DCPP VS. M.T. AND C.T., IN THE MATTER OF THE GUARDIANSHIP OF J.T. AND JA.T. (FG-21-0111-18, WARREN COUNTY AND STATEWIDE) (RECORD IMPOUNDED) ( 2019 )


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  •                                        RECORD IMPOUNDED
    NOT FOR PUBLICATION WITHOUT THE
    APPROVAL OF THE APPELLATE DIVISION
    This opinion shall not "constitute precedent or be binding upon any court ." Although it is posted on the
    internet, this opinion is binding only on the parties in the case and its use in other cases is limited . R. 1:36-3.
    SUPERIOR COURT OF NEW JERSEY
    APPELLATE DIVISION
    DOCKET NO. A-3876-17T2
    NEW JERSEY DIVISION
    OF CHILD PROTECTION
    AND PERMANENCY,
    Plaintiff-Respondent,
    v.
    M.T.,
    Defendant-Appellant,
    and
    C.T.,
    Defendant.
    _____________________________
    IN THE MATTER OF THE
    GUARDIANSHIP OF J.T. and
    Ja.T.,
    Minors.
    _____________________________
    Submitted January 29, 2019 – Decided March 5, 2019
    Before Judges Suter, Geiger and Firko.
    On appeal from Superior Court of New Jersey,
    Chancery Division, Family Part, Warren County,
    Docket No. FG-21-0111-18.
    Joseph E. Krakora, Public Defender, attorney for
    appellant (Steven E. Miklosey, Designated Counsel, on
    the brief).
    Gurbir S. Grewal, Attorney General, attorney for
    respondent (Jason W. Rockwell, Assistant Attorney
    General, of counsel; Peter D. Alvino, Deputy Attorney
    General, on the brief).
    Joseph E. Krakora, Public Defender, Law Guardian,
    attorney for minors (Melissa R. Vance, Assistant
    Deputy Public Defender, of counsel and on the brief).
    PER CURIAM
    Defendant M.T. (Mary)1 appeals from a judgment terminating her parental
    rights to two of her sons, J.T. (John) and Ja.T. (James). Defendant C.T. (Carl)
    did not participate in the guardianship proceeding or this appeal. Mary contends
    the Division of Child Protection and Permanency (Division) failed to prove the
    second and fourth prongs of N.J.S.A. 30:4C-15.1(a) by clear and convincing
    evidence. The Law Guardian supports the termination on appeal as it did before
    the trial court.
    1
    We use initials and pseudonyms for the defendants, their children, and another
    individual to protect their privacy. R. 1:38-3(d)(12).
    A-3876-17T2
    2
    N.J.S.A. 30:4C-15.1(a) requires the Division to petition for termination of
    parental rights "on the grounds of the best interests of the child" if the following
    criteria are met:
    (1) The child's safety, health or development has been
    or will continue to be endangered by the parental
    relationship;
    (2) The parent is unwilling or unable to eliminate the
    harm facing the child or is unable or unwilling to
    provide a safe and stable home for the child and the
    delay of permanent placement will add to the harm.
    Such harm may include evidence that separating the
    child from his resource family parents would cause
    serious and enduring emotional or psychological harm
    to the child;
    (3) The [D]ivision has made reasonable efforts to
    provide services to help the parent correct the
    circumstances which led to the child's placement
    outside the home and the court has considered
    alternatives to termination of parental rights; and
    (4) Termination of parental rights will not do more
    harm than good.
    The four prongs of the best interests standard "are not discrete and
    separate; they relate to and overlap with one another to provide a comprehensive
    standard that identifies a child's best interests." N.J. Div. of Child Prot. &
    Permanency v. R.L.M., 
    236 N.J. 123
    , 145 (2018) (quoting In re Guardianship of
    K.H.O., 
    161 N.J. 337
    , 348 (1999)). "[P]arental fitness is the key to determining
    A-3876-17T2
    3
    the best interests of the child." 
    Ibid.
     In guardianship cases, "the child's need for
    permanency and stability emerges as a central factor." 
    Id.
     at 357 (citing In re
    Guardianship of J.C., 
    129 N.J. 1
    , 26 (1992)).
    The Division filed a petition for guardianship pursuant to N.J.S.A. 30:4C-
    15 to -20, seeking to terminate the parental rights of Mary and Carl with respect
    to John and James. 2 In a comprehensive fifty-page written opinion, Judge
    Haekyoung Suh found the Division satisfied the four-prong test by clear and
    convincing evidence, and held termination was in the children's best interests.
    Based on our review of the record and applicable law, we are satisfied the
    evidence in favor of the guardianship petition adequately supports the
    termination of defendants' parental rights. See N.J. Div. of Youth & Family
    Servs. v. M.M., 
    189 N.J. 261
    , 279 (2007) ("A reviewing court should uphold the
    factual findings undergirding the trial court's decision if they are supported by
    'adequate, substantial and credible evidence' on the record." (quoting In re
    Guardianship of J.T., 
    269 N.J. Super. 172
    , 188 (App. Div. 1993))). Accordingly,
    we affirm.
