Penny G. v. Dcs ( 2018 )


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  •                         NOTICE: NOT FOR OFFICIAL PUBLICATION.
    UNDER ARIZONA RULE OF THE SUPREME COURT 111(c), THIS DECISION IS NOT PRECEDENTIAL
    AND MAY BE CITED ONLY AS AUTHORIZED BY RULE.
    IN THE
    ARIZONA COURT OF APPEALS
    DIVISION ONE
    PENNY G.,
    Appellant,
    v.
    N.G., H.G.,1
    Appellees.
    No. 1 CA-JV 17-0432
    FILED 2-15-2018
    Appeal from the Superior Court in Yavapai County
    No. P1300JD201200061
    The Honorable Anna C. Young, Judge
    REVERSED; REMANDED
    COUNSEL
    Robert D. Rosanelli, Attorney at Law, Phoenix
    By Robert D. Rosanelli
    Counsel for Appellant
    Law Office of Florence M. Bruemmer, PC, Anthem
    By Florence M. Bruemmer
    Counsel for Appellee Guardian ad Litem
    1     On the court's own motion, it is ordered amending the caption in this
    appeal as reflected in this decision. The above-referenced caption shall be
    used on all further documents filed in this appeal.
    PENNY G. v. DCS, et al.
    Decision of the Court
    MEMORANDUM DECISION
    Presiding Judge Diane M. Johnsen delivered the decision of the Court, in
    which Judge Kent E. Cattani and Judge Jennifer M. Perkins joined.
    J O H N S E N, Judge:
    ¶1           Penny G. ("Mother") argues insufficient evidence supports the
    superior court's order terminating her parental rights to her two children.
    We reverse and remand the severance order.
    FACTS AND PROCEDURAL BACKGROUND
    ¶2             Mother gave birth to twin girls on January 20, 2016.2 The
    twins were born about one month prematurely and had been exposed in
    utero to oxycodone, which had been prescribed to Mother. When the twins
    left the hospital, the Department of Child Safety ("DCS") placed them with
    foster parents. DCS filed a dependency action the next week; Mother began
    submitting samples for drug testing on January 29.
    ¶3            Stephen Gill, Ph.D., performed a psychological evaluation of
    Mother on April 14, 2016. Gill concluded Mother had several substance-
    abuse disorders in reported remission, as well as Bipolar Disorder,
    Attention Deficit Hyperactivity Disorder, Post-Traumatic Stress Disorder,
    antisocial personality traits and an anxiety disorder. On April 26, the
    superior court found the twins dependent as to Mother on the grounds that
    she had neglected the girls because of substance abuse, was unable to
    discharge her parental responsibilities due to mental health issues and kept
    an unfit home. DCS referred Mother for individual counseling, substance-
    abuse assessment, behavioral-health intake, parent aide, parenting classes,
    psychiatric evaluation, urinalysis testing and transportation.
    ¶4           Mother enrolled in a vocational rehabilitation program in
    August 2016 and began working toward a general equivalency diploma.
    She also regularly attended her counseling sessions: According to a letter
    from her therapist dated October 18, 2016, Mother had attended 16 of 17
    2      We view the facts and draw all reasonable inferences in the light
    most favorable to upholding the superior court's order. Jesus M. v. Ariz.
    Dep't of Econ. Sec., 
    203 Ariz. 278
    , 282, ¶ 13 (App. 2002).
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    PENNY G. v. DCS, et al.
    Decision of the Court
    therapy appointments and showed progress by "reducing her own
    perceived victimization and focusing on the overall best for her children."
    At a report and review hearing on October 18, after hearing that Mother's
    drug tests were consistently negative, the court allowed Mother to begin to
    give the twins breast milk during their visits. Gill evaluated Mother again
    on November 3 and concluded that, although she still suffered from
    depression and anxiety, her "stability is greatly increased since she was first
    seen" and she had "clearly worked very hard to stay sober."
