In the Interest of L.K.M. and C.C.M., Children v. the State of Texas

In The
Court of Appeals
Seventh District of Texas at Amarillo

No. 07-24-00138-CV

IN THE INTEREST OF L.K.M. AND C.C.M., CHILDREN

On Appeal from the 126th District Court
Travis County, Texas1
Trial Court No. D-1-FM-20-002499, Honorable Maria Cantu Hexsel, Presiding

June 12, 2025
MEMORANDUM OPINION
Before QUINN, C.J., and PARKER and DOSS, JJ.

Amy Axtell (Mother) appeals from a final order modifying conservatorship and

possession of her two children with Jason Paul Miller (Father). Through ten issues,

Mother challenges the trial court’s decisions granting Father primary custody and

exclusive decision-making rights while ordering Mother to undergo psychological

evaluations and limiting her to a step-up possession schedule. We affirm.

1 This appeal was originally filed in the Third Court of Appeals and was transferred to this Court by

a docket-equalization order of the Supreme Court of Texas. See TEX. GOV’T CODE ANN. § 73.001. In the
event of any conflict, we apply the transferor court’s case law. TEX. R. APP. P. 41.3.
Background

The Relationship and Divorce

Mother and Father had a relationship spanning over twenty years. Throughout this

period, Mother falsely represented to Father, her parents, and others that she was a

cardiothoracic surgeon when she, in fact, did not hold a license to practice medicine,

medical diploma, or an undergraduate degree.

The parties had two children: L.K.M. was eight and C.C.M. was five at the time of

final hearing. Father filed for divorce in May 2020. When Father discovered two months

later that Mother was not a surgeon, she claimed she had obtained an undergraduate

degree and had attended medical school. In August 2020, the parties signed a mediated

settlement agreement. Father subsequently learned that Mother lacked an

undergraduate degree.

The trial court rendered their divorce in January 2021, signing a decree

memorializing the judgment in August 2021. The decree appointed the parties joint

managing conservators with Mother having the exclusive right to designate the children’s

primary residence. Father received a graduated possession schedule. All remaining

rights were shared jointly, with each parent holding independent decisional rights

concerning “day to day” or “routine” medical issues.

The Children’s Deteriorating Behavior

By fall 2020, Father noticed the children becoming increasingly difficult during

exchanges when Mother was present. They refused to get out of the car or had to be

2
physically removed. Despite Father’s suggestions for counseling, the parties could not

reach an agreement. The tension escalated until May 2021, when L.K.M. struck Father

in the throat during an exchange.

In mid-2021, Mother and Father began co-parenting therapy with Jennifer Knight,

and the children entered counseling with Fiona Ryon. Ryon became concerned about

negative comments L.K.M. made about Father that seemed inconsistent with her

behavior toward him. Father reported to Mother, Knight, and Ryon that the children made

negative comments directly to him. Despite professional intervention, the parties

continued to struggle with communication and co-parenting.

The Custody Modification Battle Begins

On March 1, 2022, Father filed for modification, seeking exclusive rights to

designate the children’s primary residence and make medical, psychological, and

educational decisions. According to the evidence, Father’s modification petition was

driven by the breakdown of his relationship with his daughters, growing concerns about

Mother’s pattern of dishonesty, and their co-parenting difficulties.

The final hearing included evidence from multiple professionals who had

conducted evaluations and assessments of the parties and children.

1. Dr. Baker

In June 2022, the parties agreed to a child custody evaluation by Dr. Kelley A.

Baker, who also served as the children’s guardian ad litem. Dr. Baker conducted a

3
comprehensive evaluation that included reviewing over one hundred documents,

interviewing at least twenty collateral witnesses, and making home visits to both parents.

As part of her investigation, Dr. Baker asked each party to identify their concerns

about the other parent’s ability to parent and their relationships with the children. Father’s

concerns included that Mother engaged in behaviors that negatively impacted his

relationship with the children, misrepresented information about the children’s health, and

continued her pattern of dishonesty in ways that could endanger the children. Mother’s

concerns about Father included allegations that he did not properly feed or bathe the

children, did not emotionally engage with them, and exercised poor judgment when they

were sick.