    The guardianship trial spanned thirteen days over three months. The
    Division moved 116 documents into evidence and presented testimony from five
    2
    Defendants' two older sons are not the subject of this case.
    A-3876-17T2
    4
    caseworkers, a school principal, a licensed professional counselor, a nurse
    practitioner, and a licensed psychologist, Robert James Miller II, Ph.D. The
    Law Guardian presented the testimony of licensed psychologist Maureen
    Santina, Ph.D., and moved sixty exhibits into evidence. Mary testified and
    presented the testimony of licensed psychologist James Reynolds, Ph.D., and a
    school social worker. Mary moved three exhibits into evidence. Carl did not
    appear for trial or testify.
    Mary and Carl were the parents of four sons, L.T. and V.T., born in 2001
    and 2003, respectively, John, born in December 2004, and James, born in March
    2006. Mary and Carl were married in 2009. All four boys suffered from
    emotional and behavioral issues.      The Division received two referrals in
    November 2010 and one in December 2010 alleging physical abuse of the
    children. This led to the family receiving services from the Division's Family
    Preservation Services (FPS), which included home visits and therapy. Mary
    later revealed Carl physically abused the children by hitting them on their heads
    and beating them with belts almost daily after they became toddlers.
    In early 2011, Mary was diagnosed with major depression. In August
    2011, Carl beat and choked Mary in front of the children, resulting in his arrest
    and incarceration.     Mary pursued relief under the Prevention of Domestic
    A-3876-17T2
    5
    Violence Act, N.J.S.A. 2C:25-17 to -35, and obtained a final restraining order
    against Carl. A July 2012 amended final restraining order prohibited Carl from
    having contact with the children. Carl had no further involvement with the
    children and his whereabouts are unknown.
    After this incident, Mary and the children moved into a safe house for a
    month, followed by living in a homeless shelter for four months. In March 2012,
    Mary and the children moved into an apartment and she began working the night
    shift at a Wawa store. Two months later, Mary's boyfriend, C.C., who also
    worked at the store, moved into the residence.
    In the spring of 2012, John underwent a psychological evaluation after he
    engaged in aggressive behavior at school. The evaluation revealed John had
    significant emotional and behavioral issues.     In August 2012, John was
    diagnosed with Dissociative Disorder, which included rapid personality changes
    and intense outbursts.       The psychiatrist recommended trauma-based
    psychotherapy and that he be taught behavioral management skills.
    James was diagnosed with encopresis (fecal incontinence).       He also
    displayed behavioral problems at school.
    In December 2013, the Division received a referral Mary was not
    following through with services for the children. James's school also reported
    A-3876-17T2
    6
    an incident resulting from his incontinence. Mary agreed to take James to a
    specialist.
    In January 2014, the Division received a referral from John's school
    reporting that C.C. hit one of the older boys with a shoe. Around this time, John
    was suspended from school because of his behavior. When he returned he was
    placed in a class for emotionally disturbed children.
    In March 2014, FPS terminated services to the family after twenty-one
    sessions due to a "consistent lack of motivation" on Mary's part.        Shortly
    thereafter, Mary and C.C. signed a case plan agreeing to comply with
    psychological evaluations for the children. In May 2014, Mary was hospitalized
    after she and C.C. broke up. C.C. left the residence for good four months later.
    The Division executed a Dodd 3 removal in late October 2015. John and
    James were placed in separate resource homes. James's initial resource family
    could not cope with caring for him because of his incontinence and behavioral
    issues. In late 2015, he was placed with the resource parents who have since
    been awarded custody.
    3
    A Dodd removal is an emergent removal of a minor child without a court order
    pursuant to N.J.S.A. 9:6-8.21 to -8.82, known as the Dodd Act. N.J. Div. of
    Youth & Family Servs. v. P.W.R., 
    205 N.J. 17
    , 26 n.11 (2011).
    A-3876-17T2
    7
    John was diagnosed with Disruptive Mood Dysregulation Disorder
    (DMDD) with Posttraumatic Stress Disorder (PTSD) symptoms.               He was
    prescribed Risperdal to stabilize him, but he was removed from his first resource
    home because of his violent behavior. He was then placed with Kids Peace, an
    in-patient psychiatric facility. He was discharged about two months later and
    placed in a treatment home. In November 2017, he was placed with James in
    the same resource home.
    Mary testified she had no further contact with Carl after obtaining the
    restraining order. She testified she had "intense" therapy after the incident with
    Carl but began having panic attacks in May 2012. She completed a program for
    victims of domestic violence that reduced the frequency of the panic attacks.
    A case worker visit in February 2014 revealed clothes all over the floor,
    dirty dishes in the sink, and garbage in the residence that caused an odor. The
    Division provided Mary with wardrobes and dressers for the clothes. In mid-
    2014, Mary switched to the first shift at Wawa in order to care for the children
    after school, reducing her income. Facing eviction for non-payment of rent,
    Mary abandoned the apartment. The Division placed the family in motels for
    the next two months.      During this period the case worker had difficulty
    A-3876-17T2
    8
    contacting Mary despite buying her a phone. Mary was not cooperative in
    keeping therapy appointments.