    ¶5            In late 2016, the twins, still in foster care, began experiencing
    bouts of "explosive" "recurrent diarrhea" that occurred after their regular
    visits with Mother. On March 28, 2017, the superior court ordered that
    Mother's visitations would occur on three consecutive days each week,
    allowing DCS discretion to increase the amount of her unsupervised
    visiting time. The twins' diarrhea persisted, flaring up only after their
    contacts with Mother, and the problem grew to the point that a pediatrician
    diagnosed the twins with "Failure to Thrive" because of their inability to
    gain weight.
    ¶6           On April 26, the twins' guardian ad litem ("GAL") filed a
    motion to suspend Mother's visits for three weeks, asserting the twins
    continued to experience diarrhea after their visits with Mother. The court
    granted the motion that same day. A week later, at the next regularly
    scheduled report and review hearing, DCS recommended the case plan be
    changed to severance and adoption, and the superior court ordered DCS to
    file a motion for termination. DCS's subsequent motion for termination
    alleged neglect, mental illness and 15 months' time-in-care.          The
    termination hearing was set for August 14, 2017.
    ¶7            Meanwhile, according to medical records dated May 18, three
    weeks after the court suspended Mother's visits with the twins, the diarrhea
    had ceased and they had begun to gain weight. As a result, their
    pediatrician suggested that the twins' contacts with Mother were
    "psychosocial stressors" that had caused the diarrhea and resulting failure
    to thrive.
    ¶8            On June 22, Mother completed her fifth successful substance-
    abuse education course, with the supervisor noting she "fully participates
    in the classes and is a positive influence on her peers." Mother took her
    final recorded drug test on July 26, 2017; other than one positive test for
    alcohol and several diluted tests early in the dependency, each of her drug
    tests since the commencement of the dependency registered negative for
    each substance tested.
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    PENNY G. v. DCS, et al.
    Decision of the Court
    ¶9             At DCS's request, Dr. James Thal, Ph.D., performed a best-
    interests evaluation on June 23. Thal reviewed various DCS records and
    reports, the record of the twins' visit to the pediatrician on May 18, and the
    psychological evaluations Gill performed on April 14 and November 3,
    2016. He also interviewed Mother and the foster parents and observed the
    twins with their foster parents and with Mother. In the section of his report
    labeled "conclusions," Thal wrote:
    The interruption of visits with the mother has had a salutary
    effect on the children, suggesting that the twins primarily
    have a distressed, rather than a healthy and nurturing bond
    with their mother. Their pediatrician reports, and the foster
    parents concur, that the children's steady growth patterns
    have been re-established, seemingly lending strong support
    to the contention that the mother's impact on her children,
    despite her best efforts, have been unfavorable. This
    examiner's findings are consistent with that supposition.
    It is readily apparent that the children are most strongly
    bonded to their foster parents, their primary caregivers for
    virtually all of their lives. It is also apparent that the children
    have a relationship with their mother as well . . . .
    Nonetheless, it is this examiner's opinion that the children's
    best interest would be served by affirming their placement
    through severance and adoption with the current foster
    parents. It would be needlessly risky to disrupt [the girls']
    well-established bonds with their foster parents. That lesson
    seems to have been clearly illustrated by the recent crisis
    involving the children's weight, growth, and failure to thrive.
    Additionally, [Mother] has a long history of significant
    personal, social, and emotional problems which have been
    manifested in severe mental illnesses and significant
    substance use. She carries multiple diagnoses and, while her
    efforts are truly commendable, this is a client who is reporting
    a relatively brief period of abstinence from drugs. The
    mother's resources are quite limited and the challenges of
    caring for twin toddlers are not unsubstantial. The client's
    history appears to be one of not responding well to stressors
    though, again [Mother] is functioning reasonably well at the
    present time. The mother clearly loves her children and her
    efforts at bettering herself are impressive and commendable.
    However, it cannot be concluded that the children, given their
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    PENNY G. v. DCS, et al.
    Decision of the Court
    unique needs, can be successfully parented by [Mother] at this
    time or in the foreseeable future.
