I became involved as a support to mother, she became more comfortable with the recovery, and as she became relaxed the child became relaxed, and this is reflected in the release of ratings.  Everybody relaxed.

Follow the Co line once my intervention releases the ratings from their High Road stability.  Notice the drop to the Co-2, with a simultaneous drop in Aff to 3 and SI to 4.   The drop in Co represents a protest behavior display, something hurt, or there is a growth occurring.  The drop in Aff along with the drop in SI indicates sadness (down regulation of SI and lowered affectional warmth; the child is sad).  The drop is to a 2 (not a 1), so it’s a tiff of protest behavior rather than a fight of conflict.

This Co-2 drop occurred three days before my next session with the mother and child, and the first active session of my therapy.  Given the history of conflict in this relationship, a drop to 2 in Co is of note for recovery stability.  I had not yet had time to become an active stabilizing agent for the relationship, I had unlocked the stability of Dorcy’s recovery, and Dorcy only had 2-days of her workshop protocol rather than the structured and standard 4-day recovery protocol.   The mother-child bond may be fragile, and a Co-2 may collapse the recovery achieved by the 2-day workshop.  I took no direct steps, but I monitored the following day’s ratings to see if my active intervention was required.

The next day, the Co rose two points, to 4.  They had resolved their interaction without the need for my intervention.  Attachment bonding remained stable at it’s set-point of 3, and SI took a 2-point hop to its set-point of 6, indicating the absence of sadness.  The Co-2 tiffy with sad had been fully and successfully resolved.  We discussed the incident in session and it involved miscommunication and he became frustrated (and used inappropriate language).  A normal-range parent-child conflict, resolved entirely normally.  We developed communication and problems solving skills in our session.

This data point, Co-2 tiffy with sad, represents an important data point in the High Road ABA recovery profile.  It is the data point that indicates the degree of stability to the recovery achieved by the High Road workshop.  It is entirely stable.

(4)  Dyssynchrony

Before leaving the High Road stabilization phase of the data to enter my clinical care sessions, the variability in the three systems is notable.  The attachment system does not vary with the other two, and the there is seeming synchrony of the emotional networks (Co) with the trauma impact (SI; arousal-anxiety), which is not the desired synchrony.  The nervous system of the child his healthy, but it is not yet organized. 

The focus of my first therapy session was to impact the stability of the attachment recovery.  I hoped to raise the set-point on attachment networks to 4 (with rises into 5), I wanted to reverse the set-points for Aff and Co (attachment higher than protest), and I wanted to entrain the emotional system (protest behavior; Co) with the attachment networks (Aff).  My intervention in session 1 was on the attachment networks as the ground to organizing the regulatory systems.

(5)  Session 1: 7-Spike SI

My first therapy session is indicated by the spike in SI to 7, the arousal system became very active with the material from my first session.  Note also the rise in Aff to 4 and the 4-point rise in Co (loss of protest, increased emotional flexibility and cooperation).  He liked my session.  The rise in Aff and spiking of SI (arousal-mood) suggest he was happy, and the 4-point rise in Co indicates he was relaxed.  He liked my first session.

On the following day, Aff continued to rise to 5, SI continued to spike at 7, and Co dropped one point on rebound to 5.  He continues to be happy and relaxed, and attachment bonding is increased from my session.

(6)  Consolidation V

Two days after my session, his nervous systems consolidates the gains from the intervention, with a rebound (bounce-back) of Aff to 4, Co to 3, and SI to 5.  A nice tight synchrony of all three regulatory systems is evidenced, and in a healthy order of set-points, attachment (Aff-4) above protest (Co-3).  This V shape of three systems represents the consolidation of the therapy intervention from two days previously.  Consolidation occurs on the down-regulatory networks.  Then watch what happens.

(7)  Integration Triad

The following day, three days after the therapy session, all three regulatory networks converge on a 5 rating, high-normal.  This is an integration of the therapy intervention from three days ago.  Integration occurs on the up-regulatory networks.  The consolidation V to the integration triad is magnificent.  Then watch what happens.

(8)  Synchrony: Attachment and Protest

Once the three lines converge in integration, where did the blue line go?  Attachment (Aff) and emotional regulation (Co) are perfectly synchronized for the next four days, even on a one day bounce they remain synchronized.  The correlation of the Aff and Co ratings before the three-line integration point is r=.60, following the three-line integration point the correlation of Aff and Co is r=.94.  The two systems achieved synchrony at that three-line integration following the three-line V consolidation, and remained in complete synchrony until the intervention of my second session.