    In November 2014, Mary agreed to participate with FPS and Family
    Promise, a homeless prevention program, but missed numerous scheduled
    appointments with FPS. Mary lost her job at Wawa in January 2015, then found
    a part-time job at a restaurant in April 2015, but quit two weeks later after
    suffering an injury at work.
    In July 2015, Mary applied for and received food stamps, general cash
    assistance, and Medicaid. The food stamps were withheld after she did not
    attend scheduled social services appointments. Mary rejected the Division's
    offer of counseling and summer camp for the children.          Mary told her
    caseworker that neither she nor the children needed therapy and she was
    frustrated by the whole situation.
    School principal Christina Lauck testified that when James was first
    enrolled in 2015, he would often shut down and become non-communicative,
    and was often incontinent. It was difficult to contact and communicate with
    Mary regarding James's emotional issues or anything to do with school,
    including sending clothes and pull-ups for James. Soiled clothes sent home from
    school would still be in James's backpack when he returned the next day.
    A-3876-17T2
    9
    In September 2015, Mary was again facing eviction. Attempts to contact
    Mary regarding her housing issue were unsuccessful. In late October 2015,
    Mary sought housing assistance from the County Board of Social Services after
    being homeless for several weeks. The Division executed a Dodd removal of
    all four children. Mary testified she was reluctant to permit the boys to be given
    psychotropic medication because she previously had a bad reaction when she
    was taking them. The Division obtained a court order to place John on the
    medication.
    James "blossomed" when he was placed in the current resource home ,
    according to Lauck. He went from a student who could barely write three or
    four sentences to receiving an award for an essay he wrote. He also improved
    emotionally and in social relationships with other students.       Unfortunately,
    things changed for the worse when weekend visitations with Mary began in
    January 2017.      Lauck stated James began regressing emotionally and
    behaviorally, and the fecal incontinence returned. By September 2017, after the
    visitations ended, James was "completely different," engaging in school
    activities in a meaningful way.
    In July 2016, Mary obtained an apartment. She began receiving therapy
    in January 2017. She was promoted to night shift manager at Wawa in May
    A-3876-17T2
    10
    2017, and testified she had friends who were able to watch the older boys while
    she was at work.
    School social worker Amanda Matlee testified for Mary. She began
    counseling James at the start of the 2016-2017 school year. James was living in
    the resource home at the time. Matlee testified James's behavior began to
    deteriorate in the spring of 2017. This coincided with the Division's change of
    goal from termination of parental rights to reunification.     Matlee wrote in
    James's Individualized Education Program: "This uncertainty is resulting in a
    regression of [James's] behavior at school with multiple episodes of him shutting
    down for extended periods of time."
    The resource mother testified James was placed with her in December
    2015, and John joined in November 2017. She had three other adopted children
    who were teenagers. She stated James's incontinence ended between the time
    he was first placed with her and January 2017. Initially, James would have
    "three and four-hour long meltdowns," but this subsided over time. The resource
    mother used relaxation techniques to help James. She related James started
    playing soccer and doing other outdoor activities.
    Although James was initially excited when overnight visits with Mary
    began in January 2017, he started getting nervous as the visits approached and
    A-3876-17T2
    11
    resumed soiling himself. When the resource mother picked him up after the
    weekend visitations, James "looked a mess," and was very tired. He also began
    falling behind on school assignments and his behavior at school worsened.
    James told her the boys played video games all night keeping him awake. In
    addition, a cat kept waking him up and the boys fought a lot. The incontinence
    ended when the visits stopped.
    Amanda Mayberry, a new case worker, testified Mary worked the night
    shift on weekends and would sleep all day. James told the case worker he was
    afraid to go on visitations because his brothers would hit and kick him. John
    told her he argued a lot with his two older brothers and they were "physical"
    towards James. Mayberry also stated James began "shutting down" at school
    and John became "increasingly aggressive."       She stated these behaviors
    "decreased pretty significantly" after the weekend visitations stopped.
    Mayberry also testified Mary used babysitters who were not approved by the
    Division.
    Mayberry experienced difficulty contacting Mary. During one visit, Mary
    "completely ignored [her] existence." In May 2017, the Division again provided
    rent assistance. Mayberry described Mary as being "compliant off and on" with
    FPS and Families First.
    A-3876-17T2
    12
    John spent a few weeks at the resource home with James in the summer
    of 2017. After his placement in November, John adjusted well but had "ups and
    down[s]." By the time of trial, John was doing well in school and was in therapy.
    The resource mother testified she wanted to adopt James and her goal was to
    adopt John as well. She said gaining John's trust was a challenge but "everybody
    had been working very well with him." Significantly, the resource parents
    favored continued contact between John and James and Mary and their older
    brothers after adoption.
    In September 2017, the Division received a referral that the two older
    children were home alone. A Division special response worker found the boys
    unsupervised leading to a Dodd removal of the two boys.           Regarding the
    incident, Mary testified the man she was dating was in the house watching the
    boys when she left for work.
    The Division sought to terminate Mary and Carl's parental rights after
    John and James were placed in resource homes, off and on, for nearly two years
    due to Mary's psychological and housing issues, as well as the boy's emotional
    and behavioral problems.