Dr. Baker found no support for any of Mother’s concerns about Father, opining that

Mother’s alleged concerns were not grounded in reality. Dr. Baker testified this was

concerning because Mother’s distorted thinking puts the children at risk—she may

perceive danger when none exists, believe she needs to protect the children when

unnecessary, and make irrational decisions limiting their contact with Father.

In contrast, Dr. Baker found evidence supporting Father’s concerns that Mother

had engaged in behaviors that negatively affected his relationship with the children:

speaking negatively of Father to the children; withholding educational and medical

information from Father; limiting or interfering with Father’s time with the children; sharing

inappropriate information about the marriage and legal matters with the children; and

causing the children to choose or feel guilty for loving Father. These decisions have the

4
potential to place the children in dangerous situations when Mother fails to convey

medical information correctly or refuses to follow doctors’ orders.

Dr. Baker also documented Mother’s continued false representations during the

lawsuit. Although Mother told Dr. Baker that her parents actually knew she had not, in

fact, graduated from medical school, Dr. Baker discovered through speaking with

Mother’s parents that they still believed she was a doctor. Dr. Baker testified this was

significant because it evidenced Mother’s continued pattern of making false statements

after the divorce was rendered.

Mother also lied to Dr. Baker, claiming she had an undergraduate degree from the

University of Utah. Dr. Baker concluded this pattern affected Mother’s decision-making

and judgment, with the potential of placing the children in unsafe situations.

Dr. Baker observed patterns in Mother’s interactions with professionals. Mother

attempted to cease family therapy because she had not been copied on a scheduling

email. Following depositions, Mother attempted to have the children’s therapist (Ryon)

removed from the case. When that therapist recommended one of the children begin

weekly therapy sessions due to serious transitional problems, Mother disagreed.

Dr. Baker also investigated the parties’ communication patterns as part of her

evaluation. When Baker asked Mother how she wanted to communicate with Father,

Mother responded that she does not like communicating with him because his

communications are too frequent, high conflict, accusatory, benefit no one, and are

unconstructive.

5
Additional testimony was presented regarding communication patterns. Father

testified that Mother sometimes waited weeks or a month to respond to messages on Our

Family Wizard, an online platform designed for divorced parents to coordinate scheduling

and communicate about their children. Mother testified that she didn’t like Our Family

Wizard and was apprehensive toward it because she felt that Father had unilaterally

chosen to use it.

In a September 2023 report that was admitted into evidence, Dr. Baker made

eleven specific recommendations to the court, including that the parties remain joint

managing conservators but with Father awarded exclusive decision-making rights in

medical, educational, and psychological decisions and the exclusive right to establish the

primary residence of the children. She recommended Mother be awarded a standard

possession order with Wednesday evening possession during the school term, with

consideration for expanding Mother’s possession schedule after one year if she met

certain conditions, including meeting with a neuropsychologist and psychiatrist and

refraining from making false statements about the children’s medical conditions or

negatively impacting their perception of Father.

Dr. Baker also recommended that Father identify specific medical providers and

that Mother be required to take the children only to those providers; that Mother

immediately notify Father if the children require medical attention while in her care; that

Mother not be allowed to take children from school for medical appointments without

Father’s consent; and that Father manage all extracurricular activities in consultation with

Mother.

6
Dr. Baker supported her recommendations with testimony that she “believe[d] that

the children’s safety and their health are at risk until [Mother] gets a better understanding

of what’s going on for her and some treatment.” Baker expressed concern there had

been a lot of negative influence on the children in regards to Father, putting their

relationship with Father at risk.

Dr. Baker opined that “flipping custody” (from Mother to Father) was the best

solution for the children as it would give Mother time to “get really serious about figuring

out why she does the things she does so that she can change her behavior.” She also

testified:

. . . I really worry about a parent who will make decisions based off of false
reality. I think that’s when we put kids the most at risk because they’re not
assessing reality correctly and they truly believe that they’re -- protecting
their kids[.]

2. Dr. Sherry

Dr. Baker recommended that both parties undergo psychological evaluations. By

agreed order, Dr. Alissa Sherry was designated as the lead examiner to conduct

psychological testing of the parties.