(9)  Set-Point Stability

I had introduced organizing disruption followed by consolidation and integration by the intervention of my first session, and the regulatory systems stabilized into new set-points following their consolidation and integration from the therapy intervention.  The new stabilization set-point for SI across 3 days was 5, one point lower than it’s entry at 6, and now in the normal-range.  The new stabilization set-points for Aff and Co combined appear to be in the 4-5 range, a 1-point increase for attachment regulation from the entry levels.  All three regulatory systems are within one point or less of each other.

(10)  Session 2:  Something to Consider

The stability of synchrony achieved between Aff and Co at the integration point continues for five days following the integration, with my interventions in session 2 becoming the disruptive agent.  Session 2 of my therapy produced another immediate spike to 7 in SI, his arousal level was high.

Aff dropped by one point, and Co dropped by two, breaking their synchrony, with Aff settling on a set-point (3) one point higher than Co which dropped in the Co-2 range of “protest behavior.”  I had given him something to ponder, not verbally, but in the process of our session, as I wove our session I gave him an issue to consider.  

You can see the impact.  His stress level went up (SI-7), his emotions became more inflexible, he’s processing something (Co-2), and he didn’t like what he was processing (drop in Aff).  What happened?

He figured it out.  The next day was a 3-point rise in Aff, to a 6.  The last time there was a 6 in Aff was the three-line integration.  Now, again, Aff and Co rejoin in synchrony at 6.  The only missing component of a three-system integration is that arousal-mood is too high at 7.  He’s too happy about what he figured out.  That makes me smile.

Notice the nice V drop of entrainment of this consolidation-integration sequence, between the attachment system and emotional system (protest behavior system).  We want protest contained within the attachment networks.  Co-2 drops represent minor breach-and-repair sequences of self-individuation in a social context.  The issue is not minor disagreements, it’s how we handle them.  If we bring problematic things to the breach, the minor breach can turn into a major one.

Occasional Co-2 drops are healthy individuation, especially in an adolescent-age child.  But we want protest behavior contained within the context of healthy attachment bonds.  We want the set point for Aff to be higher than for Co, we want them entrained, and we want Aff to always remain in the normal-range or above (3-5, with occasional elevations into 6 and 7). 

The entrainment Vs of Aff and Co at data points (6), (10), and (12) all reflect the desired Aff over Co organizational structure (protest behavior guided by and within the context of attachment), with Aff remaining 3 or above (normal and healthy attachment bonding), and no Co-1 (no severely painful breach for the child).

(11)  Two-Day 7-Spikes

I find those two-day 7-spikes in SI from my sessions interesting.  On the first session they reflect the child’s happiness and relaxation as Aff moves up consistently and Co spikes to 7 and only drops one point to a 6 the following days  He felt much more relaxed following my first session of active intervention.  The second day of the SI-7 means he continued to be very social with his mother, likely his gregariousness was because he was just a relaxed and happy guy.  He’s a great guy.

The second session 7-spikes on the SI scale are different.  The first one is an increase in arousal (stress) because of the – thing – I gave him to consider in our session.  You can see his Aff drops one and his Co drops two.  He’s not happy about that thing I gave him to consider.  He’s pondering it, that’s the arousal SI-7.  It’s troubling him, that’s the drop in Aff and Co.

He figured it out.  The next day, that bounce up for Aff of 3 points and Co 4 points is his figuring it out.   That’s an impressive impact.  He’s happy and relaxed.  Good for him that he’s figuring things out.

The 7-spike in SI on the day following our session is because he’s happy again.  The SI scale measures social involvement. He was socializing a lot with his mom.  On the day of our therapy, it was his way of managing anxiety and inner stress – that’s his coping style – he has a high-set point for social regulation.  So he regulated the stress of day 1 with a 7-spike in SI.  Day 2, his Aff took a leap.  He is so happy.  His Co takes an even bigger leap. He’s relaxed.  They both merge spot on at 5.  He figured it out.  Now, the day-2 7-spike in SI is happiness.