    ¶10          At the pretrial conference on August 1, DCS withdrew its
    motion for termination. The record does not contain a transcript of the
    proceeding, but the court's minute entry described DCS's explanation as
    follows:
    The original motion for termination of parental rights was
    filed in good faith, but after further review the Department
    determined it would be in the children's best interests to give
    the mother more time to attempt to reunify because the
    mother has been compliant with her services such as UAs and
    engaging in her classes and other services. She has just fallen
    short of the 15 month mark of where the Department would
    like for her to be. Given additional time, she could reach that
    mark.
    Upon hearing that DCS was withdrawing its termination motion, the GAL
    moved orally to be substituted as the moving party, and the court granted
    the motion. Mother and the GAL then agreed to a "paper trial," at which
    Mother would waive her appearance. Having withdrawn its termination
    motion, DCS asked for leave to have a therapeutic pediatrician review the
    twins' medical records and Mother's psychological evaluation; the court
    responded that such a review did not require a court order.
    ¶11           In a written motion filed August 10, DCS again raised the
    issue of further analysis of the medical records and Mother's psychological
    evaluations; DCS moved for a 45-day continuance to allow it to obtain
    additional documents for use at the approaching "paper trial." DCS argued
    that additional analysis was required "to confirm that the result of these
    proceedings is in keeping with the best interests of the Children."
    Specifically, DCS asked for time to consult with a psychologist to ensure
    that Thal's best-interests analysis "was not too heavily influenced by the
    pediatrician's failure to thrive diagnosis and to consult with a PhD
    regarding visits between Mother and Children." On August 11, before
    either of the other parties responded, the court denied the DCS motion
    without explanation.
    ¶12          At the start of the termination trial on August 14, Mother's
    attorney moved for a continuance to allow the additional assessments DCS
    had proposed, arguing "there's more information needed to get a good
    picture of what's going on before we proceed with a severance trial." Asked
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    PENNY G. v. DCS, et al.
    Decision of the Court
    for their positions about a continuance, DCS supported the request and the
    GAL said she had no objection. Nevertheless, the court denied the motion,
    reasoning that DCS and Mother had had sufficient time after issuance of
    the Thal report on June 23 to seek additional analysis. At the ensuing trial,
    the court heard only one witness, Mother's DCS case manager, who testified
    that Mother was "no longer benefitting" from parenting skills classes, that
    Mother had shown an ability and willingness to provide for the twins, and
    that Mother has "followed through with all of her services."
    ¶13           After taking the matter under advisement, the superior court
    issued an order terminating Mother's rights as to both twins based on all
    three alleged grounds, and also found severance was in the girls' best
    interests. Mother timely appealed, and we have jurisdiction pursuant to
    Article 6, Section 9 of the Arizona Constitution and Arizona Revised
    Statutes ("A.R.S.") sections 8-235(A) (2018), 12-120.21(A)(1) (2018), and
    -2101(A)(1) (2018).3
    DISCUSSION
    A.     General Principles.
    ¶14            The right to custody of one's child is fundamental but not
    absolute. Michael J. v. Ariz. Dep't of Econ. Sec., 
    196 Ariz. 246
    , 248, ¶¶ 11-12
    (2000). The superior court may terminate a parent-child relationship upon
    clear and convincing evidence of at least one of the statutory grounds set
    forth in A.R.S. § 8-533(B) (2018). 
    Id. at 249,
    ¶ 12. Additionally, the court
    must find by a preponderance of the evidence that termination is in the
    child's best interests. Kent K. v. Bobby M., 
    210 Ariz. 279
    , 284, ¶ 22 (2005).
    ¶15             Mother does not contest the superior court's finding that
    termination would be in the best interests of her daughters, but argues
    insufficient evidence supported the court's conclusion that the GAL had
    offered sufficient evidence to satisfy the three statutory grounds for
    termination. "The fundamental liberty interest of natural parents in the
    care, custody and management of their child does not evaporate simply
    because they have not been model parents or have lost temporary custody
    of their child to the state." Santosky v. Kramer, 
    455 U.S. 745
    , 753 (1982). Thus,
    a showing that a natural parent is not the "best" parent is insufficient to
    terminate the parent's rights. See Maricopa County Juv. Action No. JS-6831,
    
    155 Ariz. 556
    , 558 (App. 1988).