Dr. Sherry found that Mother had severe issues with perception and thinking that

interfered with her functioning and presented risks to the children’s safety and health.

According to Dr. Sherry, Mother had serious deficits in reality testing, and her behaviors

fell into “quasi psychotic thinking.” Although not caused by a psychotic disorder, these

deficits were severe enough to impair Mother’s functioning, preventing her from

perceiving reality accurately or making good decisions.

7
Dr. Sherry found that Mother’s behavior fit the criteria for pathological lying: “a

persistent and pervasive pattern of excessive lying behavior occurring for longer than 6

months.” Although pathological lying is not a diagnosis in the Diagnostic and Statistical

Manual of Mental Disorders, Dr. Sherry testified that this did not invalidate her findings,

explaining that “there are rules about whether or not something is in the DSM. And some

of those rules don’t have anything to do with whether or not they’re valid concepts in

psychology.”

Dr. Sherry concluded that Mother’s lying serves to receive attention and affection,

potentially reinforcing the behavior. Her report found that because of Mother’s fear of

losing the unconditional love of her children, Mother orchestrates situations where the

children cling to her and reinforce feelings of unconditional love—even at the cost of their

relationship with Father.

Dr. Sherry’s report opined that Mother likely lacks the insight to understand how

her behavior affects the children, making it more likely she will engage in conduct that

jeopardizes their emotional or physical health and safety to create situations where the

children need her. Dr. Sherry noted that Mother’s emotional needs were so intense that

they led her to create an entirely fictional existence for over a decade. This, in turn, places

her at risk of being manipulated by anyone who suggests they can provide her with the

attention she craves, even if it endangers her and her children’s health and safety.

Dr. Sherry recommended that Mother continue weekly therapy focused on

pathological lying, trauma, and cognitive distortions; meet with a board-certified

8
neuropsychologist for evaluation; and consult with a psychiatrist for medication regarding

her cognitive distortions.

As for Father, Dr. Sherry noted that his assessment findings were normative. She

was presented no evidence that Father had ever behaved in ways considered to be

outside the norm of a loving, caring parent.

3. Dr. Thorne

Mother attempted to undermine these findings through rebuttal testimony of Dr.

Stephen Thorne, a licensed psychologist. Dr. Thorne’s testimony was based solely on

his review of Dr. Sherry’s and Dr. Baker’s reports. Dr. Thorne focused his criticism on Dr.

Sherry’s use of the phrase “pathological lying,” which he noted is not an officially

recognized diagnosis in the DSM. He suggested this term could be misleading or

inaccurate. When asked whether Dr. Sherry’s evaluation supported characterizing

Mother as a pathological liar, Dr. Thorne responded that the testing results alone would

not lead him to that conclusion.

Dr. Thorne testified that he would have described the findings differently in his

report. Rather than using diagnostic language, he would have referenced the individual’s

chronic or pervasive history of deception and lying. Despite these methodological

concerns, Dr. Thorne conceded that Dr. Sherry’s characterization did not invalidate the

information in her report. The trial court found that Dr. Thorne testified it was entirely

possible and reasonable to conclude that he might have reached similar conclusions

and/or recommendations as Dr. Sherry had he possessed the same information.

9
4. Dr. Krejci

Mother also called her individual therapist, Pamela Krejci, who had conducted fifty-

two sessions with Mother since June 2022. Krejci testified she had no concerns about

Mother’s parenting abilities. However, Krejci’s knowledge was limited to her direct

interactions with Mother and she had not spoken with the children, Father, or the other

professionals involved in the case.

Krejci testified that she had not seen any evidence in her work with Mother that

Mother was a pathological liar. When asked whether she had any concerns about Mother

remaining the primary parent of the children, Ms. Krejci responded she had none.

The Trial Court’s Decision

Following a four-day hearing in October 2023, the trial court made extensive

findings. It found Dr. Baker and Dr. Sherry credible witnesses who provided reliable and

persuasive evidence. The court additionally found that Father’s testimony was credible,

whereas, Mother’s testimony was not.