(12)  Whew

Boy, that session 2 stuff took a lot of processing across a lot of systems.  He’s recovering his stability.  There’s a down-regulation consolidation of all three systems, a release of 2 points for SI, 2 points for Aff, and 3 points for Co (he’s pooped), into a three-system consolidation V.  Look how synchronous those systems are.  That is a clean nervous system. 

Notice the consolidation V is identical to data point (6), with SI on top, one point higher than Aff, which is one point higher than Co, identical to the consolidation V of data point (6).

This is interesting.  At the consolidation V, Aff remained stable at 3, and so did the entrained Co, while SI completed the bounce back of the consolidation V, then Aff and Co completed their bounce back the following day, back into integrated entrainment at 5 (high-normal).  That is some hefty consolidation.  Two days of Aff-4 and Co-3 synchronized consolidation before an integration at 5.  Session 2 gave him some stuff to think about.  Whew.

His exit set points leaving this series are: Aff 4-5, Co 3-4, SI 5-6.  An entirely healthy and normal-range set of regulatory networks

Conclusion from the Clinical Data Set

The High Road workshop of Dorcy Pruter achieved a remarkable – truly breathtaking – recovery of healthy and normal-range functioning of a wonderful child, in two days, following three years of documented child abuse.  The recovery from complex trauma and child abuse is full, it is strong, and robust.  She handed into my clinical care, a totally normal-range and wonderful young man.  As a clinical psychologist, I am in deep respect for what Ms. Pruter accomplishes on a regular basis. 

And if there is any question about how the kids feel about the High Road workshop, for my client it was Aff-5.5, Co-6, SI-6.  He loved it.

I’ll bet he did.  Because as far as I can tell, the High Road protocol, administered in two days by Dorcy Pruter, achieved a full recovery of the child’s healthy and normal-range development.  I’ll bet that did feel pretty good.

Craig Childress, Psy.D.
Clinical Psychologist, PSY 18857







Single-Case ABA: High Road Protocol

I want to report on a clinical case from my practice, a 16 year-old male adolescent with a significant history of aggression and hostility toward his mother, provoked and supported by his father. 

The mental health documentation of the family pathology goes back to 2016.  Treatment reports from three prior mental health professionals, two PhD psychologists and an MFT marriage and family therapist, are all in complete agreement.  All three diagnosed Child Psychological Abuse in the period from the spring of 2016 to the summer of 2017, with the most recent psychologist giving a formal DSM-5 diagnosis in his written report of V995.51 Child Psychological Abuse (summer of 2017).

Both psychologists, one in 2016 and the other in 2017, expressed concerns about frequent and “inappropriate” kissing on the mouth between the son and father.  All three mental health professionals diagnosed the father with extremely pathological narcissistic personality disorder, with strong IPV (Intimate Partner Violence; domestic violence) components of spousal abuse, and directly observed hostile, verbally abusive episodes toward the spouse (and therapist) are reported by multiple therapists. 

It took a year and a half from the time that the DSM-5 diagnosis of Child Psychological Abuse was made by the treating psychologist in the summer of 2017 (after the two previous mental health providers also diagnosed psychological abuse) for the mother to finally get a protective separation order from the court.  The child was left in the care of a diagnosed abusive parent for 18 months following the formal diagnosis of child abuse by a licensed psychologist with 37 years of professional experience (and after the two prior therapists also diagnosed child abuse by the father).

A year and a half after the DSM-5 diagnosis of Child Psychological Abuse made by the treating psychologist, the court granted the mother’s request for a protective separation order.  In February of 2019 the court granted the mother full custody of her snarling, hateful, and aggressively violent 16 year-old son, so that she and her son could receive treatment after years of dominating and controlling, documented psychological abuse of the child by the father had entirely destroyed the child’s relationship with the mother. 

Mental Health Reports: Documented Pathology

The first mental health report regarding the family pathology is from the spring of 2016.  In it, a psychologist with 40 years of professional experience said,

“The father displayed in my office the most extreme, antagonistic, narcissistic-based behavior I have ever seen.”

“The father’s full manipulation of the child has completely dominated every area of his life, school, friends, family, and in particular, his displays of kissing his father repeatedly on the lips in public, these are all inappropriate.  The child lives in constant fear of displeasing his father, and has no independent thinking, apart from what his father requires.”

These are the statements from the report of a PhD psychologist in the spring of 2016.