    3     Absent material revision after the relevant dates, we cite a statute's
    current version.
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    PENNY G. v. DCS, et al.
    Decision of the Court
    ¶16            We review a termination order for an abuse of discretion.
    Mary Lou C. v. Ariz. Dep't of Econ. Sec., 
    207 Ariz. 43
    , 47, ¶ 8 (App. 2004). The
    superior court abuses its discretion if it commits an error of law. Schickner
    v. Schickner, 
    237 Ariz. 194
    , 197, ¶ 13 (App. 2015). Because the superior court
    is in the best position to "weigh the evidence, observe the parties, judge the
    credibility of witnesses, and make appropriate findings," we will accept its
    findings of fact unless no reasonable evidence supports them. Jesus M. v.
    Ariz. Dep't of Econ. Sec., 
    203 Ariz. 278
    , 280, ¶ 4 (App. 2002).
    B.     Neglect.
    ¶17           A parent's rights may be terminated based on clear and
    convincing proof that "the parent has neglected or wilfully abused a child.
    This abuse includes serious physical or emotional injury or situations in
    which the parent knew or reasonably should have known that a person was
    abusing or neglecting a child." A.R.S. § 8-533(B)(2). The superior court
    found Mother neglected the twins based on evidence that (1) the girls were
    "born substance exposed due to Mother's use of prescription opiates during
    pregnancy" and (2) the girls' diarrhea stopped and they began to gain
    weight after the superior court ended Mother's visits. But neither of these
    conclusions establishes neglect.
    ¶18            As for the court's first finding, neglect may be established
    upon proof of a "determination by a health professional that a newborn
    infant was exposed prenatally to a drug or substance listed in § 13-3401 and
    that this exposure was not the result of a medical treatment administered
    to the mother." A.R.S. § 8-201(25)(c) (2018). The twins were born under the
    influence of oxycodone, which is among the drugs listed in the neglect
    statute. See A.R.S. § 13-3401(21)(dd) (2018). But the only evidence in the
    record is that Mother was prescribed oxycodone at a constant rate of about
    one tablet per day from October 2015 through the end of January 2016;
    Mother's drug tests were negative throughout the dependency.
    Accordingly, in the absence of any evidence that the twins' exposure to
    oxycodone "was not the result of a medical treatment administered" to
    Mother, the court erred by finding neglect based on this ground. See A.R.S.
    § 8-201(25)(c).
    ¶19            Turning to the second basis for the court's finding of neglect,
    such a finding may be made when a parent is unable or unwilling "to
    provide [the] child with supervision, food, clothing, shelter or medical care
    if that inability or unwillingness causes unreasonable risk of harm to the
    child's health or welfare." A.R.S. § 8-201(25)(a). The court here found
    Mother neglected the twins because "the children suffered from diarrhea
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    PENNY G. v. DCS, et al.
    Decision of the Court
    after being with their Mother," and after the "pediatrician recommended
    Mother's visits stop . . . the children's diarrhea stopped and they began to
    gain weight at a satisfactory rate."
    ¶20            Failure to thrive risks harm to a child's health or welfare. See
    A.R.S. § 13-3623(F)(4) (2018) (defining "[p]hysical injury" as including
    "failure to thrive"). The record before the superior court, however, does not
    contain sufficient evidence to support the conclusion that Mother caused
    the twins' diarrhea and resulting failure to thrive.