    Mary testified she would be able to take care of John and James and meet
    their needs. She acknowledged the boys were "doing very well" in the resource
    A-3876-17T2
    13
    home and that it was "great" the resource parents took the time to work with
    them. Mary stated she would want to see John and James and would work with
    the resource parents if they were allowed to keep the boys.
    Dr. Santina conducted a psychological evaluation of Mary; interviews of
    John, James, and the resource mother; and bonding evaluations of the boys with
    Mary and the resource parents.      She found that Mary "has no record of
    responsible or stable independent social or financial or emotional functioning"
    and exhibited extreme levels of denial. In her report, Dr. Santina opined:
    It is my professional opinion that [Mary] has exhibited
    a pervasive lack of emotional engagement, commitment
    or protectiveness towards her children. They have
    suffered from physical abuse, witnessing domestic
    violence, emotional neglect and homelessness because
    of [Mary's] lack of responsible or responsive parenting.
    During this evaluation, [Mary] took no responsibility
    for her children's distress or the living conditions that
    traumati[z]ed them. She displaced responsibility onto
    her romantic partners, [the Division] and others. She
    denied documented failures on her part to address her
    problems or those of the children. She expressed the
    belief that there were no justifiable concerns by the
    Division that led to the removal of the children.
    Dr. Santina pointed to Mary's failure to supervise the children during the
    weekend visitations, and opined Mary:
    presents as an egocentric woman who lacks empathy or
    a sense of responsibility towards others, including her
    children. She lacks willingness to examine her own
    A-3876-17T2
    14
    behaviors that have led to her children suffering in
    various ways in her care. She has repeatedly abdicated
    her parental relationships and responsibilities and
    depended on others for the care of her children. She
    expected others to perform the care for her children that
    she herself resented.
    Dr. Santina testified Mary failed to protect the children from men she was
    involved with. In addition, she had a personality disorder with narcissistic
    features, including an inability to take responsibility and to empathize. Dr.
    Santina concluded Mary was not "currently capable of providing safe and
    effective parenting for [John] and [James]. . . and is unlikely to become a safe
    and effective caregiver in the foreseeable future." She added:
    [Mary] has been repeatedly noncompliant with services
    and shows no genuine motivation to address her
    personal and parental shortcomings. She exhibits no
    empathy or real concern for her sons. [T]here is a high
    likelihood that she will repeat past harmful emotional
    and behavioral patterns that would expose them to
    residential instability, emotional deprivation, social
    neglect and lack of appropriate supervision.
    In her bonding evaluations, Dr. Santina found that both John and James
    had emotional attachments to Mary, but her interaction with the boys was largely
    activity-oriented, with very little emotional communication or guidance. Dr.
    Santina described the session as "benign but superficial and limited;" however,
    A-3876-17T2
    15
    she did not see any "overt concerns." She concluded the boys were attached and
    bonded to Mary, but that did not outweigh Mary's parental defects.
    Dr. Santina found the interaction between the boys and the resource
    parents was quieter and less spontaneous than their interaction with Mary.
    James displayed a strong positive attachment to the resource parents. Since John
    was recently placed in their home, he had not yet formed a strong attachment to
    them.    He responded positively to the resource parents and "emotional[ly]
    communicated with them." "No concerns were noted in the interactions between
    the resource parents and the boys." Dr. Santina found the boys' interaction with
    the resource parents "was more emotionally involved" than with Mary.
    John told Dr. Santina he liked living with the resource parents and
    reuniting with James. He expressed sadness about being separated from Mary
    and said he wanted to live with her. James told Dr. Santina he liked living with
    the resource parents. "When asked his feelings about when he lived with his
    mother, he appeared tense and stated in a terse tone, 'good.'" He also stated that
    he looked forward to his weekly visits with Mary and he "sometimes misses
    being with her and would like to live with her."
    A-3876-17T2
    16
    Dr. Santina concluded both boys "presented as emotionally fragile," and
    Mary was not capable, or not motivated, to address those emotional needs. As
    to the resource parents, Dr. Santina stated:
    While it is unlikely that [John] has yet established a
    strong attachment to his new resource parents, the
    resource parents presented as capable of facilitating his
    growth and healing, as they have done with [James].
    The resource parents presented as capable of
    amelioration [of] any distress that the boys may
    experience if their mother's parental rights were
    terminated.    It is my professional opinion that
    termination of [Mary's] parental rights would not do
    more harm than good.
    Dr. Santina concluded it was in the boys' best interests to terminate Mary's
    parental rights and permanently place John and James with the resource parents.
    Although the boys would be "sad" about the termination, she opined the security
    and stability provided by the resource parents, as well as their capacity to relate
    to the boys, would ameliorate any harm that might result. Dr. Santina believed
    that even if this placement were not to succeed, "it would be potentially harmful"
    for John to return to living with Mary.
    Ilona Giordano testified for the Division as an expert in counseling. She
    began counseling James in December 2015. Giordano found the manner in
    which the resource parents managed James's issues on a day-to-day basis was
    significant, noting they calmed James and helped him through his issues. The
    A-3876-17T2
    17
    counseling appeared successful; by January 2017, James's incontinence resolved
    and he seemed happier.