The next report is from a marriage and family therapist (MFT) who treated the family in the spring and summer of 2017.  In this report, the MFT states,

“It is my belief that <child name> is a victim of Child Psychological Abuse from his father.  It is my belief that the messages <child name> has been receiving from his father have resulted in significant psychological harm to the child.  He is experiencing severe reactions to stress.”

The next mental health report is from a PhD psychologist with 37 years of professional experience.  In his report he states,

“It is clear to me that <child name>, who lives with his dad and gets a few hours per week of visitation with his mom, has been mentally and emotionally abused by his father for the past year.”

That was in the summer of 2017.  This third psychologist gave a DSM-5 diagnosis of V995.51 Child Psychological Abuse and he referred the child and mother to the High Road workshop of Dorcy Pruter.

In February of 2019, a year and a half after the formal DSM-5 diagnosis of Psychological Child Abuse, a protective separation order was granted by the court and the mother and child entered the High Road workshop.

Following the recovery through the High Road workshop, I became the treating clinical psychologist for follow-up care with the recovered child and restored mother-child bond. 

This clinical case report represents the application of a single-case ABA design to assess the effectiveness of the High Road workshop for recovery from complex trauma in childhood.  The form of complex trauma is child psychological abuse, created in the context of high-intensity family conflict and parental narcissistic and borderline pathology.

In this current case, the child had been exposed to at least three years of professionally documented child abuse.  In February of 2019, the child entered two days – two days – of the High Road workshop.  I began treatment of the mother-son relationship following the two days of the High Road workshop conducted by Dorcy Pruter.

During the workshop, Ms. Pruter collected parent rating data every morning and evening for the child’s relationship with the targeted parent, the mother, using the Parent-Child Relationship Rating Scale (PC-RRS).  When I began my treatment in March of 2019, I continued to collect the mother’s ratings on the PC-RRS for the child’s relationship behavior with her. 

This is a report on the PC-RRS data for a single-case ABA clinical recovery from the complex trauma of psychological child abuse, using the High Road protocol.

Single-Case ABA Research Design

When most people think of research, they think of an experimental research design where many people are separated into different groups, these groups then receive different experimental procedures, and group differences are measured using statistics; the experimental design.

There is a second research methodology that is equally as effective in demonstrating causality, and which is commonly used in assessing treatment efficacy, the single-case research design.

Wikipedia: Single-Subject Design

“In design of experiments, single-subject design or single-case research design is a research design most often used in applied fields of psychology, education, and human behavior in which the subject serves as his/her own control, rather than using another individual/group.”

In a single-case research design, the subject moves through a series of phases of intervention.  The initial phase (A) is a baseline assessment phase.  This is followed by a period of intervention (B), which is followed by the withdrawal of intervention and return to the baseline of no-intervention (A).

For the single-case ABA clinical recovery and treatment reported here, the initial A (baseline) phase was the pre-intervention (pre-HR) ratings on the Parent-Child Relationship Rating Scale (PC-RRS).  The intervention (B) was two days of the High Road workshop conducted by Dorcy Pruter.  The withdrawal of intervention (second A) was entry into my clinical care as the treating clinical psychologist following the High Road recovery workshop.

Instrument: PC-RRS

The Parent-Child Relationship Rating Scale (PC-RRS) is a parent rating of three features of the parent-child relationship; Affection, Cooperation, and Social Involvement.  During the High Road workshop period, these ratings were made twice daily (morning, evening).  In the follow-up clinical care with the treating psychologist, these parent ratings were made daily (end of the day).

The three items rated on the PC-RRS (Affection, Cooperation, and Social Involvement) are rated on a 7-point Likert scale from problematic (1s and 2s) to exceptionally positive (6s and 7s).  The Affection scale monitors parent-child attachment bonding.  The Cooperation scale monitors emotional disruptions (emotional flexibility and inflexibility).  The Social Involvement scale monitors arousal emotions (anxiety, stress, sadness, and depression).  The PC-RSS is designed to pick up key features of emotional and psychological functioning in healthy and unhealthy relationships.

The items are structured to reflect a normal-curve distribution, with normal-range being a middle rating of 4, extremely problematic behavior is rated a 1, and highly favorable behavior is rated a 7.  The goal for healthy development and for treatment is to achieve reasonably sustained periods of stable normal-range behavior (ratings in the 3 to 5 range) across all three indicators, Affection, Cooperation, and Social Involvement. 