    ¶21            The court based its finding on reports of two visits the twins
    made to the pediatrician, the first on April 25, 2017, and the second on May
    18, 2017. In the April record, the pediatrician wrote that the girls' repeated
    bouts of diarrhea were of an "unknown etiology," and that the twins had
    "normal labs," "negative celiac testing and negative food allergy panel." The
    pediatrician also recorded that one of the girls "did seem to improve some
    when dairy was avoided." The pediatrician observed that it was doubtful
    that the diarrhea was caused by infection, and concluded, "At this point, I
    feel we must consider psychosocial stressors as cause." The pediatrician
    added, "Perhaps the ongoing back and forth [of visits between Mother and
    the foster parents] or just visit [sic] alone are very stressful for [the child]
    resulting in [failure to thrive] and diarrhea." When the girls visited the
    pediatrician in May, it had been three weeks since their last visit with
    Mother, and their diarrhea had ceased. From that, the pediatrician seemed
    to conclude that stress from visits with Mother had caused the diarrhea,
    writing, "I feel that the results of these last 3 weeks proves that visitations
    with biological mother are NOT in the best interest of this child. . . . The
    girls are now thriving and doing extremely well [so] re-introducing that
    stressor may have devastating consequences."
    ¶22           The medical records in evidence do not reflect the results of
    any tests or analysis supporting the court's conclusion that Mother was
    doing something during her visits to cause the girls' diarrhea. After the
    visits ceased and the twins began gaining weight, the pediatrician simply
    assumed that Mother was the cause of the diarrhea without recommending
    any further tests or attempting to explain why diarrhea of unknown
    etiology began and ended as it did. The pediatrician earlier had
    recommended to DCS and the twins' foster parents "that a strict stool diary
    should be kept." The record contains no evidence that the pediatrician's
    recommendation was pursued. More to the point, the pediatrician did not
    testify at the termination trial, and the GAL did not offer any medical
    opinion to a reasonable degree of medical certainty or probability that
    Mother was causing the girls' diarrhea. See In re MH 2007-001236, 
    220 Ariz. 8
                              PENNY G. v. DCS, et al.
    Decision of the Court
    160, 169, ¶ 29 (App. 2008) (clear and convincing evidence of medical issue
    requires "evidence expressed to a reasonable degree of medical certainty or
    probability"); State v. Renforth, 
    155 Ariz. 385
    , 387 (App. 1987) ("The clear and
    convincing standard is reserved for cases where substantial interests at
    stake require an extra measure of confidence by the factfinders in the
    correctness of their judgment, though not to such degree as is required to
    convict of crime.") (emphasis added).
    ¶23           Although post hoc ergo propter hoc ("after this therefore because
    of this") may constitute some evidence of causation, under these
    circumstances, proof of causation requires more than supposition.
    "Reasoning post hoc, propter hoc is a recognized logical fallacy, a non
    sequitur. But sequence of events, plus medical proof of possible causal
    relation, may amount to proof of probable causal relation, in the absence of
    evidence of any other equally probable cause." Breidler v. Indus. Comm'n, 
    94 Ariz. 258
    , 262 (1963) (alteration and emphasis in original omitted and
    emphasis added) (quoting Charlton Bros. Transp. Co. v. Garrettson, 
    51 A.2d 642
    , 646 (Md. 1947)); Hackworth v. Indus. Comm'n, 
    229 Ariz. 339
    , 344-45, ¶ 16
    (App. 2012) ("This point of logic [that post hoc is a fallacy] is well accepted
    in our case law.").
    ¶24          Finally, even accepting the validity of the pediatrician's
    conclusion that the twins' diarrhea was caused by stress from their visits
    with Mother, the court erred by failing to consider whether that stress could
    be remediated short of severing Mother's parental rights. In seeking a trial
    continuance, DCS explained it wanted to obtain an opinion from a
    psychologist about the visitation issue. See 
    11 supra
    . Such evidence might
    have been directly relevant to resolving the children's stress, if indeed that
    was the cause of their failure to thrive.
    C.     Mental Illness.
    ¶25           The superior court also found the GAL had proven by clear
    and convincing evidence that Mother is unable to discharge her parental
    responsibilities because of her mental illness. The court relied on two
    reports for this conclusion: Gill's psychological evaluation of Mother in
    November 2016 and Thal's best-interests assessment of the twins in June
    2017. Neither report reasonably supports the court's finding.
    ¶26           Termination of a parent-child relationship because of mental
    illness requires proof that "the parent is unable to discharge parental
    responsibilities because of mental illness . . . and there are reasonable
    grounds to believe that the condition will continue for a prolonged
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    PENNY G. v. DCS, et al.