The court awarded Father exclusive rights to designate the children’s primary

residence in Travis and Williamson Counties, make medical and educational decisions

following written consultation with Mother, and receive child support. Mother was ordered

to undergo neuropsychological and psychiatric evaluations and was awarded a two-

phase step-up possession schedule.2

2 The step-up possession schedule awarded Mother standard possession with Wednesday

weekday possession during phase one, progressing to expanded standard possession in phase two if
Mother completed therapy, neuropsychological evaluation, and psychiatric treatment requirements by
January 1, 2025.

10
The trial court found that Mother’s pattern of lying since the mediated settlement

agreement impacted her credibility and the consideration of the children’s best interests.

Analysis

Mother presents ten issues on appeal, each challenging the trial court’s exercise

of discretion in modifying the terms of possession, conservatorship, and access.

The standards of review for decisions involving suits affecting parent-child

relationships are well-established and need not be reiterated in detail. Trial courts

possess wide discretion in determining custody, control, possession, support, and

visitation matters involving children. Kramer v. Kastleman, No. 03-13-00133-CV, 2017

Tex. App. LEXIS 10326, at *4–5 (Tex. App.—Austin Nov. 3, 2017, pet. denied) (mem.

op.) We will reverse only if the trial court acted unreasonably, arbitrarily, or without

guiding principles. Coburn v. Moreland, 433 S.W.3d 809, 823 (Tex. App.—Austin 2014,

no pet.). Whether the evidence is legally or factually sufficient is evaluated as part of the

abuse of discretion analysis rather than as independent grounds for reversal. Id.

We give great deference to the trial court’s assessment of witness credibility

because the trial judge directly observes testimony and can perceive nuances not

apparent from the written record. Id. at 823–24.

Modification of conservatorship requires proof that circumstances have materially

and substantially changed since the prior order, and modification would be in the child’s

best interest. See TEX. FAM. CODE ANN. § 156.101.

11
Issues One through Five

In her first five issues, Mother argues the trial court abused its discretion by

granting Father exclusive rights to: (1) designate the children’s primary residence; (2)

consent to medical, dental, and surgical treatment; (3) consent to psychiatric and

psychological treatment; (4) make educational decisions; and (5) receive child support.

Mother concedes that she and Father have had “numerous miscommunications and

disagreements about medical issues,” but believes she was not treated equally at trial—

that Dr. Baker and Dr. Sherry emphasized conduct that put her in a poor light while de-

emphasizing similar conduct by Father.

The evidence shows that Mother’s deceptions extended far beyond her twenty-

year lie about being a cardiothoracic surgeon. During the evaluation process, she

continued lying to Dr. Baker about having an undergraduate degree and falsely claimed

her parents knew the truth about her medical credentials when evidence suggests they

still believed she was a doctor. According to testimony, she made false statements about

the children’s medical conditions and withheld critical medical information from Father.

Dr. Sherry found that Mother had “severe issues with perception and thinking” that

interfered with her functioning and presented risks to the children’s safety and health.

These deficits in reality testing were severe enough to impair Mother’s decision-making

and prevent her from perceiving situations accurately. Dr. Sherry characterized Mother’s

behavior as falling into “quasi psychotic thinking”—not caused by a psychotic disorder,

but serious enough to affect her judgment.

12
Dr. Baker documented how Mother’s distorted thinking affected the children

directly. Mother spoke negatively about Father to the children, withheld educational and

medical information, limited Father’s time with them, and shared inappropriate details

about the marriage and legal proceedings. Dr. Baker warned that Mother’s inability to

assess reality correctly put the children “most at risk.”

Mother relies heavily on Dr. Thorne’s criticism of the “pathological lying”

terminology and therapist Krejci’s opinion that she had no parenting concerns. But Dr.

Thorne reviewed only Dr. Sherry’s and Dr. Baker’s reports without access to the extensive

collateral data they gathered. He acknowledged that he might have reached similar

conclusions if provided the same information. Krejci’s knowledge was limited to her

therapy sessions with Mother, without speaking to Father, the children, or the other

professionals involved.