Occasional drops into problematic 1 and 2 rated behaviors is normal and is anticipated from time to time in healthy child development.  However, sustained periods of low-level ratings of 1s and 2s would indicate issues of clinical concern.  Occasional elevations into 6 and 7 behaviors of high affection, cooperation, and social involvement are hoped for and desirable.  However, healthy child development is not a sustained period of hyper-affection, hyper-cooperation, and hyper-social involvement. 

The goal for child development is a healthy regulated state; mid-range is normal-range.  For the most part, healthy child development occurs in a regulated mid-range of flexibility.  The treatment goal using the PC-RRS is the mid-range of well-regulated relationship behavior; ratings in the 3 to 5 range for all three scales, Affection, Cooperation, and Social Involvement.

The Data


A: Child Psychological Abuse

PC-RRS ratings were not collected during the baseline period because the child’s overt hostility toward the mother that was created by the father’s psychological control of the child prevented the mother’s access to the child.  The reasonably assigned ratings for the child’s relationship behavior toward the mother during this period, based on reports from three separate clinical therapists, would be Affection=1-2; Cooperation=1-2; Social Involvement=1-2.   

B: Intervention – the High Road Protocol

In February of 2019, a protective separation order was granted by the court, and mother and son entered a 2-day High Road workshop conducted by Dorcy Pruter.  On their evening arrival the day before the workshop began, the child’s ratings on the PC-RRS were Affection=2; Cooperation=2; Social Involvement=1.

On Day 1 of the workshop, the child’s ratings on the PC-RRS began a rise that would be continual across the 2-day workshop period, reaching an evening rating on the first day of Affection=3; Cooperation=3; Social Involvement 4.5.  A normal-range parent-child relationship with the formerly targeted-rejected parent was achieved by the end of the workshop’s first day.

On Day 2 of the workshop, the child’s previous gains continued their improvement, reaching evening ratings at the end of the 2-day workshop of Affection=5.5; Cooperation=6; Social Involvement=6.

The 16 year-old adolescent had gone from a severely problematic relationship with his mother (ratings of 1-2) to a normal-range relationship by the end of the first day (ratings of 3-5), and rose into the highly affectionate, highly cooperative, and highly social range by the end of the second day (ratings of 6-7).

This represents a remarkable recovery of normal-range, and then superior functioning in the parent-child relationship within two days, following three years of documented psychological child abuse by a severely narcissistic personality parent.  In one day, the High Road workshop achieved normal-range bonding and normal-range child development.  In two days, the High Road workshop achieved superior bonding and healthy child development.

As a clinical psychologist, I am deeply impressed with the documented effectiveness of the High Road recovery workshop for complex trauma in children.

A: Withdrawal of Intervention – Follow-up Care

In March of 2019, I became involved as the follow-up clinical care treatment provider for the mother and son, following the three years of documented child psychological abuse, and two days of the High Road recovery workshop.

My first session with the mother and son begins the first data points for the clinical care ratings.  The mother’s initial daily ratings of the parent-child relationship were consistent upon their entry into therapy; Affection=3; Cooperation=4; Social Involvement=6.  The recovery gains documented for the High Road workshop are confirmed by the entry data into follow-up care with the clinical psychologist, with five straight data points in the normal-range.  

There is no reason to expect that the mother (the formerly targeted-rejected parent) would falsely report a positive relationship that did not exist.  If the mother is reporting a normal-range relationship with the child, then this is true and accurate data concerning their relationship.  The mother’s daily ratings are discussed in weekly therapy to verify rating calibration and ensure the validity of the ratings.  Problematic relationship issues that produce lowered daily scores are discussed in therapy using behavior-chain interviewing to verify rating accuracy and validity.

As therapy began to have impact, the initial stability of the normal-range relationship achieved by the High Road workshop began to fluctuate in response to my treatment interventions.  The rise in the ratings surrounding the 3/24/19 period reflects my first session of substantive treatment following my initial entry-sessions.  The fluctuations surrounding the 4/3/19 period reflect my second therapy session of substance. 