    Decision of the Court
    indeterminate period." A.R.S. § 8-533(B)(3). A showing of mental illness,
    by itself, is not enough. Maricopa County Juv. Action No. JS-5209 & No. JS-
    4963, 
    143 Ariz. 178
    , 184 (App. 1984). A movant also must establish by clear
    and convincing evidence that the parent's "mental illness or mental
    deficiency is such that it prevents the parent from discharging parental
    responsibilities. Further, there must also be evidence to support a finding
    that the illness is so severe and substantial that it will continue for an
    extended and indefinite period of time." 
    Id. ¶27 The
    superior court cited Gill's November 2016 psychological
    evaluation of Mother as evidence that "Mother has been diagnosed as
    suffering from a depressive [dis]order and an anxiety disorder." Although
    Gill concluded in November 2016 that Mother suffered from depression
    and anxiety, he did not conclude that those diagnoses would prevent
    Mother from parenting the twins. In his November 2016 report, Gill noticed
    marked improvements in Mother's outlook and mental health during the
    seven months after he first saw her in April 2016: "her stability is greatly
    increased since she was first seen on 4/14/16. She has clearly worked very
    hard to stay sober and is learning about sober parenting and living a sober
    lifestyle over time." And, contrary to the court's finding, Gill also opined in
    November 2016 that if Mother "successfully commits to and completes
    services provided for her by [DCS] to stay sober and create a healthy and
    sober lifestyle, she will likely be able to discharge her parental
    responsibilities." See Marina P. v. Ariz. Dep't of Econ. Sec., 
    214 Ariz. 326
    , 330,
    ¶ 22 (App. 2007) (relevant circumstances supporting severance are those
    circumstances existing at the time of the severance trial).
    ¶28           The court also cited as evidence Thal's opinion that "it cannot
    be concluded that the children, given their unique needs, can be
    successfully parented by [Mother] at this time or in the foreseeable future."
    Thal, however, was not retained to perform a psychological evaluation of
    Mother; nor, according to his report, did he do so. Thal was retained
    instead to perform a best-interests assessment of the twins, specifically
    addressing five questions:
    1. Given the children's current age, emotional and behavioral
    functioning, and the children's history of abuse, neglect, or
    maltreatment and the parent's ability/inability to meet the
    children's needs, is severance and adoption the most
    appropriate permanent plan for the children?
    2. Given the children's current age, emotional and behavioral
    functioning, and the children's history of abuse, neglect, or
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    PENNY G. v. DCS, et al.
    Decision of the Court
    maltreatment and history of placements in this case, is it in
    the best interests of the children to move them . . . to an
    alternative placement (for example, moving the children from
    a foster home to a relative or from one relative to another)?
    3. What is the nature and/or quality of the attachment of the
    children to their siblings/parents/caretaker/significant
    other?
    4. Given the children's current age, emotional and behavioral
    functioning, and the children's history of abuse, neglect, or
    maltreatment and history of placements in this case, is it in
    the best interests of the children to move them . . . to an
    alternative placement (for example, moving the children from
    a foster home to a relative or from one relative to another)?
    Are the children showing symptoms of attachment issues? If
    so, what are the recommended interventions?
    5. Are visits with the mother in the best interest of the
    children?
    ¶29           After reviewing the records, interviewing Mother and the
    foster placement and observing the children with them, Thal concluded that
    "severance and adoption appears to be the permanency plan which is in the
    children's best interests." But Thal's report did not address Mother's
    contemporaneous mental health, let alone its possible effects on her ability
    to discharge her parental responsibilities, the severity of any mental health
    issues Mother faced, or how long they would last.
