Part IV – Dealing with and Treatment of Parental Alienation Syndrome Or Parental Alienation

Ludwig.F. Lowenstein Ph.D

Southern England Psychological Services



The treatment of children who suffer from the effects of Parental Alienation (PA) or Parental Alienation Syndrome (PAS). The latter still has not as yet been accepted as a syndrome by DSM-IV. Treatment approaches vary with the preference of the therapist. The three main protagonists requiring help are the child or children, the alienated individual and the alienator. Many orthodox approaches are unlikely to lead to a positive result and so pioneering work is needed to ensure successful remediation.

Part IV – Dealing with and Treatment of Parental Alienation Syndrome Or Parental Alienation

Johnston et al (2001) described goals and strategies for family focussed counselling and therapy when children are alienated from a parent after separation and divorce. The confidential intervention takes place within a legally defined contract and is based upon a careful assessment on the dynamics of the multiple factors that contribute to the alienation and how the child’s development is affected. Strategies for forming multiple therapeutic alliances with often reluctant, recalcitrant, and polarised parents are discussed together with ways of helping the child directly.

It has already been indicated how important it is to diagnose the problems associated with possible parental alienation or parental alienation syndrome. Lee & Olesen (2001) describe in-depth child custody evaluations which are critical in forming an accurate understanding of families in which alienation of children is a concern. By integrating interviews and psychological test data of parents and children along with collateral information, the evaluator can differentiate an alienated child from children with other forms of parental rejection and can form a thorough understanding of the multiple contributing factors in the alienation process. This comprehensive and integrated understanding is then used to develop a clear and specific intervention plan.

Cases entering the family court with an alienated child require intensive and coordinated case management to intervene effectively (Sullivan & Kelly, 2001). It is critical to link the authority of the court with the delivery of mental health services to address the complex systemic factors that may entrench the child’s unwarranted rejection of a parent. Similar results were obtained by Gardner (2002) who considers that it is vital that the psychologist or psychiatrist involved in these cases adopts a very different attitude to the usual therapeutic methods practised by these two professionals. Efforts were made Bernet (2002) to summarise the procedures as to how a mental health professional such as a psychologist or psychiatrist should conduct a child custody evaluation. The article addressed the format for the evaluation including the initial conference with both parents, the individual meetings with each parent, the meetings with the children, outside information that should be collected, psychological testing, and the ‘wrap up’ conference with the parents and their attorneys. The current psychologist adopts a different approach of never seeing all the individuals together initially but always individually before commencing treatment Lowenstein (2005). The article by Bernet also lists the discussions and the critical factors considered in drawing conclusions and making recommendations, such as a child’s attachment to the parents, the child’s preference, and the possibility of indoctrination and parental alienation.

A number of case studies were presented by Vassiliou & Cartwright (2001). They examined 5 alienated fathers and 1 alienated mother’s perceptions of parental alienation syndrome (PAS). The data was collected via semi-structured open-ended interviews and questionnaires to identify whether there were shared characteristics among alienated families, common issues in the marital conflicts that contributed to the marriage dissolution. An attempt was made to understand the nature of the participant’s reports of alienation and what things an alienated parent might do differently. Overall, these findings indicate that there are several possible attributes, such as changes in relationships among family members, the roles of mental health and the legal professionals, as well as custody arrangements. These may be precursors or indicators of PAS.

A way of preventing parental alienation and the dire condition to which it leads was suggested by Thayer & Zimmerman (2001). They examined the conflict, divorce, and the children involved. This guide showed how to avoid the hot spots and the common traps of hostility, inflexibility, and constant squabbling. It also developed ideas on how to promote skills to sustain a co-parenting partnership based on love and concern for the children. Children of divorced parents benefited best from two parents living separately but working together. This book offers families a solution and a chance to move beyond the high-conflict divorce experiences and suggests a parenting system that allows the children to keep their family despite it being in the reconstituted manner.

The authors focus on co-parenting the children even after the divorce indicating that parents can learn to put their issues aside and deal directly and fairly with one another for the good of the children. New rules and communication styles were capable of being developed by the parents to accommodate the change in their marital status. It was also felt by the authors, that parents can learn to undo the past errors, regroup, and restructure their post-divorce parenting so the children can grow up in a loving environment in both parents homes. This rather idealistic approach, while necessary, is unfortunately not always successful.

Gardner (2001) comments that there has been a significant amount of controversy among legal and mental health professionals in regards to the question of whether the courts should order children with PAS or PA to visit or reside with their alienated parent. Gardner describes 99 PAS cases in which he was directly involved, cases in which he concluded that the court should order visitation with or transfer of primary residential custody to the alienated parent. The outcome when such orders were implemented was compared with the outcome when this recommendation was not followed. Unfortunately the premature death of Richard Gardner in 2005 may result in no further information being provided concerning this important question. Other investigators need to verify Gardner’s views regarding change of custody.