    After James's overnight visitations with Mary started in January 2017, he
    began to shut down in therapy and became more anxious, according to Giordano.
    In addition, his incontinence returned. He told Giordano he was nervous going
    on the visitations because of his older brothers and a lack of supervision. After
    the visitations ended, James became less withdrawn and more verbal. Giordano
    concluded James would thrive and succeed if he remained in the resource home.
    Giordano began treating John in December 2017. He exhibited temper
    tantrums and emotional shutdowns.       While he had difficulties engaging in
    therapy, Giordano testified John was slowly improving with each session.
    Dr. Miller testified for the Division as an expert in clinical psychology.
    He first evaluated Mary in May 2016.         Dr. Miller stated Mary appeared
    "inhibited, depressed, and exhausted" and exhibited "very little knowledge of
    the children" other than "superficial knowledge." She could tell Dr. Miller little
    of their friendships, favorite activities, and performance in school. Dr. Miller
    believed Mary, because of her childhood trauma involving her father's
    abusiveness and her mother's psychiatric problems, was unable to protect herself
    or her children from the abusive men with whom she partnered. He found Mary
    A-3876-17T2
    18
    presented symptoms of PTSD from the abuse she suffered from Carl, including
    significant sleep disturbance, hyperarousal, and avoidance. This resulted in
    Mary's pattern of dismissing or minimizing risks to the children.
    Dr. Miller found Mary was unable to make her children's needs her
    primary concern. In addition, she was unable to cope with her stress and anxiety.
    As a result, Dr. Miller concluded her parental judgment was severely
    compromised and she was unable to provide a safe and stable parenting
    environment for her children. Dr. Miller concluded treatment for Mary's PTSD
    would take three to five years and require a commitment on her part.
    Dr. Miller also evaluated Mary in October 2017. He found she was more
    exhausted, more depressed, and more inhibited emotionally than in the prior
    evaluation. She was working the night shift and only sleeping two to three hours
    during the day. She told him she was overwhelmed and tired all the time. She
    also stated she took anti-depressive medications, but stopped because she did
    not like the way they made her feel.
    Dr. Miller found Mary's explanation for John and James's removal evasive
    and inconsistent. She could not provide him with a plan to address her PTSD
    and sleep problems if she was reunified with the boys. He found Mary "seemed
    to systematically reject any kind of help." He also found John and James's
    A-3876-17T2
    19
    "resilience" would be undermined should they be returned to Mary's care, and
    they would suffer a "severe regression" and lose the progress they had made.
    He deemed Mary unable to address their special needs.
    Dr. Miller conducted a bonding evaluation of Mary and the two boys. He
    said it was clear the boys loved her and there was a secure attachment but he
    failed to see the type of parenting behavior on Mary's part that would support
    them going forward.
    Dr. Miller also conducted a bonding evaluation with the resource parents
    and found they appeared responsive to the boys' emotional needs and were
    collaborating with treatment providers. Dr. Miller found an emotional bond
    between James and the resource parents. The resource mother told him they
    were reticent about adopting John because of his violent history.
    Dr. Miller concluded the boys would suffer no enduring harm from the
    termination of Mary's parental rights because the resource parents would be able
    to mediate the effects. He opined the "least detrimental outcome in this case"
    was for James and John to remain in the care of the resource parents. Dr. Miller
    thought there would be no short-term harm if John and James remained in
    contact with Mary while living with the resource parents.
    A-3876-17T2
    20
    Dr. Miller believed John should not be returned to Mary's care even if the
    resource parents ultimately decided they could not adopt him. In that event,
    termination of Mary's parental rights would still not do more harm than good
    because Mary was a "risk factor" in John's life and because she did not have the
    energy or persistence to parent him effectively.
    Psychiatric advanced registered nurse practitioner Rosemarie Marcus
    testified for the Division as an expert in field of psychiatry relating to psychiatric
    evaluations, psychotropic medication, and remediation. She stated John was
    placed on Risperdal for DMDD that manifested itself by his hitting and kicking
    other children at school and breaking things. He was subsequently placed on
    Zoloft for depression and anxiety. She stated his mood and behavior changed
    after a month on the medications.          Marcus testified John had a "severe
    meltdown" in May 2017 when he learned he was not going to live with Mary,
    but his older brothers were.      Over time he started to look forward to the
    possibility of reuniting with James in a resource home.
    Dr. Reynolds testified on Mary's behalf as an expert in clinical
    psychology. He stated Mary and Carl had an abusive relationship that caused
    Mary's PTSD. Dr. Reynolds claimed John had a more aggressive behavior
    A-3876-17T2
    21
    pattern after he was removed from Mary's care. He described John and James
    as exhibiting some regressive behaviors in their overnight visitations with Mary.
    Dr. Reynolds described Mary as cooperative during her evaluation. He
    did not find her to be tired or depressed. He found her to be informed about the
    children and motivated to parent them, but acknowledged she had a very limited
    peer support system.