The sensitivity of the PC-RRS ratings to the effects of therapy, with distinctive periods of visible impact from therapy sessions, means that these rating are accurate and sensitive indications of the parent-child relationship.  The recovery of healthy and normal-range child development documented during the High Road workshop is confirmed by the treatment data in follow-up therapy.

The High Road workshop recovers children from abuse and trauma, and restores loving bonds of affection and healthy child development.  That is a fact.  The success of the High Road recovery protocol is documented by evidence, by the data.  It is a scientifically established fact.

There’s a reason it’s called a “single-case” research design; causality can be proven in a single case.

Findings of the Single-Case ABA for the High Road Workshop

As the current treating clinical psychologist for the mother and son relationship, it is my confirmed professional opinion that the mother-son affectional attachment bond has been fully recovered by the High Road workshop.  Not a doubt in my mind. 

The child’s healthy development has been recovered, and the child’s healthy and bonded relationship with his mother has been restored by the High Road workshop of Dorcy Pruter.  That is a scientifically confirmed fact.  Just look at the data.

From the first moment the mother-son relationship entered my treatment, their relationship was entirely in the normal-range, and their relationship has maintained that stability in response to the intrusions and perturbations introduced by therapy.  If the rating scales are picking up the effects of my therapy, the ratings are accurate reflections of the parent-child relationship.  Dorcy Pruter achieved a full recovery of the child, in two days… one day actually; normal-range ratings on the PC-RRS were achieved by the end of the first day of the High Road workshop.

The variability in the mother’s scores suggests that she has a sensitive internal calibration for her ratings.  The daily ratings are verified in family discussion with the mother and child during the weekly therapy session using behavior-chain interviewing around incidents of concern and ratings.  This data is accurate.  Not a doubt in my mind.

Following three years of psychological child abuse, child abuse confirmed independently by three separate mental health professionals, Dorcy Pruter and the High Road workshop recovered the child’s healthy and normal-range functioning in two days.  That is remarkable.

The success of the child’s recovery is remarkable, the success of Ms. Pruter’s achievement with the High Road protocol is remarkable.  Much respect from a licensed clinical psychologist. 

The recovery she achieved is verified by the ratings upon entry into my follow-up care, and has remained stable during my treatment period.


There is a reason it is called a “single-case” design – care to hazard a guess as to why?

The single case research design was the favorite research methodology of B.F. Skinner, a researcher of exemplary talent who helped found the fields of behavioral psychology and learning theory.  He didn’t trust the group differences in experimental design that might be “statistically significant” but so small as to be clinically irrelevant.  If an intervention is effective, we should be able to see the results.  That’s why B.F. Skinner preferred the single-case methodology in his research.

The effectiveness of the High Road workshop is confirmed.  I will verify the data points from my therapy, Ms. Pruter will verify her data points from the recovery workshop.  It’s true.  Absolutely verifiably true.  There is documented evidence for the effectiveness of the High Road workshop for recovering children from complex trauma and child abuse.

The High Road workshop represents evidence-based practice. 

There’s the evidence.  Right there.  It’s a lock.

Journal publication will come.  The next phase for Ms. Pruter is replication.  Do it again. 

She has already done it over 100 times.  She’s just been so busy recovering children that she hasn’t been focused on research protocols.  She has PC-RRS data on many, many families during the workshop.  And each new case represents a new single-case ABA.  Data will be collected using the PC-RRS for each new workshop and recovery, and the success of recovery – for each case – will be documented by evidence.

The data is in, the High Road workshop is evidence-based practice.  There is the evidence, right there, and each new workshop becomes a new single-case ABA, documented using the PC-RRS.  Want to replicate this research?  Please do.

What my therapy data does, is confirm her data from the workshop.  I see the recovery with my own eyes, in my treatment sessions, I see the success of the High Road workshop in the real-world recovery of my client-child and his healthy and bonded relationship with his mom.  She is beyond herself with joy.

I’m sure this research will generate further discussion in the months ahead.  As far as I’m concerned as a clinical psychologist, it’s a lock.  The High Road workshop of Dorcy Pruter is evidence-based practice and it will recover the child’s healthy and normal-range development in a matter of days.  That is a scientifically proven fact.

Not a doubt in the world.  There’s a reason it’s called a “single-case” design.  Just look at the data.  How can anyone possibly argue with that.  It’s a lock, it’s a fact.

Craig Childress, Psy.D.
Clinical Psychologist, PSY 18857