The trial court found Dr. Baker and Dr. Sherry credible while finding Mother’s

testimony was not credible. The court specifically found that Dr. Thorne’s testimony “did

not provide sufficient evidence to discount the accuracy of [Dr. Sherry’s] psychological

evaluations and opinions.” On this record, we find that a reasonable factfinder could have

credited the testimony of Father, Dr. Baker, and Dr. Sherry over the limited rebuttal

evidence. “We defer to the trial court’s resolution of factual disputes and related credibility

determinations; we may not substitute our judgment for the trial court’s judgment in those

matters.” Spence v. Davis, No. 03-22-00179-CV, 2023 Tex. App. LEXIS 564, at *5 (Tex.

App.—Austin Jan. 27, 2023, no pet.) (mem. op.).

13
The evidence supports the trial court’s finding that Mother’s distorted perception of

reality creates concrete risks: she may withhold critical medical information, make

healthcare decisions based on false premises, or continue to damage the children’s

relationship with their father. Mother has not shown that the trial court abused its

discretion. Issues one through five are overruled.

Issues Six and Seven

In her sixth and seventh issues, Mother argues the trial court abused its discretion

by ordering her to undergo a neuropsychological evaluation and meet with a psychiatrist

for evaluation, treatment, and possibly medication. Both requirements are tied to

Mother’s opportunity to obtain an expanded possession schedule.

We find the trial court’s orders directly served the children’s best interests and are

consistent with expert witness recommendations. Dr. Sherry agreed that Mother had

“severe issues with perception and thinking” that interfered with her functioning and

presented risks to the children’s safety and health. She emphasized that if Mother wished

to modify her behavior, it was crucial that she undergo evaluation by a board-certified

neuropsychologist to obtain comprehensive feedback and engage with a psychiatrist to

better understand her actions. Dr. Baker echoed both recommendations.

The process serves the children’s interests by providing Mother a clear pathway to

increased possession while ensuring their safety during Mother’s recommended

treatment process. Mother does not show that the trial court’s orders constituted an

abuse of discretion. Issues six and seven are overruled.

14
Issues Eight through Ten

In her final three issues, Mother argues the trial court abused its discretion by

ordering a two-phase, step-up possession schedule that requires her to meet certain

conditions before obtaining an expanded standard possession order.

Trial courts have discretion to establish conservatorship terms, including the

frequency and duration of visits and any necessary limitations. In re L.M.M., No. 03-04-

00452-CV, 2005 Tex. App. LEXIS 7191, at *28–29 (Tex. App.—Austin Aug. 31, 2005, no

pet.) (mem. op.); TEX. FAM. CODE ANN. § 153.193. Such restrictions “may not exceed

those that are required to protect the best interest of the child.” TEX. FAM. CODE ANN

§ 153.193. When ordering terms other than the standard possession order, the trial court

may consider the child’s age, developmental status, circumstances, and needs; the

circumstances of both parents; and any other relevant factor. Id.

Mother again relies on the testimony of Krejci and Dr. Thorne to argue for an abuse

of discretion. We have noted above that the trial court was within its discretion to discount

the testimony of these professionals.

Mother characterizes the step-up order as a “severe limitation” requiring “rigorous

preconditions.” But the trial court’s restrictions followed the express recommendations of

Dr. Baker and Dr. Sherry. Dr. Sherry concluded that Mother likely lacks insight into how

her severe perception and thinking issues affect the children, making it more likely she

will engage in behavior that jeopardizes their emotional and physical health to create

situations where they need her. Both experts recommended that Mother engage with a

neuropsychologist and psychiatrist before expanded possession could be considered.

15
Dr. Baker specifically recommended a standard possession order with Wednesday

evening visits, with consideration for expansion after one year if Mother met certain

conditions: meeting with both a neuropsychologist and psychiatrist, refraining from lying

about medical conditions, and refraining from negatively impacting the children’s

perception of Father. Dr. Baker testified that “flipping custody” would give Mother time to

“get really serious about figuring out why she does the things she does so that she can

change her behavior.”

In light of the evidence presented, the trial court did not abuse its discretion in

modifying the decree’s possession requirements.

Mother’s eighth, ninth, and tenth issues are overruled.

Conclusion

Having overruled each of Mother’s issues, we affirm the final order of the trial court.

Lawrence M. Doss
Justice

16