    Dr. Reynolds rejected Dr. Santina's conclusion that Mary was egocentric.
    He found Mary generally used appropriate parental strategies and skills when
    the children became unruly. His psychological testing did not reveal any clinical
    concerns.    He concluded Mary would have benefitted from a more
    individualized approach to therapy.         He described Mary's commitment to
    parenting as "unequivocal" but recognized she was likely to become
    overwhelmed when forced to deal with ordinary stress.
    Based on his bonding evaluation between Mary and the children, Dr.
    Reynolds found the boys "internalized" Mary as their mother, she was very
    supporting and nurturing towards them, and they appeared to feel safe and secure
    with her. He also found the boys internalized each other as siblings, and viewed
    themselves as part of a family unit.
    A-3876-17T2
    22
    Dr. Reynolds described the boys' bonding with the resource mother as
    "positive." In his view, the boys seemed to be doing very well in the resource
    home and exhibited a level of comfort and feelings of safety with her. He
    concluded the boys viewed the resource mother more as a trusted caregiver than
    a parental figure; yet found it "likely" the boys "would continue to develop a
    close relationship with her over time if they were to remain in that placement ."
    Dr. Reynolds concluded that if contact with Mary ended, the boys would
    suffer severe and enduring harm. On the other hand, regular and meaningful
    contact with Mary would mitigate that harm even if the boys remained in the
    resource home.
    Dr. Reynolds blamed the boys' regressive behavior during the weekend
    visitations with Mary on anxiety and stress. He characterized Dr. Santina's
    description of Mary as socially and emotionally dependent as a personal
    judgment rather than a psychological opinion. Dr. Reynolds recognized it was
    "certainly possible" the boys "may regress" if they returned to living with Mary
    and their older brothers, yet believed the prognosis for successful reunification
    would be "quite high" if ongoing family therapy services remained in place.
    A-3876-17T2
    23
    Based on her review of the evidence, Judge Suh determined the Division
    proved all four prongs of the best interests standard by clear and convincing
    evidence.
    With respect to prong one, the judge found Mary was emotionally
    neglectful towards the children "because her untreated mental condition
    negatively impacted her parenting capabilities. She lacked insight into the
    children's problems and did not recognize [John] and [James's] special needs.
    [John] and [James] experienced multiple layers of emotional vulnerability, and
    the emotional damage to them because of [Mary's] disengagement was
    palpable." The judge also cited Mary's failure to respond to requests from the
    Division and the schools regarding John: "When [Mary] finally consented to his
    prescribed medications, it was doubtful that she regularly dispensed it to him.
    When the school sent consent forms to [Mary], she did not respond. . . . As a
    result of [Mary's] inaction, [John's] medical needs were delayed." As to James,
    the judge found Mary's refusal to acknowledge or treat his anxiety-induced
    incontinence caused James significant emotional and physical harm.
    As for prong two, the court found:
    Because of their special needs, [John] and [James]
    require a high level of parenting that [Mary] has not
    been able to provide. No doubt, [Mary] loves John and
    James. But their behavioral problems require a
    A-3876-17T2
    24
    proactive parent who can provide stability and
    consistency, and ensure their safety. They need their
    medical and emotional needs met, a responsible adult
    to supervise them at night, and most importantly, a
    mother who can take care of her own mental health so
    she can take care of theirs.
    The judge noted the children experienced housing instability while in
    Mary's care, including three instances of homelessness.          They lived in a
    homeless shelter for several months, and were subject to threats of eviction due
    to non-payment of rent. In addition, Mary refused to cooperate with various
    social services agencies that offered to provide her with assistance to stave off
    eviction, including the Division, Family Promise, and Work First. The judge
    acknowledged Mary lived in the same residence since July 2016, thereby
    addressing the harm facing the children from the previous housing instability.
    As for Mary's mental health, the judge noted Mary refused to participate
    in cognitive based therapy despite being diagnosed with PTSD, depression,
    anxiety disorder, and a personality disorder with narcissistic and dependent
    features. As a result, she "has not been able to cure, remediate, or treat . . . her
    mental illness." In addition, Mary denied the severity of her mental health
    issues. Therefore, she "has shown no ability or inclination to become a more
    responsible parent."    The judge found Mary's refusal to treat her mental
    conditions negatively impacted her parenting capabilities, rendering her unable
    A-3876-17T2
    25
    to care for the children's special needs.    While recognizing Mary's current
    employment and housing, the judge determined she had not "remediated the
    principal harm that led to [John and James's] removal." Therefore, "[d]espite
    the Division's efforts to assist" Mary, Judge Suh concluded "there was no
    evidence that a second attempt at reunification would succeed given her
    unyielding position."
    As to the third prong, Judge Suh found the Division made reasonable
    efforts to help Mary correct the circumstances that led to the removal of the
    children. The judge noted the Division connected Mary with various service
    providers to both help avoid removal of the children and to facilitate potential
    reunification. Mary "failed to follow through with the requirements of the
    programs or failed to make herself available for the providers." Specifically,
    she "repeatedly failed to return phone calls, failed to appear for appointments,
    failed to answer the door when caseworkers or service providers arrived, and
    failed to respond to school personnel or to letters sent to the home by
    caseworkers." In addition, the Division paid for a motel and numerous services
    for the children. Judge Suh concluded "[t]he Division consistently endeavored
    to remove or ameliorate the circumstances that necessitated its intervention with
    [Mary]."