A great advocate of joint custody and shared parenting is Lowenstein (2002). The question of whether there should be sole custody or split custody (one child with one and another with another parent), after separation or divorce has in recent ways given way to a preference for “joint custody” and “shared parenting”. This eliminates the need for visitation rights and unsupervised or supervised contact for the non-custodial parent, and is preferable whenever possible. Lowenstein focussed on four main issues: (1) the problems and advantages associated with joint custody; (2) what should be done if joint parenting and custody does not work; (3) what happens to the children when there is alienation and hostility between the parents; and (4) the role of judges and the courts.

Novick (2003) in reviewing Gardner’s book on PAS appears to agree with the conclusion that the process of alienation must be reversed to prevent it becoming an ongoing way of life. Novick suggests that the strength of the book rests in Gardner’s clinical experience and expertise and that it is useful for clinicians to study Gardner’s clinical style and manner in dealing with most difficult individuals. Meister (2003) concurs that Gardner’s book is undoubtedly of great assistance to therapists in how to deal with parental alienation problems. Meister considers that Gardner has effectively placed parental alienation treatment “on the map” especially in high conflict family cases.

Other authors have commented on the pioneering work of Gardner including Goncalves & de Vincenzi (2003). The authors note that when there is a ‘war’ between parents it often leads to PAS. Different interventions and techniques are described, inspired by that of Gardner. They stress that there are some potential traps and that there is the need to coordinate therapeutic interventions with the courts involved in custody decisions.

The objective of such therapy is to prevent children and adolescents as well as adults suffering in later life from the parental alienation syndrome process. Drieu (2004) reviewed recent research into the involvement of parents in the treatment of adolescents with social alienation disorders. Characteristics of adolescents with alienation disorders often have the potential for violence. Here there is value for parental consultation in determining causes and treatment for alienation. It was felt vital to open good communication between the parents so that they may work together more effectively.

Drieu illustrates the importance of involving parents in the treatment process with a case study of a 17 year old male adolescent in France with drug dependence and internet addiction. It is unfortunate that sometimes, therapists are alienated in the process of attempting to heal or forestall parental alienation conflicts (Garber, 2004). This results when there is an impasse or rupture in the psychotherapeutic relationship between the psychologist and the patient dyad. There is therefore the need for the therapist to be both sensitive in preventing this from occurring while at the same time standing firm as to their findings observed between the parent in conflict.

In the United States a program funded by the Health and Human Services has been developed (Neff & Cooper, 2004). It was introduced in Phoenix, Arizona and has served more than 1000 families in several jurisdictions. Whereas other programs dealt with entrenched, high conflict cases and were found to be time consuming requiring an intensive 2 to 6 months, this was a program of 4 hours for the less serious alienation cases. Good results were reported.

Another study concerned itself with the evaluation of the efficacy of structural and therapeutic interventions for interrupting parental alienation towards the severe end of the spectrum (Rand et al, 2005). Follow-up was obtained on 45 PAS children from a custody evaluators practice. The child’s adjustment and relationship with both parents at evaluation and follow-up were compared. Children who had enforced visitation with the target parent or were in target parent custody, maintained relationships with both parents unless the alienator was too disturbed. In the completed alienation outcome group, the alienating parent had custody before and after the evaluation, and was able to violate court orders with impunity. Therapy as the primary intervention was ineffective and sometimes made things worse. There are several possible reasons for this including the lack of involvement of the court to make definite decisions of possibly changing custody and the lack of skill of the expert witness in providing the courts with the necessary information to act more decisively.

Perhaps the best way forward in advocated by Boyan & Termini (2005) who recommends that over time divorced parents experience moderate to severe levels of parental conflict, should be ordered by the juvenile court, family court, and superior court judges to participate in parent coordination programmes. Attorney’s, mediators, guardians ad litem, custody evaluators, physicians, and psychotherapists have referred parents to such a program. Some parents include the services of parent coordination in their settlement agreement. Two areas critical to the ongoing development of parental coordination are psychotherapists, working as parent coordinators and the need for unique training and professional support in order to provide competent assistance to these challenging families.
One thing is clear from all the information on therapeutic intervention by alleged experts, and that is the need for further research into the effects of a variety of approaches in curtailing an possibly reducing the level of alienation practised against children. Needless to say the most important ingredient in all this is the need for a close working relationship between the expert carrying out assessments and treatment and the court listening to these experts.


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