    ¶30            Termination based on mental illness requires evidence that
    the parent "is unable to discharge parental responsibilities because of
    mental illness." The sentence in Thal's report the court relied upon came at
    the end of a long paragraph in which Thal began by noting that Mother had
    a "long history of significant personal, social, and emotional problems
    which have been manifested in severe mental illnesses and significant
    substance use." Thal then observed that Mother's "resources are quite
    limited" and noted (incorrectly, based on the record in the superior court)
    that Mother had "a relatively brief period of abstinence from drugs." Before
    concluding with the sentence the superior court cited, Thal wrote that
    Mother was "functioning reasonably well at the present time. The mother
    clearly loves her children and her efforts at bettering herself are impressive
    and commendable." In short, Thal did not opine that Mother would not be
    able to successfully parent the children because of mental illness. Instead, he
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    PENNY G. v. DCS, et al.
    Decision of the Court
    apparently came to that conclusion based on a wide variety of
    circumstances he understood to be present with Mother.
    ¶31           Furthermore, the psychological reports on which Thal relied
    (from Gill's April and November evaluations) do not support his
    observation that Mother suffered from "severe mental illnesses" that would
    undermine her ability to parent. Gill's November report in particular
    concluded it was likely that Mother would be able to successfully parent
    the children if she remained committed to services and sobriety. See 
    27 supra
    . The record shows that Mother's drug tests were uniformly negative
    from the time of Gill's November report through the severance trial, and
    the DCS case manager testified that Mother did everything DCS asked of
    her, even after DCS moved to sever her parental rights. In the absence of
    any evidence that Mother had not remained committed to services and
    sobriety, and the presence of evidence to the contrary, the only
    psychological evaluation before the court at the termination trial concluded
    Mother likely would be able to parent the children.
    ¶32           In sum, the record does not reasonably support the superior
    court's finding that Mother's mental illnesses were so severe and substantial
    that they would persist for extended and indefinite periods of time. Nor
    was there reasonable evidence that Mother's mental illnesses prevented her
    from discharging her parental responsibilities. Gill did not render such an
    opinion, and in fact opined to the contrary. Thal was not retained to
    perform a psychological evaluation of Mother and did not do so. His best
    -interests report, to the extent it touched on Mother's mental state,
    contradicted the most recent report of the psychologist who twice evaluated
    Mother.
    D.    15 Months' Time-In-Care.
    ¶33            Termination based on 15 months' time-in-care requires clear
    and convincing evidence that "the child[ren are] being cared for in an out-
    of-home placement," the children have "been in an out-of-home placement
    for a cumulative total period of fifteen months or longer," DCS "has made a
    diligent effort to provide appropriate reunification services," "the parent
    has been unable to remedy the circumstances that cause the child to be in
    an out-of-home placement and there is a substantial likelihood that the
    parent will not be capable of exercising proper and effective parental care
    and control in the near future." A.R.S. § 8-533(B)(8)(c). The "circumstances
    which cause the child to be in an out-of-home placement" are those that
    exist at the time of severance. Marina 
    P., 214 Ariz. at 330
    , ¶ 22.
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    ¶34           Mother does not dispute that the twins were in an out-of-
    home placement for 15 months or longer; nor does she suggest that DCS
    failed to provide appropriate services. Instead, Mother argues there is no
    reasonable evidence to support the superior court's conclusion that she will
    be unable to exercise proper and effective care and control of the twins in
    the near future.
    ¶35           On this point, the superior court relied entirely on Thal's
    statement that "it cannot be concluded that the children, given their unique
    needs, can be successfully parented by [Mother] at this time or in the
    foreseeable future." For the reasons stated above, however, Thal's
    statement is insufficient to constitute clear and convincing evidence that
    "there is a substantial likelihood that the parent will not be capable of
    exercising proper and effective" parental control in the near future. A.R.S.
    § 8-533(B)(8)(c).
    CONCLUSION
    ¶36           For the foregoing reasons, insufficient evidence supports the
    superior court's order severing Mother's parental rights. Accordingly, we
    vacate that order and remand to the superior court for proceedings
    consistent with this decision.
    AMY M. WOOD • Clerk of the Court
    FILED: AA
    13