    A-3876-17T2
    26
    Judge Suh concluded the Division explored alternatives to termination of
    parental rights to no avail. The "relative resources" provided by Mary and the
    paternal grandmother did not wish to be considered and efforts to contact Carl
    were unsuccessful.
    The judge also determined that termination of Mary's parental rights
    would do no more harm than good "if regular and continued contact" between
    James and Mary were maintained. Even though there was a "secure attachment
    and affectionate bond" between the children and Mary, James recognized that
    placement with his current resource parents offered him a stable, safe, and
    secure home. Unlike Mary, the resource mother was "fully knowledgeable about
    [James's] needs," and had the willingness and the ability to effectuate the
    treatment plan recommended for him. In the care of the resource parents,
    "[James] is able to function as a normal child, something he did not experience
    when he lived with [Mary]."      The judge found Mary was not capable of
    providing the same structure at her home:
    To provide the same level of care, [Mary] would have
    to do more than love her children. She would have to
    engage fully in parenting, both physically and
    emotionally. To date, [Mary] has not shown that she is
    capable of this high level of engagement. She works
    nights and sleeps three hours when she returns home
    and tries to catch up with sleep on weekends. She is
    depleted when she walks in the front door. [Mary] has
    A-3876-17T2
    27
    managed to provide shelter and food . . . for the
    children, but not much more. Because of their intense
    special needs, [John] and [James] need more than an
    adult who manages the household video game schedule.
    As to John, the judge found there was an "emerging positive bond" with
    the resource parents. In addition, John expressed his wish to live with James
    and his behavior in the resource home "has remained stable." The judge also
    found John's prognosis for success with the resource family to be "guardedly
    positive." Judge Suh concluded:
    At the present time, the children's needs are being
    met. They are receiving medications and therapy that
    they desperately need. The children are cared for by
    resource parents who are empathetic, attuned to, and
    invested in both [John] and [James's] well-being. Dr.
    Santina opined, and this court accepts, that because of
    the lack of progress made by [Mary], it would be risky
    and potentially harmful to return [John] and [James] to
    their mother . . . . There is a very high risk that the
    children would regress emotionally and behaviorally in
    the care of [Mary]. The court concludes that with the
    promise of continued contact between [John] and
    [James] and [Mary] and their other brothers, severance
    of the legal bond between [John] and [James] and
    [Mary] would not do more harm than good.
    Judge Suh entered a judgment terminating Mary's parental rights to John
    and James, and the children were placed in the guardianship and control of the
    Division. This appeal followed.
    A-3876-17T2
    28
    Mary does not challenge prongs one and three of the four-prong test for
    termination of parental rights. Instead, she raises the following issues:
    I.   THE TRIAL COURT ERRED IN ITS
    CONCLUSION THAT [MARY] WAS UNWILLING
    OR UNABLE TO ELIMINATE THE HARM FACING
    HER SONS, WHEN SHE PARTICIPATED IN
    MULTIPLE EVALUATIONS, OBTAINED STABLE
    AND SUITABLE HOUSING, MAINTAINED
    EMPLOYMENT, ATTENDED THE MAJORITY OF
    VISITATION,  MAINTAINED     A    STRONG
    ATTACHMENT    BOND,   AND     EVIDENCED
    UNDERSTANDING     OF  HER    CHILDREN'S
    DISORDERS.
    II. THE TRIAL COURT ERRED IN ITS
    CONCLUSION    THAT   TERMINATION  OF
    [MARY'S] PARENTAL RIGHTS WILL NOT DO
    MORE HARM THAN GOOD, WHEN HER SONS
    DEVELOPED AND MAINTAINED A STRONG
    ATTACHMENT BOND WITH THEIR MOTHER,
    WHICH IF SEVERED, WOULD CAUSE SEVERE
    AND ENDURING HARM, AND POSSIBLY
    RENDER JOHN A LEGAL ORPHAN.
    "Appellate review of a trial court's decision to terminate parental rights is
    limited, and the trial court's factual findings 'should not be disturbed unless they
    are so wholly unsupportable as to result in a denial of justice.'"            In re
    Guardianship of J.N.H., 
    172 N.J. 440
    , 472 (2002) (quoting J.T., 
    269 N.J. Super. at 188
    ). We give substantial deference to the family court judge's special
    expertise and opportunity to have observed the witnesses firsthand and evaluate
    A-3876-17T2
    29
    their credibility. N.J. Div. of Youth & Family Servs. v. R.G., 
    217 N.J. 527
    , 553
    (2014). Even where a parent alleges "error in the trial judge's evaluation of the
    underlying facts and the implications to be drawn therefrom," deference must be
    afforded unless the judge "went so wide of the mark that a mistake must have
    been made." N.J. Div. of Youth & Family Servs. v. M.M., 
    189 N.J. 261
    , 279
    (2007) (first quoting J.T., 
    269 N.J. Super. at 189
    ; then quoting C.B. Snyder
    Realty, Inc. v. BMW of N. Am. Inc., 
    233 N.J. Super. 65
    , 69 (App. Div. 1989)).
    Guided by these standards, we conclude Judge Suh's factual findings are
    supported by substantial, credible evidence in the record, and her legal
    conclusions are sound.
    As to the second prong, Mary contends she established she was able to
    alleviate the harm she posed to John and James by maintaining a job and an
    apartment throughout the trial.    In addition, she claims she participated in
    numerous psychiatric and bonding evaluations and provided counseling for the
    boys. We are unpersuaded by these arguments. Substantial, credible evidence
    in the record supports the judge's conclusion Mary was unable to alleviate the
    psychological issues that posed a threat of harm to John and James.
    As to the fourth prong, Mary contends termination of her parental rights
    would do John and James more harm than good based on the experts' conclusion
    A-3876-17T2
    30
    that they had a secure attachment and strong emotional bond with her. Mary
    also argues the Division failed to establish removal of the boys from the resource
    home would cause severe and enduring harm. In addition, she points to evidence
    that John lacked a strong emotional attachment with the resource parents, and
    the resource parents had not definitively decided they wanted to adopt him.
    "The question ultimately is not whether a biological mother or father is a
    worthy parent, but whether a child's interest will be best served by completely
    terminating the child's relationship with that parent." N.J. Div. of Youth &
    Family Servs. v. E.P., 
    196 N.J. 88
    , 108 (2008). The fourth prong does not
    "require a showing that no harm will befall the child as a result of the severing
    of biological ties." K.H.O., 
    161 N.J. at 355
    . Rather, the issue "is whether, after
    considering and balancing the two relationships, the child will suffer a greater
    harm from the termination of ties with her natural parents than from the
    permanent disruption of her relationship with her foster parents." 
    Ibid.
     That
    decision "necessarily requires expert inquiry specifically directed to the strength
    of each relationship." 
    Ibid.
     (quoting J.C., 
    129 N.J. at 25
    ). Relying on the expert
    opinions she found more convincing and persuasive, the judge concluded that,
    on balance, terminating Mary's parental rights would not cause more harm than
    good.
    A-3876-17T2
    31
    Mary points to the resource family's lack of definitiveness as to whether
    they will adopt John. "[T]erminating parental rights without any compensating
    benefit, such as adoption, may do great harm to a child." E.P., 
    196 N.J. at 109
    .
    The permanency plan calls for the resource parents to adopt John, and the
    resource mother testified that was her goal. In the event they decide not to adopt,
    Mary may file a motion for relief from judgment under Rule 4:50-1(e) based on
    changed circumstances. J.N.H., 
    172 N.J. at 472-74
    . In determining such a
    motion, the primary issue is "what effect the grant of the motion would have on
    the child." 
    Id. at 475
    . See also N.J. Div. of Youth & Family Servs. v. T.S., 
    417 N.J. Super. 228
    , 249-50 (App. Div. 2010) (trial court directed to reexamine
    record based on post-trial changes in the evidence as to prong four). Therefore,
    any uncertainty as to John's adoption status did not prevent the Division from
    satisfying prong four.
    "It is not our place to second-guess or substitute our judgment for that of
    the family court, provided that the record contains substantial and credible
    evidence to support the decision to terminate parental rights." N.J. Div. of
    Youth & Family Servs. v. F.M., 
    211 N.J. 420
    , 448-49 (2012) (citing N.J. Div.
    of Youth & Family Servs. v. G.L., 
    191 N.J. 596
    , 605 (2007)). "In a termination
    of parental rights trial, the evidence often takes the form of expert testimony by
    A-3876-17T2
    32
    psychiatrists, psychologists, and other mental health professionals." R.L.M.,
    236 N.J. at 146 (citing Lassiter v. Dep't of Soc. Servs., 
    452 U.S. 18
    , 30 (1981)).
    "[W]e rely on the trial court's acceptance of the credibility of the expert's
    testimony and the court's fact-findings based thereon, noting the trial court is
    better positioned to evaluate the witness' credibility, qualifications, and the
    weight to be accorded to [his or] her testimony." In re Guardianship of D.M.H.,
    
    161 N.J. 365
    , 382 (1999) (citing Bonnco Petrol, Inc. v. Epstein, 
    115 N.J. 599
    ,
    607 (1989)).
    Judge Suh reviewed the evidence presented at trial, made detailed findings
    as to each prong of N.J.S.A. 30:4C-15.1(a), and concluded the Division met, by
    clear and convincing evidence, all of the legal requirements for a judgment of
    guardianship. Those findings and conclusions are supported by substantial,
    credible evidence in the record. Contrary to Mary's assertions, the judge's
    analysis of the facts tracks the statutory requirements of N.J.S.A. 30:4C-15.1(a),
    and comports with applicable case law. See, e.g., F.M., 211 N.J. at 447-54; E.P.,
    
    196 N.J. at 103-07
    . We discern no basis to disturb her ruling.
    Affirmed.
    A-3876-17T2
    33